Tratamentul prost al copiilor determin dificulti n formarea reprezentrilor mentale ale acestora despre strile mentale ale altor persoane (Fonagy et al., 2011), despre emoiile i tririle pe care le pot tri i experimenta alte persoane. Copiii abuzai se angajeaz mai puin n jocuri simbolice sau n interaciuni de joac (Alessandri, 1991); eueaz n a manifesta rspunsuri empatice n situaiile manifestrii unor emoii negative ale altor copii (Howes i Espinosa, 1985; Klimes-Dougan i Kistner, 1990; Main i George, 1985); realizeaz mai puine referine la stri interne (chiar mamele care i abuzeaz copii discut mult mai puin frecvent despre emoiile proprii sau ale copiilor lor (Beeghly i Cicchetti, 1994; Shipman i Zeman, 1999)); manifest prezena nelegerii teoriei minii mult mai trziu dect ali copii (Cicchetti et al., 2005). Precolarii abuzai dau dovad de o slab nelegere a modului n care funcioneaz mental i acioneaz adulii (During i McMahon, 1991) sau de nelegere a expresiilor faciale ale emoiilor (Camras et al., 1983; Camras et al., 1990) i demonstreaz limitri clare n relaiile i modul cum neleg i proceseaz interaciunile sociale (Mace et al., 2001; Mace et al., 1999). De asemenea, acetia manifest o ntrziere n reprezentarea mental a strilor emoionale (Frodi i Smetana, 1984; Pears i Fisher, 2005; Rogosch, Cicchetti i Aber, 1995; Smith i Walden, 1999), i o performan slab ce prezice competenele sociale pe care copii le vor manifesta la vrsta de 8 ani (Rogosch et al., 1995). Abuzul i neglijarea n copilrie a fost corelat cu diagnosticul de tulburare de tip borderline n perioada adult (Holm i Severinsson, 2008), mai exact cu sentimentele de respingere, abandon i izolare specifice acestei tulburri de personalitate (Stiglmayr et al., 2008), implicnd un sentiment intens de ruine (Levy et al., 2007; Rusch et al., 2007) putnd declana disocieri de personalitate (Philipsen et al., 2004) i auto rnire (Coid, 1993). O serie de funcii adaptative critice se formeaz nc din al doilea an de via i in de dezvoltarea corespunztoare, prin intermediul ataamentului dintre copil i persoana de ngrijire primar, a emisferei drepte a creierului i toate aceste achiziii reprezint manifestri ale unei snti mentale timpurii a individului. Aceste achiziii constau n meninerea unei imagini coerente, continue i unificate despre sine; n identificarea unei imagini corporale a propriei persoane i a relaiei acesteia cu mediul, distingerea propriei persoane de alii, recunoaterea indivizilor din aceeai specie i a altor organisme, obiecte sau locuri familiare, reamintirea informaiei biografice, nelegerea emoional i reacia la stimulii de mediu (Devinsky, 2000). Atunci cnd copiii se confrunt, de exemplu, cu lipsa sensibilitii i responsivitii paternale, aceasta conduce la dezorganizarea sinelui, caracterizat prin lipsa de coeziune a acestuia, la ndoieli n legtur cu coerena intern i continuitatea peste timp a propriei identiti, cu o stim de sine instabil i supradependena de aprobarea celorlali (Bartholomew i Horowitz, 1991 i Park et al., 2004 n Mikulicer i Shaver 2012). Aa a fost demonstrat c practic, reprezentrile despre sine reprezint o alt cale mediatoare ntre stilul de ataament i patologie (trecnd prin nivelul de distres provocat de acestea) fiind responsabile pentru nivelul patologiei dezvoltate (Mikulicer et al., 2010). n plus, Shaver i Hazan (1993) citai n Mikulicer et al., 2010) argumenteaz faptul c, figurile de ataament indisponibile slbesc sentimentul de securitate al unei persoane i contribuie la formarea unei viziuni negative despre ceilali. Acestea nu sunt singurele domenii de funcionare dependente de calitatea relaiei de ataament stabilit n primii ani de via, nivelul de inteligen de pild, la rndul su depinde de nivelul de securitate din perioada ataamentului timpuriu (Cicchetti, Rogosch i Toth, 2000; Jacobsen et al., 1994; Jacobsen i Hofmann, 1997; Jacobsen et al., 1997; van Ijzendoorn i van Vliet-Visser, 1988). n plus, alte studii au atras atenia asupra impactului ataamentului timpuriu asupra sistemelor atenionale (Belsky i Fearon, 2002; Fearon i Belsky, 2004; Jacobsen et al., 1997). Persoanele diagnosticate n adolescen cu tulburarea de personalite de tip borderline percep mai frecvent pericolul de a fi respini i mai ales situaia de abandon i neglijare comparativ cu media populaiei. Acest dezavantaj se combin cu praguri reduse la care se dezactiveaz capacitatea de a controla reprezentrile mentale, n special de a distinge starea mental proprie de cea a celorlali, aceste dou efecte conducnd mai departe la o mai dificil nelegere de ctre ceilali i chiar ei nii, att a reprezentrilor despre lumile interne ct i a raporturilor interpersonale, genernd drept consecin, o cascad de dificulti n legtur cu reprezentarea mental a altor aspecte (Fonagy et al. 2011). Aa se explic tendina acestora de a se implica n cercuri vicioase interpersonale caracterizate printr-o evident dereglare afectiv. Drept urmare, ntreruperile i dereglrile sistemului de ataament i neclaritatea propriei identiti sunt puternic legate de aceste dereglri n ataament i stau la baza patologiei borderline. Comportamentele pe care le angajeaz acetia pentru a face fa consecinelor disfuncionalitilor interpersonale (mecanismele de coping) ce produc emoii negative i stres, impulsivitate, dereglri afective i sentimente de durere interioar sunt la fel de disfuncionale, ei bazndu-se pe mecanisme de autoreglare emoional precum auto-provocarea durerii, abuzul de substan sau hipersexualitate (Fonagy et al., 2011). n concluzie, n primul an de via comunicarea emoional dintre mam i copil este ntiprit n dezvoltarea reelelor corticale laterale ale creierului bebeluului, acestea fiind specializate n analiza feelor familiale i orientarea privirii i n procesarea semnalelor emoionale vizuale sau auditive. Dezvoltarea structural i funcional a sectoarele corticale aflate n dezvoltare nainte de trei ani depind de un mediu social care faciliteaz i stimuleaz creterea creierului bebeluului i permite maturizarea unui sistem reglator responsabil pentru autoreglarea unor compartimente cruciale ale vieii viitorului adult (de supravieuire, emoional, social etc.) situat n cortexul orbitofrontal al acestuia. Responsabilitatea major pe care ntreruperea sau disfuncionalitatea timpurie a relaiei de ataament mam-copil o poart pentru reducerea plasticitii creierului acestuia i predispunerea la dezvoltarea unei patologii psihologice i fiziologice a copilului este bine documentat prin intermediul studiilor (Schore, 1994; Caldji et al., 1998; Cirulli, Berry i Alleva, 2002; Graham, 1999; Schore, 1999, 2001). Strile emoionale i biologice disruptive, negative ale copilului ce rmn n mod repetat, nerezolvate de ctre mam sau relaiile sociale timpurii generatoare de stres pentru copil, pun bazele unui ataament denumit insecurizant, a deficitelor n sistemul autonom limbic drept (responsabil pentru autoreglare emoional) i dezvoltarea unei predispoziii pentru tulburri psihiatrice i psihosomatice ulterioare (Schore, 2005). Bowlby consider chiar c deprivarea de ngrijire matern are urmtoarele consecine: dezvoltare ntrziat, agresivitate, anxietate dependent (comportamentul de agarea copilului de mam), ntrziere n dezvoltarea intelectual, inadaptare, psihopatologie emoional, depresie i delicven (Speltz et al., 1990; Champagne et al., 2001). Tipul de ataament prezentat de ctre mam, ca rezultat al proprilor sale experiene de via n relaiile de ataament, reprezint un alt aspect problematic ce poate impacta prin natura raporturilor imprimate n relaia cu propriul copil, dezvoltarea cortical a bebeluului, dou dintre cele trei stiluri de ataament identificate n rndurile adulilor reprezentnd mai degrab o premis negativ n startul unei bune interaciuni propice dezvoltrii optime. Veste bun este aceea c odat cunoscute aceste particulariti ale stilului de ataament pot fi suplinite sau corectate cel puin n raport cu bebeluul aflat n perioada cea mai critic de dezvoltare a sa.Simona Mlescu, Psiholog clinician i psihoterapeut autonomwww.clujpsihoterapie.ro, Tel. 0745366754Str. Clinicilor Nr. 50, Et. 1, Cluj NapocaSkype:cabinetsimonamalaescu(Credit for the image: Ovtscharoff i Braun, 2001 n Schore, 2010)[1] Pentru un rezumat al studiilor care demonstreaz acest lucru vezi Schore, 2000, 2005.[2] Teoria minii (Theory of mind) Formarea conceptului despre mintea unei alte persoane i funcionarea independent a acesteia fa de cea proprie. Abilitatea de a-i reprezenta mental faptul c ceea ce vede, experieniaz, crede i tie el nu coincide cu ceea ce vede crede sau deine ca informaie o alt persoan, faptul c modul n care percepe el realitatea nu este identic pentru toate persoanele.[3] Un sistem bio-psihosocial, activat de copil n scopul obinerii i pstrrii siguranei n condiiile n care nu se simte n siguran sau ntr-un mediu familiar sau n condiiile n care exist vre-un pericol de ndeprtare a figurii principale de ataament (cel mai adesea mama), sistem necesar i care faciliteaz iniial supravieuirea i apoi dezvoltarea cognitiv i emoional corespunztoare a copiilor n primii ani de via. Bowlby (1982:179) i-a definit ataamentul printe-copil drept comportamentul social instinctiv biologic activat n mod special la ndeprtarea mamei (sau orice alt eveniment amenintor la dresa relaiei cu persoana de care este ataat) i constituie rezultatul unei serii de sisteme ce au ca rezultat apropierea mamei (stimulii care linitesc cel mai rapid sistemul de ataament sunt reprezentai de ctre sunetul, vederea sau atingerea de ctre mam).[4] Stilul de ataament caracteristic unei persoane adulte reprezint un tipar utilizat sistematic, de reprezenti i ateptri din partea unei relaii i a celuilalt implicat, emoii i comportamente aferente acestui tipar, care rezult din internalizarea/nsuirea unei anume istorii de experiene de ataament pe care individul le-a trit din copilrie i pn n viaa adult. (Fraley i Shaver, 2000). 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