Monthly Archives: November 2013

Thanksgiving in Cambodia

#15 in my book blogs from “Don’t Try This at Home,” Chapter 3

Cambodia Napalm“Once again”  I thought, “Fall 2008 surely was the end of my world. Surely it could get no worse than this.”  So ended “Isolation Row,” my last post three weeks ago from my book.  Little did I know that 2008 could, and did, get a whole lot worse.  The gods of Pain had barely gotten started on my file.

By September 2008 I couldn’t take any more isolation row as prescribed by my first two therapists or I’d have bonked one. Meanwhile back in the real world the bills were mounting, so I worked out my nervous energy (read “anxiety”) in a whirl of new business projects. Remember the Newport Beach financier who took me on as her protege to write her book – but then all her banks collapsed?  Like writing a book about nuclear war in the middle of a nuclear war?  Well, I just went at it again.

Wrestling my demons to the bathroom floor, I forced myself to write a three-page memo to a company in San Diego, offering to market their power plants in Asia.  I e-mailed it to the Vice President, left a message, and nearly passed out when he returned my call next day.  He said the memo was “brilliant,” and two days later I was in his office.  Negotiations with his staff, however, dragged on for months as they did not have his vision, to put it mildly. They wanted to await the November 2008 election as they worried the new Administration wouldn’t support nuclear energy (it didn’t). They worried the banking collapse meant there would be no financier appetite for new ventures (there wasn’t).

Meanwhile my friends at the South Korean central bank were calling in a tizzy (wouldn’t you), worried the U.S. financial system melt down would take them with it. They had a Seoul government rep in Los Angeles take me to dinner. He asked me to write a white paper for South Korea to take to a world financial summit next spring on how to prevent the meltdown of the global foreign exchanges. No pressure, of course, just in my spare time. This minor project didn’t resolve neatly or quickly either.

In other words, “nuclear war” just kept happening, which did little to bolster my nearly-expired self-confidence or bank account. At least it pushed therapy with its “Inner Child” poppycock off my agenda during September-October 2008, easy to do because all that failed therapy only made my emotional pain worse.

And now for Mom

BVH-00701395 Then back on the East Coast there began a train of events which pushed me, my crisis, and any emotional needs for help (not being met by failed therapy anyway) well and truly off the agenda. Actually more like buried my stuff under a very large landslide.

Mom.

Mom had been “home alone” in Florida since Dad passed away in June and my younger sister the Wall Street lawyer in New York thought we should check on Mom regularly. In mid-September, in the middle of furious negotiations in San Diego over the fate of the national electricity grid, it was my turn to make a two-day visit.

Mom was never eager to see me (a long story for next week), so sis and I made my trip a surprise. Landing in Miami, I hopped a cab and phoned Mom en route to her place to say, “Surprise! I’m on the way.” Her reaction shocked me, even at that late date. “You can’t do this to me,” she yelled, “I don’t want you here! I don’t want to see you, leave me alone!” By the time she hung up she was in hysterics.

I phoned sis in New York from the cab. “Could you talk to Mom?” I said. “I’m afraid to give her heart failure, plus now I feel really awful; maybe this wasn’t a good idea?” But my poor sister Linda had spent so much time in the last six months commuting to Florida to tend our parents that she was worried about the stress on her job. Someone had to see Mom, and I was elected.

The problem was that if I couldn’t make it work, I was the problem.

“Why do you always have to fight with her? Couldn’t you just be sweet?” sis wanted to know.  Now, my sister is a famously nice person with a permanent glowing smile through thick and thin — but not when it came to anything which upset Mom. No one in our family would dispute a cousin’s recent statement that “your mom was a very strong-willed person, and a very emotional person.” Well, when Mom wasn’t happy, no one was happy, as the saying goes (it’s hackneyed for a reason).

It had to be my bad if things weren’t going swimmingly. “I can’t leave work any more and it’s your job to visit Mom so just get it done,” sis said point blank. Naturally I agreed; I thought it was our job to make Mom happy and so it must be my fault if she weren’t. I didn’t even notice until years later when I finally put this incident under a microscope that there was no room for anyone to even consider the collateral damage to me.

Doing the Right Thing, I ignored the arrows lacing into my heart and the terrified looks from the cab driver and dissolved in silent sobs in the back seat. We duly arrived at Mom’s place, whereupon she had to calm down so as not to cause any lifting of eyebrows amongst the upscale neighbors. The visit proceeded in an uneasy truce and I returned to my project negotiations in California.

Mozart’s Requiem – Again

Kathy @ 2008 Requiem AnaheimOn October 5, 2008 I again performed Mozart’s Requiem, this time as soprano soloist, in Anaheim.  After the previous events of 2008, you can already see my glazed stare in this photo taken minutes after the performance.

Three days later, as my last dream to accomplish something with my life by reestablishing my international business was in play, my phone rang again from back East, just as it had the day after I sang the “Requiem” the previous May.

This time it was my sister, calling to say Mom had been hospitalized in Miami with chest hemorrhaging and heart failure. She had smashed her ribs in a bad fall at home while the live-in nurse was watching TV.  Yes, this actually happened a second time.  Whenever I sing Mozart’s Requiem, a parent begins to die.

Again, time to leave the biz meetings and get back on the plane from California to Florida; truth is verily stranger than fiction. I would be afraid to ever sing that Mozart piece again, if I had any more parents.  Mozart’s Requiem was my favorite work for most of my life, and I don’t have any more parents, but I have not sung it again to this day.

Now my emotional crisis, the battle royal in therapy, the economic disaster, and my high-stakes attempts to jump-start my career were wiped off the agenda.  Now it was all about Mom in earnest.

I’d worried over the years that Mom lacked perspective; one rarely heard her speak of the eternal nature of love or the immortality of the soul.  I’d long been concerned that she might not be at peace when the time came.  Indeed.  Peace, to paraphrase Henry Kissinger, was the light at the end of the tunnel which turned out to be an oncoming train.

October and November 2008 with Mom in Florida were my psychological Cambodia.  It was going to get a whole lot worse, and “better” had just been summarily wiped off the agenda.

First came the genocidal doctors with the insurance hounds at their heels. Their sole concern seemed to be to remove Mom from whichever ward she was on, before the Medicare police could find her and cut their funding to the hospital in retaliation for the doctors allowing Mom to stay anywhere too long. They moved Mom from ward to ward, forcing her to undergo vigorous physical therapy to prove she should be hospitalized at all, which for a woman her age in her condition was in fact brutality. Finally Mom collapsed after physical therapy.

As a result our intrepid doctors summarily booted her out of the regular hospital wing and moved her to the hospice wing, where they said, mincing no words, she had an allotment of a few weeks before she’d have to leave, one way or the other.  Ouch.  “Welcome to the U.S. health care system” said my sister by phone.

To be clear, no one thought Mom would die; she had a bright mind and a strong constitution. Rather, my sister was up north working the retirement homes in New York 24 x7 to find a place into which to move Mom. We all thought she was just headed for a stressful plane flight.

Where’s My Daughter?

Adam & Eve Expulsion_from_GardenBut then there was Mom herself, who in essence began to snarl when I arrived back in Miami and continued to do so for six weeks. It wasn’t that she was in pain; the nurses saw to her meds.  She said herself that she was not in pain.

Mom, simply put, did not want to see me, as she had in fact clearly stated earlier and for decades. In fact about seven and a half minutes into each of my weekly Sunday phone calls to her, Mom had had a certain habit of hanging up on me – for about 25 years.

Curiously now, however, Mom was also hanging up on her friends and relatives as they called.  She folded the phone even on bridge partners from the retirement home who sounded anxious to see her and terrified that they themselves were next for hospice. But Mom flat out refused to see them, didn’t care anymore what anyone thought and did precisely as she felt.  Not only with me, but with all sorts of folks.

Mom had always been known to put on a happy face and be entertaining with her jokes to friends at her retirement complex or with shoe store clerks.  Now, actually it was remarkable to watch the change.  Apparently she was done with appearances, for why bother?

The nurses and I kept telling Mom in detail how we were going to get her to New York, I’d fly with her on the plane, she’d be fine with Linda.

The problem was, however, that Mom had never been willing to discuss questions such as “why and for what do we live.”  She’d always dismissed them as impractical nonsense from fools who haven’t worked as hard for a dollar as she.  She was pragmatic to the point of scorning theory as idiocy.  But in life as in science there’s a reason for theory, and when the time came for faith and belief, Mom didn’t seem to have enough inside upon which to base a view of ‘Now what?’

“Oh God, it is fearful thing, to see the human soul take wing,” as Byron put it, especially when it doesn’t have a wing to wing it.

Mom seemed to get no comfort from God, nor even be aware of the subject, for starters.  She also seemed to get no comfort out of seeing my sister’s loving smile.  Even the appearance of Linda’s two handsome sons from New York did almost nothing to lighten Mom’s face.  She seemed to get no comfort out of having brought her family, and my sister’s family, into being, of having friends (who never set foot in the hospital due to the hang-ups) of having a very long and until just these weeks, healthy and prosperous life, nice clothes, fine homes, and international vacations.  All of the things she always said were so important didn’t seem to bring her much joy in the end.

I had to spend a lot of hours watching this and felt driven to make sense of it.  As best I could grasp, Mom was terrified of something but I couldn’t dismiss it as fear of death since people do die in peace.

All this would have been gut-wrenching to watch just as an observer.  But then, I was not an observer.  I was the designated pin cushion.  Mom had made no bones for decades that she pretty much didn’t want me anywhere, least of all in that hospice at the end.

It got to where I’d arrive in her hospital room each morning and Mom would roll over and turn her face away.  When the nurses were dressing her or when she wanted something, she would raise her voice and say, “Where’s my daughter?” whether I were standing right before her, or down the hall on a business call to San Diego or Seoul.  When I’d say, “I’m right here, Mom,” she’d growl, “Not you. Where’s Linda?”

Now look, Adam and Eve had a Perfect Parent, but a 50% failure rate when producing their kids. Moral: Babies are really easy to damage.

Yes it felt bad at my end – but what if this were my paranoia?  What if Mom in reality was a fine (if not Perfect) parent, but I (like Eve) were somehow damaged, and had some mess in my head which made me project my own neurosis onto Mom?  I sure didn’t want to do a re-run of that dreadful “Mommie Dearest” or demonize my own mother…

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This is from Kathy’s forthcoming book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment DisorderHow I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series of excerpts from the rest of her book each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.

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From the Butt End of Evolution

Luggage on cartFear with a capital F has been bred deep into our neurons since man first walked the earth. Neurobiologists call it the “negativity bias” of the brain.  For most of history, our brains needed to fear a stick far more than we needed to enjoy a carrot. “If you fail to avoid a stick in the Serengeti today, you’re finished – but if you don’t find a carrot today, you’ll likely be alive to find one tomorrow,” as Dr. Rick Hanson puts it.[FN1]

It hits me that my trauma is a cosmic joke based on fear: I’m the logical consequence of human evolution.  And the numbers are coming in now to show that our failure to respect how our bodies have evolved is the reason 50% of Americans have some degree of Adult Attachment Disorder, childhood ACE trauma, and the resultant dire medical effects.

“This is your Captain speaking from the Butt End of Evolution,” I joked to a friend. “Since we left the caves, the brain has been evolving to develop an ever-more exquisite ability to feel fear.  Only the most fearful and anxious of us survived.

“Finally my great-grand parents traveled from London to Cape Town to Canberra to Denver while having 13 children, of whom my grandma was the 12th.  How much attachment, attuned face-to-face emotional attention, could grandma have received? Do the math; she couldn’t have gotten much more attention than the 12th piece of luggage. So how much attuned parenting could she have given my mother?

“By that point humans had evolved to be so fearful and anxious that great-grandma probably treated my grandma like luggage, who treated my mother like luggage, then my mother didn’t even want the luggage; she didn’t want a child, as she made clear to me.  So here I am at the Butt End of Evolution: I couldn’t manage to procreate at all, or stay married.  I have no children and no family.

“The moral is: if you have a lot of emotional baggage, the reason might be that you, too, were treated like luggage.”

Too depressing?  Never fear!  There are solutions.

Child Production Failure Rate: 50%

Scared Sick book coverLook: Adam and Eve got perfect parenting, but still had a 50% failure rate in producing good kids. Translation? Babies are very easy to damage, and this problem has been around a long time. But it’s never been acceptable and it’s getting worse.

Last week I wrote that our society now has a 50% failure rate  at producing healthy human children, by many medical, mental, and psychological health yardsticks which show a remarkable correlation.

The Adverse Childhood Experiences (ACE) Study documents that childhood trauma and its consequent serious medical issues affect over 50% of the population of the U.S. and cause the risk factors that underlie the 10 most common causes of death in our country.

The Adult Attachment Interview (AAI), meanwhile, shows that some 50% of Americans are “insecurely attached,” meaning they have some degree of attachment disorder, another form of childhood trauma which may underlie many of the childhood traumas in the ACE Study.

The statistics keep coming. According to “Scared Sick” by Robin Karr-Morse, nearly 50% of Americans have high blood pressure, high cholesterol, or diabetes; one in eight has two of these.  Some 68% of adults are over weight and more than one-third are obese, and 26% of adults over 18 suffer from a diagnosable mental disorder.  One in three children born in the last five years will develop diabetes. [FN3]

Negativity Bias of the Brain

Saber Tooth Tiger cropWell, what’s at the root of childhood trauma, which seems to be a major cause of all this?

Fear.  We need to understand fear, to reverse this. “Fear has shadowed human life since our species emerged,” says the first sentence of “Scared Sick.”

“Neuroscience tells us the brain has a negativity bias.  It’s designed like Velcro for negative events and Teflon for positive ones,” says Dr. Ron Siegel, Phd. “Evolutionarily if our ancestors forgot what they saw the sabre-tooth tiger do, or what happened to someone who got too close to a cliff, they wouldn’t have survived to produce offspring.  Our chill, relaxed forerunners all got eaten in the Serengeti before they could become our ancestors.  Survivors were those who remembered the bad stuff and were  good at jumping when the sabre-tooth tiger showed up.

“Stress-related disorders are a huge health problem today, but most of them don’t kill us before we’re done reproducing,” he concludes, “especially if you go back a few thousand years where people didn’t live beyond 40. Stress-related disorders make us miserable, but they don’t kill us until after 40.” [FN5]

“The velocity of change in our environment and the nature of the fears we face as a consequence has evolved much faster than our biological systems for dealing with them,” “Scared Sick” states. “Americans regularly wake up, work, parent, drive, play, eat, and sleep with the twin offspring of fear—anxiety and depression—holding court in their brains and bodies. This is our shared daily bath: in our homes, on the road, in the workplace. The result? Soaring addiction, anxiety, depression, attention disorders and post-traumatic stress…”

Luggage and Emotional Baggage

Last night, Ancestry.com confirmed my worst fears and then some.  I’m the product of four generations of attachment failure.  I already had 80% of the story from family by word of mouth.  But last night  in under an hour online, I found U.S. federal census records that hit me in the gut.

Luggage 13+ PiecesMy maternal grandmother’s parents were born in London, according to family lore; Grannie and her sisters my great aunts all reported they had 13 children, of which my grandmother Jennie was the twelfth, born in 1906 in Denver. These relatives also often separately remarked, as though it were totally unrelated and uninteresting, that the family moved from London, England, to Cape Town, South Africa, to Canberra, Australia, to Denver, Colorado, then New York City, during all this.

In early 2011 I read a quote in a book on attachment disorder which said: “Mothering well doesn’t come naturally. What comes naturally is mothering as you were mothered.” [FN7]

Then I remembered the 13 children and the trans-continental travels, and it hit me that if these reports were true, that my great-grandma –- just by the math –- had been able to give my grandma Jennie about as much attention growing up as one of the traveling suitcases, if she were lucky.  That would have left Jennie without mothering skills to pass on to my mother, which made some sense out of why I had never noticed my mother to have been overflowing with motherly affections.

Last night family tales became reality. I learned that Grandma Jennie’s dad, my great-grandfather, was named Maurice and was born in London in 1860; his wife Esther was born in London in 1872.

Luggage 1920 Census v3Then I found the 1920 U.S. Federal Census shown here. All of the names of their children listed here, correspond to people I’ve either met or heard about.

Plus the 1910 U.S. Federal Census shows Maurice in Colorado where my grandmother Jennie was born; I’ve definitely got the right people.

But here’s the scary thing. The household of Maurice age 60 and Esther age 48, by then in New York City, included Rose age 34, Clara age 21, Gertrude age 16, Jennie age 14, and Simon age 11. Good grief, that means Rose was born in 1886 when her mother Esther was 14! Then Clara was born in 1899, Gertrude in 1904, Jennie in 1906, and Simon in 1909.

I’m shocked just to see such a large family in official records; it brings flesh and blood to real life. How could poor Esther take care of them all? How did she survive herself, did she ever sleep? How did they all survive all that travel? Did they have enough to eat?  Did they have any place to sleep? The sheer size of it feels traumatic to me, maybe in my bones.

Plus in 1886 when Rose was born, her dad Maurice was 26. It seems he knocked up Esther at 13 or 14 and absconded with her to South Africa.

And what about the 13-year gap between Rose and Clara? There are only 5 children in this 1920 census out of 13 births reported by numerous people to me in person. Did Rose not marry while her 6 or 8 younger siblings born on either side of Clara left the household, and are thus not shown on this census page? Or did large numbers of the children die in terrible ocean voyages or epidemics like the 1917 influenza?

How did one get from London to Cape Town to Canberra to Denver to New York back then, anyway? For most of human history before 1800, including most of human biology, people didn’t move around. Wikipedia reports fewer than one million immigrants—perhaps as few as 400,000—crossed the Atlantic during the entire 17th and 18th centuries.

But after 1800 we had the spreading use of the steam engine, electricity, railroads, the Gold Rush which developed the continental United States. Now, the new explosion of mobility was a very good thing; it allowed millions to escape tyranny and grinding poverty in Europe. From 1836 to 1914, over 30 million Europeans immigrated to the United States.

Steerage Dinner on the first emigrant ship to NZ 1850sBy the end of the 19th century even the poorest could get into the steerage hold of a steamship, shown above, where they all lived like luggage for weeks. The peak year of European immigration was in 1907, when 1,285,349 persons entered the country.  By 1910, 13.5 million immigrants were living in the United States. [FN8]

Why? “To better our lives!”  That’s why we’ve created these fabulous technologies.  Yet we don’t see what living at this faster pace does to our nervous systems and our ability to attune to human beings, person to person. This has only accelerated since 1920, until today society is substituting computers, video games, and other addictions, for yesterday’s simple face-to-face human contact.

We’ve got the “negativity bias” bred into our brains because our chill ancestors got eaten in the Serengeti so only the antsy, anxious ones survived.  Then in the industrial revolution we ended up with vastly reduced family time, to where  people were treated like luggage.
Today the IT revolution has virtually done away with face time.

But “the primal mood of the human being separated from close connection to other human mammals is fear,” says Dr. Tara Brach. Welcome to the Root Issue of what we’ll have to heal.

Footnotes

FN1  Types of early man are thought to have originated in Africa’s Serengeti plain.  Hanson, Rick PhD., “Neurodharma: How to Train the Brain Toward Mindfulness,” webiner series “The New Brain Science: Compelling Insights for State of the Art Practice,” September 28, 2011, www.NICABM.com.
“We’ve got to get rewards, we’ve got to get food, we’ve got to get mates, we’ve got to get shelter –  the carrots in evolution. On the other hand, we have to avoid sticks. We have to avoid predators; we have to avoid aggression in our primate band; we have to avoid natural hazards; we have to avoid pain,” Hanson writes.
“So the brain has bias toward scanning for negative information, focusing on it, ignoring any good news, then storing that negative experience very deeply – in just one trial learning. For example, humans and other animals learn much more quickly from pain than from pleasure. To teach a rat to not go down a tunnel, you only have to shock it once. But to train it positively to go down another tunnel that has cheese, you’ve got to send it there a few times before it remembers.
“John Gottman’s findings show that on  the average it takes about five positive interactions in a couple to make up for a single negative one. Negative interactions are five times as powerful as positive interactions.  Seligman found it’s easy to train dogs, and by extension, humans, in helplessness. It only takes a handful of trials to train a dog into a sense of futility and depression. But it takes many, dozens and dozens, sometimes over a hundred trials to re-train that dog to see it can do something about it.”

FN3   Karr-Morse, Robin, Wiley, Meredith,  “Scared Sick,”  Penguin Basic Books, 2012; Introduction, p.xiv

FN4  White, Martha C., “The Real Reason New College Grads Can’t Get Hired,” Time, November 10, 2013 http://business.time.com/2013/11/10/the-real-reason-new-college-grads-cant-get-hired/#ixzz2kgHn3dNZ

FN5  Siegel, Ronald D. “The Neurobiology of Mindfulness: Clinical Applications ,” Webiner series “The New Brain Science: Compelling Insights for State of the Art Practice,” October 5, 2011, www.NICABM.com.  See also his seminal work:
Germer, Christopher K., Siegel, Ronald D.
, editors, “Mindfulness and Psychotherapy,” Guilford Press, 2005

FN 6  Perry, Bruce, MD, PhD, “Born for Love: The Effects of Empathy on the Developing Brain,” speech to Annual Interpersonal Neurobiology Conference “How People Change: Relationship & Neuroplasticity in Psychotherapy,” UCLA Extension, Los Angeles, March 8, 2013; Bruce D. Perry and Erin P. Hambrick, “The Neurosequential Model of Therapeutics,” Reclaiming Children and Youth Magazine, Fall 2008 vol 17. nr 3, www.reclaiming.com, (UCLA handout); Perry, Bruce, “Overview of Neuro-sequential Model of Therapeutics (NMT),” article on www.childtrauma.org, 2010

FN7   Verrier, Nancy, PhD, “Coming Home to Self: The Adopted Child Grows Up,” self-published, Lafayette, CA, 1993

FN8  Wilson, John, ‘The voyage out – Life on board’, Te Ara – the Encyclopedia of New Zealand, updated 15-Nov-12 http://www.TeAra.govt.nz/en/artwork/4237/steerage-passengers-eating-dinner

FN8   Brach,Tara, PhD, “The Mindful Path to Radical Acceptance,” Webiner series “The New Brain Science: Compelling Insights for State of the Art Practice,” October 25, 2011, www.NICABM.com.

This is a blog done as a study for Kathy’s forthcoming book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment DisorderHow I accidentally regressed myself back to infancy and healed it all.”  Watch for her posts each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.

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Substance Abuse or Survival?

Substance Abuse or Survival Mechanism?
What the ACE Study Tells Us About – Ourselves …  November 8

BrousBlog7a ACE pyramidLast Friday Nov. 1, down the road from county Mental Health Services in San Diego, CA, eleven local activists from the mental health, health care, social outreach, and justice systems met for lunch.  We discussed the Adverse Childhood Experiences (ACE) Study, research on 17,421 average clients at an average San Diego HMO, who were simply asked if they’d had bad childhood experiences, physical or emotional. The study compared their childhoods, to whether they later developed life-threatening physical medical conditions and/or addictions.

The data revealed staggering proof of the health, social, and economic risks that result from childhood trauma.  It showed that such trauma and its consequent serious medical issues affect over 50% of the population of the U.S.  The ACE Pyramid shows that Adverse Childhood Experiences often lead to impaired thinking, unhealthy behavior, life-threatening disease, and are topped off by early death.

The ACE Study participants are mostly middle-class, college-educated HMO clients. Two-thirds (64-67%) had one or more types of childhood trauma, and 38-42% had two or more types.   One in six had an ACE score of 4 or more, and one in nine had an ACE score of 5 or more.  Child trauma and its lethal results affect an unknown higher percent of Americans raised in poverty.  A national average of all economic groups would likely show 50% or more suffer severe trauma from ACEs.

This is not an issue to which one might donate at Christmas, then forget. This could well be about you and your family, and almost any American.  So why are you and your family in the dark?

How can almost 20 years of official study on 17,421 people be so far under our radar? The ACE Study began in 1995 at Kaiser Permanente, the largest HMO in California, as joint research with the U.S. government Centers for Disease Control (CDC). First results were reported in the 1998 American Journal of Preventive Medicine by chief investigators Dr. Vincent Felitti MD of Kaiser, Dr. Robert Anda, MD of CDC and their colleagues, and have appeared in over 60 medical journals. [FN1]

The public info gap is not for lack of alarm-ringing. Drs. Felitti and Anda, who started as curious scientists and became passionate advocates, have burned the global lecture circuits.  ACEsConnection, its news site ACEsTooHigh and their creator, science journalist Jane Ellen Stevens, have spent the last eight years knocking on national media doors and spurring grassroots education. [FN2]

Felitti SoCal ACEs Nov1 2013 cropOur Nov. 1 lunch was the first meeting of  “SoCal ACEs,” the Southern California chapter of ACEsConnection, started by another career writer, me, with Jane’s help. We’re all passionate about ringing the alarm.  While we were passionately passing the curry, in walked Dr. Vincent Felitti himself, much to our surprise.

“Public Health Problems – or Personal Solutions?”

Dr. Felitti made some eye- opening comments to our SoCal ACES lunch, remarks he’s made before in speeches, DVDs, and videos released by the CDC and other agencies. [FN3] Yet since so few have gotten his message, it’s necessary to repeat his comments, and flatly state the implications. Sometimes a badly needed wake-up call can feel as if it were in-your-face.  Sorry to play Paul Revere, but we can do plenty about this – if we have the courage to get to the bottom of it and think it through.

Based on the ACE Study statistics, Dr. Felitti said, “The risk factors which can be  attributed to Adverse Childhood Experiences include… about 2/3 of all alcoholism, about half of all drug abuse, and about 3/4s of intravenous drug use (in the U.S.).  These are the risk factors that underlie the 10 most common causes of death in the United States.  With an ACE score of zero,” he notes, “You have a very medically un-interesting population:  non-obese, non-smoking, non-alcoholic, non-diabetic, non-hypertensive. No internist has a chance of making a living with that group. But with an ACE score of 4 or more, this is big medicine!

“And,” Dr. Felitti continued, “the things that we call ‘risk factors’ are in fact, effecting coping devises.  This is an important idea.

“Many of these things termed ‘public health problems’ are in fact, personal solutions.  Personal solutions to problems (ACE) that are well-hidden, by time, by shame, by secrecy, by social taboo (many child traumas are sexual, physical, and emotional hidden for a lifetime).

“Public health problem = personal solution?  That’s a pretty heavy-handed statement, but I feel very comfortable making it…

“This is what psychoanalysts have been saying for a hundred years; but they’ve been saying it based on two cases or four – and we’re saying it based on 18,000 cases.  One way of describing it would be: you have this large base of individuals with Adverse Childhood Experiences, and most of them are going to be impaired as a result in some way, maybe socially, maybe emotionally, maybe cognitively…

Felitti ACE DVD 3-min Preview screenshot“By the time they become adolescents and have some freedom, they ordinarily will try to do something to feel better, and hence initiate what we call health-risk behaviors, but which might be called more properly ‘self-help behaviors.’  Those, over time, will produced disease and disability in many of them, and a significant portion of them will die early,” as the ACE pyramid shows. (‘Early Death’ being the top of the pyramid.) [ FN4]

“Swiss psychoanalyst Alice Miller says: ‘The truth about our childhood is stored up in our bodies, and lives in the depths of our souls’,” Dr. Felitti ended.  ” ‘Our intellect can be deceived, our feelings can be numbed and manipulated, our perceptions can be shamed and confused, our bodies tricked with medication. But our soul never forgets. And because we are one whole soul in one body, some day our body will present its bill.’

“In this study, we are looking at it literally. The cost of this is truly enormous. Whoever would have thought that pediatrics, is the breeding ground for internal medicine.”

The ACE Study “provides more understanding about the lives of hundreds of millions of people around the world who use biochemical coping methods – such as alcohol, marijuana, food, sex, tobacco, violence, workaholism, methamphetamines, thrill sports – to escape intense fear, anxiety, depression, anger,”  as Jane Stevens told the Huffington Post.  Such  compulsive forms of self-abuse, also including internet porn and more, are endemic to every income bracket.

“Public health experts, social service workers, educators, therapists and policy makers commonly regard addiction as a problem,” she writes. “Some, however, are beginning to grasp that turning to these drugs is a normal response to serious childhood trauma, and that telling people who smoke or overeat or overwork that these are bad for them and that they should stop, doesn’t register when those approaches provide a temporary, but gratifying solution.” [FN5]

Trauma and Survival

Are all these people broken crop3Do all these individuals “just happen” to be broken? Are they the problem?  Or at least, are they mere individual problems?

Or is our society as a whole, which is producing human
children with a 50% or higher failure rate, the thing which needs major policy changes and a great deal of healing?

To be clear: this is not to condone, aid, or abet the abuse of
alcohol, marijuana, food, sex, tobacco, violence, workaholism,
methamphetamines, internet porn, thrill sports, and many
more. No need for right or left wing to get on a soap box.

Nevertheless the real question now is: what if all this substance abuse, and the disease, broken families, crime, and other tragedies which flow from it, is in scientific fact, a survival mechanism?

What if the human organism, when subjected to the childhood traumas reported in the ACE Study, reacts with these addictions as a form of sheer biological and physiological necessity?  What if these behaviors turn out to be necessary for the raw survival of each separate traumatized individual being turned loose to fend for his or her self under current conditions in this country?

Consider their alternative. Let’s not condone “Early Death” for millions.

One consulting engineer told me, “We’ve tried everything based on the assumption that ‘they’ are the broken widgets. But what we’re doing isn’t working, because we’re just producing more and more broken widgets. Einstein’s definition of insanity is repeating the same procedure and expecting to get a different outcome. Engineering science says at this point in any process, that it’s our assumptions and axioms which are wrong and we need a paradigm shift.”

Let’s define “Adverse Childhood Experience.” Just as everyone should know their cholesterol score, everyone should know their ACE score.  Take the ACE Questionnaire from the Centers for Disease Control, the same questions used on the ACE Study and in follow-on ACE Surveys done by 21 states and several nations globally.

aceslistIt asks about 10 types of childhood trauma. The first five questions are personal: Did you suffer childhood sexual abuse, physical abuse, physical neglect, verbal abuse, or emotional neglect? The last five relate to family: Did you have a family member in jail, a family member with mental illness, a mother suffering domestic violence, an alcoholic parent, or a parent who disappeared?

Medical doctors – and most Americans – long assumed “these things” are products of poverty and violence.  Yes, these things are scary: childhood sexual abuse, physical abuse, physical neglect, family members in jail, with mental illness, or domestic violence — and often assumed to be the effects of poverty.  So government, social agencies and others have focused on the basic physical needs of poor families for food, clothing, shelter, health, education, etc. It was and is still necessary. But not sufficient.

Doctors also assumed “these things” rarely if ever happen to middle-class, college-educated folk such as the 17,421 ACE Study participants – all of whom had jobs and great health care or they wouldn’t be in Kaiser Permanente!  As Dr. Felitti puts it, “nice people don’t ask about these things, and most doctors are nice people.”

But “these things,” the ACE Study reveals, do happen in middle/ upper-class families – 40-60% of the time. Childhood sexual abuse, and physical abuse may be scary – but they happen in higher income brackets. Verbal abuse and emotional neglect?  Many higher income families dismiss these as unimportant – they happen all the time. Kids are told to “suck it up,” behave and achieve since others are worse off.

A mother suffering domestic violence, an alcoholic parent?  Not unheard of in well-off suburbia. A family member with mental illness?  Most middle income folk growing up in the 1960s or 70s – like the ACE Study participants — never heard of Bi-Polar, Borderline Personality Disorder, or such, and never asked if a parent had it. Yet many parents did, we now know. Parents who disappear? Death, divorce, and walk-outs do happen here.  But more widespread “disappearance” takes many forms usually dismissed as unimportant: parents who are physically around but mentally out to lunch, unable to handle emotional connection (tech term “attunement”), always stressed out, or plain hostile to kids.

Thus we arrive at today, with “these things” of childhood ACE trauma occurring in half of higher income brackets and surely a far higher percent of lower income brackets – still most doctors don’t ask. “These things” are not discussed – and considered irrelevant to medicine.

Don’t worry, we’ll get to “What to Do” (Harvard’s working on it).

But first, let’s nail down the fact that the ACE issue is every family’s problem, not some issue about “them.” Let’s take this up close and personal.  Let me tell you a bit of my story.

The Heartbreak ACE of Attachment Disorder

This is not an academic issue to me. I had a 30-year career in the fast lanes of New York City and Washington DC, as an economist for 18 years in New York, then in Washington as a technical writer.  There I produced complex documents for Pentagon subcontractors for 12 years, while pursuing my hobby as an opera singer. I was too busy flying around the world to have children and build a family.

Suddenly in 2007, I faced divorce from a 27-year marriage to my college sweetheart, leaving me bankrupt.  A move to California was followed by the death of both my parents in 2008 and then two bad rebound affairs – five life disasters in two years.  My persona cracked wide open and there was nothing inside, so I took myself to therapy.

I learned that I was an unwanted pregnancy, born with a terrible infection which nearly killed both my mother and me, and incubated at birth for numerous weeks. But my first two therapists in 2008-2009 were about as good at healing as Torquemada. They had no insight into the topics in this article and never mentioned the ACE Study, what my post-natal experience might mean, or even the word “trauma.”  In fact, I was a patient in Kaiser Permanente in Anaheim, CA for two years after that, working nearby. I even made an appointment with a (third) Kaiser therapist, but left when she had nothing to say. No one ever mentioned the ACE Study.

Brousblog1a Perry brains X-secIn 2011 I heard about “Adult Attachment Disorder” at a church meeting (sic), and decided that was me.  I began researching attachment and brain science, and writing a book about my experience. “Science has only recently demonstrated that unless kids are given deep emotional connection (‘attachment’) from birth by parents or other humans, infant neurological systems don’t develop well. They can now do brain scans showing that chunks of neurons in some brain regions don’t fire; it’s dark in there,” I wrote.  It’s called “in-secure attachment” or attachment disorder.

I figured out myself that my persistent feeling that “parts of my brain were dark” had been a result of my incubation. Later in 2011 a fourth and competent therapist finally confirmed it. Much later in March 2013, I was at a conference where Dr. Bruce Perry, MD of the Child Trauma Academy in Houston, showed these brain scans. The scan at above right is of a normal 3-year old; the scan at left, of a 3-year old with attachment disorder. Parts of it are dark. That hurt.

I went to attachment and brain science conferences, and bought every book I could get by Judith Herman, Ruth Lanius, Daniel Siegel, Allan Schore, Bruce Perry, Bessel van der Kolk, Peter Levine, and so on. Check the footnotes in my book blogs.

Deluged with the bad news about my brain, at some point I dimly recalled that Dr. Perry had also mentioned something called the ACE Study, so I Googled it and logged into ACEsConnection.  The first thing I saw was a video of a baby in a Polish orphanage that turned my heart and digestive tract inside out.

Baby Casey fr video crop2Brace yourself before you watch – this is what the physical pain of attachment failure looks like.  (Click the link above and scroll down to this photo).  Left alone for weeks or months in the under-staffed Warsaw facility, Baby Casey did not get the “face time,” physical holding, emotional attunement, or any of the millions of interactions required for an infant’s brain to grow. [FN6]

Humans, from the instant of birth, require a constant stream of “emotional, spiritual, psychological, and physical inputs” from another loving human, says Dr. Mary Jo Barrett of the University of Chicago —  just as we require air, food, and liquid. “Complex or developmental trauma is about traumatic interruptions [of that stream],” she notes. “I from birth…have a series of relationships where I am emotionally, spiritually, physically vulnerable… If my spirit, my emotional stability is endangered, my physical being, is endangered, if I am repeatedly interrupted in the context of these relationships, these repetitions create a person who spends their life in fight, flight or shut down.” [FN7]

A child left without this input stream learns that its own hard-wired biological needs are terrifying.  “I learn that what I experienced internally and expressed externally with a cry, was met by a response that didn’t make any sense to what I needed,” says Dr. Daniel Siegel, MD of UCLA. “The organization of that child’s brain will be quite different, as neurons which fire together, wire together.

“I will have learned: it doesn’t matter what I’m feeling, because people don’t get me what I need. So I’ll learn to live without calling out to other people, and studies show, as I have those experiences over and over again, I will actually have a different way of being in the world.  Ultimately, I’ll become quite disconnected, not only from other people, but even from my own internal bodily self and my emotional experience. ” [FN8]

The emotional pain and terror are so intense, the child will do anything to distract itself from those screaming needs. “In this distress I can only comfort myself in ways that are often maladaptive – I may bite myself, I may rock myself perpetually, trying to distract myself from my needs,” Dr. Siegel states. Such children “have all sorts of self-regulatory processes that are not interpersonal. They are very isolated.”

The fight-or-flight stress chemicals flood the bloodstream at a level which feels so terrifying, the baby would rather pass out — or  die — than feel it. “The baby thinks it’s going to die,” Dr. Nancy Verrier says. [FN9]

I saw Baby Casey and said, “She’s trying to knock herself out.” How many times have I felt that in the last few years: “The baby thinks it’s going to die” becomes “I feel like I want to die.”

“From the very beginning to the very end of our lives together, Casey suffered from violent and debilitating rages and temper tantrums,” her father John Brooks writes in his new book “The Girl Behind The Door.”  “The ‘experts’ told us she’d grow out of it; we just had to be tougher with her. How clueless they – and we – were.” Despite loving parents and a beautiful home, Casey and her family were unaware of the enormity of her buried emotional pain.  Casey took her own life at 14.

Why Do We Drink?

We’ve just  detoured to the “attachment” ball park to gather a wider set of data on Dr. Felitti’s original Big Question:

Do so many Americans use alcohol, tobacco, marijuana, meth, IV drugs, food, sex, violence, workaholism,  sports, internet porn, etc. for sheer survival?  Are they compelled to medicate with these to escape an intense fear, anxiety, depression, or anger which if they had to feel it, might literally kill them — by body part failure or suicide?  Suicide rates are abnormally high in the ACE population; compared to ACE Study participants with zero ACE traumas, those with four ACEs are 12 times more likely to attempt suicide.

Are the high-ACE folks who want to avoid suicide, doing things sure to cause “early death” in a few years or decades, as the ACE Pyramid shows, in order not to die now?  That’s one way to do “survival.”

I’ve learned the hard way that if we want to help sick people (and Lord knows I’ve been one), we’ve got to get at the science of what drives them. We’ve got to deal in reality, not prejudice.

So here’s what Attachment Theory and brain science say about attachment and substance abuse like alcohol.

Harvard Science of Neglect Video screenshot“At birth we are biologically waiting for input from adults around us to ‘serve and return,’ a back and forth interaction that literally shapes the architecture of the infant brain,” report Dr. Jack Shonkoff, M.D., Director of Harvard’s Center on the Developing Child and his colleagues in a 2012 video “The Science of Neglect.”  “It begins when a child looks at something, observers something, that’s the serve. The return is when the parent responds to the child. When serve and return is broken, you literally are pulling away the essential ingredients for the development of human brain architecture… When a baby is not attended to, that is a sign of danger to the baby’s biological systems, so its stress systems are activated. In a brain that is constantly bathed in stress hormones, key synapses, the connections between nerves, fail to form in critical regions of the brain.” [FN10]

And the flood of stress chemicals doesn’t just stop. It can go on for years and decades, biology gone haywire.  Bruce Perry explains it in terms of how the three regions of the brain react. His slide below shows the highest thinking “cortex” level of the brain in blue, the next higher emotional-attachment-relational “limbic’ brain in green, and the lowest survival brain, aka reptilian brain, made up of the cerebellum and the brain stem, the foundation of the entire brain, in yellow and red.

The survival brain doesn’t think and it has no feelings for others. It’s only job is to keep our breathing, heart beat, and basic functions going so we survive. “We run into three things that cause developing brain neurons to get screwed up, causing across the board developmental trauma,” Perry said in March at UCLA.

“1. Intra-uterine insult – stress, threat to the mother, or BrousBlog9c Perry Slide1 Brain 4 Partssubstance abuse by the mother adversely effect brain neurons. In particular, the brain stem (survival brain) must be organized before you are born. So there is a lot of activity there and it’s the most vulnerable part of the brain in the womb.  With stress in utero, we have a cascade of mental and physical problems in every part of the body and brain. Brain stem neural networks organize before birth and influence every part of the brain, so every part of the brain will be dysreglated.

“2.  Disrupted Attachment: If you disrupt post-natal bonding, if the caregiver is not capable of attuned, regulated care giving, all these brain networks will be dysregulated.

“3. Post-natal Trauma such as violence in the home. With all three, we have a 100% prospect that this child’s going to be dysregulated,” Perry stated. “But because of the way we’ve ‘invented’ our health service delivery models, the pediatrician treating his asthma won’t make the connection to his intra-uterine insult.  The psychiatrist will just give him ritalin and whatever the drug rep tossed on his desk.”

So why do people drink?

“We can’t persuade people with developmental trauma with a cognitive argument (cortex brain), or compel them with an emotional affect (limbic brain), if their brain stem (survival brain) is dysregulated,” Perry warns.  “We can’t talk people in this kind of alarm state into doing the right thing, because their thinking brain’s been turned off by the alarm state.  And we  can’t reach their emotional-attachment-relational (limbic) brain if they feel so threatened they get into an alarm state, because they can’t feel reward from relations with people.

“If their brain stem, the foundation of their entire brain as a whole, is completely dysregulated, the only way they can feel reward is from sweet/salty/fatty foods, alcohol, drugs, sex, and so on. They know in their head that it’s wrong to steal from Grandma, and they may love Grandma in their heart – but at that moment, cognitive beliefs, or even human relational consequences, can’t relieve their anxiety.  They are in such distress in the lowest parts of their survival brain that it (survival brain) needs the reward of the drugs too badly.

“In fact, they can get to the point where they can’t feel any reward at all –  reward can’t even reach the lower part of the brain, if they’re so ramped up and anxious. At that point, the ONLY thing they want is to relieve the distress, and the only thing that can do it is to drink.  Alcohol will reduce the anxiety. It also makes us more vulnerable to other unhealthy forms of rewards.”  [FN 11]

When Vincent Met Mary: Survey Says

Mary Main & Dan Siegel December-2010-UCLALike ACE trauma, Attachment Disorder has also been demonstrated to affect 50% of Americans – but completely independently.  That’s why I have a “bucket list” item to see that Dr. Vincent Felitti’s been introduced Dr. Mary Main of the University of California, Berkeley, shown here with Dr. Dan Siegel at UCLA.

British psychiatrist John Bowlby developed Attachment Theory in the 1950s. [FN12]  In 1978 Bowlby’s American co-worker Mary Ainsworth showed that the way an infant behaves with strangers when its mother leaves, shows the quality of mothering it’s getting — and predicts its emotional traits for life.  Ainsworth wrote that 69% of children are “securely attached” to mom. [FN13]

In 1982, Ainsworth’s student Mary Main and her own students created the Adult Attachment Interview (AAI). This interview shows (with 79%+ accuracy!) how securely attached they got as kids. It also remarkably predicts what kinds of relations they have as adults with co-workers, dates, and mates. [FN14] Dr. Main concluded by 1996 that only 55% of Americans are in fact securely attached, and Dr. Ainsworth agreed. That’s a shocking low number; it says 45% have some attachment disorder.

Now take the radical changes since 1996 in how humans relate, since the rise of cell phones, texting, the internet and its electronic “social” networking.  There’s nothing social about it.

“Well-developed human beings can self-regulate their emotional state by being with other humans,”  top neuro-scientist Dr. Stephen Porges says. “But what about people who regulate their emotional state with objects?…We’re in a world now being literally pushed on us, by people who are challenged in their social regulation, and we’re calling this ‘social networking.’  We’re using computers, we’re texting — we’re stripping the human interaction from all interactions… We’re allowing the world to be organized upon the principles of individuals who have difficulty regulating emotionally in the presence of other human beings.” [FN15]

Three specialists who have seen a large volume of patients over almost 20 years’ clinical experience since 1996 have confided their concern to me in person this year, that with people spending so much more time online, texting, on the phone, etc, rather than face to face, we’re lucky if we’ve got 40% securely attached these days.  That would mean 60% by now have some attachment disorder.

So do 45% or 60% of Americans have some attachment disorder?  Unclear, but 50% is a reasonably conservative estimate.

Now:  what if the 17,400 ACE Study participants were to be given Dr. Mary Main’s Adult Attachment Interview? Might there be a correlation between the 38-42% of ACE participants with two or more ACE incidents, and the general population’s 45% score for insecure attachment?

You can already hear 1980s TV show “Family Feud” host Richard Dawson shouting: “Survey Says!”

“Addiction as an Attachment Disorder”

Attachment disorder is surely a major component of many Adverse Childhood Experiences.

Flores, Addiction as Attachment DisorderAs to ACEs and substance abuse, note Dr. Philip J. Flores’ 2004 book entitled “Addiction as an Attachment Disorder.”

Dr. Flores reports that the human need for social interaction is a physiological one, linked to the well-being of the nervous system, as we’ve already seen. When someone becomes addicted, he says, mechanisms for healthy attachment are “hijacked,” resulting in dependence on addictive substances or behaviors. Flores believes that addicts, even before their addiction kicks in, struggle with knowing how to form emotional bonds to connect to other people.

Co-occurring disorders, such as depression and anxiety, make it even harder to build those essential emotional attachments. “We, as social mammals, cannot regulate our central nervous systems by ourselves,” Flores said. “We need other people to do that.”  That’s Attachment Theory 101.

While it’s commonly understood that early childhood attachments to parents and family are necessary for healthy development, Flores says, emotional attachments remain necessary throughout adulthood. It’s not enough, he says, to “just stop drinking. ” To achieve long-term well-being, addicts need opportunities to forge healthy emotional attachments.

Flores reports that this is the reason for the phenomenal success rate of Alcoholics Anonymous over more than 50 years.  When people walk into an A.A. meeting, the whole point is to admit openly that they are an alcoholic and yet to feel fully accepted for exactly who they are, with no condemnation.  What a relief! This experience of, in essence, pure attachment, may be the best attachment experience in their lives – and most people who walk in and experience this, miraculously, stay sober for decades or a lifetime.

“What A.A. does… is what good psychotherapy does,” says Flores. It provides “a community for people to break their isolation and start to connect on an emotional level with other people.” [FN16 ]

Dr. Flores’ study is one of many cited in “Does Science Show What 12 Steps Know?” — a lengthy feature in the August 2013  National Geographic about the use of solid human emotional attachment to heal addiction behavior.  [FN17]

If most addictions are caused by the way in which attachment disorder underlies many ACEs, now we know what to do.

Heal the Adults, Heal the Children

To the extent the ACE Study, attachment disorder, and the biology of brain stem dysregulation have become understood in the last ten years, many alarmed at this have focused on creating “preventative programs” to alert parents to be more attentive to their infants and to these issues.  By itself this is necessary.

But again, it’s not sufficient.  Here’s the major problem: if half of today’s parents themselves, like so many adult ACE Study participants, have moderate to severe brain stem trauma, will pamphlets, on-line seminars and Facebook campaigns do it? What do we do about all the attachment disorder in adults?

In just one example of many, several experts report that the infant brain, from conception and early cell division, must divide cells and grow based on some kind of rhythm, and for nine months it is driven to tune on a cellular level to its mother’s heart and breathing rates, among her other vitals.  “We have a pregnant employee who’s an athlete who’s resting heart rate is 40 beats/minute; she’s likely to have a very relaxed baby who likes relaxed rhythms. And a hyper-thyroid mother whose heart rate is 95 may have a baby who finds a higher regulating rhythm,” Bruce Perry reports.

But a mother with ACE trauma herself, hysteria, or any high stress often has  “a totally irregular heart rate, breathing and other vital signs,” he notes.  “These moms end up with kids who are difficult to sooth because the mother had no rhythm consistently present for them to entrain to in utero. After birth, they can’t find any rhythm that is soothing.” [FN18]

No amount of public information is going to solve this problem for this mother or her baby.  Such mothers themselves, even the most determined to love their baby, require deep psychological and biological healing for their own trauma. That is often true for fathers who marry such women as well.

Dr. Joanne  Loewy, Director of the Louis Armstrong Center for Music & Medicine at Beth Israel Medical Center in New York, and her colleagues nationally, have published extensively on the superiority of lullabies which are personally recorded by the parent (versus pre-recorded music) to sooth preemies and term babies born with other need for ICU or incubation stays. [FN19]

But if a mother isn’t “attuned” inside herself, how can she truly attune to her baby?  I had so little ability to attune to a baby in my 20s and 30s that I literally “didn’t even have it in me” to have children.  “I would have thought the very idea would have been absolutely terrifying to you,” my last therapist said (I finally found a good one).  Without far-reaching programs to heal the parents, many will remain biologically incapable of attuning to children.

It’s Adult Attachment Disorder which is the underlying cause of childhood trauma – not babies.

Harvard Build Adult Capabilities, Improve Child OutcomesIn his video “Building Adult Capabilities to Improve Child Outcomes: A Theory of Change,” Dr. Jack Shonkoff at the Harvard University Center on the Developing Child explains this to a degree.  He notes that programs to distribute information and advice to parents and caregivers have limited effect.  Dr. Shonkoff calls for active training of the adults on focusing attention, working in teams, and  regulating their own emotions.  This is a good start. [FN20]

But it took deep emotional attachment to heal the adult me over the last years. It required a broad safety net: an empathic, painstaking therapist skilled in Adult Attachment Theory; support groups modeled on the A.A. principle of total acceptance and emotional attachment for the wounded; and close friends who were serious about staying attached to me because they wanted to heal, too.

As Dr. Felitti told me November 1 in San Diego, “After we talked to the very first round of ACE Study participants about their childhood experiences in the results of their ACE questionnaires, we saw a staggering 20% or higher reduction in the number of medical complaints, office visits, and other indicators of physical ailments in the next year alone.  Over and over, people thanked us for simply listening to them and their stories.”

“I want to thank you for caring enough about people to read all those charts and find out what happens to all of us who are molested, raped and abused in childhood,” one ACE participant wrote to Dr. Felitti.  “I suffered for years. The pain became so great I was thinking of jumping off the San Diego Bay Bridge… How many people may have taken their life because they had no program to turn to? How many lives can be saved by this program?”

That’s human emotional attachment: being seen, being known, just as we are, warts and all, by another human being – and then being fully accepted, and finally feeling that we belong.

Any wonder that “Avatar” was such a hit, when at the end theAvatar I see you2 giant Na’vi heroine Neytiri picks up her fiancee Jake with his tiny, crippled, broken body in one hand, looks into his eyes, and says “I see you?”  In Na’vi that means: “I see your soul, and I love you for who you truly are.  You really belong now.”

People have an enormous craving to be accepted for who they really are and to feel they truly belong, without having to fear all the stress of performance to earn a little affection or condemnation of their warts.  That longing seems to be going unsatisfied in the lives of, gosh, would that be about 50% of Americans?

Just what the Harvard study said an infant needs for brain development: attunement.  Just what some 50% of us apparently did not experience enough as infants and children – for babies do all sorts of things which are far from perfect! Yet we needed to feel accepted and to belong, to grow out of it.

This is what Dr. Felitti, Dr. Anda and company gave their ACE Study participants by simply listening to their terrible stories for the first time in their lives.  From all these experiences, we can begin to craft a program broad enough to heal.

Footnotes

FN1   Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS, “Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study,” American Journal of Preventive Medicine 1998;14:245–258.   http://www.ncbi.nlm.nih.gov/pubmed/9635069?dopt=Abstract

FN2  They’ve gotten articles into the New York Times in Sept. 2012 and just this past October 30, as well as in Salon, This American Life Radio, and more.  See David Brooks, “The Psych Approach,”  Sept 27, 2012; www.nytimes.com/2012/09/28/opinion/brooks-the-psych-approach.html?_r=0
Thomas Rogers, “How stress is really hurting our kids:  New science shows that childhood trauma can cause cancer, heart disease and other problems,” Jan 2, 2012 www.salon.com /2012/01/02/how_stress_is_really_hurting_our_kids/
David Bornstein, “Protecting Children From Toxic Stress,” Oct. 30, 2013, http://opinionator.blogs.nytimes.com/2013/10/30/protecting-children-from-toxic-stress/?_r=0

FN3  Dr. Felitti made the same remarks as those quoted here from his 13-minute video  “Adverse Childhood Experiences” at www.youtube.com/watch?v=GQwJCWPG478

FN4  Centers for Disease Control (CDC), “ACE Study DVD Pre-View movie,”  http://www.youtube.com/watch?v=v3A_HexLxDY

FN5  Jane Ellen Stevens, “The Adverse Childhood Experiences Study: The Largest, Most Important Public Health Study You Never Heard of, Began in an Obesity Clinic,” original in Huffington Post, Oct. 8, 2012,  Part 1 of 3: http://www.huffingtonpost.com/jane-ellen-stevens/the-adverse-childhood-exp_1_b_1943647.html

FN6  John Brooks, “Video of Baby Casey in the Orphanage,” Warsaw, Poland, 1991, from “The Girl Behind the Door: An Adoptive Father’s Lessons Learned About Attachment Disorder,” at http://parentingandattachment.com/the-girl-behind-the-door/.  Original video: http://parentingandattachment.com/meet-my-casey/.

FN 7  Barrett, Mary Jo, MSW, “How to Treat the Patient Without Further Trauma,” June 29, 2011 webinar, NICABM.com.  She is professor at the University of Chicago, founder and director of the Center for Contextual Change, co-author of “Systemic Treatment of Incest,” and co-editor of “Treating Incest: A Multiple Systems Perspective.”

FN8  Siegel, Daniel J., MD,  “Early childhood and the developing brain,” on “All in the Mind,” ABC Radio National, Radio Australia,  June 24, 2006: www.abc.net.au/rn/allinthemind/stories/2006/1664985.htm

FN9  Verrier, Nancy PhD., “Coming Home to Self: The Adopted Child Grows Up,” self-published, Lafayette, CA, 1993

FN 10  Harvard University Center on the Developing Child, “The Science of Neglect: The Persistent Absence of Responsive Care Disrupts the Developing Brain: Working Paper 12,”  2012, www.developingchild.harvard.edu.  Accompanying video “InBrief: The Science of Neglect”  and PDF summary at http://developingchild.harvard.edu/resources/multimedia/videos/inbrief_series/inbrief_neglect/
by Jack P. Shonkoff, M.D., Director Harvard University Center on the Developing Child & Harvard Medical School Professor of Pediatrics;  Linda C. Mayes, MD, Yale University School of Medicine;  et. al.

FN11  Perry, Bruce MD,  “Born for Love: The Effects of Empathy on the Developing Brain,” speech at conference “How People Change: Relationship & Neuroplasticity in Psychotherapy,” UCLA Extension, Los Angeles, March 8, 2013. See also “Overview of Neuro-sequential Model of Therapeutics (NMT)” at www.childtrauma.org, 2010

FN12   Bowlby, John, “The Nature of a Child’s Tie to His Mother,” British Psychoanalytical Society, London, 1958; “Attachment and Loss,” New York, Basic Books, 1969

FN13  Ainsworth, Mary D.S., Blehar, M.C., et al, “Patterns of attachment: A psychological study of the  Strange Situation,” Erlbaum, Hillsdale, NJ, 1978

FN14  For articles and documentation by Mary Main and background on the AAI, see “The Adult Attachment Interview (AAI): Mary Main in a Strange Situation,” at http://attachmentdisorderhealing.com/adult-attachment-interview-aai-mary-main/

FN15  Porges, Stephen, PhD: – On Social Neworking: page 15 of his April-June 2012 webinar: “Polyvagal Theory,”  http://www.stephenporges.com/images/NICABM%20April%202012.pdf
– Overview of his work, 2013: “Body, Brain, Behavior: How Polyvagal Theory Expands Our Healing Paradigm,”  NICABM Webinar, http://stephenporges.com/images/NICABM%202013.pdf
– On Trauma, 2013: “Beyond the Brain: How the Vagal System Holds the Secret to Treating Trauma,” http://stephenporges.com/images/nicabm2.pdf
–  Academic background, 2001: “The polyvagal theory: phylogenetic substrates of a social nervous system,” International Journal of Psychophysiology 42 Ž, 2001, 123 146, Department of Psychiatry, Uni ersity of Illinois at Chicago, http://www.wisebrain.org/Polyvagal_Theory.pdf

FN16  Flores, Phlip J, PhD, “Addiction as an Attachment Disorder,” Jason Aronson, Inc.  Publishing,  2004

FN17  National Geographic, “Does Science Show What 12 Steps Know?,” August 2013, http://news.nationalgeographic.com/news/2013/08/130809-addiction-twelve-steps-alcoholics-anonymous-science-neurotheology-psychotherapy-dopamine/

FN18  In addition to Dr. Perry’s speech in FN11 op.cit., see for example Mindlin, Galina, MD, PhD, “Your Playlist Can Change Your Life,” Sourcebooks, Inc., Naperville, IL, 2012.

FN19   Loewy, Joanne V. et. al,  Journal of Pediatrics, April, 2013  http://pediatrics.aappublications.org/content/early/2013/04/10/peds.2012-1367.abstract

FN20  Shonkoff, Jack MD et. al,  Harvard University Center on the Developing Child,  “Building Adult Capabilities to Improve Child Outcomes: A Theory of Change http://developingchild.harvard.edu/index.php/activities/frontiers_of_innovation/

Tagged with: Adult Attachment Disorder, Adult Attachment Theory, Attachment Disorder in Adults, Adult Attachment Interview, Brain science, Brain stem, Developmental Trauma, Emotional pain, Limbic Brain, Vincent Felitti, Bruce Perry, Daniel Siegel, Mary Main, Jack Shonkoff

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Isolation Row

#14 in my ongoing book blogs from “Don’t Try This at Home”

Last week my second therapist Dr. Rita was telling me to “heal yourself” to where I was reduced to singing Verdi arias about being doomed to live alone in a cave forever.  So I just felt worse.

isolation cell blueYet Rita continued drumming in the isolation message. “You don’t need Dan,” she scoffed about the rebound guy.  “You don’t need anyone else.  What you need is, to stop trying to heal the child who’s sick, with some guy’s d–k.  Just heal yourself.”

No, I may have New York potty mouth, but that did not come from me.  Yes, you did see that in this polite book on brain science, because that, verbatim, was the instruction from a therapist, at my great personal financial and emotional expense.

That is a quote directly from this refined, soft-spoken, highly educated lady, right in the middle of her technical shrink-speak in my 2008 notebook – and I doubt she coined the rhyme.  It must be standard trade jargon in some PhD circles.

Note the irrational but seamless segue asserting that only total isolation can work.  Going to other people, anyone at all, is linked to the disgust and mortification of “going to some guy’s d—k.”

I’d never heard of different ways to “go to other people” back then, but what about Dr. Rita?  Had she never heard of a middle ground somewhere between an isolation cell, and a “d—k?”  Say, go to a pastor, a divorce seminar, a women’s group, or a girlfriend?

Or maybe, gasp, go to your therapist for emotional support?  I sure never wouldda thunk of that at the time!  By then, that would have sounded to me like a nice outing to visit Torquemada. “Why do they call him Torquemada?” asks Mel Brooks.  “Because you can’t torq him outta anything!” [FN1]

While it did turn out to be true that neither sex nor romance can heal childhood emotional pain, can it be done by lying alone on a sheet covered in applesauce?  (Oct. 11 blog)

 Death Sentence

Mel Brooks Torquemada crop best”But this is a Death Sentence,” my emotional limbic brain, otherwise known as my heart, responded forcefully from deep within. “This feels like a Death Sentence,” I kept telling Rita, “This isn’t working!

“I do need someone else to love me!” I would go to her in tears saying.  “If you tell me do it myself, that means I’ll be alone forever!  Something feels terribly wrong!  It makes me queasy to say I have to do it myself, like I’m not good enough that someone else would love me enough to help me.  It’s a sinking feeling.  You’re telling me that no one else is going to love me enough to help me, which means I must be intrinsically unlovable.”

By making clear to me that they wouldn’t work with me unless I found a phantom inner child I just could not find, both my first and second therapist were in fact telegraphing just that. “You’re the problem, everyone else can do it, you’re uncooperative, we can’t work with you, you’re a failure.”

Not too far from “unlovable,” is it?

I joke now about Mel Brooks pronouncing death sentences (above).

But back then, as I searched for an inner child, all I could feel was a bottomless well of emotional pain and terror like something out of the real Inquisition.  I’d find something really horrifying deep inside which I was afraid to look at, and have repeat nightmares about dead fish with horribly dead eyes (or worse unmentionable themes).  No inner child, just horror.

Is that horror, me? Am I a freak with some kind of inner dead fish or inner monster, instead of a “normal inner child”? The whole time, I can find no mention in my notes of the word “trauma.”  But what, I ask you, was all of this, if not trauma?

The only thing I could do, once in this  down-spiral result of the isolation, was to sit in my room hugging a pillow, and repeat to myself how badly I wanted to be held by someone, anyone — anyone at all.  Then I’d think of how Dan the rebound guy held and caressed me head to toe for hours and days on end, for the first time ever in my life.  (For some reason my ex preferred tennis rackets, and my parents were too busy.)

In particular, I would recall the overwhelming sense of relaxation I experienced with Dan, in a way that bowled me over.  Granted, a funny way to talk about relaxation.  But it was that big a contrast to my “normal” of the time, which after all was a very high- performance, finish-off-the project and bring home the bacon “normal” more suitable to someone as relaxed as, say, Donald Trump (possibly the least relaxed being on Earth.)  “You just take all the tension out of my body” I used to tell Dan.

It got to where I’d walk into his room after work, take off my watch and literally throw it against the far wall – hard, because it was a really big room – at which point we would both dissolve into gales of laughter.  Temporarily.

Romance vs Therapy?

But now all that was gone, and I was the living opposite of relaxed.  Now the original Dan emotional pain which drowned out my Dad’s funeral, blew out my transcontinental air budget, hijacked my world and sent me running into therapy would start all over again, in an endless loop of grief.

True ManhoodCertainly my thinking brain was growing dimly aware that for all his tractor-drivin’, gun-slingin’ he-man manners, Dan was not much of a real man when it came to women.  Somewhere in the same 2008 notes I also wrote quite reasonably that his no- attachment credo couldn’t be right because “if all men treated women that way there would be no one to care for the children and no more human race.”   Wouldn’t a real man stand up to protect a woman (from guys like him) ?

Yet go tell that to my emotional limbic brain while it was locked up alone.  Ha.

How was I to stay away from men, when romance was the only thing left on the planet which appeared to offer some semblance of holding?  I felt sure this kind of holding must be “bonding” (aka attachment). [FN2]   I had been totally unaware of the existence of this wonderful thing until the “Inner Child Workbook” revealed it to me, and also revealed that I lacked it so utterly.  Now, all I could think of was:  couldn’t I please get some bonding before I die?

Around this time without even thinking I wrote something in a notebook, then blanked out on it completely and put it away.  A few months  later going over my notes, I noticed it with a shock and here is what I wrote:  “Dan loved me more than anyone in my entire life has ever loved me.”

Huh? An astonishing thing to say, given Dan’s predatory behavior and utter lack of regard in throwing me out of his farm house days after my dad’s death.

Still, I stared at that sentence for a long time: “Dan loved me more than anyone in my entire life has ever loved me.”  And then I had to admit to myself despite all reason, that it was true — not that I’d dare tell another soul, least of all my, er, therapist.

I just flat out did not feel as though I had gotten anything near the kind of love that Dan had given me, however meager, in the almost two years we were together, from my mom, dad, ex, or anyone in my life before.

A sad statement on the state of my soul but still the truth is the truth.

And hey, compared to both my therapists, Dan did love me a heck of a lot more. What after all, did they give me? No wonder I kept trying to crawl back into Dan’s arms in subsequent romances – at least from Dan I got something!

Where were the diagnostic tools – or any diagnostic method? Where was the Adult Attachment Interview, I ask again? Hadn’t Dr. Rita read any Adult Attachment Disorder books or anything on adult Attachment Theory or adult Attachment Disorder?

Once again I thought, Fall, 2008 surely was the end of my world.  Surely it could get no worse than this.

————————————–
This is from Kathy’s forthcoming book DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.  Watch for the continuing series of excerpts from the rest of her book each Friday, as she explores her journey of recovery by learning the hard way about adult attachment theory, attachment disorder in adults, and the Adult Attachment Interview.

Footnotes

FN1  Mel Brooks, “History of the World Part I” (film), 1981; Brooks plays Grand Inquisitor Tomas Torquemada (among others).

FN2  Technically there is a fine distinction between”bonding” and “attachment” in recent psychiatric literature, but for years therapists used the terms interchangeably.

Tagged With: Adult Attachment Disorder, Adult Attachment Disorder Books, Adult Attachment Theory, Attachment Disorder in Adults, Adult Attachment Interview, Divorce, Rebound, Emotional pain, Grief, Inner Child, Therapy, Trauma, Limbic Brain

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