Medullary Man

cortical man

The term ‘Medullary Man’ — and its cortical counterpart — does not appear as an explicit theoretical construct in the depth-psychology canon proper, yet the conceptual architecture it names permeates a substantial strand of the neurobiologically inflected literature that borders and increasingly interpenetrates that canon. Within this corpus, the medullary register designates the phylogenetically ancient brainstem organization — particularly the nucleus ambiguus, the dorsal motor nucleus of the vagus, and the nucleus of the solitary tract — that governs visceral, autonomic, and homeostatic life prior to and largely independent of cortical modulation. Schore’s developmental neurobiology casts the medullary-cortical axis as the developmental axis of affect regulation itself: medullary noradrenaline systems are recruited before the orbitofrontal cortex matures, and their subsequent integration constitutes the neurobiological substrate of the emerging self. Porges frames a parallel polarity through the polyvagal lens: the evolutionary ascent from unmyelinated, reptilian DMNX vagal control toward myelinated, mammalian NA-based social engagement represents a movement from purely medullary to corticobulbar governance of relational life. Damasio’s proto-self and primordial feelings similarly anchor subjectivity in brainstem structures before the cortex elaborates them. The tension organizing this literature is whether the medullary level represents a deficit to be regulated or a primary ground of being whose suppression by cortical ‘civilization’ constitutes its own pathology — a question that returns the neurobiological discussion to depth psychology’s oldest concerns.

In the library 16 passages

the efferent pathways that regulate the social engagement system originate in medullary structures (i. e., nucleus of cranial nerve V, nucleus of cranial nerve VII, nucleus ambiguus). Second, corticobulbar pathways, which originate in frontal cortex, enable the possibility of efficient cortical regulation of these medullary source nuclei.

Porges establishes the medullary-cortical polarity as the structural axis of the social engagement system, with frontal cortex exerting regulatory authority over phylogenetically ancient medullary nuclei.

Porges, Stephen W., The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation, 2011thesis

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there is an intensive expansion of the innervation of the orbitofrontal association cortex by the parasympathetic lateral tegmental noradrenergic system of the lower brain stem medullary reticular formation.

Schore identifies the ascending medullary noradrenergic pathway as the neurochemical mechanism by which brainstem-level affective regulation becomes integrated into orbitofrontal cortical functioning during development.

Schore, Allan N., Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994thesis

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The maturation of descending regulatory fibers allows for the onset of an even more efficient orbitofrontal Jacksonian control of spontaneous activity, manifested in the curtailment of practicing behavioral hyperactivity.

Schore invokes Jacksonian hierarchy to describe how mature corticobulbar development progressively subordinates medullary spontaneous activity to cortical regulatory control.

Schore, Allan N., Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994thesis

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The NA is a continuum of interconnected subdivisions, beginning rostrally at the level of the facial nucleus and extending caudally to the spinal medullary junction.

Porges details the nucleus ambiguus as the cardinal medullary structure organizing cardiopulmonary and social vocalization functions, defining the anatomical substrate of medullary-level regulatory organization.

Porges, Stephen W., The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation, 2011thesis

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structural similarity of the orbito-frontal-medullary mechanisms that underlie them… a direct connection from this ‘visceral sensory cortex’ to the nucleus of the solitary tract (NTS) in the medulla, a component of the brain stem vagal complex.

Schore documents the direct orbitofrontal-to-medullary anatomical pathway as the structural basis for cortical modulation of visceral and autonomic states.

Schore, Allan N., Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994supporting

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Medullary noradrenaline neurons of the solitary nucleus contain a very high number of glucocorticoid receptors… The medial part of the NTS, including the general region of the A2 cell group, is known to play a role in the control of cardiovascular homeostasis.

Schore demonstrates that medullary noradrenaline neurons serve as transducers between neuroendocrine stress signaling and cardiovascular homeostasis, positioning the medullary level as integral to psychobiological self-regulation.

Schore, Allan N., Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994supporting

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parasympathetic medullary noradrenaline and parasympathetic hypothalamo-pituitary-adrenocortical neuroendocrine systems provide an inhibitory function… the former is a short-term ‘stop’ mechanism, the latter long-term.

Schore distinguishes the medullary noradrenergic system as a rapid inhibitory brake operating on a shorter time-scale than hypothalamic-cortical neuroendocrine regulation.

Schore, Allan N., Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994supporting

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the primary motor fibers of the vagus originate from two separate and definable nuclei in the medulla: the dorsal motor nucleus of the vagus (DMNX) and the nucleus ambiguus (NA).

Porges locates the phylogenetic stratification of vagal control within distinct medullary nuclei, providing the anatomical ground for distinguishing primitive from evolutionarily advanced medullary organization.

Porges, Stephen W., The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation, 2011supporting

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medullary catecholaminergic neurons are known to possess axon collaterals projecting to different parts of the forebrain… The primary function of these A2 neurons which target limbic structures is ‘to relay visceral information to forebrain sites involved in neuroendocrine and/or emotional control.’

Schore establishes medullary A2 catecholaminergic neurons as the ascending relay linking visceral body states to limbic-forebrain emotional processing.

Schore, Allan N., Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994supporting

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medullary noradrenaline neurons are known to innervate forebrain regions… orbital neurons are known to send direct connections to the solitary nucleus, and all other limbic structures which project to this brain stem area and process similar information have reciprocal connections with it.

Schore emphasizes the bidirectional reciprocity between medullary solitary nucleus and orbitofrontal-limbic cortex as the neuroanatomical substrate for mutual regulation between medullary and cortical levels.

Schore, Allan N., Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994supporting

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These important brain-stem nuclei do not produce mere virtual maps of the body; they produce felt body states. And if pain and pleasure feel like something, these are the structures we first have to thank.

Damasio grounds the earliest layer of subjective feeling in brainstem nuclei, positioning medullary-level structures as ontologically prior to cortical consciousness.

Damasio, Antonio, Self Comes to Mind: Constructing the Conscious Brain, 2010supporting

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this frontolimbic structure represents the cortical system that is fundamentally involved in mediating the central autonomic manifestations of emotional behavior and in regulating motivational states.

Schore characterizes the orbitofrontal-medullary axis as the convergence point at which cortical emotional behavior and medullary autonomic function are unified.

Schore, Allan N., Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994supporting

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the organization of the mammalian brainstem has evolved to have a ventral vagal complex, consisting of NA and the nuclei of the trigeminal and facial nerves, that coexists with the dorsal vagal complex, consisting of the DMNX and NTS, that regulates vegetative processes and is observed in reptiles.

Porges presents the mammalian brainstem as a stratified medullary architecture in which phylogenetically newer social-regulatory structures overlay older vegetative ones.

Porges, Stephen W., The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation, 2011supporting

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experience-dependent maturation of these specific orbitofrontal-subcortical connections in the middle of the second year may allow for the appearance of the emergent adaptive function of visually triggered conservation-withdrawal, a primary regulatory process for organismic homeostasis.

Schore links the developmental maturation of orbitofrontal-medullary circuitry to the emergence of conservation-withdrawal as the organism’s first cortically mediated homeostatic response.

Schore, Allan N., Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994aside

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What did the lizard feel when he was eating his hard-won lunch? I suspect that his brain stem registered the successful compl[etion].

Damasio uses the lizard’s collicular behavior as a phenomenological thought experiment to distinguish purely brainstem-mediated registration from cortically elaborated conscious experience.

Damasio, Antonio, Self Comes to Mind: Constructing the Conscious Brain, 2010aside

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