Category Archives: Attachment

Healing Student Trauma: Film Debut, Orange County

paper-tigers-kelsey-movie-creditsSave the date Oct. 14 in Orange County, CA!  It’s the OC’s first screening of James Redford’s “Paper Tigers,” a film on how Lincoln Alternative High heals traumatized students with new relationships.  Such “Trauma-Informed Care” has begun in schools, medical settings, judiciary and social services nationally, with top results. It can help any organization.

Watch the two-minute trailer now: PaperTigersMovie.com

From rough areas, Lincoln High’s students were headed for the “School to Prison Pipeline.”  Then Principal Jim Sporleder took this Walla Walla WA school run by gangs, with 789 suspensions and 50 expulsions a year, and turned it around.  Suspensions fell 85-90%, expulsions fell 30-50%, and attendance, GPAs, and state exam scores rose. Graduation rates rose five-fold. Students got into college with $30K in scholarships. It was so dramatic that Robert Redford’s son James Redford made this film.

On Sept. 19, Mr.  Sporleder and my other friends at ACEsConnection spoke on this work at the White House in Washington. The White House Fact Sheet features ACEsConnection and our 10,000-person organization in its third bullet under “Online Community Support for Educators.”

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“Paper Tigers” Film Screening, Friday, October 14, 7 pm
Center For Spiritual Living, 1201 Puerta Del Sol, San Clemente CA 92673
– A documentary by James Redford, Director –

– Hundreds of screenings already organized nationally –
Admission free. To ensure seats, click “Register” button here.
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How did Principal Sporleder do it?   “Let’s stop asking kids ‘What’s wrong with you?’   Sporleder told his staff — and start asking ‘What happened to you?’  Then, let’s be quiet and listen with compassion.”

If a student used the “F” bomb, instead of detention they saw the principal. “What bad stuff happened that you’re so upset?” Jim would ask. “My Dad left for Iraq, again!” or “Mom’s drunk so no breakfast,” they’d say. They’d pour out their hearts until Jim reached them emotionally and they felt heard. As they could feel and verbalize emotions, they acted out less.

Leveraging the ACE Study

How did Jim Sporleder learn to do all this?  It began when he found out about the Adverse Childhood Experiences (ACE) Study.  The ACE Study revealed that some 50% of Americans suffer childhood trauma, and that it can flood students’ brains with toxic stress to where they can’t learn.

He also found a wealth of resources on ACEsConnection.com, the social network site for the ACE Study just cited by the White House this week.

Then Jim, the school staff and the students all studied the ACE Study together. Everyone saw that the students weren’t freaks, but instead their behavior was their bodies’ natural reaction to horrible experiences over years.  Student self-respect grew.  As Robin Williams told Matt Damon, “It’s not your fault:” https://www.youtube.com/watch?v=UYa6gbDcx18

The ACE Study and Trauma-Informed Care show that one caring, dependable adult, a teacher or other mentor, can give a kid the relationship they need to heal. Once adults “got them,” the students turned around.

–ACE Study Video by Dr. Vincent Felitti, MD, co-study director: https://www.youtube.com/watch?v=GQwJCWPG478
–Full story on Lincoln High:  https://acestoohigh.com/2012/04/23/lincoln-high-school-in-walla-walla-wa-tries-new-approach-to-school-discipline-expulsions-drop-85
–Trauma-Informed Care  http://www.samhsa.gov/nctic/trauma-interventions

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Kathy’s blogs explore the journey of recovery from childhood trauma by learning about Adult Attachment Disorder in teens and adults, Adult Attachment Theory, and the Adverse Childhood Experiences (ACE) Study.
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Comments are encouraged, with the usual exceptions; rants, political speeches, off-color language, etc. are unlikely to post.  Starting 8-22-16, software will limit comments to 1030 characters (2 long paragraphs) for a while, until we get new software to take longer comments again.

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Psychotherapy and Love

Thich nhat hanh PlumVillage.OrgI went through three bad therapists before I found my current one, and for the first two years, I kept asking him the same question:  “You’re just a hired gun, right?  ‘What’s love got to do with it?’  What good can this really do me, since it’s just business?”

Then one day I was reading Thich Nhat Hanh’s “The Heart of the Buddha’s Teaching” (photo above by PlumVillage.org).  On page 5, Nhat Hanh writes this of his youth in Vietnam: “I grew up in a time of war. There was destruction all around – children, adults, values, a whole country. As a young person, I suffered a lot. Once the door of awareness has been opened, you cannot close it.  The wounds of war in me are still not healed. There are nights I lie awake and embrace my people, my country, and the whole planet with mindful breathing…”

I dissolved in tears, that such a leader of men could live with this terrible pain.

Then he says: “Please don’t run away from your suffering. Embrace it, and cherish it. Go to the Buddha, sit with him, and show him your pain.  He will look at you with eyes of loving kindness, compassion, and mindfulness, and show you ways to embrace your suffering and look deeply into it. With this understanding and compassion, you will be able to heal the wounds in your heart…”

Just as suddenly I flashed on a picture of my therapist, grey beard and all. Whoa, he’s a Christian therapist, and I’m (or was) a nice Jewish girl from Long Island — so “trust me,” as we say in New York, Dr. R. was the furthest thing from my mind when I picked up Nhat Hahn’s book.

But now it hits me like a ton of bricks:

“Oh: Buddha!,” I said, speaking mentally to Dr. R.  “This is how you look at me, this is how you create deep changes in my soul…” And then I was really bawling and calling Dr. R’s tape to leave a message reading him Nhat Hanh’s passage — saying, more or less, “OK, now I get it!  This is real attachment, it’s the real deal!  Hey, Buddha…”

[ Find a good therapist: http://attachmentdisorderhealing.com/resources/attachment-therapists-directory/  ]

Emotional Investment

Sir Walter Raleigh_by_'H'_monogrammistIn the years since, we’ve discussed it, and lived it, and he says it — but now I knew: Dr. R. is 100% invested in me.

Not the way he’s invested in 40lks or in paying his mortgage; he could make a living an easier way. Instead, he chooses to invest his emotions and attachment into his clients as a dear friend would. He chooses to lay his soul out under me like a warm limbic carpet of deep emotional support, as Sir Walter Raleigh did his cloak for Queen Elizabeth.

That takes courage and ginormous simply plain human compassion and sheer humanity.

Recently I read these words by Sir Richard Bowlby, son of the founder of attachment theory, addressing therapy for adopted children — but it goes for anyone who needs deep therapy, and it made my whole body sob:

“The… intervention …involves clinicians taping into their own empathic capacities to help children feel supported to such a degree that direct connections can be forged between the reality of children’s traumatic experiences and the parents and/or clinicians being able to tolerate their pain and so regulate the child’s distress down to a manageable level. The recognition that another person can truly understand and tolerate their pain can be a major contribution to the client’s therapeutic outcome. ” http://www.beyondconsequences.com/bowlby.html

If you consider the level of pain that I get into with developmental trauma since the sperm hit the egg, Dr. R. is tolerating hell on wheels – and that is because he did not shrink (ooooops, bad pun) from the only way to gain that skill: he has looked deeply within himself in years past, and he has done his own trauma healing as deeply as he’s asking me to do.

[This post originated when I saw a comment on an article by therapist Dr. Laura K. Kerr, in which the commentator felt that therapy can’t be more than a business transaction; original at: http://www.socialjusticesolutions.org/2015/04/01/trauma-informed-psychotherapy-puts-body-love-back-mental-healthcare/#comment-125547]

 “General Theory” on Therapy and Love:

Limbic Resonance - Boise State UnivThe psychiatric text “General Theory of Love” shows that human beings depends for survival on our mammalian “limbic brain,” and that as we grow, our minds and souls are healthy and feel well, or don’t, depending literally upon love.  [FN1]  (Click on graphic to open; from Boise State University News.)

It also documents that good therapy is nothing but love.  The problem, they point out, is that too many therapists can’t manage that kind of good therapy.

Our caregivers create our infant brain via “limbic resonance,” they report, the resonating of an adult’s limbic brain with an infant’s limbic brain — via attuned deep eye contact.  “By looking into his eyes and becoming attuned to his inner state, a mother can intuit her baby’s feelings and needs,” they write. “The regular application of that knowledge changes a child’s emotional makeup.”

When the mother attunes to the infant with deep love, the infant learns that love is safe, forms a secure attachment, feels a sense of belonging and a sense of peace.  “Attachment penetrates to the neural core of what it means to be a human being” they write, and thus the book’s title. It’s all about love and nothing but love. More details: http://attachmentdisorderhealing.com/love-theory-2/

The book’s second half demonstrates that psychotherapy works when it does, only due to love — love precisely of the above deep nature.  And therapy doesn’t work when limbic resonance and love don’t flower.  It’s got nothing to do with a charity date or even such foolishness as “re-parenting.”

It’s just plain and simple deep human compassion, eye to eye.  For that reason, “psychotherapy is physiology,” they state.

“When a person starts therapy… he is stepping into a somatic state of relatedness, ” they report. “Evolution has sculpted mammals… (to) become attuned to on another’s evocative signals and alter the structure of one another’s nervous systems.  Psychotherapy’s transformative power comes from engaging and directing these ancient mechanisms.  Therapy is a living embodiment of limbic processes as corporeal as digestion or respiration.

“Speech is a fancy neocortical skill, but therapy belongs to the older realm of the emotional mind, the limbic brain.

“Love is not only an end for therapy; it is also the means whereby every end is reached. (p.168-9)  The first part of emotional healing is being limbically known – having someone with a keen ear [a good therapist-kb] catch your melodic essence.” (p.170)

Unfortunately there are a lot of incompetent therapists hiding behind their desks and diplomas, refusing to really relate. “Some therapists recoil from the pivotal power of relatedness. They have been told to deliver insight — a job description evocative of estate planning or financial consulting, the calm dispensation of tidy data packets from the other side of an imposing desk,” writes “General Theory.”

“A therapist who fears dependence will tell his patient, sometimes openly, that the urge to rely is pathologic. In doing so he denigrates a cardinal tool. A parent who rejects a child’s desire to depend raises a fragile person. Those children, grown to adulthood, are frequently among those who come for help.

“If patient and therapist are to proceed together down a curative path, they must allow limbic regulation and its companion moon, dependence, to make the revolutionary magic.

“Many therapists believe that reliance fosters a detrimental dependency. Instead, they say, patients should be directed to “do it for themselves” – as if they possess everything but the wit to throw that switch and get on with their lives.

Limbic Revision

Limbic Revision tumblr_nbam9cX0hI1tbev4jo1_500“But people do not learn emotional modulation as they do geometry or the names of state capitals. They absorb the skill from living in the presence of an adept external modulator, and they learn it implicitly,” the book states.  ” Knowledge leaps the gap from one mind to the other, but the learner does not experience the transferred information as an explicit strategy. Instead, a spontaneous capacity germinates and becomes a natural part of the self, like knowing how to ride a bike or tie one’s shoes.”  (p.171) (graphic by N.Bam on Tumblr)

“People who need regulation often leave therapy sessions feeling calmer, stronger, safer, more able to handle the world. … The longer a patient depends, the more his stability swells, expanding infinitesimally with ever session as length is added to a woven cloth with each pass of the shuttle, each contraction of the loom. And after he weaves enough of it, the day comes when the patient will unfurl his independence like a pair of spread wings. Free at last, he catches a wind and rides into other lands.” (p.172)

“Knowing someone is the first goal of therapy…  Therapy’s last and most ambitious aim is revising the neural code that directs an emotional life. (176)  Psychotherapy changes people because one mammal can restructure the limbic brain of another… (p.177)

“Describing good relatedness to someone, no matter how precisely or how often, does not inscribe it into the neural networks that inspire love. Self-help books are like car repair manuals: you can read them all day, but doing so doesn’t fix a thing.

“Working on a car means rolling up your sleeves and getting under the hood, and you have to be willing to get dirt on your hands and grease beneath your fingernails. Overhauling emotional knowledge is no spectator sport; it demands the messy experience of yanking and tinkering that comes from a limbic bond. If someone’s relationship today bear a troubled imprint, they do so because an influential relationship left its mark on a child’s mind.

“When a limbic connection has established a neural pattern, it takes a limbic connection to revise it. (p.177)”

“The person of the therapist is the converting catalyst, not his credo, not his  location in the room, not his exquisitely chosen words or silences… The dispensable trappings of dogma may determine what a therapist thinks he is doing, what he talks about when he talks about therapy, but the agent of change is who he is. (187)

“The brevity of mini (psycho)therapies is another efficient forestaller of healing. The neocortex rapidly masters didactic information, but the limbic brain takes mountains of repetition.  No one expects to play the flute in six lessons or to become fluent in Italian in ten. ”  (p.189)   “The skill of becoming and remaining attuned to another’s emotional rhythms requires a solid investment of years.”  (p.205)

“The limbic connectedness of a working psychotherapy requires uncommon courage. A patient asks to surrender the life he knows and to enter and emotional world he has never seen; he offers himself up to be changed in ways he can’t possibly envision. As his assurance of successful transmutation he has only the gossamer of faith…

“Only human love keeps this from being the act of two madmen. (p.190)”

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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.

Footnotes

FN1  Lewis, Thomas, MD; Amini, Fari, MD; Lannon, Richard, MD; “A General Theory of Love”,  Random House, New York, 2000.
Dr. Lannon interviews at: www.paulagordon.com/shows/lannon/
Preface excerpts at:  www.nytimes.com/books/first/l/lewis-love.html
Dr. Lewis specifically on therapy:  www.goodreads.com/author/quotes/1503539.Thomas_Lewis

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The Adult Attachment Interview (AAI) (Pt.2 of 2): Mary Main’s Scary Parent Study

Scary Parents

Mary Main BerkeleyPart 1 of this blog Jan. 23 concluded that by 1978, Dr. Mary Ainsworth’s estimate for U.S. babies was that (A) 23% were Avoidant insecure (avoid parents); (B) only 69-70% were Securely Attached; and (C) 8% were Ambivalent insecure (unhappy and indecisive).  [FN1, 11]

By 1988, her Strange Situation study had been done with 2,000 infant-parent pairs in 32 studies in 8 countries. By 1999 it  had been done globally with 6,282 infant-parent pairs. Some countries varied, but worldwide results averaged out the same as Ainsworth’s 1978 original. [FN1, 9, 11]

In 1973 Mary Main [above] became Ainsworth’s grad student at Johns Hopkins in Baltimore, working on the Strange Situation experiments from the start. After her doctorate, Main moved to Berkeley, to see if Ainsworth’s Kampala and Baltimore findings would replicate.[FN8]  In 1978 she ran a Strange Situation study of 189 Bay Area infant-parent pairs and made the same findings. [FN10]

But by 1979 Dr. Main was making her own discoveries—out of concern about the parents. “In none of Ainsworth’s original observations was the possibility considered that some mothers… could also be frightening,” Main notes. “For my dissertation at Johns Hopkins, I watched 50 children in the Strange Situation… Using Ainsworth’s three-part classification (secure, avoidant and ambivalent), I found at least five infants could not be classified.”  Ainsworth was concerned, too; in fact, she’d left some babies in her Secure set only since they didn’t fit her other two sets. [FN8]

By 1982, Main decided to “extend attachment theory to include the import of infant exposure to anomalous fear-arousing parental behaviors… The mother is the haven of safety that must be approached in times of danger. However, when the infant’s biological haven of safety has simultaneously become a source of fright, the infant is placed in an irresolvable and disorganizing approach-flight paradox,” she said.  [FN8]

Soon after 1982, Main and Ainsworth agreed that some 15% of babies actually formed a new, fourth group: (D) Insecure Disorganized. Their mothers were so frightening that the babies couldn’t develop any consistent response at all. These infants “exhibited a diverse array of inexplicable or overtly conflicted behaviors in the parent’s presence” including “disorganization, disorientation, and confusion.” This includes crying loudly then suddenly freezing; ignoring the parent to rock on hands and knees; moving away; raising hand to mouth in fear; or even swiping at the parent’s face. They seemed vulnerable to dissociation.   [FN8, 11]

This finding that a whopping 15% of average U.S. babies are so insecure they’re almost incoherent was so shocking it was checked for years. [FN11, 12] But the number held. Worse, among children of American adolescent mothers the rate is over 31%, and is over 25% in many Third World nations. [FN13]

To remove the 15% of disorganized babies from Ainsworth’s original 69-70% Secure, reduced the Secure set to only 54-55%.  What was up with parents that 45-46% of their kids couldn’t manage secure attachment?  If so, Main would have  four categories: Avoidant 23%, Ambivalent 8%, Disorganized, 15%, Secure 55%.  [FN1, 11]

That was how researchers, including Dr. Benoit in footnote 1, read Main’s documents for 20 years 1990-2010. See also footnote 11.

In numerous writings, Main and colleagues called the disorganized group a new “fourth category,” a category in addition to Ainworth’s original three, and added that most disorganized subjects had been classed “secure” under Ainworth’s original three categories, but in fact belonged elsewhere.
FN12 Main M, & Solomon J (1986): ” …the majority of these…disorganized-disoriented infants would have been identified as secure… had we forced them into the standard classification system.
FN11 vanIjz1999, p.226 :  “the limits of the traditional Ainsworth et al. (1978) coding system became apparent because many children with an established background of abuse or neglect nevertheless had to be forced into the secure categoryDisorganization of attachment is usually considered a type of insecure attachment...”

Dr. Ainsworth herself, co-authoring a volume with Dr. Main in 1990, writes on page 480:  “… it is acceptable to consider adding…the fourth D category that Main identified as disorganized… Now that so much careful work has been done to explore the ramifications of this new category, it may be accepted as a valuable extension of the Strange Situation classificatory system.”

Recently, however, there has apparently been over-use and abuse of the term “disorganized” by social services and courts, such that Dr. Main’s group began around 2011 to criticize the “reification” of disorganized as a category:

“Main, Hesse, and Hesse (2011, p.441) have criticized the “widespread” and “dangerous” presumption that infants can be divided into four categories of comparable status… Solomon expresses particular concern:
“\’ The reification of our work from its context—and a lack of awareness of the grounding of our ideas in the behavioral and theoretical contributions of Bowlby and Ainsworth—has lead readers to treat D as a category equivalent in kind to ABC, rather than recognizing it as a phenomenon that runs orthogonal to the basic Ainsworth patterns. (personal communication, April 2013) ‘/ ”
from: “The Emergence of the Disorganized/Disoriented (D) Attachment Classification, 1979–1982,” by Robbie Duschinsky, Hist Psychol. 2015 Feb; 18(1): 32–46.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321742/
Cited within which: “Attachment theory and research: Overview with suggested applications to child custody,” Family Court Review, 49, 426–463, Main M., Hesse E., & Hesse S. (2011).

The Adult Attachment Interview (AAI)

Mary Main '09 Bowlby-Ainsworth award(Inge Bretherton,Everett Waters)Either way, by 1982 Main had seen enough to begin developing the Adult Attachment Interview (AAI).  She’d seen plenty of disorganized babies – that meant a lot of scary parents. She needed a way to document the behavior of parents. [FN14] (Right: Dr. Main receives the Bowlby-Ainsworth Attachment Award, 2009.)

The AAI was designed to document the level of secure, loving attachment the parents had, during their own childhoods with the babies’ grandparents. Parents were asked “both to described their attachment-related childhood experiences – especially their early relations with parents – and to evaluate the influence of these experiences on their development and current functioning.”

Parents were studied not just on facts they gave, but on how coherent a narrative they could produce quickly. That’s easy for folks who had a secure childhood, but difficult for folks who did not. The AAI questions are designed to “surprise the unconscious” to yield information about the “state of mind with regard to attachment” that might not otherwise show up. Each AAI was taped and transcribed verbatim. Then transcripts were classified by specific patterns by independent trained specialists. [FN15, 10]

In 1983 Main also created the “Berkeley Longitudinal Study” to take the Bay Area infant-parent pairs in her 1978 Strange Situation, and study them for a generation. In 1978, the babies were 12-18 months old; Main and her team re-studied these pairs when the kids reached age 6 in 1983, and studied the kids again when they reached 19 in 1996.  [FN8].   In 1983 Main and her team gave three completely different tests to the Bay Area pairs:

— 1. The six year olds were again studied with their parents in the Strange Situation (as in 1978 when they were infants).

— 2. The “sixes” were also individually (without parents) given a new Separation Anxiety Test (SAT): they were shown pictures of children being separated from their parents, then asked how they felt. This was taped, transcribed and sorted by Main’s student Nancy Kaplan into Ainsworth’s three sets: secure, avoidant and ambivalent. [FN16, 8]

— 3. The parents were given the AAI (without their kids). Responses were sorted into three set of adult attachment matching Ainsworth’s three 1978 categories of infant attachment: Secure-autonomous (matching infant Secure), Dismissing (infant Avoidant)  and Preoccupied (infant Ambivalent). (Main’s new 4th category wasn’t in use until after 1990.) [FN 17, 8, 10]

Astonishing Results You’ve Never Heard

Mary Main, Erik Hesse '09 Bolwby-Ainsworth AwardDr Main’s first 1983 results were so astonishing that attachment researchers have been buzzing ever since.  (Dr. Main and Dr. Erik Hesse, right.) Her results were also so important that it’s outrageous that your doctor never learned this in medical school; your therapist (and mine) never heard of this; you’ve never heard of it; and so you have to read about it here, since the media doesn’t report it. It’s hard to even find this story on the internet; I had to sleuth it out.  Her results were:

First: the six year olds’ 1983 responses with parents in the Strange Situation correlated strongly to their 1978 responses in the Strange Situation as infants five years earlier. In 1978 the infants were Securely attached 69%;  Avoidant 23%, and Ambivalent 8%. In 1983 the same kids at six were the same as they had been as infants, in the same percents. [FN7]

Second: the six year olds’ 1983 solo responses to the SAT photos also produced the same results and percentages.

Third: The parents’ 1983 solo responses to the Adult Attachment Interview correlated strongly with just how their own kids had behaved as infants, five full years earlier.  The parents also turned out to be Secure-autonomous (matching infant “Secure”) 69%;  Dismissing (matching infant “Avoidant”) 23%;  and Preoccupied (matching infant “Ambivalent”) 8%.

Fourth:  The match of the parents’1983 AAI security with how securely their babies behaved five years back in 1978, was at an unheard-of level. It correlated more than 70% of the time, in a field where a 20% correlation is highly significant. “A marked relation between a parent’s discussion of his/her own attachment history (AAI), and the offspring’s Strange Situation behavior 5 years previously, had been uncovered.”  [FN8, 10]

Fifth: When the 1978 infants reached age 19 in 1996, they too were given the Adult Attachment Interview. Again results correlated strongly: the 19 year olds’ responses in the AAI in 1996, correlated precisely to their infant behavior in the Strange Situation in 1978, their behavior at six in 1983, and to their parents’ 1983 AAI responses.

That means the Strange Situation predicts an infant’s behavior for life, and the AAI proves it.  [FN8, 10]

Sixth: When after 1990 Mary Main’s four categories were used, the results of all the tests were just as strongly correlated across Main’s four categories, as when data were sorted into only three sets. Main’s four categories did become Avoidant 23%, Ambivalent 8%, Disorganized, 14-15%, and Secure 54-55%.  Whenever responses to the Strange Situation, SAT, and AAI were sorted into these four sets,  the same percents were found. [FN1, 11]

By 2009, over 10,500 subjects globally had been given the AAI and the results continued to average out the same.  [FN18]

“Researchers worldwide have replicated the relation originally uncovered in the Bay Area study between a parent’s status in the Adult Attachment Interview and an infant’s Strange Situation response to that same parent… The same average parent-to-child, secure/insecure match of 75% holds even when the interview is conducted before birth of the first child…

“Describing the strength of this relation across studies conducted several years ago, van I Jzendoorn (1995) calculated that it would take 1,087 further attempted replications, every one yielding insignificant results, to reduce the present relation between adult and infant attachment status to insignificance,” Main concluded. [FN7, p.1091]

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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.

Footnotes

FN1  NIH: Benoit, Diane, MD, FRCPC, “Infant-parent attachment: Definition, types, antecedents, measurement and outcome,” Paediatr Child Health, Oct 2004; 9(8) p. 541–545 at: www.ncbi.nlm.nih.gov/pmc/articles/PMC2724160/  4th subhead “Measurement” reports:
“The three ‘organized’ strategies (secure, avoidant and resistant) are assessed in the Strange Situation (SS), a 20-minute laboratory procedure where patterns of infant behaviour toward the caregiver following two brief separations are categorized… “Infants with secure attachment greet and/or approach the caregiver and may maintain contact but are able to return to play, which occurs in 55% of the general population… Infants with insecure-avoidant attachment fail to greet and/or approach, appear oblivious to their caregiver’s return… avoiding the caregiver, which occurs in 23% of the general population. Infants with insecure-resistant [ambivalent] attachment are extremely distressed by separations and cannot be soothed at reunions,  displaying much distress and angry resistance to interactions with the caregiver, which occurs in 8% of the general population.” [This NIH article earlier reports that the remaining “approximately 15% suffer insecure ‘disorganized’ attachment,” citing their own footnote which states “In normal, middle class families, about 15% of  infants develop disorganized attachment.” [23%+8%+15%  = 46% not securely attached.]

FN2  Felitti VJ, MD; Anda RF, MD, et. al, 1998, “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.  Detailed article on the ACE Study: http://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/

FN3  Karr-Morse, Robin, Wiley, Meredith,  “Scared Sick,”  Penguin Basic Books, 2012

FN4  Porges, Stephen, PhD, “Body, Brain, Behavior: How Polyvagal Theory Expands Our Healing Paradigm,” 2013, http://stephenporges.com/images/NICABM%202013.pdf
“Beyond the Brain: Vagal System Holds the Secret to Treating Trauma,” 2013, http://stephenporges.com/images/nicabm2.pdf
–“The Polyvagal Theory for Treating Trauma,” 2011, http://stephenporges.com/images/stephen%20porges%20interview%20nicabm.pdf
–“Polyvagal theory: phylogenetic substrates of a social nervous system,” International Journal of Psycho-physiology 42, 2001,  Dept. of Psychiatry, Univ. Illinois Chicago, www.wisebrain.org/Polyvagal_Theory.pdf

FN5   Earned secure attachment occurs when we experience harmful parenting, so we start with insecure attachment, but find ways to “rise above” childhood trauma and “are now securely attached… What’s more important than what happened to us, is how we’ve made sense of our own childhood,” Dr. Dan Siegel says. “When we make sense of our past… we become free to construct a new future for ourselves and for how we parent our children. Research is clear: If we make sense of our lives, we free ourselves from the prison of the past.”  (Source: video by Dr. Mary Main, Dr. Erik Hesse, Dr. Daniel J. Siegel, Dr. Marion Solomon: https://www.youtube.com/watch?v=YJTGbVc7EJY )
The question is: what ways?  How do we “rise above” and “make sense” of our childhood trauma?
“Mindfulness has been shown to be effective in healing insecure attachment,” say Siegel’s recent writings. “The purpose of both psychotherapy and mindfulness practice is to provide this internalized secure base. Attunement, whether it is internal in mindfulness, or interpersonal in attachment, is what leads to a sense of secure base.” (The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration, W.W. Norton, 2010;   Mindsight: The New Science of Personal Transformation,  Random House, 2010).
“The regular exercise of mindful awareness seems to promote the same benefits–bodily and affective self-regulation, attuned communication with others, insight, empathy, and the like–that research has found to be associated with childhood histories of secure attachment,” Siegel wrote earlier. “ Mindfulness and secure attachment alike are capable of generating… the same invaluable psychological resource: an internalized secure base.” (Siegel, 2007, Wallin, 2007, p. 5-6).
In his 1999 book “The Developing Mind: How Relationships and the Brain interact to shape who we are,” (Guilford Press),  Siegel defined “earned secure/autonomous attachment” as a pattern noticed by therapists doing the Adult Attachment Interview:  “individuals whose experiences of childhood… [were] likely to produce insecure attachment (avoidant, ambivalent, or disorganized),” but their AAI interview responses instead show “a fluidity in their narratives and a flexibility in their reflective capacity, such that their present state of mind with respect to attachment is rated as secure/autonomous. These individuals often appear… to have had a significant emotional relationship with a close friend, romantic partner, or therapist, which allowed them to develop out of  insecure…into a secure/autonomous AAI status.”

FN6  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

FN7  Main, Mary,  2000, “The Adult Attachment Interview: Fear, attention, safety and discourse processes;” also titled “The Organized Categories of Infant, Child, and Adult Attachment: Flexible vs. Inflexible Attention Under Attachment-Related Stress,” Jour of Amer Psychoanalytic Assoc, 48:1055-1095; 2000.  *p.1091: “The same average parent-to-child, secure/insecure match of 75% holds even when the interview is conducted before birth of the first child…” Lifespanlearn.org/documents/Main.pdf

FN8  Main, Mary, 2005, with Hesse, Erik & Kaplan, Nancy, “Predictability of Attachment Behavior and Representational Processes at 1, 6, and 19 Years of Age – The Berkeley Longitudinal Study,” Chapter 10 of “Attachment from Infancy to Adulthood: The Major Longitudinal Studies,” edited by Klaus E. Grossmann, Karin Grossmann, and Everett Waters, pp. 245–304, New York: Guilford Press. Main refers to it as “Regensburg.”
https://lifespanlearn.org/documents/5.Main Regensburg 2005 .pdf
–Main’s summary of the Strange Situation in this document:
“Ainsworth structured the Strange Situation procedure to include three of Bowlby’s ‘natural clues to danger’ in eight episodes:  1. Introduction to the room.  2. Mother and infant are left alone in a toy-filled environment whose unfamiliarity supplies the first natural clue to danger.  However, the mother’s presence is expected to provide the infant with security sufficient for exploration and/or play.  3. Providing a second clue to danger, a stranger joins the mother and infant.  4. The mother leaves the infant with the stranger, providing two combined clues to increased danger. 5. The mother returns, and the stranger departs…. Many infants initially seek proximity but then, reassured of their mothers’ nearness, resume play. 6.  The mother leaves, and the infant remains entirely alone in the unfamiliar setting. Infant distress can be strong at this point, and this episode is often terminated rapidly. 7. The stranger, rather than the mother, enters the room. 8. The mother returns… By now, most infants are expected to be crying, and actively not only seeking proximity to mothers, but also… indicating a strong desire to be held… Nonetheless, they are expected to settle and renew interest in exploration and play by the end of this 3-minute period…
“Somewhat surprisingly, Ainsworth found that infant responses to separation and reunion in this procedure fell into three distinct, coherently organized patterns of attachment (“secure,” “insecure-avoidant,” and “insecure-ambivalent” (Ainsworth, Blehar, Waters, & Wall, 1978). … Given the length and complexity of this chapter, we suggest individuals divide reading to its three central parts (secure attachment, pp. 261–273; avoidant attachment, pp. 273–279; and disorganized attachment pp. 279–288).”

FN9  (1988 van Ijzendoorn: on global proof of Ainsworth’s 3 categories; written before Main’s 4 category put in use)
van IJzendoorn, Marinus H.; Kroonenberg, Pieter M.  “Cross-Cultural Patterns of Attachment: A Meta-Analysis of the Strange Situation,” Child Development,Vol 59 No 1, Feb 1988, p.147–56.   Abstract: http://www.jstor.org/discover/10.2307/1130396?uid=3739560&uid=2&uid=4&uid=3739256&sid=21103831443011

FN10   Hesse, E., (2008) “The Adult Attachment Interview: Protocol, Method of Analysis, and Empirical Studies,” Chap. 25 of Cassidy, Jude &  Shaver, Phillip R. (Eds), “Handbook of Attachment: Theory, research, and clinical applications,” 2nd edition, 2008, p. 552-598, New York, Guilford Press. It was online (I downloaded it Aug. 2014) but was taken down or has web issues; try here: http://icpla.edu/wp-content/uploads/2012/10/Hesse-E.-Adult-Attachment-Int-Protocol-Method-ch.-25.pdf   [His 1999 version in Cassidy & Shaver’s 1st edition, Chap. 19,  “The Adult Attachment Interview: Historical and current perspectives,” p. 395-433 wasn’t online.]

FN11  van IJzendoorn MH, Schuengel C, Bakermans-Kranenburg MJ, Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants and sequelae. Dev Psychopathol. 1999; 11:225–49. [PubMed] at https://openaccess.leidenuniv.nl/bitstream/handle/1887/1530/168_212.pdf?sequence=1

FN12  Main, Mary, & Solomon, Judith, (1986), “Discovery of an insecure disoriented attachment pattern: procedures, findings and implications for the classification of behavior,” in Brazelton T, Youngman M. Affective Development in Infancy, Ablex, Norwood, NJ
Main, M., & Solomon, J. (1990). “Procedures for identifying infants as disorganized/disoriented during the Ainsworth strange situation,” in Greenberg, M. T., Cicchetti, D., & Cummings, M. (Eds.),. Attachment in the preschool years: Theory, research, and intervention (pp. 121-160), University of Chicago Press

FN13  “Among children of American adolescent mothers, the rate is over 31% (Broussard 1995). Disorganized attachment is also common among the Dogon of Mali (~25%, True et al 2001), infants living on the outskirts of Cape Town, South Africa (~26%, Tomlinson et al 2005) and undernourished children in Chile (Waters and Valenzuela 1999),” reports NIH [op cit FN1; NIH cites v. Ijzendoorn 1999 and the other authors just mentioned]

FN14  George, Carol, Kaplan, Nancy, & Main, Mary, “Adult Attachment Interview,” Unpublished MS, Department of Psychology, University of California at Berkeley, third ed. 1996.  Original 74-page MS dated 1984, 1985, 1996.  Described in FN10 op cit Hesse 2008. ( I have it, but it was removed from the web during 2014.)

FN15  Main, Mary B., “Adult Attachment Interview Protocol,” 11 pgs, 20 questions, no date or publisher. Dr. Main requires intensive training for use of the AAI. The questions per se, marked “Do not reproduce this material without permission of the author,”  are here:  http://www.psychology.sunysb.edu/attachment/measures/content/aai_interview.pdf   UCLA’s Lifespan Learning Institute in Los Angeles holds AAI workshops and has an extensive CD  lectures on the AAI at www.lifespanlearn.org

FN16  Kaplan, Nancy, (1987), Separation Anxiety Test (SAT): “Individual differences in six-year-olds’ thoughts about separation: Predicted to actual experiences of separation,”  Unpublished doctoral dissertation, University of California, Berkeley.
Kaplan, N. (2003, April), “The development of attachment in the Bay Area study: One year, six years, nineteen years of age.” Paper at the biennial meeting of the Society for Research in Child Development, Tampa, FL.

FN17  Main 1985; Main & Goldwyn 1984

FN18  Bakermans-Kranenburg MJ, van IJzendoorn MH, “The first 10,000 Adult Attachment Interviews,” Attach Hum Dev. 2009 May; 11(3): 223-63. doi: 10.1080/14616730902814762 at http://www.ncbi.nlm.nih.gov/pubmed/19455453

More by Mary Main on the AAI:
Main, Mary, PhD, “Introduction to the special section on attachment and psychopathology: 2. Overview of the field of attachment,” Journal of Consulting and Clinical Psychology, 64, 237-243, 1996
Steele, Howard and Miriam, Editors, “Clinical Applications of the Adult Attachment Interview,” The Guilford Press,  New York, 2008

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The Adult Attachment Interview (AAI) (Pt.1 of 2): Mary Ainsworth’s Strange Situation

Mary Main & Dan Siegel December-2010-UCLAOnly 55% of us had “secure attachment” as infants, according to research on 6,281 infant-parent pairs done during 1970-1999. [FN1, 2]  This would worry us all if we knew what it meant, because the other 45% of us suffer “insecure attachment.”  That means 45% of us have trouble with committed relationships.

It’s worrisome because the attachment we had as kids continues all our lives in our relationships, say related studies of over 10,500 adults done during 1982-2009. [FN3]  Plus, we pass our “insecurity” on to our own children.

These are the “quiet blockbuster” results of, first, Dr. Mary Ainsworth’s 1970-1978 “Strange Situation” study of babies, as extended by her assistant Dr. Mary Main. (Dr. Main & Dr. Daniel J. Siegel, above)

Second, Dr. Main discovered enough upset babies to become concerned about the parents. She created the Adult Attachment Interview (AAI) to study the adults in 1982. Her results, released 1984-96, showed 42-45% of adults were not securely attached, analogous to the infants above.

This 45% “insecure” figure starts to explain why we’ve got a 50% divorce rate, If  (like me) you’ve tried dating after divorce, it won’t surprise you that science shows almost half the adults out there can’t manage a secure, committed, relationship. Ouch, you’ve experienced it.

And if 45% of us were “insecurely attached” in 1999, what’s the percent in 2017?  In 1999 most of us hadn’t heard of the internet. In almost 20 years since, email, texting, and so on have further trashed our ability to relate in person. Several psychotherapists interviewed for this blog said that a round number of “about 50%” is a  conservative estimate for how many Americans lack secure attachment today. Many believe it’s much higher.

Here’s more “about 50%” data.  The 1998 Adverse Childhood Experiences (ACE) Study showed that 64-67% of  17,421 middle class subjects had one or more types of childhood trauma, and 38-42% had two or more types.  In less privileged populations, these numbers are far higher. A national average of all economic groups would likely show 50% or more suffer ACE trauma.

The ACE Study lists physical and sexual abuse and 8 other types, including traumas that happen to newborns like physical and emotional neglect. Such trauma puts children into “fight-flight,” a chronic state proven to shut down the organism’s capacity for feelings of attachment and love. Think soldier in a battle, ramped up in “fight-flight”– he’s not into love. [FN4]

Half of us are in serious emotional health and medical trouble,  and don’t even know it.  Let’s get informed; then we can heal. If we didn’t get securely attached as kids, we can develop “earned secure attachment.”  “It’s possible to change attachment patterns,” as Main’s colleagues Dr. Dan Siegel and Dr. Marion Solomon say. [FN5]

 Strange Situation  Experiment

bowlby-johnAttachment Theory isn’t new, it just gets too little air time. British psychiatrist John Bowlby (left) developed it in the 1950s while dealing with the post-WWII crisis of dislocated orphans. [FN6]  Bowlby believed that all infants would seek to stay close to parents, since “proximity-seeking behavior” is best for survival. In 1952 he published a study of toddlers’ responses to separation from parents. It showed that “when toddlers were placed in unfamiliar surroundings that provided no stable caregivers, they underwent three… stages of response to separation: protest, despair, and finally detachment,” writes Mary Main. [FN7]

Mary Ainsworth ca 1990Dr. Mary Ainsworth studied with Bowlby in London 1950-54, then studied this same “proximity-seeking behavior” (attachment) in infant-mother pairs in homes in Kampala, Uganda, published as “Infancy in Uganda” (1967).  Next, she “found astonishing similarities”  in Baltimore, MD pairs. [FN7]

So Ainsworth created the Strange Situation in the early 1970s, as a science experiment at Johns Hopkins in Baltimore to document this infant behavior. “Ainsworth deliberately structured the Strange Situation to include three of Bowlby’s ‘natural clues to danger’… to arouse babies to seek proximity” to the parent, Main says. Researchers watch and video-tape through one-way glass, as infant-mother pairs react to apparent danger.  First the babies respond to the strange lab room; then to two entrances of a stranger; then separation from mother at two different times. [FN8]

All or most babies were expected to stay close to parents as Bowlby thought.  Such babies “that Ainsworth termed ‘secure,’ play and explore happily prior to separation; show signs of missing the parent during separation, such as crying and calling; seek proximity immediately upon the parent’s return; and then return to play and exploration, ‘secure’ once again in the parent’s presence,” said Main. [FN8]

But 30% of babies did not act secure — they avoided mom.  Given a choice, they show no preference between mom and the stranger.  “While a majority of infants behaved as expected and were termed secure, to Ainsworth’s amazement six showed little or no distress at being left alone in the unfamiliar environment, and then avoided and ignored the mother upon her return.”  [FN7]

Ainsworth decided to categorize these babies separately, as “avoidant” of mother, so now she had two types: (A) Insecure Avoidant, and (B) Secure. She concluded that their mom didn’t respond to them, or respond with enough sensitivity to understand their actual need, so the infants felt “insecure.”  [FN8]

Still later Ainsworth saw that of the insecure babies, some had yet a third reaction: actually, they were “ambivalent” about mom. They were very distressed when mom left, but on her return, they alternated between avoiding and frantic clinging–plus, they never calmed down. Research showed that ambivalent attachment results from moms who are sometimes available, sometimes not, so babies learn they can’t depend on mom to be there when they need her.

Thus it was that “surprisingly, Ainsworth found that infant responses to separation and reunion fell into three distinct, coherently organized patterns of attachment,” and added a third category: (C) Insecure Ambivalent, Main reports. [FN8-9]

By 1978, Ainsworth’s estimate for U.S. babies was (B) Securely attached 69%; (A) Avoidant 23%, (C) Ambivalent 8%.

By 1988, her Strange Situation study had been done with 2,000 infant-parent pairs in 32 studies in 8 countries. By 1999 it  had been done globally with 6,282 infant-parent pairs. Some countries varied, but the worldwide results averaged out the same as Ainsworth’s 1970s studies. Amazing, but it makes sense considering the U.S. is a global melting pot. [FN1, 9, 11]

But stay tuned for my next blog Feb. 6, when Ainsworth’s grad student Mary Main gets into the act big time.  Main found that Ainsworth’s concept of Securely Attached had flaws that made necessary a whole new fourth category of attachment failure.  And a whole lot fewer than 69% turned out to be “secure.”

If you can’t wait for Part 2 on Feb. 6, the whole article is here: http://attachmentdisorderhealing.com/adult-attachment-interview-aai-mary-main/

———————————
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  NIH: Benoit, Diane , MD, FRCPC, “Infant-parent attachment: Definition, types, antecedents, measurement and outcome,” Paediatr Child Health, Oct 2004; 9(8) p. 541–545 at: www.ncbi.nlm.nih.gov/pmc/articles/PMC2724160/  4th subhead “Measurement” reports:
“The three ‘organized’ strategies (secure, avoidant and resistant) are assessed in the Strange Situation (SS), a 20-minute laboratory procedure where patterns of infant behaviour toward the caregiver following two brief separations are categorized… “Infants with secure attachment greet and/or approach the caregiver and may maintain contact but are able to return to play, which occurs in 55% of the general population… Infants with insecure-avoidant attachment fail to greet and/or approach, appear oblivious to their caregiver’s return… avoiding the caregiver, which occurs in 23% of the general population. Infants with insecure-resistant [ambivalent] attachment are extremely distressed by separations and cannot be soothed at reunions,  displaying much distress and angry resistance to interactions with the caregiver, which occurs in 8% of the general population.” [This NIH article earlier reports that the remaining “approximately 15% suffer insecure ‘disorganized’ attachment,” citing their own footnote which states “In normal, middle class families, about 15% of  infants develop disorganized attachment.” [23%+8%+15%  = 46% not securely attached.]

FN2  Felitti VJ, Anda RF, et. al, 1998, “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.  Detailed article on the ACE Study: http://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/

FN3  Karr-Morse, Robin, Wiley, Meredith,  “Scared Sick,”  Penguin Basic Books, 2012

FN4  Porges, Stephen, PhD, “Body, Brain, Behavior: How Polyvagal Theory Expands Our Healing Paradigm,” 2013, http://stephenporges.com/images/NICABM%202013.pdf
“Beyond the Brain: Vagal System Holds the Secret to Treating Trauma,” 2013, http://stephenporges.com/images/nicabm2.pdf
–“The Polyvagal Theory for Treating Trauma,” 2011, http://stephenporges.com/images/stephen%20porges%20interview%20nicabm.pdf
–“Polyvagal theory: phylogenetic substrates of a social nervous system,” International Journal of Psycho-physiology 42, 2001,  Dept. of Psychiatry, Univ. Illinois Chicago, www.wisebrain.org/Polyvagal_Theory.pdf

FN5   Earned secure attachment occurs when we experience harmful parenting, so we start with insecure attachment, but find ways to “rise above” childhood trauma and “are now securely attached… What’s more important than what happened to us, is how we’ve made sense of our own childhood,” Dr. Dan Siegel says. “When we make sense of our past… we become free to construct a new future for ourselves and for how we parent our children. Research is clear: If we make sense of our lives, we free ourselves from the prison of the past.”  (Source: video by Dr. Mary Main, Dr. Erik Hesse, Dr. Daniel J. Siegel, Dr. Marion Solomon: https://www.youtube.com/watch?v=YJTGbVc7EJY )
The question is: what ways?  How do we “rise above” and “make sense” of our childhood trauma?
“Mindfulness has been shown to be effective in healing insecure attachment,” say Siegel’s recent writings. “The purpose of both psychotherapy and mindfulness practice is to provide this internalized secure base. Attunement, whether it is internal in mindfulness, or interpersonal in attachment, is what leads to a sense of secure base.” (The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration, W.W. Norton, 2010;   Mindsight: The New Science of Personal Transformation,  Random House, 2010).
“The regular exercise of mindful awareness seems to promote the same benefits–bodily and affective self-regulation, attuned communication with others, insight, empathy, and the like–that research has found to be associated with childhood histories of secure attachment,” Siegel wrote earlier. “ Mindfulness and secure attachment alike are capable of generating… the same invaluable psychological resource: an internalized secure base.” (Siegel, 2007, Wallin, 2007, p. 5-6).
In his 1999 book “The Developing Mind: How Relationships and the Brain interact to shape who we are,” (Guilford Press),  Siegel defined “earned secure/autonomous attachment” as a pattern noticed by therapists doing the Adult Attachment Interview:  “individuals whose experiences of childhood… [were] likely to produce insecure attachment (avoidant, ambivalent, or disorganized),” but their AAI interview responses instead show “a fluidity in their narratives and a flexibility in their reflective capacity, such that their present state of mind with respect to attachment is rated as secure/autonomous. These individuals often appear… to have had a significant emotional relationship with a close friend, romantic partner, or therapist, which allowed them to develop out of  insecure…into a secure/autonomous AAI status.”

FN6  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

FN7  Main, Mary,  2000, “The Adult Attachment Interview: Fear, attention, safety and discourse processes;” also titled “The Organized Categories of Infant, Child, and Adult Attachment: Flexible vs. Inflexible Attention Under Attachment-Related Stress,” Jour of Amer Psychoanalytic Assoc, 48:1055-1095; 2000.  *p.1091: “The same average parent-to-child, secure/insecure match of 75% holds even when the interview is conducted before birth of the first child…” Lifespanlearn.org/documents/Main.pdf

FN8  Main, Mary, 2005, with Hesse, Erik & Kaplan, Nancy, “Predictability of Attachment Behavior and Representational Processes at 1, 6, and 19 Years of Age – The Berkeley Longitudinal Study,” Chapter 10 of “Attachment from Infancy to Adulthood: The Major Longitudinal Studies,” edited by Klaus E. Grossmann, Karin Grossmann, and Everett Waters, pp. 245–304, New York: Guilford Press. Main refers to it as “Regensburg.”
https://lifespanlearn.org/documents/5.Main Regensburg 2005 .pdf
–Main’s summary of the Strange Situation in this document:
“Ainsworth structured the Strange Situation procedure to include three of Bowlby’s ‘natural clues to danger’ in eight episodes:  1. Introduction to the room.  2. Mother and infant are left alone in a toy-filled environment whose unfamiliarity supplies the first natural clue to danger.  However, the mother’s presence is expected to provide the infant with security sufficient for exploration and/or play.  3. Providing a second clue to danger, a stranger joins the mother and infant.  4. The mother leaves the infant with the stranger, providing two combined clues to increased danger. 5. The mother returns, and the stranger departs…. Many infants initially seek proximity but then, reassured of their mothers’ nearness, resume play. 6.  The mother leaves, and the infant remains entirely alone in the unfamiliar setting. Infant distress can be strong at this point, and this episode is often terminated rapidly. 7. The stranger, rather than the mother, enters the room. 8. The mother returns… By now, most infants are expected to be crying, and actively not only seeking proximity to mothers, but also… indicating a strong desire to be held… Nonetheless, they are expected to settle and renew interest in exploration and play by the end of this 3-minute period…
“Somewhat surprisingly, Ainsworth found that infant responses to separation and reunion in this procedure fell into three distinct, coherently organized patterns of attachment (“secure,” “insecure-avoidant,” and “insecure-ambivalent” (Ainsworth, Blehar, Waters, & Wall, 1978). … Given the length and complexity of this chapter, we suggest individuals divide reading to its three central parts (secure attachment, pp. 261–273; avoidant attachment, pp. 273–279; and disorganized attachment pp. 279–288).”

FN9  (1988 van Ijzendoorn: on global proof of Ainsworth’s 3 categories; written before Main’s 4 category put in use)
van IJzendoorn, Marinus H.; Kroonenberg, Pieter M.  “Cross-Cultural Patterns of Attachment: A Meta-Analysis of the Strange Situation,” Child Development,Vol 59 No 1, Feb 1988, p.147–56.   Abstract: http://www.jstor.org/discover/10.2307/1130396?uid=3739560&uid=2&uid=4&uid=3739256&sid=21103831443011

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Neurofeedback: Healing the Fear-Driven Brain

Sebern FisherPsychotherapist Sebern Fisher gave a great webcast on October 22, 2014 in the NICABM series, about neurofeedback (biofeedback to the brain), which gives us access to our brain function frequencies.

Neurofeedback, she said, is a computer program therapists use in their office, training clients on it to get them in touch with their own brain waves, learn what’s good for the brain, and calm their thoughts.

The brain is organized from the womb in oscillatory patterns, Ms. Fisher says, so we with developmental trauma, early neglect and abuse, have disorganized and dysregulated brains.  Our fear circuits dominate.  Neurofeedback can calm these erupting circuits and even grow neural connectivity, which helps us create a more coherent sense of self, so we feel safer and more centered. [FN1]

Folks with difficult parents often grow up with a “fear-driven brain” as I did — and it’s a huge relief to find out we’re not freaks — we’re a chunk of the mainstream.  In fact, maybe 50% of Americans have some degree of this “attachment disorder” due to parents who were too scary to attach to. Of course it’s not their fault either; odds are, our grandparents were too scary for our parents to attach to, and so on back, inter-generationally.

I was particularly struck watching Ms. Fisher’s NICABM video as she repeated again and again how many people are walking around with a “fear-driven brain.”  Her 2010 radio interview “Attachment Disorder, Developmental Trauma and Neurofeedback” says she spent decades trying to heal kids with early attachment wounds, but found we can’t talk to the parts of the brain formed from conception to 36 months; those parts have no speech. So she made no progress until she tried neurofeedback in 1996. It can talk to those parts: http://www.futurehealth.org/Podcast/Sebern-Fisher-Attachment-by-Rob-Kall-100516-497.html

I’d bet maybe 20% of us have “developmental trauma” like that, as I do, which means that life was one continuous trauma “since the sperm hit the egg.” For what it looks like when Mom is too scary for her child to attach, check http://attachmentdisorderhealing.com/developmental-trauma-2/

I was moved to tears by Ms. Fisher’s more recent interview “Neurofeedback in the Treatment of Developmental Trauma,” as she described how deeply necessary love and attachment are to the creation of a human brain. It’s because we crave the regulation of our nervous system which love can bring, that our brains respond to neurofeedback signals which feel calmer and even loved: http://shrinkrapradio.com/452-neurofeedback-in-the-treatment-of-developmental-trauma-with-sebern-fisher-m-a/

And: here’s an amazing blog by Dr. Tina Hahn MD, “My Neurofeedback Journey,” on the BrainPaint® home neurofeedback system she’s using.

Find a Neurofeedback Practitioner: Online Directories:
1. EEG Spectrum International [Ms. Fisher’s husband John Fisher was president of this co.] Directory: http://www.esiaffiliatesforum.com/providers
2. EEG Institute Provider Directory: http://directory.eeginfo.com/

Trauma, Up Front and Personal

Ms. Fisher got into therapy and attachment work in the first place because she herself had developmental trauma.  She also had a lot of head injury and traumatic brain injury.  One of the first things to be healed when Ms Fisher began neurofeedback herself were her terrible migraines, which have never returned.  She still uses neurofeedback because, she says, “I have had a lot of head injuries so I am at a greater risk of Alzheimer’s than other people, but all of the signs of head injury and traumatic brain injury that I had are all gone.”

Here are some salient quotes from Ms. Fisher’s  NICABM interview:

“Neurofeedback is biofeedback to the neuronal activity of the brain. It is a computer interface where you pick up the firing of the brain in the EEG (electro-encephalogram) in real-time, scrolling for a therapist and client to look at together. By challenging their brain through feedback, we can see that the EEG is changing,” she starts.

“And obviously the change that I am most concerned about is change in levels of fear. Mostly what I am concerned about is quieting fear, so let’s take that situation. We know that the fear circuits are in the temporal lobe and that survival’s fear circuit, the survival amygdala, is in the right hemisphere. We’re trying to say to the brain – not to the person– “Stop practicing that fear-driven over-arousal. Chill. Get quiet!”

“Now, if people could do this on their own, they wouldn’t need the game or the neurofeedback. [So she’s never harsh on the person; she just re-trains their brain.] We have to find the frequency that works for that particular individual – it’s going to be different for everyone. They tell me two or three days later that, on the whole, they have been calm, they have been sleeping, they are less reactive, and/or they are making easier eye contact. That is what I mean by works….

“I had a young woman, who had been adopted from a third-world country. She had been in an orphanage after having been delivered in a shoebox from a police station. They fed her with an eyedropper, not ever expecting that she was going to live. She had every possible level of disorganization: she couldn’t read; she bumped into doorjambs; she had a very difficult time negotiating through life.

“I was now meeting her out of a mental hospital, and she was in her twenties. [After neurofeedback training] she comes in and tells me this story. She was always the last one chosen for any sports team, as you can imagine, when she was a kid, and now she’s stabilized enough to be dating. She is out with a guy, they are waiting to go to a movie, and they go to a batting cage – she hits 90% of the balls. Therapy could never get somebody from bumping into walls to being able to hit 90% of the balls! Her boyfriend was very impressed…

“Neurofeedback is deeply organizing to the nervous system. This goes deep into the nervous system; neurofeedback is healing deep into the CNS, the central nervous system, and through the brain.

“I had one patient who was given the diagnosis of Borderline Personality Disorder and had been hospitalized multiple times. She very much wanted to do neurofeedback training because she felt like she had gone as far as she could with psychotherapy, and she still wanted to drive off a bridge every day!  We used two different protocols: the eyes-open protocol – it doesn’t matter what the specifics were for her – but she got stabilized in 20 sessions, and then we did the alpha-theta protocol. She did 30 or 40 sessions. All together, she had about 60 sessions, then it was over. She did not meet any criteria for Borderline Personality and she no longer wanted to jump off a bridge.

“She actually got married and had a baby, and went on to advance her career. I saw her once after that ending, and it was when a pet that had been her primary object of attachment, was killed in a freak accident. She came back in and she was very distressed. An additional trauma can also throw the brain back into its known pattern of firing. So we trained about four times, to address the state she was in, and she very quickly reorganized and was off again.

Repair of Attachment with Neurofeedback

(Interviewer Dr. Buczynski): “How do you think of attachment and repairing of attachment in regard to neurofeedback?

Fisher: “Oh, that’s a wonderful question, and it is somewhat amazing that this happens. In my experience, what I have seen is that people always seem to want relational connection.

“Things can get in the way – if you are having something akin to a seizure and you’re constantly living in fear; it is very difficult to imagine relationship as a primary part of your life. But we are social creatures; we are meant to relate to one another. That is our safety; that is our harbor, as my patient said, and when you find a way to quiet the fear-driven brain, what emerges quite spontaneously are the attachment circuits.

“I had one patient who was self-abusing and dissociative when she came into sessions. She had not seen her mother nor talked about her mother – so this wasn’t a result of conversation – but her mother had not behaved ideally. She came in one day [after neurofeedback treatment] and said, “I think you might be interested in this: I called my mother last night.” It was spontaneous, and now we could talk about the reality of her mother’s trauma.

“Now, this had been presented to her multiple times, and it even occurred to her, but the dysregulation and high arousal of her nervous system made it pretty meaningless. I see that happening a lot. I see spontaneous family reunion that I have nothing to do with orchestrating, and often, without even talking about it, I see it happen with people who train their brains.”

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Kathy’s 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 “Neurofeedback: Soothe the Fear of a Traumatized Brain: How a New Intervention Is Changing Trauma Treatment,” Sebern Fisher, MA, BCN, Psychotherapist and Neurofeedback practitioner, Private Practice, Northampton, MA;  10-22-14 Webinar interview by Dr. Ruth Buczynski, National Institute for the Clinical Application of Behavioral Medicine (NICABM), http://www.nicabm.com/treatingtrauma2014/post-info/

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Comments are encouraged with the usual exceptions; rants, political speeches, off-color language, etc. are unlikely to post.  Starting 8-22-16, software will limit comments to 1030 characters (2 long paragraphs) a while, until we get new software to take longer comments again.

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California ACEs Summit

CA ACEs Summit Nov.2014At California’s first ACEs summit November 5-7, “Children Can Thrive,” over 200 health professionals, policy leaders and advocates gathered in San Francisco. They created a national model for a statewide dialogue on the biggest public health problem facing California today: Adverse Childhood Experiences (ACEs).  They focused on programs in health, education, juvenile justice and child welfare at the local and state levels, and how national policies can support those efforts.

Also exciting, Google.org announced a $3 million grant November 3 to the Center for Youth Wellness (CYW), the clinic started by Dr. Nadine Burke Harris, organizer of the CA ACEs Summit.  The grant is specifically aimed to get enough scientific documentation that childhood trauma causes adult onset diseases, to actually make toxic stress a diagnosis code billable for insurance: http://www.sfgate.com/bayarea/article/Google-gives-3-million-to-Nadine-Burke-Harris-5865372.php

Dr. Harris’ clinic “focuses on what is known as adverse childhood experiences and toxic stress — issues like neglect, abuse, exposure to violence and household dysfunction that can damage a child’s developing brain and body.  Burke Harris said that 1 in 10 of the children she sees has experienced not just one of those traumas, but four or more,” the San Francisco Chronicle reported November 3. “Even though Burke Harris’ work has been lauded by former Secretary of State Hillary Rodham Clinton — who featured the doctor in a video for her Too Small to Fail philanthropic campaign last year — it has been a challenge raising enough money….

“/’This grant is built on science,’ said Google’s Justin Steele. “If they prove it works in Bayview, we’d love to see it scale up across the country.’  …Burke Harris said the grant will enable her team to develop a clinical protocol to address toxic stress. That will be key to making the issue into something that insurance companies can understand — and cover. Now, insurers don’t.”

Summit on Adverse Childhood Experiences
by Jane Stevens and Staff of ACEsConnection.com
ACEs are traumatic experiences, such as abuse, neglect and household dysfunction, which can result in toxic stress and have a profound effect on a child’s developing brain and body. Research shows that nearly two-thirds of Californians have reported at least one adverse childhood experience.The Center for Youth Wellness videoed the main conference sessions November 5-7, and will post those videos, including a presentation about ACEs by Burke Harris, a conversation between her and Dr. Vincent Felitti, one of the co-founders of the ACE Study, and Jamie Redford showing the trailer from  “Paper Tigers”, a documentary about Lincoln High, a trauma-informed school in Walla Walla, WA.

ACASkids-1The ACEs Connection Network team participated and reported on the breakout sessions, which weren’t videoed. On the first day, Elizabeth Prewitt covered health (CA ACEs Summit: Overall health depends on much more than healthcare, pediatricians and other public health specialists agree).

Joanna Weill covered juvenile justice (CA ACEs Summit: Juvenile Justice Panel), and the discussion that occurred during the panel that covered ACEs from a national perspective.

In that session, Sylvia Paull was inspired by Esta Soler, founder of Futures Without Violence, and, in the education panel, by the pioneers transforming cultures of public schools from punishment to compassion. Elizabeth Prewitt covered the state panel (CA ACEs Summit: Building the ACEs movement in 3 states).

Alicia St. Andrews of ACEsConnection.com shares reports on the panel at the CA ACEs Summit on how local groups are getting organized to stop the trauma and spread compassion and healing instead, here:  CA ACEs Summit Building the Foundation to Help Children Thrive: Strategies to address the impact of ACEs
ACEs 101 FAQs – What are ACEs?
by Jane Stevens, founder, ACEsConnection.com

ACEs are adverse childhood experiences that harm children’s developing brains so profoundly that the effects show up decades later; they cause much of chronic disease, most mental illness, and are at the root of most violence.   Read more: http://www.acesconnection.com/blog/aces-101-faqs

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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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Dreaming of a Safe America – Laura Kerr

Safe America Dream Laura KerrThis guest blog by Dr. Laura Kerr, PhD, Stanford University, really struck me.  For Americans as people, and our government, she notes, “unconscious dreams and unresolved traumas influence our defensive reactions to threat, much like the child that suffers chronic traumatization is altered by conditions of abuse and neglect.”  Dr. Kerr is a  mental health scholar who writes about trauma, grief and loss — and the social cost of our often not knowing they exist, or how to heal them.

“Dreaming of a Safe America,” by Dr. Laura Kerr

The airstrikes against the Islamic State, a decidedly violent and oppressive group, are deeply unsettling, bringing forth memories of 9/ll and the Iraq and Afghanistan Wars, along with fears that America will never extract itself from this region of the world, or be safe from revengeful terrorist groups. At such times, it’s natural to become defensive, fearful, and even hopeless.

One of the things that makes America a wonderful place to live is that we feel entitled to freedom and safety and feel others are entitled to freedom and safety too. Yet rarely do airstrikes like the ones on Syria feel like a simple exercise in the protection of human rights. America has too many unresolved traumas, too many unspoken desires, for the public to trust a motive as simple as the preservation of freedom and safety.

In this blog post, I try to understand how unconscious dreams and unresolved traumas influence our defensive reactions to threat, much like the child that suffers chronic traumatization is altered by conditions of abuse and neglect. I believe we are at a time in our nation’s history when we must examine the disparity between what we have dreamed of becoming and deal with the reality of what we are: stressed, even traumatized, increasingly fragmented, yet also passionate, resourceful, and capable of honest evaluation. But first we have to let go of our defenses. Even during times of war.

American Dreams

The United States, perhaps like all nations and all people, is caught in unconscious, conflicting drives and denied vulnerabilities. In Dreaming Up America, historical novelist Russell Banks identified three dreams at the heart of America’s unconscious conflicts, dreams that originally drew people to America:

There was El Dorado, the City of Gold that Cortez and Pizarro dreamed of finding. And then there was Ponce de Leon’s dream of the Fountain of Youth, where you could start life over again, and the New England Puritan dream of God’s Protestant utopian City on a Hill, the New Jerusalem…. We can think of there being three braided strands, or perhaps three mutually reinforcing dreams: one is of a place where a sinner can become virtuous, free from the decadence of the secular cosmopolitanism of Old Europe; another is of a place where a poor man can become wealthy; and a third is of a place where a person can be born again.” (2008, pp. 6-7)

The three conflicting impulses of these dreams — renewal, materialism, and spirituality — shape the nation, its institutions, social life, and the American psyche. They determine the myths Americans attempt to live, the fantasies that grab our imaginations, the ideals we hold, and our expectations for the future. These dreams also have a shadow side. They contain the unresolved traumas of past generations, and thus also perpetuate fear, shame, addictions, and disavowed needs. Without healing the shadow side of these dreams, the United States has no other option than to play out its conflicting state of impulses in unhealthy and destructive ways.

These disparate dreams of wealth, rebirth, and redemption have been with the American people since the country’s inception, although according to Banks, they became a source of internal tension after the Civil War. The United States emerged from this conflict as a nation state, which implied, at least in principle, the resolution of internal conflicts for the purpose of creating an integrated and interdependent nation. However, as we know all too well, this was not the case.

Following the Civil War, the United States was incapable of true integration. For one thing, the Civil War was particularly gruesome. Over 620,000 people died — far more Americans than in any other US-involved conflict. (About 1,264,000 soldiers have died in the nation’s wars.) And although the Civil War ended slavery, it did not end racism or inequality, and thus failed to uphold the ideal of universal, inalienable rights laid out in the Constitution, the doctrine intended to unite us all as equals.

Thus, after the Civil War, there was a false sense of integration. To use psychological parlance, we could say the US created a false self. The creation of a false self is common to trauma survivors. It hides the split off aspects of experience and identity that either the survivor is unaware of, or fears retribution for, if others were to know the traumatized parts and the memories they hold. And Americans have suffered many traumas — including the numerous wars, slavery, oppression, racism, sexism, as well as family violence — and all reveal the failure of democracy to create a country of safe and equal citizens.

When caught in a habitual cycle of denying or dissociating parts of ourselves, event the faintest reminders are susceptible to unconscious projection onto others. When traumatic memories are particularly offensive, and contain overwhelming feelings of shame or helplessness, the need to rid oneself of the offending and unacceptable traits and emotions can lead to a search for a scapegoat, someone or something to contain the overwhelming feelings that otherwise might shatter the fragile persona that keeps them at bay.

And indeed, the United States often functions much like the trauma survivor who projects the wounded parts of itself onto scapegoats rather than risk the uncertainty of facing a traumatized past. Scapegoating happens in relation to other countries and peoples when we demonize them, and in our own country when people are devalued or brutalized due to their ethnic origins, their gender or their sexual orientation, the region of the country they live in, or their lack of resources. And often those who have been victimized later become the ones seeking scapegoats.

For the rest of this post and its invaluable footnotes, CLICK HERE: http://www.laurakkerr.com/2014/09/24/dreaming-safe-america/

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Kathy’s news blogs expand on the ideas in 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 Kathy and her guest bloggers write about attachment disorder in adults, trauma, grief and loss, adult attachment theory, and the Adult Attachment Interview.

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Polyvagal Theory: Trauma as Reptilian Freeze

Polyvagal Theory Book Amazon1Neuroscientist Dr. Stephen Porges appeared in my last few blogs; let’s explore his 1994 discovery of the Polyvagal Theory.  Dr. Porges runs brain-body research at top psychiatry departments (University of Chicago and University of North Carolina Chapel Hill).

And he always says he wasn’t looking for a polyvagal theory. He was just researching ways to measure the vagus nerve, the 10th cranial nerve running between the brain stem and most of the body.

Until 1994, textbooks said there are two parts to the autonomous nervous system (ANS).  First, the sympathetic system mobilizes us for fight and flight, but is harmful if it stays on too long, making us tense, anxious and prone to disease. Second, the parasympathetic inhibits mobilization, so it was believed to be calming and healthy. Textbooks taught that “the net result was a balance between a pair of two antagonistic systems,” Porges says. The vagus nerve makes up a chunk of the parasympathetic; “it functions like a brake on the heart’s pacemaker.” [FN]

This two-part model broke down “as I was conducting research with human newborns to measure heart rate, assuming vagal activity was protective,” Porges says. “If newborns had good clinical outcomes, they had a lot of vagal heart rate going up and down with breathing. Babies with flat heart rates were at risk.  So I wrote a paper in the journal Pediatrics to educate neonatologists.

“Following publication, I received a letter from a neonatologist who noted that… the vagus could kill you, and that perhaps too much of a good thing was bad. His comments startled and motivated me to challenge our understanding of the nervous system.

“I immediately understood what the neonatologist meant. From his perspective, the vagus can kill, since it is capable of life threatening bradycardia and apnea — massive slowing of heart rate and cessation of breathing. For many pre-term infants, bradycardia and apnea are life threatening.  I now framed the ‘vagal paradox.’  How could the vagus be both protective and lethal? For months I carried the neonatologist’s letter in my briefcase.”

Poly Faces of Vagus

Polyvagal Anatomy Diagram

Porges went back to the evolution of anatomy, and saw that in fact there are two different vagus circuits — a total of three ANS circuits, not just a pair.  The two circuits “come from two different areas of the brain stem, and they evolved sequentially,” one far earlier.

“This motivated me to develop the polyvagal theory, which uncovered the anatomy and function of two vagal systems, one potentially lethal, and the other protective,” he says.

“Immobilization, bradycardia, and apnea are components of a very old, reptilian defense system, ” Porges says. “If you look at reptiles, you don’t see much behavior — because immobilization is the primary defense system for reptiles… it’s an ancient vagus nerve.”  This pre-historic nerve has no myelin, a nerve coating of  protective protein and fat.

Porges found mammals have this unmyelinated vagus, on the dorsal (top) side of the nerve, which immobilizes us, too —  “and that immobilization reaction, adaptive for reptiles, is potentially lethal for mammals.”

Porges also saw that among the “firsts” which began with mammals, a new vagus with myelin develops on the ventral underside of the nerve.  “So mammals have two vagal circuits,” he found. ” The myelinated circuits provide more rapid and tightly organized responses. The new mammalian vagus is linked to brain stem areas that regulates the muscles of the face and head. Every intuitive clinician knows that if they look at people’s faces and listen to voices,  controlled by muscles of the face and head, they know the physiological state of their client.”

Neuroception:  It’s Just Not Cognitive

Porges adds that our more primitive neural circuits operate by “neuroception” — totally involuntarily.  “Neuroception is not perception,” he says. “Neuroception does not require an awareness of things going on.  It is detection without awareness. It is a neural circuit that evaluates risk in the environment… When confronted in certain situations, some people experience autonomic responses such as an increase in heart rate and sweating hands. These responses are involuntary. It is not like they want to do this.”

The polyvagal theory emphasizes that our nervous system has more than one defense strategy – and whether we use mobilized flight/flight or  immobilization shutdown, is not a voluntary decision.  Outside the realm of our conscious awareness, our nervous system is continuously evaluating risk in the environment, making judgments, and prioritizing behaviors that are not cognitive.

Next, he says, “humans and other mammals, as fight/flight machines, only work if they can move and do things. But if we are confined, if we are placed into isolation, or if we are strapped down, our nervous system reads those cues and functionally wants to immobilize.  I can give you two interesting examples: one is a news clip I saw on CNN and the second  from my own personal experience.

“I saw a CNN news broadcast with a video clip of a plane whose wings were tipping up and down as the plane was tossed by the wind. The plane did land safely and the reporter went to interview the people. He asked one of the passengers how it felt to be in a plane that looked like it would crash. Her response left the reporter speechless. She said, “Feel? I passed out.” For this woman, the cues of a life threat triggered the ancient vagal circuit. We don’t have control over this circuit.

“Many people who report abuse especially sexual abuse, experience being held down or physically abused. These abused clients often describe a psychological experience of not being there. They dissociate or pass out. The abusive event  triggered an adaptive response, to enable them not to experience the traumatic event.”

Porges’ second example, noted in my Aug. 22 blog, was his own attempt to have an MRI – in which his body flat out overruled his powerful thinking brain. “I wanted the MRI.  But something happened to my body when I entered the MRI that triggered my nervous system into…wanting me to mobilize to get out of there.” So the nurses let him out.

Porges was asked by one interviewer, “What would have happened if you called to be let out — but no one came?”

“Now we’re talking!,” said Dr. P. “So now I am stuck in there, I can’t get out; I am in this confined area. That would be totally like being physically abused, being held down, going through all these same things.” Like the plane passenger who defaulted back in evolution to her most primitive system, he might have dissociated or passed out.

“The problem, of course, is how do you get people back out of that?” Porges asks. ” If a life threat puts a human into this state, it may be very difficult to reorganize to become ‘normal’ again.”

Friday Sept. 26:  Videos and audios on Polyvagal Theory

Friday Oct. 3: Dr. Porges on how to “get people back out of” the reptilian freeze of trauma.

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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.

Footnotes

FN Porges, Stephen, PhD, “The Polyvagal Theory for Treating Trauma,” 2011, http://stephenporges.com/images/stephen%20porges%20interview%20nicabm.pdf
—“Body, Brain, Behavior: How Polyvagal Theory Expands Our Healing Paradigm,” 2013, http://stephenporges.com/images/NICABM%202013.pdf
“Beyond the Brain: Vagal System Holds the Secret to Treating Trauma,” 2013, http://stephenporges.com/images/nicabm2.pdf
—”Polyvagal theory: phylogenetic substrates of a social nervous system,” International Journal of Psycho-physiology 42, 2001,  Dept. of Psychiatry, Univ. Illinois Chicago, www.wisebrain.org/Polyvagal_Theory.pdf

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“General Theory of Love” on Mammals

BrousBlog6c General Theory“A General Theory of Love”  by Thomas Lewis MD,  Fari Amini, MD, and Richard Lannon, MD, is all about why it’s so important that we are mammals.  They say it’s vital that we value our mammalian attachment system and stay close to other mammals.   Here are  quotes and some great MP3 audio clips from “General Theory,” to follow up on Dr. Stephen Porges’ writings on our mammalian attachment system last week.

“A body animated only by the reptilian brain stem is no more human than a severed toe.  Reptiles don’t have an emotional life,” says General Theory.  “The advent of the mammalian limbic lobe, uniquely, allows mammals to care for their own, have emotions, and risk and lose life for another.”

“When mammals showed up on the planet, their method of reproduction was different. Unlike reptiles, they gave birth to live helpless young that had to be nurtured or wouldn’t survive,” said co-author Dr. Tom Lewis in a 2008 interview.   “The parent had to monitor the physiology of the baby.

“This lead to the development of a part of the brain called the Limbic Lobe, which we share with all mammals.  Infants’ physiology is incomplete on its own; babies can’t get to sleep on their own, they need to be lulled to sleep; they can’t soothe themselves, instead they seek out someone who can soothe them.

“Just as infants need the regulating presence of the external contact figure, all of us are like infants, only bigger, and we also need the regulatory influence… Most people think their body is self contained, that sugar levels are monitored internally and so on, oxygen, hormones.  It’s very surprising that this not true – there are physiological parameters regulated by other people outside own body.

“In our culture we construe loneliness as weakness, as a character defect… But it’s based on brain evolution; there’s no choice about it. Just as when you’re hungry, or low on water and feel thirst, loneliness is a real physiological feeling telling you you need something vital.  It hurts so much because it’s important to your health.”

Love is the glue that keeps people and societies together, says Dr. Richard Lannon in a terrific series of mp3 clips of  interviews by radio host Paula Gordon.  He explains fundamental human biology which makes our connections to others fundamental.

He relates the mammalian brain’s limbic system to being alive, to parenting, to being happy, to appreciating beauty and explains why we cannot “think our way” to fulfillment:   http://www.paulagordon.com/shows/lannon/mp3/RLannonConv2.mp3

Dr. Lannon says it is good mothering which leads to secure attachment and explains the profound implications of the importance of optimally tuning in to a child. He describes how the ideas in General Theory of Love expand on (as well as part company from) traditional psychotherapy.

He reviews the profound, central importance of long-term, sustaining support networks for humans.  He notes that most social forces currently work in the opposite direction:
http://www.paulagordon.com/shows/lannon/mp3/RLannonConv3.mp3

Dr. Lannon explains why self-help books usually are no help. He distinguishes General Theory of Love from that genre, explaining why we cannot intellectually (neocortex) control our emotions (in the limbic brain.) He argues for integration of the different ways of knowing – thinking neocortex and emotional limbic – urging us to give the limbic system its due – while pointing to the terrible social price we are paying for not doing so.

He describes what happens when people do not attach, personally and in society.  http://www.paulagordon.com/shows/lannon/mp3/RLannonConv4.mp3

Humans have been given the gift of being a social animal, says Dr. Lannon, who urges us to be more of what we are. He reminds us that emotions are innate and that we all have them and must “tune” them, comparing this to tuning an instrument.

He describes humans as open-loop systems, deeply affected by our relationships with other and NOT independent of each other. He expands on, “We create each other.” He assures us that we can change, but only with the help of other people. He reminds us of the tremendous power social interactions have to heal, reminding us of research which shows that brains continue to grow into old age. http://www.paulagordon.com/shows/lannon/mp3/RLannonConv5.mp3

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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.

Footnotes

FN1  Lewis, Thomas, MD; Amini, Fari, MD; Lannon, Richard, MD; “A General Theory of Love”,  Random House, New York, 2000.  See Dr. Lannon interviews at: www.paulagordon.com/shows/lannon/
Preface excerpts at:  www.nytimes.com/books/first/l/lewis-love.html
On therapy:  www.goodreads.com/author/quotes/1503539.Thomas_Lewis

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Mammalian Attachment System Heals Trauma

Stephen Porges magesDr. Stephen Porges writes in his groundbreaking “Polyvagal Theory” that mammals like us aren’t made for trauma.  We’re made primarily to attach to other mammals, which makes us feel safe, secure and good.  When that fails, we’re also made to go into a secondary fall-back option of fight/flight; we get aggressive or at least defensive. And it feels bad; we know something’s wrong.

But we’re not made to be in fight/flight for a long time, so when we’re caught in fight/flight and can’t get out, mammals are forced back into a third, even more primitive system: reptilian freeze, aka immobilization or dissociation.

“If you go to a pet store and look at the reptiles, you don’t see much behavior, because immobilization is the primary defense system for reptiles,” says Porges. “But if you look at the small mammals, hamsters and mice, they are running around. They are socializing.”

“Some reptiles can shut down and go underwater for several hours and be fine. The shut-down system works well if you are a reptile, because reptiles don’t need much oxygen and don’t need to support a big brain…

“But this immobilization reaction… is potentially lethal for mammals. If a life threat triggers a biobehavioral response that puts a human into this state, it may be very difficult to reorganize to become ‘normal’ again,”  he warns. [FN]

I talked about that kind of trauma last blog.  I was suddenly thrust into a medical system that ignored all these mammalian basics.  No matter to whom I turned for communication and  information, nobody saw me, nobody heard my questions, nobody seemed to care what happened. No mammalian response.

So instead of being about to simply sit and be “Present” with the sudden survival threat of a surgical knife coming at me, I had to take all the perfectly normal fight/flight feelings which that causes, and “stuff  it.”  Because I had to push myself into hunting and gathering all that info alone. Which threw me into reptilian freeze, just as my body was designed by the Manufacturer to do.  That’s trauma.

Mammals Should Be Seen – And Heard

Cats Bad Day, I fix itBut, good news: I got out of that trauma in under a week, thanks to Dr. Porges’ primary state: mammalian attachment.

The first thing that happened was I took a step myself, to get myself “seen” and “heard” – I wrote that blog.  It went out to almost a thousand readers, and the response was terrific.  In particular, lots of nice warm mammals in my Life Team support system started to call and write to me, and wow did that feel good.

“Dearest Kathy,” wrote one reader, “I just read your latest blog post, and it sounds rough.  I hope things are calming down and straightening out, and I wish I could be there to help. Do call if you want. – A big, warm, long hug….”

Now this gal and I go way back decades, though she’s on the east coast where I haven’t seen her since 2009. But we were attached mammals for so long, that in 2011 I woke up one morning dreaming I’d been singing Handel’s  Messiah, things went terribly wrong – but suddenly there at the foot of the stage, she appeared – to give me a big hug. “Oh!  It’s her!  She knows me. She sees me — the real me, the me who really is.”

And about three hours later that same day in 2011, my cell phone rang and…. it was her.  Across 3,000 miles.

“The evolution of the nervous system starts with the un-myelinated vagus nerve, which does immobilization. Reptiles have this oldest defensive system,“ says Porges.

“With mammals, a newer circuit, a uniquely mammalian vagus which is myelinated, comes online.  So mammals have two vagal circuits, which originate in different areas of the brain stem. The new mammalian vagus is linked in the brain stem to areas that regulates the muscles of the face and head.  Every clinician knows that if they look at people’s faces and listen to their voices, which are controlled by muscles of the face and head, they will know the physiological state of their client.

“If we are protected with the newer mammalian vagal circuit, we do fine. When our mammalian social engagement system is working, we feel calm, we hug people, we look at them and we feel good.

“These mammalian part of our  nervous system  enables social interactions to calm our physiology and to support health, growth, and restoration.  When a person is facially expressive, has vocal intonation, has an expressive face and whose eyes are open when we talk to them,”  then we feel seen, heard, and connected.

“Thank you for actually ‘seeing’ me and knowing me,” I wrote back to my gal pal last week after she saw my blog. “It’s got everything to do with plain old simple mammalian attachment, in which we  just ‘be with’ each other, and feel safe.

“And just this morning, it hit me: Oh, Mom again. I was under survival threat as an infant because I was raised in a glass box, which is interpreted by the infant brain stem as a survival threat. Google ‘Still Face Experiment’  – it shows how infants go nuts when nobody sees them, nobody hears them – nobody responds.

“So today, survival threat  (surgical knife) will cause me to over-react.  ‘Of course’ says my wonderful attachment-based psychotherapist,  ‘it’s baked into your brain stem.  Give yourself some grace, have your reaction, and then do the reality check.’   So when the doctors exhibit the same reptilian behavior as Mom: nobody hears me, nobody sees me, nobody responds?   ‘Of course’ — bam, it  triggers the whole infant deep neurological experience.

“The minute I put that together, I had a good cry, then started to feel absolutely fantastic.  Because suddenly I knew: it’s not about the doctors or the surgery — it’s about my mammalian attachment system.  No matter what happens with the surgery or the doctors, it won’t matter – as long as I get with mammals.  And what a relief.

“Because now I do have mammalian attachment to my friends, my therapist, and a few other important people – like God – now I do have “Safe People.”

“So suddenly now the surgery is no big deal because the doctors will do a great technical job like well-trained reptiles, and back to what really counts, my mammalian support system is taking care of my mammal needs big time.  Which brought me an enormous relief of tension, and feeling of support.”

And no sooner did I figure this out, than my email dings –  and it’s her again.

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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.

Footnotes

FN  Porges, Stephen, PhD, “The Polyvagal Theory for Treating Trauma,” 2011, http://stephenporges.com/images/stephen%20porges%20interview%20nicabm.pdf
—“Body, Brain, Behavior: How Polyvagal Theory Expands Our Healing Paradigm,” 2013, http://stephenporges.com/images/NICABM%202013.pdf
“Beyond the Brain: Vagal System Holds the Secret to Treating Trauma,” 2013, http://stephenporges.com/images/nicabm2.pdf
—”Polyvagal theory: phylogenetic substrates of a social nervous system,” International Journal of Psycho-physiology 42, 2001,  Dept. of Psychiatry, Univ. Illinois Chicago, www.wisebrain.org/Polyvagal_Theory.pdf

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