神经科学与临床研究杂志

The Relationship Between Neuroscience and Internal Conflicts in a Psychodynamic Approach to the Treatment of Autism Spectrum Disorder

Susan P Sherkow

The Sherkow Center, founded in 2012, applies a psychoanalytically-informed developmental approach to the understanding and treatment of autism spectrum disorder (ASD) in children, adolescents and adults. The Sherkow Center Approach is rooted in models of ASD that integrate perspectives from neurobiology and the psychoanalytic model of developmental processes from birth through adulthood. These models outline the roles of neural connectivity and processing, along with intra-psychic and interpersonal dynamics, in the development, maintenance, and treatment of ASD. On the neurological level, autism appears to alter the ways that regions of the brain communicate with each other. For example, characteristic autistic deficits in social- emotional cognition and behavioral self-regulation appear to result from to early developmental dysfunction of the orbitofrontal-amygdala circuit of the brain. The Sherkow Center Approach includes counseling parents by describing this neurological phenomenon as a disconnect between the thinking brain and the emotional brain. We hypothesize that psychodynamic treatment improves the functioning of this circuitry in autistic children—in other words, that treatment helps repair the connection between the thinking brain and the emotional brain. Existing evidence on neuroplasticity supports this possibility. There is evidence that behavioral intervention