Article summary with The body comes first. Embodied reparation and the co-creation of infant bodily-self by Montirosso & McGlone - 2020

What is the bodily-self?

The bodily-self is a certitude which supports the ability to perceive our body as separate from other entities and provides the basis of self-perception. It involves neural representation, modulation of physiological homeostasis, and perception of body ownership. Information about the bodily-self depends on exteroceptive signals (somatosensory, visual, vestibular) and interoceptive signals (pain, hunger, itch, etc.). The information from these signals is integrated into the bodily-self representation. The processing of information from the body begins during the first year of life and possibly starts in-utero. 

How does the bodily-self develop during infancy?

The formation of the bodily-self is driven and progressively refined by learning about sensorimotor contingencies via interactions between brain-body-environment and self-generated actions. During infancy, the bodily-self is not only dependent on inherited neuro-maturational processes, but also upon relational experiences of body-to-body-interactions. From birth, an infant is engaged in body-to-body interactions with their mother. These interactions support bio-behavioral synchrony, which is the coordination of biological and behavioral signals during moments of social contact, and support the infant´s bodily-self perception

What is the importance of maternal touch for the infants development and development of the infants bodily-self?

Tactile interactions between parent and infant play a central role in the developing social, emotional, and physical needs of the infant. Touch is a multidimensional and dynamic system and has a unique role on perception of body ownership. Newborns are able to detect multisensory integration of body-related information both for the temporal and spatial properties of visual-tactile stimulation. Touch can enhance the early subjective feelings of body ownership and support multisensory integration, which improves and becomes increasingly more specialized with experience. Interpersonal tactile stimulation can integrate information between modalities and support the development of bodily self-perceptions in the infant.

What is interoception?

Interoception can be defined as the sense of the internal state of the body, and generally refers to the ability to perceive physiological changes, especially from internal organs such as the heart, lungs, and skin. Interoception plays a role in the development of perception, higher-order cognitive processes and affect. It is also associated with the ability to recognize emotion and contributes to the perception of the self.

How is early infancy interoception affected by interpersonal exchanges?

Interoceptive functioning may be associated with the quality of early interpersonal relationships. A mother´s interoceptive functioning can play a role in the early exchanges with the infant (mothers heartbeat, breathing, etc). Ventral-ventral parent-infant contact and other embodied interactions involve activation of the mother´s bodily sensations and possible modify the interoceptive sensitivity which supports moment-by-moment adaptation to interactive demands and the needs of the infant.

What is maternal sensitivity?

Maternal sensitivity is the ability to respond promptly and in an active, warm, appropriate, acceptant, and flexible way to the infant´s signals. Maternal sensitivity relies partially on perceptual processing of the infants body. A more refined maternal perception of the infant body cues is associated with higher maternal sensitivity.

What is parental embodied mentalization?

Parental embodied mentalization (PEM) is the parental capacity to comprehend the infant´s mental states from their body movement and adjust their own kinesthetic patterns accordingly. Parenting heavily relies on this nonverbal, bodily based and biological co-regulation. Greater PEM is associated with greater social competence, fewer behavioral problems, and greater cognitive functioning later in infancy.

What is the insula?

The insular cortex is a part of the brain that is believed to be involved with consciousness and the regulation of the body´s homeostasis. It has some important characteristics with regards to bodily self-perception and interoception:

• It is among the earliest cortical regions to develop and differentiate. The insular and somatosensory cortices are functional at very early stages of postnatal life.
• Insula neurons have a specific cytoarchitecture with Von Economo neurons, which are implicated in body self-perception.
• The insular cortex is strongly involved in the regulation of homeostasis, in the elaboration of interoceptive inputs, and in somatosensory perception with respect to pleasant tactile stimulations.

What are C-tactile afferents?

When we are touched, there is a specialized sub-modality of touch sensing and processing its affective properties. The dual-touch system consists of two parallel neural pathways, one for the affective touch (with the CT neurons) and one subserving discriminate touch. C-tactile (CT) neurons are a class of neurons that innervate the human skin. They are mechanosensitive unmyelinated C-fibers that respond optimally to the gentle caressing touch that are typical of nurturing care. They project primarily to the dorsal posterior insula and to brain networks involved in social perception processing. The preferred stimulus for CTs respond to specific velocities, forces and temperatures that are experienced by an infant during skin-to-skin nurturing care.

What is the Mutual Regulation Model?

According to the Mutual Regulation Model (MRM), mothers and infants (or caregivers and children) are linked subsystems of a dyadic system and each of them regulate disorganization and its costs by a bidirectional process of behavioral signaling and receiving. The model suggests that in typical interactions, mothers and their infants fluctuate between attuned and misattuned states and recovery attunement states by a process called reparation.

What is embodied reparation?

Embodied reparation describes the process by which each partner modifies their own bodily states, making it possible to shift from bodily misattunement to bodily attunement. Frequent misattunements are also called interactive ruptures and happen most of the time during face-to-face interactions between mother and infant. Dyadic reparation is critical for the development of infants´ self-regulatory capacities and scaffolding an implicit inner sense of self-efficacy in regulating the stress that is caused by socially challenging conditions.

What is the role of interoceptive experience in the embodied reparation process?

During misattunement, any discrepancy from the expected state of the body generates a physiological unbalance in the infant´s body. They start to show bodily, behavioral, and emotional signals which convey to the mother the infant´s state. The discrepancies can be minimized by performing actions to modify the bodily state of either the mother or the infant. Embodied reparation allows the infant to reduce the discrepancies within the interoceptive system using the mother´s body. Efficient embodied reparation allows the infant to recover a stable interoceptive experience, which in turn supports a positive experience of the own bodily-self.