The developing mind by daniel j siegel

Praise forThe DeveloPing MinD“A tour de force of synthesis and integration. Siegel has woven a rich tapestrythat provides a compelling account of how our interpersonal worlds and neuralsystems form two important pillars of the mind. The second edition brings thelatest neuroscientific evidence to the fore; it is a ‘must read’ for any student orprofessional interested in mental health, child development, and the brain.”—RichaRd J. davidson, PhD, William James and Vilas Professor ofPsychology and Psychiatry; Founder and Chair, Center for InvestigatingHealthy Minds, University of Wisconsin–Madison“With the original publication of The Developing Mind, the field of interpersonalneurobiology was born. Siegel’s genius for synthesizing and humanizing neuroscience, attachment, and developmental theory made the book a bestsellerand attracted thousands to this new field. The second edition benefits fromover a decade’s worth of additional findings, reflections, ideas, and insights. Iencourage you to take Siegel up on his offer to share this fascinating journey,whether for the first time or for a return trip. You won’t be disappointed.”—Louis cozoLino, PhD, Department of Psychology,Pepperdine University“When The Developing Mind was first published, Siegel’s proposal that mind,brain, and relationships represented ‘three aspects of one reality’ essential tohuman wellbeing still seemed closer to inspired speculation than teachablescientific knowledge. Just over a decade later, the neurobiology of interpersonalexperience has grown into one of the hottest areas of psychological research.Over two thousand new references surveyed for the second edition testify tojust how far neuroscientists, developmental psychologists, and clinicians havebrought the field as they begin to more fully chart the interplay of mind, body,and relationships. This splendid second edition—at once accessibly written andmeticulously documented—provides a comprehensive guide to this emergingscience.”—saRah BLaffeR hRdy, PhD, Professor Emerita of Anthropology,University of California, Davis“Siegel describes his book as ‘a journey into the developing mind,’ and no one isbetter equipped to invite psychotherapists and other students of human impulsesto share this remarkable adventure. In clear and inspired prose, he reviews factsand theories about the human brain that can be difficult to grasp. He explainshow the brain differentiates and enables the creative and passionate mind of achild to share meaningful intentions, experiences, imaginative beliefs, relationships, community, culture, and language. He puts this understanding inthe service of a humane and respectful psychotherapy that can give integrity toyoung lives that have become anxious, chaotic, and rigid.”—coLwyn TRevaRThen, PhD, FRSE, Professor Emeritus of ChildPsychology and Psychobiology, University of Edinburgh, United Kingdom“Fulfilled my wildest expectations. Instead of laboriously struggling to learnabout neurobiology, I found myself fairly effortlessly assimilating informationbecause 1) the author is able to present his material in the context of interpersonal relationships in general and the treatment dyad in particular, and 2) theauthor is a master of lucidity, avoids pedantry, and succeeds in making his dataclinically useful.”—American Journal of Psychiatry“Readable, thoughtful, and informative.”—Educational Leadership“I knew that this book was one I should keep handy when I wanted to improvemy understanding of information on which the future science of psychiatrywill be based.”—Journal of Clinical Psychiatry“A remarkable book. . . . The Developing Mind boldly transcends the reductionism that characterizes so much of contemporary psychiatry.”—Psychiatric Times“Current, thorough, closely argued. . . . One of Siegel’s major gifts is for presenting anatomical, neurological, research, and clinical information while stillpointing out what remains unknown. He explores infant–parent relationships,emotions, states of mind, and how knowing about them can help one improveone’s relationships and capabilities for developing successfully.”—Booklist“Why can’t we remember what we did at age three? Why are some childrenunusually shy? What is the biochemistry of humiliation, and how can it be‘toxic to the developing child’s brain’? New and plausible answers to thesequestions emerge from Siegel’s synthesis of neurobiology, research psychologyand cognitive science. . . . His subject—how we become the people we are—deserves to hold many readers spellbound.”—Publishers Weekly“The story Siegel tells is indeed fascinating, essentially describing the transactional processes that happen at the interface between developmental neurobiology and the environment of an individual. He links every level of the systemfrom cell chemistry to brain architecture, to caregiver–infant attachments, tointerpersonal relationships in adulthood. . . . This is a book to stimulate, illuminate, and drive our understanding of human developmental processes forwards and I suspect that The Developing Mind will be seen as a milestone workin the future.”—Journal of Child Psychology and Psychiatry“Brilliant. . . . It should probably not be read at one sitting, but sifted slowly asyou would a 20 year old port. . . . This is not just a book for bright psychiatricresidents or child fellows, but child psychiatrists young and old, overworked orunderpaid. It offers a glimpse of new horizons in the profession.”—CanadianChild Psychiatry ReviewThe DeveloPing MinDThe Developing MindHow Relationships and the BrainInteract to Shape Who We AreS ec o n d e d i t i o ndaniel J. SiegelTHE GUILFORD PRESSnew York London© 2012 Mind Your Brain, Inc.Published by The Guilford PressA Division of Guilford Publications, Inc.72 Spring Street, New York, NY 10012www.guilford.comAll rights reservedNo part of this book may be reproduced, translated, stored in a retrievalsystem, or transmitted, in any form or by any means, electronic, mechanical,photocopying, microfilming, recording, or otherwise, without writtenpermission from the publisher.Printed in the United States of AmericaThis book is printed on acidfree paper.Last digit is print number: 9 8 7 6 5 4 3 2 1The author has checked with sources believed to be reliable in his efforts toprovide information that is complete and generally in accord with the standardsof practice that are accepted at the time of publication. However, in view of thepossibility of human error or changes in behavioral, mental health, or medicalsciences, neither the author, nor the editor and publisher, nor any other partywho has been involved in the preparation or publication of this work warrantsthat the information contained herein is in every respect accurate or complete,and they are not responsible for any errors or omissions or the results obtainedfrom the use of such information. Readers are encouraged to confirm theinformation contained in this book with other sources.Library of Congress CataloginginPublication DataSiegel, Daniel J., 1957–The developing mind : how relationships and the brain interact to shape whowe are Daniel J. Siegel. — 2nd ed.p. cm.Includes bibliographical references and index.ISBN 9781462503902 (hardcover: alk. paper)1. Developmental psychology. 2. Interpersonal relations. 3. Intellect.4. Brain—Physiological aspects. I. Title.BF713.S525 2012155—dc232011052460For MaddiviiAbout the AuthorDaniel J. Siegel, MD, is an internationally acclaimed author, awardwinning educator, and renowned child psychiatrist. He is Clinical Professorof Psychiatry at the School of Medicine of the University of California, LosAngeles, where he serves as CoInvestigator at the Center for Culture, Brain,and Development, and CoDirector of the Mindful Awareness ResearchCenter. He is also the Executive Director of the Mindsight Institute, aneducational center devoted to promoting insight, compassion, and empathyin individuals, families, institutions, and communities. Dr. Siegel’s booksinclude Mindsight, Pocket Guide to Interpersonal Neurobiology, The Mindful Therapist, The Mindful Brain, Parenting from the Inside Out, and The WholeBrainChild.ixPreface to the Second EditionWelcome to the fascinating world of interdisciplinary thinking. I invite you to join me on this journey to explore the intricate intertwining ofmind, brain, and relationships. Since the publication of the first edition ofThe Developing Mind over a dozen years ago, much has emerged from theobjective study of science and the subjective knowledge of internal reflection. This book honors these distinct but equally important realms of knowledge that will inform our travels.In this second edition, I have had the deep honor to incorporate whatI’ve learned from scientists, psychotherapists, educators, philosophers, contemplative practitioners, and community leaders. The field that the firstedition of this book introduced—“interpersonal neurobiology,” or simply“IPNB”—has grown in wonderful ways since then. It now has its own organizations (see the Global Association for Interpersonal Neurobiology Studies,or GAINS), indepth educational programs (see www.mindsightinstitute.com),and a professional library of over two dozen textbooks.My goal in thoroughly updating the references and revising the text forthis edition is to make the ideas of IPNB and its scientific foundations as clearand concise as possible. I have had the good fortune of having 15 dedicatedand bright research interns work by my side during the initial phases of thisrevision process. Their assignment was twofold: to “prove the first edition ofthis book and the ideas behind IPNB to be wrong” so that we could discardany proposals that were outdated or unfounded in the literature, and to offerany new research that presented alternative views. In this effort, over twothousand new scientific papers were reviewed; each paragraph of the book(projected on the wall at the Mindsight Institute) was collectively examined;and any necessary changes were made. In this process, we had the advantageof fresh minds exploring the foundations of IPNB to see whether any ofthe hypotheses set forth over a dozen years ago had since been proven withnew studies and emerging technology. When we found that the majority ofx Preface to the Second Editionpropositions were in fact supported by new findings, the shared experiencewas exhilarating.We also had the opportunity to interview several readers of the firstedition—many of them teachers of the book for over a decade now—and toask them, “What should be changed in the second edition?” Their virtuallyuniform response was “Nothing, except to update the scientific references.”So to stay true to the positive reception of the first edition, here in the secondedition you’ll find that the text has been thoroughly updated to reflect theresearch advances in various fields. I have also added special discussions ofculture, gender, temperament, genetics, and the role of consciousness and itsneural correlates in various mental and social processes. Most of the proposals have been supported by research findings enabled by recent technologicaladvances, and for those that remain hypotheses, the text still reflects theirstatus as educated guesses. Keeping the distinction between implications anddatasupported findings clear was an important feature of the original textand remains a goal for this edition, and for the field of IPNB as a whole.This new edition also has an epilogue reflecting on various practical andscientific aspects of this approach, as well as a glossary of terms to improveaccess to some of the intricate ideas and their vocabulary. In addition, thereare new figures and frequent “pullout” quotations to support those whoenjoy and benefit from these visual aids to learning. In discussing examplesthroughout the book, I alternate between the thirdperson singular pronouns “she” and “he” to avoid sexist usage. Naturally, all examples of individuals are presented without identifying features.The Developing Mind has become a favorite book in a variety of programs; I hope that this second edition continues to be as well received. I lovewriting books, and returning to this first work to create a second edition hasbeen a labor of love. This edition may have roughly the same sequence ofchapters, but it is filled with fresh material and the integration of many newideas and applications. I am grateful for all of the input we have receivedfrom readers from around the globe, and also to the many authors and conference cofaculty members who share in the passion for creating a consilient approach to this work. Marion Solomon and Bonnie Goldstein havebeen a wonderful team in bringing IPNB to the professional audience at ourannual UCLA gatherings, and I thank them for their leadership in our professional community. Kitty Moore, the initial editor at The Guilford Presswho brought this work into the world, is a joy to work with, and I am thankful for all of her support and wisdom over the years. Barbara Watkins workedwith me on the daytoday, linebyline editing, and I cannot say enoughin gratitude for her superb skills and for the way she kept the whole in mindwhile also paying such careful attention to detail and continuity. We had theexciting challenge of taking something people loved, updating it completely,Preface to the Second Edition xiand maintaining the essence of its heart and soul, while also refining themessage with clear and integrated prose. It has been a pleasure to pore overthese pages with her to get the book ready to go to press. Marie Sprayberryagain magnificently copyedited the manuscript, and Martin Coleman servedas production editor.I would also like to thank the wonderful individuals who are a part ofthe Mindsight Institute, which serves as an intellectual home for IPNB. Ourglobal online course participants’ international perspective on the field andits application is invaluable for seeing the many ways in which this work canbe applied across cultures. Input from students, both local and at a distance,has been a driving force for this work and motivates all of us to keep the fieldcurrent. The members of our staff, including Stephanie Hamilton and Whitney Stambler, have made working here a pleasure. Whitney was devoted tomaking the extensive references and notes well integrated throughout thebook, and I thank her for those efforts. I am also grateful for the assistanceof Eric Bergemann and Aubrey Siegel in helping to do some of the finalcopyediting of the manuscript. Caroline Welch, our CEO, has been bothan inspiration and a powerful presence in helping us to organize our workand create a vision for the many possible applications of IPNB in the world.I thank her for her leadership, which is at the heart of this second edition’smessage.To dive into over a dozen disciplines of science and explore the consilient findings that emerge is naturally quite a challenge. For the first edition,the library was my second home, where I’d spend long hours wading intothe stacks of periodicals. Since then, there has been an exponential increasein the number of journals and research articles accessible through our interconnected digital library via the Internet. Taking on this goal of updatingthe book was a joy with the fabulous group of interns who joined in on theintellectual adventure. Working together, we could explore research data,crossreference a wide range of studies, integrate ideas, and weave all of thesetogether in creating the second edition. I am deeply grateful for the companionship of this “mindful bunch”: Lisa Baldini, Kimberly Clark, HannahFarber, Julien Fyhrie, Victoria Goldfarb, Riley Kessler, Cyrus Nahai, Benjamin Nelson, Karen Olivares, Suzanne Parker, Francesca Reinisch, GregorySewitz, Katey Solzberg, Lucy Walsh, and Anabel Young. We went on a creative journey of discovery together, and I am thankful for their dedication tothis project. It is my sincerest wish that this book you hold in your hands willmaintain its usefulness as a solid resource, helping us to support the development of healthy and resilient minds throughout our lives.xiiiPreface to the First EditionWhat is the mind? How does the mind develop? This book synthesizes information from a range of scientific disciplines to explore the idea thatthe mind emerges at the interface of interpersonal experience and the structure and function of the brain.Like many adolescents, as a teenager I became filled with a particularintellectual passion: I was fascinated with people and the nature of the mind.Through a series of journeys, I eventually became a psychiatrist, specializingin the care of children and families. Along the way have been encounterswith a wide variety of people and the stories of their lives. Trained in science and immersed in human struggles, I found myself naturally trying tounderstand the process of human development—of how people become whothey are—by investigating what was known from research and getting asclose as possible to the subjective experience at the core of people’s lives. Thisbook presents the integration of this effort to gain insights into the mind andhuman development.From mountaintops and quiet conversations to lecture halls and the bustling discussions of a weekend conference, this exploration of the nature ofthe developing mind has come to involve people from many walks of life.At recent seminars, I have met with a range of professionals—in child development, education, medicine, neuroscience, psychology, public administration, and social work—to discuss basic questions regarding the mind andthe ways experience shapes development. These experiences as an educatorhave motivated me to synthesize this work into a framework that providesan integrated scientific foundation regarding the interpersonal and neurobiological basis of the developing mind.This book may be useful for those working in a variety of disciplines.Understanding these processes can enable clinicians to help patients heal.Academicians may find such an interdisciplinary effort useful in gaininginsight into how their own work relates to independent fields of research.xiv Preface to the First EditionEducators can benefit from insights into how emotion and interpersonalrelationships are fundamental motivational aspects of learning and memory.For child development specialists and others who care for children, knowing how forms of communication directly shape a child’s developing braincan be essential in creating programs that are scientifically based and thatcan optimize the care of children. For many other people, learning abouthow the mind emerges from the substance of the brain and the processes ofinterpersonal relationships can provide useful insights that can improve theirprofessional as well as personal lives. Interpersonal experience shapes themind as it continues to develop throughout the lifespan. This book is abouthow these interpersonal processes occur and how we can utilize ideas aboutneurobiology to help others, and ourselves, to grow and develop.In my own field of psychiatry, the tremendous expansion of neuroscientific research seems to have been interpreted in the extreme by some as a callto “biological determinism”—that is, to a view of psychiatric disorders as aresult of biochemical processes, most of which are genetically determinedand little influenced by experience. This impression may sound reductionistic, but I wish that the sense of demoralization expressed by many educators and students in psychiatry didn’t support the notion that the field hasbeen losing its mind in favor of the brain. What is ironic, and what up untilnow has not been well known, is that recent findings of neural science infact point to just the opposite: Interactions with the environment, especiallyrelationships with other people, directly shape the development of the brain’sstructure and function. There is no need to choose between brain or mind,biology or experience, nature or nurture. These rigidly applied divisions areunhelpful and inhibit clear thinking about an important and complex subject: the developing human mind.As I was finishing up the last chapter revisions for this book, an articleby a renowned neuroscientist who is also trained as a psychiatrist appearedin the American Journal of Psychiatry. Eric Kandel’s paper “A New IntellectualFramework for Psychiatry”1 suggests that the field of psychiatry in recenttimes has suffered from a series of damaging divisions within its ranks. Thesedivisions have blocked the ability to integrate a wide range of informationabout human experience, mind, and brain. It is my hope that presenting ascientifically grounded synthesis focusing on these domains will enable suchprofessional divisions to give way to a new conceptual foundation that willbe useful for clinicians and others who help people develop.Although it is important to be aware of the significant and very realcontributions of genetic and constitutional factors to the outcome of development, it is equally crucial that we examine what in fact is known abouthow experience shapes development. Such a balanced view enables us asparents, for example, to have a sense of responsibility for the experiences wePreface to the First Edition xvprovide without the unnecessary burden of guilt generated by the belief thatour actions are solely responsible for the outcome of our children’s development.One factor turning some mental health care providers’ attention awayfrom the role of experience in human development may be our attempt toavoid some of the devastating errors of the past. Not so long ago, the mothersof children with autism were accused of being “refrigerators”; the families ofpatients with schizophrenia were said to be giving “double binds”; individualswith bipolar disorder were given thousands of hours of therapy, in search ofthe “psychological cause” of their mood swings; and people with obsessive–compulsive disorder were thought to be repressing some early trauma thatmay have produced their worries. In each of these painful examples, we asprofessionals looked toward experience to explain the causes of our patients’anguish and dysfunction. Despite the goodness of our intentions, these viewswere misguided and not helpful to our patients. They produced accusationsof blame and a sense of guilt that were unfounded. They did not lead togrowth or healing in our patients or their families.Many people have been spared devastating amounts of pain and sufferingbecause of our modern understanding of psychiatric illness and the appropriate use of pharmacological agents. Psychiatry has had to embrace the notionthat the brain contributes to mental dysfunction, in order to pursue theseextremely important avenues of medical care. But losing sight of the important role of experience, especially social experience, in shaping the minddoes not help us to understand development or to help our patients.If social factors—that is, human relationships—shape the developmentof the brain and the mind, how does this occur? The purpose of this bookis to explore this question by examining some ways in which interpersonalexperience shapes the developing mind and fosters emotional wellbeing.An exciting challenge in writing this book has been to attempt to deepenan understanding of subjective everyday life, of the mind and human relationships, by drawing on the objective views of science. The benefit of thisapproach is that we can learn much more about what creates human experience than is possible with only everyday logic or selfreflection. For example,by learning how the circuits in the brain develop during the first years oflife, we can gain insights into why older children or adults generally cannotconsciously recall their experiences before the preschool years. By learningabout the nature of how the brain creates an awareness of other minds, wecan begin to understand the biological basis for emotional communicationand what may be occurring when empathy is not a part of human relationships. In addition, understanding how trauma affects the developing braincan yield insights into the subsequent impairments in memory processingand the ability to cope with stress. Using science to understand the mindxvi Preface to the First Editionhas provided a powerful tool for deepening our comprehension of subjective mental life and interpersonal relationships. These insights have proventremendously useful in helping others grow and develop.To see how these neurobiological ideas help others develop and heal notonly has fueled my enthusiasm, but has generated the energy required for thecompletion of this book. This task would not have been possible without theloving support of my family. How many times they heard the excited call“It’s finished”, only to find me working on the next draft a few weeks later.Their continuing encouragement is of immeasurable importance to me.When The Guilford Press initially asked me to write this book, its focuswas to be on memory and psychotherapy. Since that time, the topic of thebook has broadened; it has come to include, with the helpful assistance ofmy patient editor, Kitty Moore, the much wider topic of these fundamentalquestions about the mind, the brain, and human relationships. I thank her forher belief in the work and her skillful help with the process of bringing it tocompletion. I would also like to express my appreciation to the efficient andresponsive publication staff at Guilford, and especially to Anna Brackett andMarie Sprayberry, for their thoughtful attention to the text.In my professional life, it can’t be overstated that my patients have hadthe largest impact on my clinical education. In ways both professional andpersonal, they have taught me more than I ever dreamed I’d learn in a lifetime. I have also had the good fortune of having had several clinical teacherswho have been especially supportive and helpful in my development as a psychotherapist, including Jim Grotstein, MD, Chris Heinicke, PhD, ReginaPally, MD, Arnold Scheibel, MD, and Don Schwartz, MD. Also along thejourney have been many students—especially those in the Infant and Preschool Service, which I directed with Mary O’Connor, PhD, at UCLA,and at the Mindsight Institute and around the globe in our online class—whose questions keep an investigating and conceptualizing mind reflectiveand excited about trying both to understand and to communicate complexideas. One of the most moving teaching experiences has come from theopportunity to work with many teams of psychotherapists from over a dozennations in Eastern Europe who have been struggling to deal with the ravages of political wars and childhood abuse. The Children’s Mental HealthAlliance Foundation, directed by Pamela Sicher, MD, and Owen Lewis,MD, has developed a novel educational program to teach these devoted andsacrificing therapists the basic elements of evaluating, treating, and (we allhope) preventing child abuse in their developing nations. It is inspiring tosee their dedication, and exhilarating to hear that the ideas of this book havebeen accessible and useful across cultures.These issues about how experiences shape the brain and organize themind were topics of passionate discussion for a local study group called,Preface to the First Edition xviiaffectionately, the IDCNS (Institute for Developmental and Clinical Neural Science). My thanks to its members—Lou Cozolino, PhD, Allan Schore,PhD, Judith Schore, PhD, and John Schumann, PhD—for our intellectualcompanionship on this journey into mind and brain. My childhood friendand longtime conversation partner in matters of the mind, Jonathan Fried,has offered valuable comments on the text and has been especially helpfulin pointing out the abundance of “thuses” in the original manuscript; thusI thank him. Others who have read this work at various stages in its evolution and have provided immensely useful comments and questions includeDaniel Attias, the late