Monthly Archives: June 2014

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Dan Siegel on Explicit Memory

Dan Siegel hand model 3Dr. Daniel J. Siegel uses his “hand model” of the brain to show schools kids, and the rest of us, how we need all three of the brain’s main parts to be working, and to work together.  Say the wrist is the spinal cord.  Then the palm represents the reptilian brain stem, the thumb is the emotional limbic brain, and the fingers are the thinking frontal cortex. Video: www.youtube.com/watch?v=DD-lfP1FBFk

But last week, we said that neither the brain nor the mind can simply create memories like a video camera makes movies.  Instead, first we receive a flood of raw sensory data packets from the outside world which is scattered around the body, the nerves and the primitive reptilian brain stem.  And the primitive brain stem (palm of hand) doesn’t think — or have conscious memories.

For real permanent memory, which he calls “explicit memory,” Siegel says we need the hippocampus, which is up above the brain stem, in the limbic emotional lobe (thumb).  The hippocampus is responsible to A. integrate the raw sensory data into a coherent picture, and B. put a “time tag” on it – transfer it into long-term permanent memory, where it can be retrieved later.  That’s the only way to get it into conscious thought, which occurs in the frontal cortex, the highest cognitive part of the brain (the fingers in his model).

Explicit memory is what we usually “think” of as memory; it’s a “thinking memory” or “cognitive memory,” a memory we can remember in our thinking brain. It’s “the whole movie,” for which a caption of sorts has developed in the higher parts of the brain to say: ‘this is a dog, and it’s this particular dog right now” – as opposed to that dog you saw in 1994.

But there are (at least) four ways in which the hippocampus may not be available  –  which means, humans easily may not remember traumatic events, Siegel shows.

Four Ways to Turn Off Hippocampus

Scarecrow That's Me all overFirst off, from conception to 36 months, even in a 100% healthy child with secure attachment, the hippocampus isn’t working yet; doesn’t have enough myelin to fire, it’s just not online. Events which happen during this first 45 months of life just don’t automatically become conscious memories.  Siegel gives an example of a toddler bitten by a dog.  But this is also true for any memory function a toddler has, of all events pleasant or frightening, before the hippocampus is fully working around age 3.

“Let’s say I’m 6 months old and I’m bitten by a dog on the hand,” Siegel says. “And then I’m 2 and again I’m bitten by a dog on my hand. So I’m going to have a feeling of fear when I see dogs, I’m going to have a feeling of pain in my body,  I’ll have many memories, all implicit – feeling of fear, feeling of pain in my hand, visual what does a dog look like, barking sound what does a dog sound like – and the feeling that I want to get ready to run

“Implicit memory when it’s encoded and just stays in that pure form goes into storage where it’s just changes in my synaptic connections,” he says.  It’s purely a set of raw unconscious body memory packets.

Without a functioning hippocampus, the data sits scattered all over the body – like the straw Scarecrow in the Wizard of Oz.  “They tore my legs off and threw them over there,” he says. “ Then they took my chest out and threw it over there.”  “That’s you all over,” says the Tin Man.

So neither of these two incidents, the bite at six months or the bite at age 2, ever got integrated into a coherent conscious memory  – nor did they ever get a “time tag” put on them, a clear concept that the two incidents happened in 1992 and 1994, say.

What happens to this person as an adult 20 years later in 2014 when he sees a dog?  “Now today I hear a dog barking,” Siegel goes on, and my brain goes to retrieve whatever memory it has of “dog.”

“The retrieval of a memory is the firing of neural patterns that are similar to but not identical with, what was encoded at the initial time of the experience.

“But here’s the most important lesson about memory integration:  Implicit-only memory does not feel like it’s coming from the past.  When I hear a dog, I just feel fear, period.  I don’t say,  ‘Oh, I was bitten at six months, at two years… yeah, dogs can hurt you.’  No; I just feel scared – and I get ready to run [without thought.]  Maybe I focus on the fangs of a little puppy and I see a wolf – not just a little cute puppy.  Fear hijacks my perceptual system.” [ FN1]

Second, the hippocampus itself can be damaged during those 45 early developmental months (one reason it’s called “developmental trauma.”)  If an infant or toddler has repeatedly frightening experiences, such as hostile adults continuously in the home, the neurology of the primitive brain stem gets thrown off enough that it can harms the development of the higher brain lobes — which are outgrowths of the brain stem. The hippocampus can be badly damaged, to where when we feel scared irrationally, we physically can not “think our way out” just as Dr. Bessel van der Kolk told the New York Times.

This was me; I’d been told that I’d had infant trauma from conception to 36 months.  Listening to Siegel it hit me that talk therapy (and other cognitive work) regarding events and feelings during years no one can remember, had to be a waste of time. Siegel said the memories were lying around un-assembled in my body.

One of the next webinars I heard was his friend Dr. Peter A. Levine, talking about how to assemble these body memories, using “somatic experiencing.”  So I took Dr. Levine’s book “Healing Trauma” to my therapist and said: “Sorry you’re not familiar with somatic work, but I got traumatized before I was 3 and had a thinking brain, so the trauma’s baked down into my body parts, where talk and cognition can’t get at it.  This book is what we’re going to do.”  Our results were spectacular. [FN2]

Third, Siegel said that even if the hippocampus develops pretty well, trauma after 3 years of age and at any point in life, floods the body with so much stress hormones that  this can turn off the hippocampus. “If you massively secrete cortisol stress hormone, at the same time you’re secreting adrenaline, cortisol, in high amounts, shuts off the hippocampus temporarily.  Over the long run, it can actually kill hippocampus cells.

“But adrenaline increases the synaptic changes in implicit memory. So what we’ve just described, a useful vision for PTSD, is a model for explaining flashback of phenomena: when an implicit memory is reactivated without any explicit elements, the hippocampus hasn’t been involved to experience these things in awareness. So it’s not the same as unconscious memory or anything like that. These are elements encoded, stored and now retrieved into awareness, but when they’re implicit only, they have no tagging that they’re coming from the past.” [FN3]

Fourth, there are types of trauma where a person older than age 3 with a functional hippocampus can literally, during a traumatic event, dissociate themselves to avoid experiencing it when it’s happening  – so they can’t remember it later.  “You can divide attention,” says Siegel.  “If you’re being attacked you can focus on a beautiful beach, so you’ve taken your hippocampus out of the picture – but unfortunately you can not block the implicit coding [of the raw separate bodily memories of what was actually being done to you -kb]…

“If you were betrayed by your father or mother, if they abandoned you or hurt you or ignored you in terrible ways, it makes no sense that that would happen to you. So how do you make sense of something which doesn’t make any sense?,” says Siegel.  “It turns out that the part of our hippocampus which is the narrator is in the left hemisphere, but it has to draw on the hippocampus in the right hemisphere for storage of autobiographical data.

“Say your dad drank and he attacked you — so you dissociated and thought about the beach.

“So now [years later] the therapist asks you ‘What did that feel like, were you terrified of your parents?’   Your left narrator wants to cooperate, so it calls over to the right side and asks ‘Any feelings of fear of parents over there?’ and the right side answers back ‘Nothing over here, Dan, but sand and water.’  But your body also feels fear and you  may be sick to your stomach — none of it conscious.”   [FN4]

——————-

Kathy’s news blogs expand on her 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 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.

Footnotes

FN1   Siegel, Daniel J., MD, “Domains of Integration,” July 27, 2010 lecture audio  http://www.drdansiegel.com/uploads/DomainsofIntegration.mp3  To download, right click Play arrow, left click Save Audio As  [or go to http://www.drdansiegel.com/resources/audio_clips/  scroll down to title, right click to download]

FN2  Levine, Peter A., PhD, “Healing Trauma: A Pioneering Program for Restoring the Wisdom of Your Body,” ‘Sounds True, Inc.,’ Boulder CO, 2005; ISBN 1-159179-247-9

FN3   Siegel, Daniel J., MD, “How Mindfulness Can Change the Wiring of Our Brains, October 12, 2011 Webcast, National Institute for the Clinical Application of Behavioral Medicine (NICABM), http://www.nicabm.com/mindfulness-2011-new/

FN4   op cit  FN1  Siegel, “Domains of Integration”

Daniel J. Siegel, MD, is clinical professor of psychiatry at the UCLA School of Medicine on the faculty of the Center for Culture, Brain, and Development and founding co-director of the Mindful Awareness Research Center.  He is a Distinguished Fellow of the American Psychiatric Association and Executive Director of the Mindsight Institute. He is also Founding Editor for the Norton Professional Series on Interpersonal Neurobiology which contains over three dozen textbooks.

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

Books by Dan Siegel:
–”The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are,” (Guilford, 1999). How attachment in infancy and childhood creates the brain and the mind.
–”Healing Trauma: Attachment, Mind, Body, and Brain,” Marion F Solomon, Daniel J Siegel, editors,  New York, NY:  W.W. Norton and Company;  2003.   357pg  Reviewed by Hilary Le Page, MBBS at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2553232/
–”The Mindful Brain: Reflection and Attunement in the Cultivation of Well-Being,” (Norton, 2007)
–”The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration,” (Norton, 2010)
–”Mindsight: The New Science of Personal Transformation,” (Bantam, 2010)
–”Parenting from the Inside Out: How a Deeper Self-Understanding Can Help You Raise Children Who Thrive,” (Tarcher/Penguin, 2003) with Mary Hartzell
–”The Whole-Brain Child: 12 Revolutionary Strategies to Nurture Your Child’s Developing Mind,” (Random House, 2011) with Tina Payne Bryson, Ph.D
–”Brainstorm: Power and Purpose of the Teenage Brain,”  (Tarcher, 2013)

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Dan Siegel on Re-Membering Trauma

brousblog4a Siegel Hawn CooperDr. Daniel J. Siegel, MD (far left) introduced me to brain science, and I write about brain scientists like him ‘cos they saved my life. Without them, I’d still be a successful, all-head talk technical writer for Pentagon sales.  I’d be unaware of my childhood attachment trauma, unable to feel my past, dissociated, and miserable with anxiety.  My cholesterol would still be over 240, my kidneys headed for failure.

But in March 2011, I clicked on the wrong link in a friend’s email and ended up watching a Dan Siegel webinar on how the brain works in trauma. [FN1]  That’s where my healing began.  Siegel flies around the world trying to alert parents and others about how childhood experiences affect the brain.  “You sent us a brain in the mail !” Anderson Cooper exclaims in this Sept. 2012 Anderson Live clip. [FN2]

Dan Siegel is sooo relevant to the May 22 New York Times’ dig against Dr. Bessel van der Kolk for speaking of “repressed memories.”  If it’s traumatic, we remember it, period, the Times says;  “Harvard psychologist Richard McNally called the idea of repressed memories ‘the worst catastrophe to befall the mental health field since the lobotomy’.”  But many of McNally’s peers said his allegation wasn’t proven.  Harvard’s Lisa Najavits called McNally’s statement “disappointing… landing too forcefully on one side…by no means an end to the debate.” [ FN3]

Siegel’s work suggests that the Times best go back to science school.  Dr. Siegel shows extensively that if it’s traumatic, we may very well not remember it coherently.

More important, we almost certainly won’t be able to feel the bodily feelings caused by the trauma, which are still stuck in our bodies.  And until we can feel those, we won’t be able to heal the trauma.  Siegel illuminates the numerous brain mechanisms which can cause our entire memory system to be fragmented and to misfire badly.

In that first webinar I saw by accident, Siegel said he got started in psychiatry in the 1980s studying the hippocampus, which integrates raw incoming sensory data, into composite conscious memory. Siegel shows there are (at least) four ways in which humans may not remember traumatic events – because their hippocampus wasn’t working.

Implicit Memory

Triune Sixtine Brainforest Octopus is viscera www.mindful.ca  4-625x1024Check out the history of the word “re-member”– in Shakespeare, for example. “Re-member” literally means putting parts of our body (members) back together again, ie, “getting ourselves together.” And now science has shown: memories actually start in the body, not in the thinking brain.

Memories start as raw incoming sensory data.   And if the hippocampus isn’t on duty, the body is as far as memories get; memories get stuck in the body.  (Illustration shows the “hippo” as a curved grey area center of brain by dancer’s foot.  Credit:  “The Brain Forest,” Copyright © 2012 by Dr. Stéphane Treyvaud. All rights reserved, at http://www.mindful.ca/in-detail/the-sixtine-brain/ ).

Say you’ve never seen a video, TV, or film; go back before that — to most of human history.  Siegel explains that if a dog approaches me, for example, my brain can’t just “take a video”and give me a whole, coherent overview, with headline “this is a dog.”  It also doesn’t automatically give me a date of today for this dog here, now.  Nor does it automatically tell me that I saw another dog back in 1994 and that was a different dog.

Instead, says Siegel, first, I get a flood of distinct sensory inputs which have nothing to do with each other – or with thought.  I get discrete packets of sensory data from the eyes, ears, nose, and other parts of my body.  My sense of sight gets a visual “look” of the dog; my sense of smell gets a whiff; my ears may hear a bark or pant.  All three are entirely separate incoming sensory data.  If a bottle of milk were coming, I’d get a touch memory as to its temperature from finger nerves, a taste memory from lingual nerves, etc.

These bits of incoming data are “implicit memory,” Siegel explains, “changes in synaptic connections…like puzzle pieces.”  Each one is a separate sensory memory housed primarily in the nerves reporting in from the body parts where it happened — optical nerve, olfactory nerve, auditory nerve and so on.

Each of those nerves also reports the different implicit data to the non-thinking instinctive brain stem, which also stores parts of these memories and — this is key — without being able to integrate them.  The lizard and frog in the cartoon represent the brain stem, ‘cos it functions at about the level they do – reflexively and by instinct.  No integration, no thinking.

But: what if the dog (or any other being or event) is hostile?  Now, I get an additional flood of unrelated data: my gut gets tight, my heart rate goes up, breath quickens, leg muscles tense to run. It all happens by instinct, instantly, and it bypasses thought altogether. Again: no thinking involved.

Check out the octopus at bottom of the cartoon. “Around our heart, lungs and intestines, we have a web of nerve cells so complex as to correspond in size to the brain of a cat,” says illustration author Dr. Stéphane Treyvaud. “Similar webs of nerve cells may also be found around the muscles.” It’s represented by the head and near arms of the octopus at bottom — and as Treyvaud notes elsewhere, he learned this in his studies with Dan Siegel.  [FN4]

Reporting up from all those visceral nerves of the body cavity is the vagus (10th cranial) nerve, which dumps all this lower body sensory data into the primitive brain stem, shown as the longer arms of the octopus reaching up to the green brain stem lizard.  Siegel and his colleague Dr. Stephen Porges write extensively on the neuroscience of this. [FN5]

Siegel refers to everything under the thinking frontal cortex as the “downstairs brain,” and this octopus is a good visual. Because if the dog, or anything else, is hostile, not only do I have all those sight, smell, and sound data packets to manage -– I’m also hit with a flood of “downstairs” bodily data packets.

Now what?  Well, now I need my hippocampus to be working, or I’m in serious trouble. Let that sink in until next week.

——————————

Kathy’s news blogs expand on her 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 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.

Footnotes

Daniel J. Siegel, MD, is clinical professor of psychiatry at the UCLA School of Medicine on the faculty of the Center for Culture, Brain, and Development and founding co-director of the Mindful Awareness Research Center.  He is a Distinguished Fellow of the American Psychiatric Association and Executive Director of the Mindsight Institute. He is also Founding Editor for the Norton Professional Series on Interpersonal Neurobiology which contains over three dozen textbooks.

FN1   Siegel, Daniel J., MD, “How Mindfulness Can Change the Wiring of Our Brains,” October 12, 2011 webcast, National Institute for the Clinical Application of Behavioral Medicine (NICABM), www.nicabm.com http://www.nicabm.com/mindfulness-2011-new/

FN2  Anderson Live, September 24, 2012; also at http://www.drdansiegel.com/resources/video_clips/  then scroll down for 2012 videos

FN3  Najavits, Lisa M., PhD, Assoc. Prof of Psychiatry, Harvard Medical School and Director Trauma Research, McLean Hospital, “Book Review, ‘Remembering Trauma’ by Richard McNally,” Journal of Nervous and Mental Disease, Vol. 192, No. 4, April 2004  http://www.seekingsafety.org/7-11-03%20arts/4-04%20fin%20SCAND%20VERS-jnmd%20rev%20mcnally.pdf

FN4  http://www.mindful.ca/in-detail/the-sixtine-brain/

FN5  Porges, Stephen, PhD, 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

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

Books by Dan Siegel:
–“The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are,” (Guilford, 1999). How attachment in infancy and childhood creates the brain and the mind.
–“Healing Trauma: Attachment, Mind, Body, and Brain,” Marion F Solomon, Daniel J Siegel, editors,  New York, NY:  W.W. Norton and Company;  2003.   357pg  Reviewed by Hilary Le Page, MBBS at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2553232/
–“The Mindful Brain: Reflection and Attunement in the Cultivation of Well-Being,” (Norton, 2007)
–“The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration,” (Norton, 2010)
–“Mindsight: The New Science of Personal Transformation,” (Bantam, 2010)
–“Parenting from the Inside Out: How a Deeper Self-Understanding Can Help You Raise Children Who Thrive,” (Tarcher/Penguin, 2003) with Mary Hartzell
–“The Whole-Brain Child: 12 Revolutionary Strategies to Nurture Your Child’s Developing Mind,” (Random House, 2011) with Tina Payne Bryson, Ph.D
–“Brainstorm: Power and Purpose of the Teenage Brain,”  (Tarcher, 2013)

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Readers Defend Van der Kolk

Bessel van der Kolk pic Trauma CenterI had the most comments ever last week, as readers spoke up to defend Dr. Bessel van der Kolk (left) and his ideas about somatic (body) healing for trauma, after the sideswipes against science by the New York Times May 22.  But the comments section got buried under all the footnotes I had to put in my letter to the Times to document their ignorance, so I’m posting the comments here where they’re easy to find.

 

Barbara Findeisen | June 7, 2014
Thank you, Kathy, you speak for many of us.  Did you see the “60 Minutes” show that Sunday? Most of my friends in the field do not think cognitive (therapy) is the way to go.

Some do. I have a hunch it is because they are afraid of their own trauma and need to be in control. As I am sure you know it an be messy when you are back in that pain and terror.

Kathy | June 8, 2014
Dear Barbara,
I’m grateful for your work on somatic healing and attachment trauma at Star Foundation (www.starfound.org).  A transcript of the May 25 “60 Minutes” show on PTSD is here.  Personally I was horrified by the VA forcing vets to do cognitive talk therapy, retelling their trauma over and over.
Not only Dr. van der Kolk but also somatic therapy experts Dr. Peter A. Levine, Dr. Pat Ogden, Belleruth Naparstek, Janina Fisher, and others with extensive vet experience warn that “just talk” about trauma only makes victims relive the trauma.  So it gets worse.
That’s why I took Dr. Levine’s somatic book “Healing Trauma to my therapist; he’s an attachment expert, but into cognitive talk therapy.  I said: “Sorry you’re not familiar with somatic work, but I got traumatized before I was 3 and had a thinking brain, so the trauma’s baked down into my body parts, where talk and cognition can’t get at it. This book is what we’re going to do.”  Our results were spectacular.  Levine’s results with vets are also spectacular.

Cheryl Sharp | June 9, 2014
While the coverage of van der Kolk’s work looked good on the surface, the innuendos throughout left me feeling that it was more of an attack.

It would have made much more sense for the article to go further and talk about why the way he works with people actually works, such as follow up with Bruce Perry’s work.

Only when people understand how the brain gets stuck and that the only way to that part of the brain is through the body, will they understand that healing and recovery is a real possibility.

Kathy | June 9, 2014
Amen when it comes to healing!  Dr. Bruce Perry, MD, Dr. Dan Siegel, MD, Stephen Porges and show that trauma shuts down higher brain functions like cognition. Instead, body parts and the primitive brain stem get “stuck” repeating bodily feelings from the past trauma events. Without higher brain functions, we can’t put the past trauma events into long-term memory. Instead, our body is reliving the past, now.
Siegel also says trauma memories can get so fragmented that we can’t gather them into a working picture at all; they sit scattered around the nervous system and body.
Perry says  “rhythmic regulation” by body movement can get the brain stem to calm long enough to let the higher brain functions come on line.
The Times ignores all this and repeats Richard McNally’s 2005 insistence that all trauma is remembered — though many said at the time that his work lacked proof. Lisa Najavits called McNally “disappointing… landing too forcefully on one side…by no means an end to the debate.”

Jane | June 9, 2014
Kathy, thanks for this informative post.  Several parents in my online support group have been discussing this very issue – body work to heal trauma – this past week.

Kathy | June 9, 2014
Thank you Jane!  Bruce Perry, Dan Siegel and others show even a normal child’s brain has no capability to remember much from conception to 36 months of age. Memories come in as discrete packets of sensory data from the eyes, ears, nose, etc., and sit in the body and primitive brain stem.
Only when the higher cognitive  functions like the hippocampus kick in around age 3, can we create real long term memory.
But if developmental trauma occurs from conception to 36 months, the primitive brain stem gets so traumatized that it harms the development of the higher brain lobes — which are outgrowths of the brain stem. The hippocampus, our ability to create long term memory, and many other higher brain functions can be badly damaged.
So we physically can not “think our way out” as van der Kolk says.

Rebecca | June 7, 2014
Excellent. Glad you wrote a defense. Have you heard back from them??

Kathy | June 8, 2014
No, nothing yet; frankly I didn’t expect anything.
They’re like King George or Marie Antoinette… They think they are Royalty at The Most Important Newspaper In The World – so they can just print anything they like, and the rest of us peons must cower.
Like I said, I grew up in New York and I’m not impressed.
When Thomas Edison invented the light bulb, they literally wrote an editorial denouncing him as a charlatan. I don’t have a copy of it anymore but maybe you can find it on the internet?

—————————–

Kathy’s news blogs expand on her 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 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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In Defense of Van der Kolk

Bessel van der Kolk portrait by Matthew WoodsonThe New York Times May 22 spotlighted Dr. Bessel van der Kolk MD’s idea that to change the way we heal a traumatized mind, start with the body (as noted last week). (Van der Kolk portrait by Matthew Woodson for the Times, left.)  But the Times had its own slant, some of it not cricket.

So here’s the letter I wrote to the Times about the gnarly
innuendos they also threw in — against Dr. van der Kolk.
These are innuendo against the science of how the human
organism deals with trauma and how widespread trauma

Some 50% of Americans have insecure attachment trauma
and roughly 50% of us suffer one or more types of Adverse Childhood Experience (ACE) trauma.  But the Times isn’t sounding the alarm about that.  Instead they’re damning the scientists trying to sound the alarm, with faint praise and innuendo.

I grew up in New York; I’m not impressed by Their Majesties.  I don’t care to let the Times’ arrogance stand.

————————–
Subject: J. Interlandi 5-22 Van der Kolk feature
From: Kathy Brous   Date: Thursday, May 29, 2014
To: Letters@nytimes.com, “Sheila Glaser” <sfglaser@nytimes.com>
Cc: “Jeneen Interlandi” <jeneeni@yahoo.com>

Re:  “A Revolutionary Approach to Treating PTSD” by Jeneen Interlandi, May 22 New York Times Magazine

Dear Editors,

I appreciate Ms. Interlandi’s  allowing Dr. Bessel van der Kolk the space to explain that “to change the way we heal a traumatized mind, start with the body.” It’s especially true that standard “cognitive” treatments often don’t work, “patients are still suffering, and so are their families. We need to do better,” as van der Kolk says.

Of 208 reader comments, I only found two that didn’t hail his work; the two attacked van der Kolk for stating that “repressed memories” are possible.

But so, in effect, does the Times – and more. Which I found alarming.

“In the 1990s, van der Kolk served as an expert witness in a string of high-profile sexual-abuse cases that centered on the recovery of repressed memories, testifying that it was possible… for victims of extreme or repeated sexual trauma to suppress all memory of that trauma and then recall it years later in therapy,” Ms. Interlandi wrote.

Then, as if seamlessly, she segued into this next sentence: “In the 1980s and ‘90s, people all over the country filed scores of legal cases accusing parents, priests and day care workers of horrific sex crimes, which they claimed to have only just remembered with the help of a therapist… But as the claims grew more outlandish — alien abductions and secret satanic cults — support for the concept waned… Harvard psychologist Richard McNally called the idea of repressed memories ‘the worst catastrophe to befall the mental health field since the lobotomy ‘.”

Bessel website pix vanderKolkportrait1I loathe witch trials; I was alarmed.  Is van der Kolk a butcher?  So I did an extensive internet search, and found zero evidence that van der Kolk personally had anything to do with the fraudulent cases.  Let alone aliens or cults.

Then I realized that the Times doesn’t have a single footnote to show it either. Is it all innuendo?

In my search, the worst van der Kolk’s worst critics could do, was to condemn him for repeating his clinical findings that repressed memories are possible. Period. [1]  Yes it’s horrible that there was a witch hunt in the 1980s-90s. It’s horrible that others distorted van der Kolk’s findings and as a result, innocent people were jailed.

But it’s just as much of a distortion to accuse him of doing the witch hunting. Is Edison responsible for everything ever done under electric lights?

The Times doesn’t report any of that.

The Times also doesn’t report this: since Richard McNally, Elizabeth Loftus and others flatly declared repressed memory to be impossible in 2002-2005, several peer reviewers have concluded that they were (flatly) wrong. The American Psychological Association website now states that while most traumas are remembered, “repressed memories” are also often reported and quite possible — and far more research is needed before anything can be dismissed. [2]

I appreciate Ms. Interlandi for covering trauma and van der Kolk, and at such length. I appreciate she seeks balance. But was that balance?

She also describes a follow-up visit she made to the Iraq vet with PTSD, whom van der Kolk treated using group therapy in the article’s opening passages. She concludes the article by reporting that the vet has no idea whether it worked or not. This leaves readers thinking: “Hmm. Van der Kolk?  His stuff doesn’t work.”

Without any review of what van der Kolk’s actual recovery rate might be?  Why the innuendo?  Where are the facts?

The Times also doesn’t report another key fact: according to Veterans Administration chief PTSD authority Dr. Matthew Friedman and several other studies, only 10-15% of veterans who experience war trauma incidents, come down with enduring full-blown PTSD. The rest heal within a relatively finite period. [3]

Traumatized little boyThe problem is the “invisible elephant” on the national mental health lawn: child trauma.

Child trauma is a topic Dr. van der Kolk discusses constantly, but which the article only mentions in passing, by way of asking whether it can be remembered or not. Yet the ACE Study has already shown that roughly 50% of us suffer one or more types of childhood trauma.

Those 10-15% who get PTSD? They are almost always survivors of some unrelated childhood trauma, which damages memory during brain development, such that yesterday’s events continue to be experienced as today’s events. That means the Iraq vet in the article, who has enduring PTSD, very likely had childhood trauma, a huge topic in itself.  [4]

To address child trauma — and what it would really take to fully heal this vet — would require giving Dr. van der Kolk the space for a whole other article. Which more than 200 of your readers would welcome.

Unless there’s a reason why not?

Unless we instead might have an article by those who allege that van der Kolk promoted the fraudulent cases — if, that is, they can show proof? And please: proof means footnotes and documentation.

Kathy Brous, Dana Point, CA
http://attachmentdisorderhealing.com/blogs/

Footnotes (provided in letter to the Times)

FN1  The False Memory Syndrome Foundation (FMSF) (www.fmsfonline.org), the premier site exposing fraudulent accusations based upon false trauma memory, has dozens of references to Bessel van der Kolk testifying on the science. Yet it never mentions that he supported any particular therapy, therapists, false memories or particular cases at all.  It certainly never connects him to anything to do with aliens or satanic cults.

FN2  The American Psychological Association’s 2007 “Working Group on Investigation of Memories of Child Abuse” presented findings mirroring those of the other professional organizations. The Working Group made five key conclusions:
“1. Controversies regarding adult recollections should not be allowed to obscure the fact that child sexual abuse is a complex and pervasive problem in America that has historically gone unacknowledged;
“2. Most people sexually abused as children remember all or part of what happened to them;
“3. It is possible for memories of abuse that have been forgotten for a long time to be remembered;
“4. It is also possible to construct convincing pseudo-memories for events that never occurred;
“5. There are gaps in our knowledge about the processes that lead to accurate and inaccurate recollections of childhood abuse.”
– Source: Colangelo JJ, “Recovered memory debate revisited: practice implications for mental health counselors,  PRACTICE, Journal of Mental Health Counseling, 2007

The American Psychological Association’s website www.apa.org/topics/trauma/memories.aspx?item=1 currently adds:
“Q: Can a memory be forgotten and then remembered? Can a ‘memory’ be suggested and then remembered as true?
“A: Experts in the field of memory and trauma can provide some answers, but clearly more study and research are needed. What we do know is that both memory researchers and clinicians who work with trauma victims agree that both phenomena occur.
“However, experienced clinical psychologists state that the phenomenon of a recovered memory is rare (e.g., one experienced practitioner reported having a recovered memory arise only once in 20 years of practice). Also, although laboratory studies have shown that memory is often inaccurate and can be influenced by outside factors, memory research usually takes place either in a laboratory or everyday setting. For ethical reasons, researchers do not subject people to a traumatic event to test their memory. Because it has not been directly studied, we can not know whether a memory of a traumatic event is encoded and stored differently from a nontraumatic event.
“Some clinicians theorize that children understand and respond to trauma differently from adults. Some furthermore believe that childhood trauma may lead to problems in memory storage and retrieval. These clinicians believe that dissociation is a likely explanation for a memory that was forgotten and later recalled. Dissociation means that a memory is not actually lost, but is for some time unavailable for retrieval. That is, it’s in memory storage, but cannot for some period of time actually be recalled. Some clinicians believe that severe forms of child sexual abuse are especially conducive to negative disturbances of memory such as dissociation or delayed memory. Many clinicians who work with trauma victims believe that this dissociation is a person’s way of sheltering him/herself from the pain of the memory.
“Many researchers argue, however, that there is little or no empirical support for such a theory.”

FN3  “We know that if a hundred people are exposed to a traumatic episode…that most of them will not develop PTSD… The pre-traumatic risk factors are things you really can’t do anything about: whether your parents were well adjusted or had a mental health history, whether you were previously exposed to a disruptive household – your father was an alcoholic or that you were very poor and there was a lot of deprivation, or there was physical or sexual abuse during your childhood.”
– Source: Dr. Matthew Friedman, “Psychological First Aid: Diagnosis and Prevention of PTSD,” June 8, 2011 webcast, National Institute for the Clinical Application of Behavioral Medicine, www.nicabm.com
Dr. Matthew Friedman recently retired from the position of Executive Director and now serves as Senior Advisor at the U. S. Dept. of Veterans Affairs National Center for PTSD. Source: www.ptsd.va.gov/professional/continuing_ed/presenters/matthew-j-fri… [Dated March, 2014]

FN4  “The purpose of this study was to compare rates of childhood abuse in Vietnam veterans with and without combat-related posttraumatic stress disorder (PTSD).
“Results: Vietnam veterans with PTSD had higher rates of childhood physical abuse than Vietnam veterans without PTSD (26% versus 7%). The association between childhood abuse and PTSD persisted after controlling for the difference in level of combat exposure between the two groups.
“Conclusions:These findings suggest that patients seeking treatment for combat-related PTSD have higher rates of childhood physical abuse than combat veterans without PTSD. Childhood physical abuse may be an antecedent to the development of combat-related PTSD in Vietnam combat veterans.”
– Source: Bremner JD, Southwick SM, Johnson DR, Yehuda R, Charney DS, “Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans,”.Am J Psychiatry. 1993 Feb; 150(2):235-9.  http://www.ncbi.nlm.nih.gov/pubmed/8422073

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Kathy’s news blogs expand on her 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 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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