Introduction

To survive, living organisms must adapt to their environment by recognizing signs in the context and responding to them in life-preserving ways, by maintaining internal somatic communication about their own state, and by reproducing. All of these are accomplished by recognizing signs, attributing meaning to them, and organizing a life-preserving response (Hoffmeyer 2008). Such biosemiotic processes enable organisms to engage in life-promoting activity at moderate levels of arousal (e.g., seeking food, a moderate drain on energy resources that also accesses resources), life-defending activity at high levels of arousal (i.e., response to danger, a substantial depletion of resources), restorative inactivity at low levels of arousal (i.e., sleep that makes gathered energy resources available for use), and, among mature individuals, reproductive activity at high levels of arousal. These correspondences between various types of activity and the arousal level that accompanies and sustains them is the basis for arousal to function as a somatic representation of danger (extremely high or low arousal), and safety (medium-low arousal) (cf. Danese and McEwen 2012). An ever-emergent balance among these (McEwen 1998a, b) is required to ensure that there are sufficient resources for life-preservation, reproduction, and caregiving for the next generation of life.

In social species, reciprocal interpersonal communication between individuals augments intrapersonal semiotic processes to fulfill these functions. Specifically, individuals regulate relationships in ways that promote protection of the self, reproduction with a partner, and caregiving of the children until their reproductive maturity (Bowlby 1969/83; Belsky 2012; Crittenden 1995). Each of these functions is best fulfilled through enduring attachment relationships (specifically, parent–child, partner-partner, and child–parent). Further, attachment relationships bring together each person’s genetic, neurological, experiential, and cultural endowment (Crittenden et al. 2014). That is, all factors that are known to affect development and adaptation are active in attachment relationships. Attachment also addresses individual differences (Ainsworth et al. 1978; Crittenden 1995, 2008) and the varied developmental pathways that produce difference (Bowlby 1988; Crittenden 2008, 2014). In other words, biosemiotic processes in attachment relationships are the basis for early adaptation within infant-parent attachment as well as later adaptation or maladaptation. We explore these ideas with particular attention to pre-verbal processes.

Somatic arousal is the base upon which all other life processes are built because it maintains or fails to maintain life. Human neonates cannot meet their own survival needs, nor can they easily change their state of arousal (for example, when falling asleep or waking up). They can, however, produce behavior that adult humans can interpret as signs and respond to so as to help infants’ to change their level of arousal. Infant crying, movements, facial expression and other bodily indicators all attract mothers’ attention, are given meaning by mothers, and result in maternal action that helps babies to establish rhythms of changing arousal. Such non-verbal communication between mothers and neonates also facilitates infants' use of somatic information to regulate their own states. When mothers are able to manage their babies’ arousal, their infants are safe, fed, rested, and, when in a state of alert and moderate arousal, able to explore meaning-making processes in response to a wide range of stimuli. The last of these is crucial to long-term adaptation. When mothers are less able to assist infants, infants experience greater extremes of arousal and more of their learning occurs in hyper- or hypo-aroused states. This heightens attention to and iconic recall of threatening stimuli (Kuhbandner et al. 2011; Sutherland and Mather 2012); such processing ‘short-cuts’ increase short-term safety, but may reduce long-term adaptation because they are not readily open to reflection.

People who come to mental health treatment are poorly adapted to their circumstances, suggesting that they do not transform incoming sensory information to action sufficiently well. Moreover, many have problems regulating their own arousal in ways that promote health and survival (Porges 2011). Finally, most have experiences with exposure to danger (Hertzman 2013; Kendler et al. 2011; McLaughlin et al. 2012) in which they were unable to protect themselves adequately or unable to restore their somatic arousal to life-preserving rhythms or both. The danger may be in the past or present or both. Psychotherapists function like mothers to promote patients’ learning to recognize important internal and external signs, to attribute helpful meanings to the signs, and to organize adaptive responses that will improve the functioning of the patient. This paper describes individual differences in how mothers manage life-preserving reciprocal communication with neonates and then applies the same principles to psychotherapy.

Attachment as a Universal Semiotic Process

The interactive system that protects infants is called “attachment” (Bowlby 1969/83). Initially only parents are attached to the baby, with the baby forming a specific attachment to each parent toward the end of the first year of life. As infants mature, they learn to make meaning of sensory stimulation, particularly that provided by their parents’ behavior when infants feel threatened (Mather and Sutherland 2011). By 1 year of age, this learning (drawn from the semiotic interaction of their body with the environment, as mediated by the parent) becomes observable as individual differences in protective attachment strategies, based on differences in maternal interactive behavior during the previous year of life (Ainsworth, et al. 1978). The attachment strategy reflects individuals' regularity in the selection of certain types of DRs to interpret information and dispose action.

However, infants are not just recipients of parents’ behavior: with their bodies, facial and vocal expression, infants elicit psychological meaning-making and protective action from their parents. Regularities in such parental responses can be considered protective parenting strategies. These are shaped by the parents’ past experience, their genetic endowment, their cultural context and by their infants’ individual characteristics. The most efficient infant learning occurs when infants are moderately aroused and parents ‘scaffold’ infants’ input by functioning in the infants’ ‘zone of proximal development’ (ZPD, Vygotsky, in Rieber and Carlton 1987). In other words, the parents interact in the range of infants’ incipient abilities to support their emergence - while letting infants act alone when they are capable and acting protectively for infants when the infants cannot yet protect themselves. Scaffolding is particularly important to nonverbal communication (Hoffmeyer 2007) because such communication predominates during protective, caregiving and reproductive behavior.

Notably, all neurological processes are inherently the same, differing only in the completeness of processing (from brainstem to cortex) and the priority given to subroutines for handling different qualities of information. Three types of information are important to survival. The most essential is (1) ‘somatic’ information about the organism’s state; somatic information represents the body’s integrity or, conversely, vulnerability. All further transformed information is based on somatic ‘body maps’ (Damasio 2010), i.e., everything is represented in relation to one’s body. Two further transformed types of information are (2) ‘cognition’ which is based on temporal contingencies of sensory information and (3) ‘affect’, based on the intensity of contextual stimulation. All three types of information are used to construct mental and behavioral protective self-, partner-, and child protective strategies. They interact with maturation and changing external circumstances to yield ever-emergent adaptations to life situations (Crittenden 2015). Attachment and parenting strategies have neuro-psychological correlates, that is, mental strategies for making meaning of sensory information so as to dispose behavior.

Individual Differences in Attachment and Parenting Strategies

Three major groupings of individual difference in strategies were described by Ainsworth (and many other theorists, cf. Crittenden 2000). In attachment terminology, these are called Type A (a bias toward finding meaning in cognitive information), Type C (a bias toward finding meaning in affective information) and Type B (unbiased use of both sorts of information). The relation of these types to somatic information is not yet clear.

The strategies reflect dyadic and, later, individual adaptations to experienced danger. Some adaptations (Types A and C) have limited semiotic freedom (Hoffmeyer 2010), using only part of humans’ representational potential; these ‘short-cuts’ in processing allow quick recognition of danger and fast implementation of well-tested protective behavior. The Type B strategy permits greater inclusion of alternative representations, thus having more semiotic freedom and resulting in more adaptive flexibility. On the other hand, the B strategy requires both more time and full maturation to achieve this flexibility. The B strategy emerges in infancy and childhood when parents function in their infants’ zone of proximal development (ZPD), thus, scaffolding the infants’ behavior optimally. This occurs most often when conditions are relatively safe.

When conditions are stressful or even dangerous, parents usually interact less synchronously. Their children tend to organize Type A or C strategies. This promotes survival in the short-term. Over long-term, however, the psychological short-cuts of the Type A and C strategies limit individuals’ semiotic freedom and thus their adaptability in new circumstances. Of course, there is no possible adaptation without survival. Consequently, the non-B strategies protect children until maturation can enable more sophisticated psychological processes that might override earlier shortcuts.

Attachment Strategies as Interpretants

Attachment strategies were first described by Ainsworth in both home and laboratory settings (Ainsworth, et al. 1978). The function of attachment was to maximize maternal protection while permitting safe infant exploration. For infants who organized a Type B strategy, mothers were readily available to read infants’ signals and respond in their infants’ zone of proximal development; communication between these mothers and their infants was direct and reciprocal, with errors quickly corrected. Infants who organized a Type A strategy had mothers who did not like negative affect or tactile communication; their infants were watchful without using negative affective signals and learned to behave in ways that did not elicit negative affect from their mothers. Mothers of infants who organized a Type C strategy were unpredictably available but tolerated – or even positively reinforced – negative affect and physical proximity; their infants escalated negative affect increasingly rapidly when they could not predict, on the basis of maternal communication, what their mothers would do. These three forms of dyadic regulation had, in the short term, the effect of maximizing the chances of immediate protection and comfort, given what parent and infant had learned about each other. The dyadic interaction that underlays attachment and parenting strategies can be described as a series of signs, each interpreted so as to dispose the behavior of each interactant towards the goal of protecting the vulnerable member of the dyad from danger and reducing distress.

Neurological and Psychological Aspects of Attachment as an Interpretant

Attachment-related meanings are made from sensory inputs by processing through the brain. Parallel processing of sensory inputs from in- and outside the body activates multiple neural pathways, each of which each disposes a motor response or inhibition of response. These neural pathways can be considered multiple “dispositional representations” (DRs, Crittenden 2008; Damasio 1994; Popper and Eccles 1977) of the self in the current context. Each DR reflects the meaning given to a pattern of sensory stimulation (functioning as a sign) through the response disposed by the representation itself. In other words, the DR can be seen as an interpretant of the sensory stimulation that activates it (the sign) and the meaning attributed to the sign would be the disposed behavior. At any given moment, a pattern of sensory stimulation activates multiple DRs that can be similar or different, compatible or incompatible.

Multiple DRs are examples of high semiotic freedom: each individual in a relationship can attribute several possible meanings to the other’s behavior. The choice of which DR to enact is crucial to the individual’s immediate safety and comfort as well as cumulatively, over many such exchanges, to the probability of behaving similarly in the future. In this way, the interpretant function benefits from previous learning.

In semiotic terms, each person activates multiple interpretants (that is, DRs) for aspects of the behavior of the other person. Consistency in the process that selects the most protective DR can be conceptualized as a meta-interpretant. This learned adaptation is the expectation that one semiotic process, among the array of possibilities, will be the most rapidly and reliably protective. It results in patterns of contextually anchored behavior grouped and labeled as the ABC attachment strategies.

This raises the question of how infants learn to select among the various DRs. Is there a kind of sign that is more reliably protective? Might too quick protective action interfere with exploration? Is there time to consider all possible responses and select the best? Of course, it depends! On how close in time or space the danger appears to be and how severely harmful it might be. Different DRs make different meanings about exactly these things. There is, in other words, a cost/benefit ratio to implementing one DR rather than another. If an infant always interprets the slightest sign of change as danger and chooses the DR that disposes clinging, the infant will never have the advantage of exploration. On the other hand, if an infant always selects the DR that disposes exploration, the infant will be insufficiently protected. If a routine answer is not employed, then each situation will need to be evaluated uniquely and that is neither efficient, nor safe under conditions of proximal and substantial danger. Attachment strategies, as meta-interpretants, are the expected best way to organize an adaptive response based on each dyads’ past experience together.

Memory Systems and DRs

The near infinite variety of pathways through the brain, that is DRs, can be clustered as ‘memory systems’ (Schacter and Tulving 1994). The Dynamic-Maturational Model of Attachment and Adaptation (DMM; Crittenden 1995, 2008; Crittenden, et al. 2014) has added somatic ways of knowing and connotative language to Tulving and Schacter’s set of memory systems. Each focuses on qualitatively different information that is processed differently through the brain and each disposes some action (or inaction).

Some of these memory systems are preconscious and preverbal, that is, they yield implicit meanings. For example, organic states that signal danger or safety are somatic memory; the temporal order of events that preceded and followed danger is procedural memory; the contextual stimulation that was perceptually simultaneous with danger is imaged memory (called ‘perceptual’ memory by Tulving and Schacter). These signs are quite proximal to the danger and often reflect both iconic and indexical processes. These early developing memory systems function rapidly (due to relatively limited processing), thus facilitating quick and reliable protective responses.

Later developing memory systems (in both development and evolution) use meanings that are language-based, that is, largely symbolic, and can be explicit and conscious (involving more extensive processing). They consist of verbal descriptions of bodily states that warn of danger, that is, ‘body-talk’, beginning at about 2 years of age (cf. Wilkinson 2003); generalizations about future danger, that is, semantic memory, beginning at about 5–6 years of age; words and phrases for the intensity of danger, that is connotative language, beginning at about 6–7 years of age. These symbol-based memory systems allow for linguistic, logical, and abstract mental processing; such processing requires more time, but enables refinement of representation. It also allows for verbal communication, greatly enhancing interpersonal cooperation and scaffolding around protection from danger. However, linguistic representation is vulnerable to self-generated errors in meaning attribution (and consequently in disposed action (Fig. 1)).

Fig. 1
figure 1

The organization of memory systems

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The most complex integrative mental functions involve combining, comparing and contrasting DRs in order to select the best or construct a more comprehensive DR that encompasses explanations of discrepancies, correction of errors and inclusion of understandings. Event recall (which is reconstruction of past events from currently activated neural networks some of which were activated during the event) is episodic memory, beginning at about 3–4 years of age. Reflective integration, beginning concretely at about 6–7 years of age and abstractly in adolescence, permits individuals to consider numerous instances at once, seeking commonalities and differences that can inform future behavior. Integrative memory systems enable humans to construct detailed representations of specific instances of danger or more general understandings of causality, consequences, and personal responsibility for these. This level of meaning-making is essential to flexibility of strategic functioning.

The information processing basis of the Type A pattern of attachment is conceptualized in the DMM as the predominance, in information processing about danger, of “cognitive” information, that is, procedural and semantic memory systems (or DRs).

The information processing basis of the Type C pattern of attachment is conceptualized in the DMM as the predominance, in information processing about danger of “affective” information, that is, imaged memory and connotative language (or DRs).

Type B organization is characterized by the absence of strategic shortcuts and, therefore, no bias toward acceptance of cognitive or affective DRs. Instead, parallel processing is maximally allowed in these organizations, permitting the widest variety of DRs to be available to the higher-level cortical processing. This is the basis for reflective and integrative functioning. This longer processing route is used particularly when there is ambiguity or discrepancy among the less completely processed DRs (for example, when one’s gut feeling doesn’t match what one knows semantically about the situation).

Mother-Infant Interaction and the Development of Attachment Strategies

The attachment strategies, that is, mental habits for processing information to yield protective behavior, are the outcome of infants’ experience with their attachment figures around regulating arousal and making meaning of information, particularly when there is threat or the infant feels anxious. The reliance of the infant on the more experienced parent as a source of information is adaptive in the infant's developmental niche – even when the outcome is not Type B attachment.

Because of infants’ immaturity, mothers’ ability to scaffold infant behavior is crucial to infants’ development. When the infant behaves (for example, cries), the mother gives meaning to this behavior (using her mind in organized ways, i.e., using her attachment strategy) and she behaves. Mother’s behavior, in turn, generates sensory stimulation for the infant, which might or might not change the infant’s state. If it does, it indicates that the infant made implicit meanings of mother’s behavior (another semiotic process). The mother’s DRs can include both preconscious and verbal DRs (especially semantic generalizations about the meaning of the baby’s behavior or what she thinks she should do) whereas the baby would send somatic signs and slowly develop procedural and imaged representations of himself with his mother. Mother-infant interaction, in other words, can be seen as a series of semiotic exchanges that reciprocally shape meanings and meaning-making processes. The mother is expected to scaffold the development of the immature child because of the greater semiotic freedom of the mature brain. Of course, conditions other than maturity influence mothers’ ability to scaffold infants’ behavior and this will affect the meanings infants derive from interaction.

Three Mother-Infant Dyads

To illustrate mother-infant semiotic processes, we describe three dyads interacting in a 3-min sequence where the directions are ‘play with your baby as you usually would’ (Crittenden 1988). The babies are 6 weeks old. To highlight the comparison, all of the mothers kiss their babies, but the kisses are given very different meanings by the babies. In each case, the kisses mark a rupture in the interaction. Of course, every dyad of every age has frequent ruptures (30 % ruptures in infancy, Tronick 2007). Ruptures are only a problem if they are not repaired by learning new meanings and responses. These three dyads show three different biosemiotic processes around the mild threat and discomfort of rupture.

Dyad 1 (‘Oooooo’): Attuned, Well-Scaffolded Interaction, Consistent with Attachment Type B

Description of the Interaction

In Dyad 1 (‘Oooooo’), the baby is just waking up after falling asleep with a full belly. As he blinks and stretches, his mother looks at him and says: “How are you feeling now? Are you okay? Are you ready?” She burps him and then moves him into a well-supported face-to-face position on her knees. He is squirming a bit, with his eyes and arms floating about. His mother strokes his cheek; no change in the baby. She talks, ‘answering’ all of his movements with sound. No change. His eyes float past her face, then jerk back to gaze at her. Gazing at his mother, the baby imitates her open mouth - slowly. His mother s-l-o-w-l-y opens and closes her mouth again. He imitates his mother, who matches his processing speed. Intense pleasure is written on both their faces. He looks at her intently. She opens her mouth. He keeps looking. Repeat. She suddenly leans toward him and plops a soft kiss on his cheek. His eyes and mouth fly open in surprise and his head tips back. She pulls back and says ‘Ooooooooo’, beginning with high/fast intonation and steadily dropping and slowing the sound. He looks at her steadily, with pleasure on his face as she looks back.

Biosemiotic Structure of the Interaction

In biosemiotic terms, the interaction goes like this: (Table 1)

Table 1 Semiotic sequence for Dyad 1 ('Oooooo')
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Condensing this sequence, we get several bouts of: baby sign, mother interpret, mother act creating a sign that her baby doesn’t perceive as self-relevant. Then the baby finds his mother’s eyes, an innate (genetically prepared) interpretation is made (Meltzoff and Moore 1977) and the action of seeking the mother’s gaze is produced. The mother interprets this as meaning her baby is ready to engage and she opens her mouth. A few sequences of mutual signs, interpretations, and responses occur. At first mother and baby become increasingly attuned, then the baby only gazes (but with evident pleasure). The mother has signaled in words that she wants action; when the baby only looks, she abruptly kisses him. This breaches their synchrony. She has misinterpreted his sign (steady gazing) and, acting on her misinterpretation, has disrupted him. She immediately interprets his mild distress as self-relevant and corrects the intrusion distally and his arousal vocally. They regain harmony almost immediately.

Biosemiotic Learning

In just 3 min, both mother and baby learn about each other. This learning will enable their next interaction to build on this one, possibly beginning sooner (for example, with the baby seeking, instead of randomly finding, his mother’s eyes) or extending longer before a rupture (possibly because the mother learned a new meaning for her son’s inactive gazing) or with the baby initiating a repair.

Dyad 2 (‘Dance!’): Predictable Misattuned Interaction that Lacks Scaffolding, Consistent with Attachment Type A

Description of the Interaction

Dyad 2 (Dance!) begins similarly to 'Oooooo', but when the baby does not respond immediately (as Baby 1 did not), the mother perceives the lack of response as self-relevant and interprets it as rejection. Her DR disposes behavior that denies rejection and declares affection: she kisses the baby immediately. The kiss startles the baby who turns away. This is interpreted by the mother as further rejection which leads to a DR of offering many kisses and squeezing the baby’s face close to her own while orienting them both toward the camera, with mother smiling. The baby frowns and turns away. The mother asks the baby to ‘dance’ and bounces him up and down on her leg. The baby turns away with a sad face. This continues for 3 min until the mother has full, toothy smiles and the baby is limp in her arms (like a rag doll) and with a sad face. When the mother is still, the baby turns back to her.

Biosemiotic Structure of the Interaction

This mother perceives the same lack of engagement from her baby as did Mother 1, but she interprets its meaning differently which results in a disruptive kiss and pretense of dancing. By seeing the baby only through her own need to be accepted by him, Mother 2 reacts in ways that change the baby’s lack of attention to the rejection that she had initially expected. When the baby’s pulling back and looking sad become clear, the mother interprets the need to appear happy and bounces the baby. Being out of synchrony with her baby, the baby pulls away harder, then gives up the entire process of engaging (by looking out blankly and hanging limply.) The baby’s arousal drops and he appears depressed. When his mother stops misinterpreting, the baby engages with positive signals. His mother smiles to the camera.

Biosemiotic Learning

In biosemiotic terms, the baby learns that displaying negative affect causes more intrusion whereas showing positive affect – even when he feels bad – results in positive maternal behavior. The baby learns to discard somatic DRs in favor of procedural DRs that include displaying false positive affect.

In this case, the mother had been depressed and suicidal when she became pregnant, had sought an abortion but it failed, and ‘read’ in her baby’s behavior the evidence of her pervasive failure - that she expected to find. Unlike Mother 1, she was unable to make new meanings from failed sequences and to use the new meanings to dispose new and more attuned behavior.

Dyad 3 (‘Hey, you!’): Unpredictable Misattuned Interaction, with Intermittent Scaffolding, Consistent with Attachment Type C

Description of the Interaction

The baby is lying on his back and his mother is leaning over him. She leans closer and gently pokes his face a few times (not unlike Mother 1’s stroking the cheek). The baby looks, then turns away with a little protest. His mother pauses and pulls back, looking at him – as if he were a strange creature that she didn’t recognize. The baby is calm and unfocused (like Baby 1). Then mother leans in quickly, pokes his chest several times, saying ‘Hey, you! I’m your mama! Look at me!’ The baby looks, then his face squeezes up in a scowl and he emits pre-cry sounds. His mother picks him up, puts him against her shoulder and rocks him, saying, ‘It’s me! It’s okay, it’s me!’ He calms. She puts him on his back again, hunting for his eyes. When he looks, she repeats the poking, he wiggles uncomfortably and cries. His mother becomes frustrated and says sharply, ‘Hey you! I’m your mother! Look at me. Smile!’ The baby cries, the mother picks him up, he calms and so on. By the end of 3 min, the mother is frantic and unhappy and the baby is aroused and distressed.

Biosemiotic Structure of the Interaction

The mother misinterprets mild signals from the baby and acts on DRs that reflect her desires. But when her baby gives strong negative signals, she interprets the baby’s meaning from his perspective and uses a baby-centered DR of comforting. Her baby perceives this and calms in her arms which she interprets, accurately, as shared engagement. Based on that, she acts on a DR of seeking activity from him. Because this is intrusive and out of his zone of proximal development, the baby interprets the signs as self-relevant and unpleasant; he protests. And so forth. Over time, this baby is likely to learn to intensify his signaling and to seek fairly constant holding – because in calmer moments his mother loses the connection to him.

Biosemiotic Learning

Both mother and baby learn that the signs from the other are self-relevant; their experience is that of being engaged closely all the time. But neither is able to find a response that predictably maintains both the connection and pleasure in the connection. Mother 3 needed very strong negative signals from her baby in order for her to interpret his perspective (with a DR of meeting his needs); in the absence of such strong signals, her needs took precedence in her interpretation and selection of a DR to enact (see Crittenden 2015). Put another way, when her baby was distressed, the mother became attuned. When he was not distressed, her desires took priority and she behaved in misattuned ways that did not scaffold his behavior. The dyad experienced escalating negative arousal, near continuous engagement, and mutual frustration in the context of mutual desire for each other.

The Biosemiotics of Human Interaction

These three dyads provide a great deal of information about how humans connect for both immediate survival and also more general learning processes. Dyad 1 (Oooooo) engaged successfully because, at the beginning of the interaction, the mother first checked her son’s somatic state (by perceiving and interpreting his somatic signs) and then modified her behavior to assist him to reach an alert and attentive state. This was crucial because, without somatic comfort, the rest of the interaction could not proceed. The innate trigger of eye contact brought them together. Thereafter they alternated behavior such that each perceived self-relevance in the other’s behavior (signs) and made interpersonal meaning of it. The infant initially acted on somatic DRs, but as his attention became focused on his mother, a procedural DR of imitation was constructed. This too depended on innate releasers (Meltzoff and Moore 1977) but became voluntary and intentional as the dyad repeated the pleasurable sign-interpretation-action sequence. The mother, on the other hand, was largely conscious and sometimes verbal about the signs that she perceived, the meanings that she attributed, and the DR that she selected to enact. She regulated the process by scaffolding her contribution to fit her son’s zone of proximal development. A crucial event occurred when the mother acted on her DR of expecting her son to continue to imitate and misinterpreted his sign of engaged looking. That ruptured their synchrony. The repair of the rupture depended upon the mother reconsidering the meaning of her signs to her son (the kiss) and acting so as to repair the rupture. The repair was managed primarily through somatic distance and an imaged sound. If the semiotic process develops as it has begun, Baby 1 will learn to trust the meanings generated by his brain. In the ultimate sense, he will be secure.

In Dyads 2 and 3, synchrony was not obtained because, initially, somatic comfort was not considered and achieved. The interactions became more like extended breaches than synchrony interrupted by a breach. Further, the mothers’ attributions about the baby’s signs regarding the breach were self-protective DRs (as opposed to infant-centered DRs) which, when enacted, magnified the breach, albeit in opposite ways (of lowered arousal in Dyad 2 'Dance!' and increased arousal in Dyad 3 'Hey, you').

Functionally, (a) somatic comfort, (b) scaffolding in the zone of proximal development by the mother, and (c) repair of the inevitable breaches were crucial components of successful interaction that promoted infant development. In each the mother, functioning as the baby’s attachment figure, took responsibility for adapting her behavior to her son’s. In Dyads 2 'Dance!' and 3 'Hey, you', the mothers used past DRs of being endangered by inadequate performance (Dyad 2) and rejection (Dyad 3) as interpretants. These DRs of past experiences became psychological procedures for making meaning of and responding to their babies’ signs; that (a) left the infants with too high or too low arousal, (b) failed to establish harmonious dyadic processes of meaning-making/action/modification and (c) left the infants without processes for repairing ruptures.

Processes such as those in Dyad 2 and 3 are expected to occur in environments where danger abounds and resources are scarce. In such environments, infants are better adapted if they learn strategies that lead them to expect danger and organize responses to the expected danger. Such strategies become ingrained in functioning such that they become the default process for attributing meaning and organizing behavior. The more immediate the danger is, the less synchronous the interactions with the attachment figure will be, and in turn this will lead to more extreme strategic organizations to ensure survival - in the short term. This, however, can limit future development because the precision of the adaptation to current danger reduces future flexibility to changes in the self or context. In that case, the individual might continue to make meaning using strategies that reflect an immature self or past experience with danger, thus limiting future adaptation. This suggests a protection-based view of psychopathology.

Psychotherapy as a Transitional Attachment Relationship

When there is a mismatch between a protective strategy and the demands of the current context, the mismatch is usually perceived as affective distress or cognitive dissonance by one or more family members. If these do not result in an adaptive change of strategy, someone may experience somatic discomfort. Affective distress, cognitive dissonance, or somatic discomfort, accompanied by failing strategies that limit life functions, can define psychopathology and may dispose seeking help. Psychotherapy can be considered a special type of helping process embedded in a transitional attachment relationship that uses semiotic scaffolding processes similar to those described for parents and infants (Crittenden and Dallos 2014).

Scaffolding Family Meaning-Making Processes

Suffering individuals (designated patients and their families) seek treatment with an implicit or explicit request for protection and comfort. The attachment function of the therapeutic relationship is transitional, in that it is expected to terminate when the problems underlying distress are resolved both psychologically in flexible meaning making and interpersonally in enduring and safe relationships in which ruptures can be repaired. When psychotherapists function as transitional attachment figures, they work in patients’ zones of proximal development to modify patients’ use of their attachment strategy as an interpretant. Put another way, psychotherapy might be directed toward changing the danger (when possible) and scaffolding the development of family members’ information processing in ways that promote multiple parallel semiotic processes, together with a psychological strategy for integrating these to dispose adaptive behavior.

We propose that the process for accomplishing this in treatment is similar to that used in infant-mother interaction. In both, somatic readiness is foremost and is followed by the attachment figures' shaping of temporal and contextual synchrony in the attached persons’ zones of proximal development. The inevitable ruptures of synchrony become occasions for generating change processes. Therapists scaffold this process by highlighting opportunities for change. The goal is to establish a repair process, then transfer it from therapeutic relationships to family relationships during the therapy and then to life outside therapy. One could say that semiotic synchrony establishes the therapeutic attachment relationship whereas shared repair of ruptures promotes change.

Older patients can use language to describe this process, but the process itself is based on implicit exchanges with reflective integration becoming most useful after the implicit semiotic process of rupture and repair can be managed, even if awkwardly. That is, language can speed the process of recognizing implicit behavior, but should not run ahead of it (as did Mother 3’s words that claimed connection before the baby experienced connection). Similarly, narrative and reflective therapies should follow, rather than guide, experience. On the other hand, therapists often use metacognitive reflective processes to select or generate therapeutic DRs from among their own professional and personal DRs (Landini 2014).

A Biosemiotic Perspective on Diagnosis of Psychopathology and the Process of Treatment

In order to treat psychopathology, one needs to know the natural history and etiopathogenesis of dysfunction: what causes it, how it advances, how it can be reversed and how to prevent others from experiencing it. Because little of this is known for psychopathology, very influential institutions and individuals have called for a new nosology of psychopathology (cf. Wang and Insel 2010 for the US National Institute for Mental Health; the Division of Clinical Psychology of the British Psychological Society 2013). Insel, as Director of the NIMH, concluded after a decade of carefully organized comparative clinical trials that (1) Cognitive Behavioral Therapy, pharmacological treatment, and treatment by one’s family doctor are equally ineffective, except that treatment by one’s family doctor is sometimes a bit more effective, (2) no further tests of treatment will be run by the NIMH until research defines the genetic and neurological processes that underlie the development of psychopathology, and (3) symptom-based diagnoses (e.g., DSM and ICD) are not useful for guiding treatment. It is particularly noteworthy that Insel has specified that gene-by-experience interactions leading to neurological variation (instead of aberrant genes) are expected to underlay psychopathology. The British Division of Clinical Psychology suggested looking at relationships to develop a diagnostic replacement for DSM and ICD.

We think these positions are compatible and that, with the addition of ideas from the DMM and biosemiotics, the DMM may offer a logical and coherent theoretical basis from which to design a new nosology of maladaptive behavior that can lead to effective approaches to treatment. Notably, the focus would move from symptomatology to interpersonal adaptation, particularly within families. The DMM offers the ideas that (1) exposure to danger organizes both psychological and behavioral protective strategies, (2) the family is the basic organizational unit, (3) attachment figures shape organizational processes, and (4) developmental pathways throughout the lifespan can explain the occurrence of maladaptive functioning. Human biosemiotics, as described in Dyads 1–3, demonstrate the process through which genetic potential is shaped by experience to yield variations in the neurological ‘interpretant’ function (i.e. dispositional representations in varied memory systems) as well as variations in the psychological and interpersonal processes for selecting and enacting responses. These psychological and behavioral strategies could become the precursors of a neuro-behavioral nosology tied to adaptation.

Regarding treatment, the DMM of Attachment and Adaptation proposes that therapists should function as transitional attachment figures by (1) assessing and modifying (if necessary) somatic functioning before (2) beginning the biosemiotic process of scaffolding family members’ meaning-making process to yield more adaptive DRs and behavior. It might be worth noting that psychiatry, in relying heavily on pharmacological treatment, addresses somatic functioning and the need for arousal to be in the alert and comfortable range before psychological and behavioral functioning can be expected to change. Pharmacological treatment alone, however, is insufficient because interpersonal scaffolding is needed to generate change. Psychotherapists use interpersonal treatment processes to capture some aspects of the transitional attachment figure function as well as addressing interpersonal scaffolding and strategies for repairing breaches in interaction and relationships. However, most psychotherapies lack:

  1. (a)

    attention to somatic functioning,

  2. (b)

    recognition of the role of early exposure to danger in organizing the psychological and behavioral strategies that dispose maladaptive behavior,

  3. (c)

    a nomenclature for differences in interpersonal processes,

  4. (d)

    sufficient attention to implicit processes (instead depending prematurely on language, reflection, and integration),

  5. (e)

    awareness of the need for the psychotherapist to function as a transitional attachment figure in each person’s ZPD, scaffolding behavior in ways that will transfer out of the therapy.

Put another way, both somatic stabilization and therapeutic relationships are needed. Neither, by itself, is sufficient to achieve lasting change in adaptation.

Human biosemiosis (Hoffmeyer 2008) encompasses a wide range of processes. Strikingly, language and consciousness, despite being almost universally applied in psychotherapy, are not the most essential processes for human adaptation and survival. Instead, implicit somatic processes and derived cognitive and affective processes for making meaning of experience underpin both protection and verbal reflection. Further, when implicit processing is not adaptive, both linguistic transformations of implicit information and also direct acquisition of therapists’ statements can carry implicit misattributions into a second layer of misconstrued meaning. Thus, the outcome of the individual’s best effort to extract protective meaning from their experience can be endangering behavior. When such outcomes are repeated and seem unchangeable, patients feel both unsafe (and may be unsafe) and also unable to trust their own mental processes. Treatment that uses scaffolded semiotic processes in each patient’s ZPD, particularly around repairing tiny moment-to-moment ruptures, holds the potential to reshape protective attachment strategies (the meta-interpretants) and to transfer that potential to reflective thought and relationships outside the therapy.

The most fruitful outcome of therapy is enduring and safe family relationships. However, even when dangerous family relationships and external dangers cannot be changed, patients can come to know their own minds and gain control over how they use information to regulate their behavior. This will free them from the past, leaving them secure regarding their own psychological processes. To enable someone who has suffered to be calm and confident about the functioning of their own mind so that they can avoid eliciting harm and have a basis from which to establish supportive relationships seems an appropriate outcome for psychotherapy.