Category Archives: Trauma

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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“Heal trauma? Start with the body”

Bessel van der Kolk by Matthew Woodson, NYT 5-22-14“Bessel van der Kolk wants to change the way we heal a traumatized mind — by starting with the body,” reports Jeneen Interlandi in the New York Times Magazine May 22. (Dr. van der Kolk in session drawn by Matthew Woodson for the Times.)

It features Dr. van der Kolk’s new approaches to healing trauma by group therapy, yoga, meditation, EMDR, and “rhythmic regulation.”  I’ve reported on this in these recent posts: http://attachmentdisorderhealing.com/developmental-trauma/  and http://attachmentdisorderhealing.com/developmental-trauma-3/

“Trauma has nothing whatsoever to do with cognition,” van der Kolk says. “It has to do with your body being reset to interpret the world as a dangerous place.” That reset begins in the deep recesses of the brain with its most primitive structures (brain stem), regions that, he says, no cognitive therapy (frontal cortex) can access.

“It’s not something you can talk yourself out of.”

It’s a great Friday read: “A Revolutionary Approach to Treating PTSD” by Jeneen Interlandi, New York Times Magazine, May 22, 2014 at: http://www.nytimes.com/2014/05/25/magazine/a-revolutionary-approach-to-treating-ptsd.html?smid=tw-share&_r=2#permid=11865712

OK, it’s a bit off my topic. The Times doesn’t mention attachment trauma, although van der Kolk talks about that constantly. As to healing, it focuses on adult war PTSD. It only speaks to child trauma by debating what a child abuse victim can and can’t remember (not much of a call to heal child trauma).

But Ms. Interlandi does let van der Kolk speak to his charge that there is a lot more trauma than we think, and that standard “cognitive” treatments are not working. “Patients are still suffering, and so are their families. We need to do better,” van der Kolk says.

“Van der Kolk says he would love to do large-scale studies comparing some of his preferred methods of treatment with some of the more commonly accepted approaches,” she points out. “But funding is nearly impossible to come by for anything outside the mainstream. In the wake of the Sept. 11 terrorist attacks, he says, he was invited to sit on a handful of expert panels. Money had been designated for therapeutic interventions, and the people in charge of parceling it out wanted to know which treatments to back.

To van der Kolk, it was a golden opportunity. We really don’t know what would help people most, he told the panel members. Why not open it up and fund everything, and not be prejudiced about it? Then we could study the results and really learn something. Instead, the panels recommended two forms of treatment: psychoanalysis and cognitive behavioral therapy.

“So then we sat back and waited for all the patients to show up for analysis and C.B.T. And almost nobody did.” Spencer Eth, then medical director of behavioral health services at St. Vincent’s Hospital in Manhattan, (later) gathered data on the mental-health care provided to more than 10,000 Sept. 11 survivors.

The most popular service by far was acupuncture. Yoga and massage were also in high demand. “Nobody looks at acupuncture academically,” van der Kolk says. “But here are all these people saying that it’s helped them.”

Out of 208 reader comments to the Times, I only found two that weren’t deeply grateful for his approach, as I am.  These two didn’t mention healing either.

Enjoy reading about Dr. van der Kolk today, but read carefully – the Times, ever a bit arrogant, puts in some gnarly innuendos I didn’t like, which the two comments made worse. So I had to do further research on this one.  My results to come next week…

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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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Bruce Perry and Children’s Choirs

Cantoria1 Youths larger della_robbia_02I’ve reported Dr. Bruce Perry’s in Washington May 4 to talk on healing trauma at the National Council.

What’s that got to do with this sculpture of children singing in the Cathedral of Florence in 1436 to kick off the Renaissance?  Everything!

Dr. Perry says it’s brain science to regulate the brain stem with “patterned, repetitive, rhythmic regulation,” featuring yoga, meditation, deep breathing, and singing, principles so fundamental they go back to the dawn of man. [FN1]

Who can imagine life without singing?  In every culture, long before writing, the only way to pass down an idea was to sing it. Aryans have sung Vedas since 5,000 BC or before. Hebrews sang Psalms as far back as 2,500 BC, long before they were written down ca. 1400 BC. [FN2  ]

Want to regulate kids? Teach them to sing! Gathering children to sing in choirs was the core of the Greek educational system since at least 700 BC, and there were choir schools for kids in Europe at least since the 900s AD. [FN3]  Singing in choirs brings kids into organized personal connection with other living, regularly-breathing human beings.  Being connected and in harmony with other humans is what best regulates human beings – today brain scientists call it “limbic resonance.” [FN4]

Amira Willighagen 1Singing gives kids a voice!  Children have been known to sing gloriously even today. Watch 9-year old Amira Willighagen sing in Amsterdam last year.

She did it without any training.  Amira just went on the internet looking for songs, found this Italian aria, and learned it by imitating.  Clearly she found a terrific adult soprano – we can hear the inflections of a highly-experienced adult in Amira’s voice. [FN5]

St Thomas Choir1AOr take the St. Thomas Boys Choir of Leipzig. When J.S. Bach became music director in 1723, the choir school was already 511 years old. Click here for the boys singing a Bach “Gloria.”    [FN6]


Born to Sing

Cantoria2 Boys10-12 & Teens della_robbia22If a child can speak, he can sing; most kids can sing before they can speak. Training children to sing as young as possible is a principle of civilization. Electronic culture has forgotten it to our peril as our kids whack out on machine-made noise. We need a revolutionary approach as old as the hills.  We need children’s choirs on a mass scale.

These children singing on the “Cantoria” by Lucca della Robbia, sculpted 1431-36, were placed in the Cathedral as public ads, to urge parents to bring in their kids for training. This is the level of culture and education which later produced Bach, Haydn, Schubert and Beethoven. Was their genius just magic?  Why don’t we have composers today, who produce music on such a scale (and they did it all without electronic equipment) ?

Answer: Bach & co. were trained as children to sing harmonic, complex polyphony (4-6 different musical lines at once).  So complex, harmonic music was what they heard in their heads as little kids. They were bilingual; music was their second mother tongue.  To them, it was simple: as soon as they could hold a pen, they would just start to write down their musical ideas. That tradition continued in Europe until the end of the 19th Century.

And there’s another reason everybody loves music: it’s because every body loves music. Music is literally built into kids’ bodies from the hour of conception.  Our bodies physically need it. And kids know that instinctively, from infancy.

“The first music encoded deep within your memory are the earliest vibrations that made you – the rhythms and tempos of your first cells,” writes Galina Mindlin, MD and music therapist.

“As your cells began to develop with the rhythms of your mother’s heartbeat and the whooshing sounds vibrating through her placenta and your umbilical cord, these first musical scores began entraining (two or more rhythms synchronizing into one) in your brain… your brain was already establishing the relationship for how music affects you today…   Newborns can almost immediately show some memory of sounds they encountered in the womb… Before any of us is capable of speaking words, we can recognize changes in notes and rhythmic patterns…” [FN7]

The Mother of All  Trauma

Cantoria3 Boys 10-11 playing stringsWhat about trauma healing?  Consider this: from 1348-1350, the Black Death, the mother of all trauma, killed half the population of Asia and Europe. In Italy, Florence’s population was reduced from 120,000 in 1338 to 50,000 in 1351. Many thought civilization was finished. [FN8]

Then a handful of intellectuals devised the idea of a re-birth or “Renaissance,” a project to unite a new economics to feed the population, with the science, philosophy, and arts to uplift them.  Florence had a famous problem whose solution could inspire people with hope. At the city’s center lay the massive Cathedral of Florence, begun 1296 — but no one had any idea how a dome could be built large enough to cover such a space without collapsing. Work was also delayed by waves of plague for decades. The roof lay open for over a century as people prayed in the rain.

During 1402–1404, Filippo Brunelleschi and his friend Donatello visited Rome to study the ancient ruins and the Pantheon on which the Cathedral was modeled. They returned to build the first “classical” buildings in Florence. In 1420, Florentine banker Cosimo de’ Medici (1389-1464) bankrolled Brunelleschi to work  16 years to complete the first octagonal dome in history to be built without a wooden supporting frame. [FN9]

What did they do in that Cathedral? They brought in the children of the city and taught them to sing, to show there was hope for the future, that  the children could be saved from the jaws of death. These sculptures just above show that by the age of 9-11, kids were singing (and playing) complex four and six part polyphony.

Note the rounded mouths in all the sculptures (and in the St. Thomas boys). Vocal scholars can tell you what note they’re singing by how large of an egg-shaped mouth they’re making.

The dome was ready in time for the Council of Florence which opened in the Cathedral on March 25, 1436, the date often cited as the start of the Renaissance. Inside were featured these sculptures of children singing in the choir loft by Lucca della Robbia.  Flemish composer Guillaume Dufay and many of his colleagues were brought to Italy to teach advanced musical composition.  Dufay’s advanced motet Nuper rosarum flores was composed for the 1436 opening and sung from della Robbia’s choir loft by kids like these in the sculptures.

Cosimo de’ Medici and his grandson Lorenzo de’ Medici (1449-1492) also backed philosophers Marsilio Ficino and Pico della Mirandola. Pico’s 1486 “Oration on the Dignity of Man” stated the Renaissance Idea: each individual human soul is a divine spark of God, not a beast of burden as under feudalism.

Cantoria4 Boys 5-10 Sing-Dance1A webThese sculptures show that in Florence, the Dignity of Man began with the dignity of the children.  These kids have been taught to sing even younger, at 5 to 8 years.  Della Robbia did several sculptures of toddlers singing as well (more than I have space to show!).

Cantoria5 Infant singingEven infants sang, singing with their families perhaps while they learned to speak.This child is not much older than 2.  Kids who started this early acquired the experience it took to produce genius in many fields.

San Diego Trauma-Informed Renaissance?

I’ve seen this kind of singing of fine music in choirs make traumatized children happy.  Musicians who run children’s choirs will tell you that.

San Diego Childrens Choir1 earlyyears_collageThe San Diego Children’s Choir (right), founded 1990, now has 5 branches with  over 250 participants. It also has a neighborhood outreach program that spans many low-income areas full of traumatized children including City Heights and other areas.

City Heights is also where Principal Godwin Higa has been turning Cherokee Point Elementary into an advanced trauma-infomed school since 2008. Three professors at San Diego State and community organizers Dana Brown and Dorothy Zirkle worked with the City Heights community to develop a two-year $684,094 pilot project at Cherokee Point, the Wellness and Restorative Practice Partnership (WRPP), funded by the California Endowment.

I can’t be with Bruce Perry in Washington May 4, but I will be in San Diego May 2, talking to  my friend Dana Brown and other members of the San Diego Trauma-Informed Guide Team (SD-TIGT) about Bruce Perry, Bessel van der Kolk, and the brain science of trauma.  SD-TIGT is leading the way among county health and welfare institutions to implement trauma-prevention and trauma-healing practices in schools, medical, and social facilities.

If Principal Higa and Dana haven’t met the folks at the San Diego Children’s Choir yet, maybe I’ll be able to provoke something.  Even if they’ve met, maybe we can expand their forces. As a result of the economic crisis, San Diego just lost its opera company, the San Diego Opera.  The city must be full of struggling singers, school music teachers and private voice teachers who would jump at the chance to teach every child at Cherokee El to sing Bach.

Next step: find our Cosimo de’ Medici to pay these already financially-pressed musicians and educators, so they can put in the hours necessary every week at Cherokee El. Then stand back.

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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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Footnotes

FN1  Lucca della Robbia, Cantoria (Choir Loft), shows children singing, dancing,and  making music to “praise the Lord” in the words of Psalm 150. Photos  at http://commons.wikimedia.org/wiki/File:Cantoria_di_luca_della_robbia_11.jpg

FN2  http://en.wikipedia.org/wiki/The_Arctic_Home_in_the_Vedas

FN3  Chorus members in Greek theater were trained in childhood from around 700 BC.  Greek theater always included a chorus, whose members also danced and spoke, but also sang. [http://en.wikipedia.org/wiki/Greek_chorus ]  Both boys and girls were trained to sing.  [http://www.amazon.com/Choruses-Young-Women-Ancient-Greece/dp/0742515249 ]  Greece and Rome founded many children’s singing schools [ http://www.boychoirs.org/library/history/hist014.html ] The Schola Cantorum in Rome was formed in the seventh century to train boys in reading and singing.
The Vienna Boys Choir, formalized in a 1498 letter by Maximilian I Habsburg, goes back to the year 957 when Bishop Wolfgang of Regensburg created his cathedral choir [ http://www.boychoirs.org/library/history/hist014.html  and http://en.wikipedia.org/wiki/Vienna_Boys%27_Choir ] The first choir school was founded at  St. Paul’s Cathedral, London in 1127, the second at St. Thomas’ Church, Leipzig in 1212. A boarding school for choristers at the Kreuzkirche in Dresden is mentioned in 1300, a choir known now as the Dresdner Kreuzchor. The Vienna Boys Choir received a solid musical education, many went on to become professional musicians such as Franz Schubert.
[ http://en.wikipedia.org/wiki/Choir ].

FN4  Lewis, Thomas, MD; Amini, Fari, MD; Lannon, Richard, MD; “A General Theory of Love”, Random House, New York, 2000.  Lannon interviews : www.paulagordon.com/shows/lannon/

FN5  Amira Willighagen video: http://news.distractify.com/default-category/a-shy-9-year-old-girl-takes-the-stage-these-people-will-never-forget-what-follows/

FN6  St.Thomas Choir video:  https://www.youtube.com/watch?v=A-apSehviiQ&list=PL517BEEF15EA64268

FN7  Mindlin, Galina, MD, PhD, “Your Playlist Can Change Your Life,” Sourcebooks, Inc., Naperville, IL, 2012  More here:
www.nicabm.com/nicabmblog/what-healthy-brains-sound-like-how-brain-music-therapy-is-helping-first-responders/

FN8  The Black Death was one of the most devastating pandemics in human history, peaking in Europe between 1348 and 1350 with 30–60 percent of Europe’s population killed. It reduced world population from an estimated 450 million to between 350 and 375 million in the 14th century. http://en.wikipedia.org/wiki/Consequences_of_the_Black_Death

FN9  Walker, Paul Robert, “The Feud That Sparked the Renaissance: How Brunelleschi and Ghiberti Changed the Art World,” Harper Collins, 2003

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Developmental Trauma: What You Can’t See…

Bessel van der KolkWhat you can’t see, can hurt you.

Dr. Bessel van der Kolk, MD (left) and leaders in brain science and attachment are calling for a hard look at developmental trauma.  Developmental Trauma Disorder (DTD) was identified by van der Kolk in 2005, but the psychiatric Powers That Be deny it exists. [FN1]

“Clearly our field would like to ignore social realities,” Dr. van der Kolk said recently, “and study genes…”

He’s also shown it’s at the root of borderline personality disorder and bipolar disorder. He implies (I’m sure it’s true) that it’s at the root of most cases mis-diagnosed as  ADHD/ADD.  See van der Kolk video: http://www.acesconnection.com/clip/bessel-van-der-kolk-childhood-trauma-affect-regulation-and-borderline-personality-disorder-69-min

I dubbed it “trauma since the sperm hit the egg” when I realized I had it.  Dr. Allan Schore calls it “trauma in the first 1000 days, conception to age two.”  It used to be called “complex PTSD” (C-PTSD) or “Early Trauma” (ET).

Developmental trauma starts in utero when we don’t have much more than a brain stem, and goes on during the pre-conscious years. It can continue until 24 or 36 months depending on when the thinking brain (frontal cortex) comes on line.  That’s up to 45 months living in general anxiety to non-stop terror — before age 3.  A very long time to an infant.

DTD occurs as a continual process, not discrete incidents, while a baby has not developed a thinking brain able to recall incidents.  Frequently it occurs before there are any discrete incidents.

“No one can see it” means “it never happened.”  As I’ve said, “No one beat me or raped me. What’s wrong with me?”  Try getting that treated.

Neuroscientists Dr. Daniel Siegel, MD, Dr. Bruce Perry MD and others detail how attachment failures cause developmental trauma in this video: www.youtube.com/watch?v=jYyEEMlMMb0 [FN2]

Insecure Attachment as the Cause

Allan Schore 2DTD is a “Relational Trauma, trauma in the context of a relationship” as Dr. Allan Schore (left), father of attachment theory in the U.S., identified it in the 1990s. [FN3] Only relational processes can explain DTD, not incidents.

Yet all the American Psychiatric Association (APA) can fathom is Post-Traumatic Stress Disorder (PTSD) — since it’s caused by a visible incident such as war injury or rape. Developmental trauma has no incident. It’s ingrained in brain and visceral tissue, with no obvious “big bang,” so some call it “little ‘t’ trauma,” as opposed to visible PTSD “Big ‘T’ Trauma.”

Insecure attachment and attachment disorder generally are the cause of developmental trauma, not vice versa, Dr. van der Kolk details in his May 2005 Psychiatric Annals pdf  noted above and in FN1.  He emphasized this again in a terrific May 10, 2013 speech at Yale on child trauma, borderline personality disorder and bipolar disorder (click for video).  He lists DTD’s symptoms as relational and chronic: inability to concentrate or regulate feelings, chronic anger, fear and anxiety; self-loathing; aggression, self-destructive behavior. [FN4A]

Working with the National Center for Child Traumatic Stress Complex Trauma Network (NCTSN), van der Kolk reports that he ran a survey of 40,000 children nationally being treated for multiple traumas. Most of them  “do not meet the criteria for PTSD… (as) the majority of issues are not specific traumas, but issues in their attachment relationships,” he says.

Van der Kolk describes studies by his colleague Dr. Marylene Cloitre, on attachment problems as the cause of DTD.  “Marylene looked at chronic complex trauma symptoms, then she did child attachment interviews, Dr. Mary Main’s interviews, in which I hope all of you have been trained, because they are very very helpful to see what were peoples’ experiences of their childhoods,” he said [referring to the Adult Attachment Interview (AAI)]. [FN4B]

Dr. Cloitre found “that pure PTSD symptoms are a function of specific traumatic incidents, but the other symptoms she identified – affect dysregulation, mood regulation, anger expression, chronic suicidality, self-injury, disturbance in relations with self and others… do not occur in PTSD.  They are rather a function of a disturbed attachment relationship,” van der Kolk repeated.

Yet psychiatry, he says, “is not good at treating attachment difficulties. There is very little treatment” of it.  Innovative somatosensory healing programs at van der Kolk’s Trauma Center in Boston using “theater programs, yoga, martial arts for kids, etc. — to get them inter-personally attuned — are not standard treatment even though we do statistical research and publish it,” he notes.

The Body Keeps the Score

Bessel Book bodykeepsscoreBecause DTD happens before we have a thinking brain, the body is forced to store all the memories as somatic trauma. “There is somatization. The body keeps the score,” he says, the title of his latest book, “this is a somatic experience, and you become a terrified organism. Your immune system changes, your stress hormone system changes and your perception of your body changes.”

PTSD’s existence was hard to get recognized at first, too. It took Dr. van der Kolk and friends a chunk of the 1970s and ’80s to get the government to stop insisting that war trauma didn’t exist. Doctors finally established the diagnosis PTSD by showing that Vietnam vets were re-living discrete terrifying incidents from the past.

But “in fact there was no basis for any opinion about the prevalence” of any childhood trauma, even of childhood sexual abuse, before the 1995-1998 Adverse Childhood Experiences (ACE) Study,  study co-director Dr. Vincent J. Felitti, MD, notes. “That’s because such information is almost completely protected by shame and secrecy, by families, and by individuals.  Doctors also have been inhibited by our own ignorance and major gaps in our training, from asking into certain areas of patient history.” [ FN5]

In 1995 Felitti ran an obesity program at Kaiser Permanente in San Diego. But he had a 50% drop-out rate, just when those quitting were losing up to 100 pounds.  “As we interviewed almost 300 of the dropouts, every other person spoke of having childhood sexual abuse; most of them seemed to have been waiting to tell someone after hiding it for years,” Felitti said. “They also often mentioned verbal and physical abuse and other traumatic experiences such as watching their mother being beaten.

“We were amazed. I thought, ‘This can’t be true. People would know if that were true. Someone would have told me in medical school.’  [FN6]

“We wanted to know: to what degree does this happen in the whole population?  That’s how we created the ACE Study.  We took at first 8 and later a total of 10 categories of traumatic childhood experiences which we’d heard about from our obese patients, then found 17,421 average, middle-class adults who agreed to interviews.

“We were astonished to find that the percent of the general public who suffer from traumatic experiences in childhood and adolescence is far higher than imagined… Two-thirds (64-67%) of middle class subjects had one or more types of childhood trauma, and 38-42% had two or more types. One in six had an ACE Score of 4 or more; one in nine had an ACE Score of 5 or more.”  In less privileged populations the numbers are far higher.

Similarly, Dr. van der Kolk describes a patient in the 1980s who could not recall if she were sexually abused, yet drew portraits of her family with menacing genitals. “So we went to the textbook — Freedman,  Kaplan, & Sadock’s  ‘Comprehensive Textbook of Psychiatry’ — with which I sat for my board exam in psychiatry.  It said:  ‘Incest is very rare; it happens in 1 out of 1.1 million women.’   At the time there were about 200 million Americans, so I thought, ‘Hmm… About 100 million women, 110 women are incest victims; how come 47 of them are in my office?’/” [FN4 Yale video.]

“The text says it is also very benign,” he went on quoting it: ‘There’s no agreement about the role of father-daughter incest as a source of psychopathology. The act offers an opportunity to test a fantasy whose consequences are found to be gratifying and pleasurable…In many cases it allows for a better adjustment to the external world.  The large majority of them are none the worse for the experience ’. ”  [FN7]

Developmental Trauma: Psychiatrists Still in Denial

Shrink knitting my brainBut even today, until DTD is in the APA’s official Diagnostic and Statistical Manual of Mental Disorders (DSM), most mental health professionals will not diagnose or treat it, and no insurance company will cover it.

So in 2012 Dr. van der Kolk’s NCTSN network submitted data on 200,000 children around the world to the APA to document DTD.  He spoke on DTD before the National Association of State Mental Health Directors, which treats 6.1 million patients a year with a $29 billion budget, and they wrote to the APA urging that DTD be included in the next DSM-5 in 2013.

But the APA refused and in June 2013, issued DSM-5 without mention of developmental trauma. Van der Kolk in his Yale video ridicules the APA for asking only two questions on child trauma in preparing DSM-5: “1. Can we assume life was pretty good growing up? and  2. Was anyone in your family a drug addict or an alcoholic?”

“Clearly our field would like to ignore social realities,” van der Kolk responds, “and study genes or biological functions — because for us to actually find out how the environment shapes the brain, would get us into very difficult situations.”

The APA refusal letter actually made a veiled dig against the Adverse Childhood Experience (ACE) Study and denied that “childhood adverse experiences” are a “substantive” problem – which is outrageous.  Dr. van der Kolk read that letter at Yale in May 2013 and let ’em have it:

APA:  “The consensus was there was just too little evidence to include DTD in the DSM-5. There have not been any published accounts about children with this disorder.”
Dr. vdK aside: “No, because it’s not in the textbooks!”

APA: “The notion that childhood adverse experiences lead to substantive developmental reduction is more clinical intuition than a research-based fact. “
Dr. vdK aside: “We submitted research data on 200,000 children from around the world to substantiate our diagnosis.”

APA: “The statements made cannot be backed up by prospective studies.”
Dr. vdK aside: “Actually, they can.”

Dr. van der Kolk could make a lot more money as a TV comedy star, after dealing with this idiocy for a lifetime. Despite the tragedy, his psychiatrist audience also had a good laugh — the APA is that absurd.

Developmental trauma is the “invisible” part of “the Silent Epidemic of Attachment Disorder.” [FN8]. DTD can happen as a by-product when a mother or her child are beaten or sexually abused – but it also happens on a wide-spread basis with no visible incident.

Perhaps 20-40% of our population goes through life never knowing they even have DTD. That’s why many of them go on to become leaders of industry and government. That’s why Dr. van der Kolk has said that the US Congress is “dissociated,”  or they’d feel the simple human compassion to know that sending youth to war brings back a flood of PTSD suicides.  (To me that means more than 50% of Congress has attachment problems, which is why they made a career of trying to control others. ) [FN9]

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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  van der Kolk, Bessel, MD, “Developmental Trauma Disorder: Toward a rational diagnosis for children with complex trauma histories,” Psychiatric Annals 35:5, 401-408, May 2005   www.traumacenter.org/products/pdf_files/preprint_dev_trauma_disorder.pdf
This article also details how developmental trauma is attachment-based:  “Early patterns of attachment inform the quality of information processing throughout life [11]. Secure infants learn to trust both what they feel and how theyunderstand the world…. (more),” he reports.
But “When caregivers are emotionally absent, inconsistent, frustrating, violent, intrusive, or neglectful, children are liable to become intolerably distressed and unlikely to develop a sense that the external environment is able to provide relief. Thus, children with insecure attachment patterns have trouble relying on others to help them, while unable to regulate their emotional states by themselves. As a result, they experience excessive anxiety, anger and longings to be taken care of. These feelings may become so extreme as to precipitate dissociative states or self-defeating aggression…”
Dr. van der Kolk has been Medical Director of The Trauma Center in Boston for 30 years (www.traumacenter.org).

FN2  Daniel Siegel, MD, et.al, “Trauma, Brain & Relationship: Helping Children Heal,” www.youtube.com/watch?v=jYyEEMlMMb0
Introductory video on Attachment Disorder and how development of the mind-body system can cause trauma. Copies at www.postinstitute.com/dvds.

FN3  Schore, Allan N., PhD, “Effects of Early Relational Trauma on Right Brain Development, Affect Regulation, & Infant Mental Health,” 2001, www.trauma-pages.com/a/schore-2001b.php

FN4A  van der Kolk, Bessel, MD: Video, Yale University, May 10, 2013, “Childhood Trauma, Affect Regulation, and Borderline Personality Disorder,” http://acesconnection.com/video/bessel-van-der-kolk-childhood-trauma-affect-regulation-borderline

FN4B  Cloitre, Marylene, et. al, (NYU Child Study Center, Department of Psychiatry, New York University Medical College,  marylene.cloitre@nyumc.org), “Attachment organization, emotion regulation, and expectations of support in a clinical sample of women with childhood abuse histories,”   Journal of Traumatic Stress, 2008 Jun;21(3):282-9. doi: 10.1002/jts.20339.  Abstract: Despite the consistent documentation of an association between compromised attachment and clinical disorders, there are few empirical studies exploring factors that may mediate this relationship. This study evaluated the potential roles of emotion regulation and social support expectations in linking adult attachment classification and psychiatric impairment in 109 women with a history of childhood abuse and a variety of diagnosed psychiatric disorders. Path analysis confirmed that insecure attachment was associated with psychiatric impairment through the pathways of poor emotion regulation capacities and diminished expectations of support. Results suggest the relevance of attachment theory in understanding the myriad psychiatric outcomes associated with childhood maltreatment and in particular, the focal roles that emotion regulation and interpersonal expectations may play. http://www.ncbi.nlm.nih.gov/pubmed/18553408

FN5   Vincent J. Felitti, MD;  Robert F. Anda, MD, MS;  “The Lifelong Effects of Adverse Childhood Experiences,” Chapter 10 of Chadwick’s “Child Maltreatment,” Sexual Abuse and Psychological Maltreatment, Encyclopedic Vol 2 of 3, STM Learning, Inc., Saint Louis, p.203-215; March, 2014

FN6   Stevens, Jane, “The Adverse Childhood Experience Study” — the largest, most important public health study you never heard of — began in an obesity clinic,”  ACEsTooHigh.com

FN7  Freedman, Alfred M., Kaplan, Harold I., & Sadock, Benjamin J.,  “Comprehensive Textbook of Psychiatry,” 2nd Edition, Williams and Wilkins Co., Baltimore, 1975; 2609 pages.  Now in 9th edition; known since 4th edition as “Kaplan and Sadock’s.”

FN8  Lanius, Ruth A., MD; Vermetten, Eric; Pain, Claire; Editors, “The Impact of Early Life Trauma on  Health and Disease: The Hidden Epidemic,” Cambridge University Press, 2010. “Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician,” American Academy of Pediatrics,  2012 (New York Times 1-7-12), and many more.

FN9  van der Kolk, Bessel, MD, “What Neuroscience Teaches Us About the Treatment of Trauma,” June 6, 2012 webcast, National Institute for the Clinical Application of Behavioral Medicine  (NICABM) : Most of Congress is “dissociated,” van der Kolk told this 2012 globally-televised webcast, or they’d feel the simple human compassion to know that sending youth to war brings back a flood of PTSD suicides. We already knew from Korea and Vietnam that “for every solider that will die on the battlefield, there will be 30 suicides, as is happening right now,” van der Kolk said.  But “society dissociates from the reality of it and then Congress says, ‘Oh, gosh, isn’t that amazing!’  No it’s not amazing, that’s what happens!”
Short promo clip: http://www.nicabm.com/nicabmblog/how-trauma-traps-survivors-in-the-past/
Link to buy video, mp3 audio, transcripts: http://www.nicabm.com/trauma-2012-new/
On Congress, see also http://www.theatlantic.com/politics/archive/2014/06/why-it-matters-that-politicians-have-no-experience-of-poverty/371857/

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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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Dr. Vincent Felitti: “The Origins of Addiction”

Felitti ACE DVD 3-min Preview screenshotAfter I heard Russell Brand say that what compels addicts is the “hole in me,” I wrote Feb. 14 that this means:  “parts of my brain are dark.”  And it’s so painful, we just medicate.  Ten % of us use hard drugs and alcohol.  Another 40% abuse tobacco, food, gambling, internet porn, sex, sports and more.

All these, abused, cause premature death.  Huge numbers of us are in pain so bad, we’d rather die than live with it.

In response, Dr. Vincent J. Felitti with great patience sent me his 2003 article, “The Origins of Addiction: Evidence from the Adverse Childhood Experiences (ACE) Study.”  It reported these facts 10+ years ago in hard statistics — and more.

Until we treat the underlying ACE trauma, Dr. Felitti says, nothing will change and a high percent of people will continue to die early.  These abuses create the top ten causes of death in the U.S.

This week I’m writing to send you Dr. Felitti’s article and make it your Friday read.  [ FN1]   Click here for the English pdf.

Methamphetamine 1943 AdDr. Felitti also sent this fascinating photo, a full page ad in a 1943 American medical journal for the successful new antidepressant of that day, Methamphetamine.  “Does it mean anything that in impure form and unknown dose the same chemical is sold as the street drug known as crystal meth?” he wrote.  “Like maybe, ‘My kid is buying antidepressants on the street’ ? ”

If anyone says Dr. Felitti “wants to hand out drugs,” I’d love to see them in libel court.  Nope, his message is short and sweet.

Unless we treat ACE trauma, traumatized people will find something, anything, somehow, to numb the horrific emotional pain of ACE trauma.  They’d rather be dead than live with it un-numbed.  And what they find will kill most of them prematurely.  Period.

“Our findings… imply that the basic causes of addiction lie within us and the way we treat each other, not in drug dealers or dangerous chemicals,” Dr. Felitti states.  “They suggest that billions of dollars have been spent everywhere except where the answer is to be found…

“Because cause and effect usually lie within a family, it is understandably more comforting to demonize a chemical than to look within,” he concludes.

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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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FN1  Felitti, Vincent J. , MD, “The Origins of Addiction: Evidence from the Adverse Childhood Experiences Study,”
English version of the article published in Germany as:
Felitti VJ, “Ursprünge des Suchtverhaltens – Evidenzen aus einer Studie zu belastenden
Kindheitserfahrungen,” Praxis der Kinderpsychologie und Kinderpsychiatrie, 2003; 52:547-559. http://attachmentdisorderhealing.com/resources/key-articles/

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Substance Abuse or Survival?

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

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

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

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

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

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

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

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

“Public Health Problems – or Personal Solutions?”

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

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

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

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

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

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

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

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

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

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

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

Trauma and Survival

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Heartbreak ACE of Attachment Disorder

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Why Do We Drink?

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

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

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

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

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

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

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

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

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

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

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

So why do people drink?

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

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

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

When Vincent Met Mary: Survey Says

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

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

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

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

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

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

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

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

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

“Addiction as an Attachment Disorder”

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

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

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

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

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

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

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

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

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

Heal the Adults, Heal the Children

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Footnotes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Isolation Row

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

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

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

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

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

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

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

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

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

 Death Sentence

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

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

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

Not too far from “unlovable,” is it?

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

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

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

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

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

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

Romance vs Therapy?

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

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

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

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

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

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

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

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

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

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

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

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

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

Footnotes

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

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

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

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Down the Rabbit Hole

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

When Dr. Rita heard about my exploits last week with “The Inner Child Workbook” and the applesauce caper, she said, “Well, I thought you could do some reading, but we don’t recommend doing those exercises unsupervised.” Now you tell me; the damage was done. [FN1]

I was terrified by my lack of bonding (attachment) which the Workbook had revealed.  But from my notes, I was too terrified to realize that I should try to describe it to Dr. Rita.  Anyway, she had her own agenda, which caused more damage.

Inner Child Garden w. fairyIn guided imagery, a professional creates a script for a sort of dream sequence and has the patient imagine it, to uncover feelings locked in the subconscious.  It’s a fine tool in the right situation, but this weren’t it.

“Close your eyes,” she said, “and imagine you’re going down, down, down below the ground. You emerge onto a path to a secret garden. You see a little girl about 5 coming toward you. Imagine you take the child’s hand; notice how tiny it is.”  She had me sit with the girl by a stream awhile “to get used to each other,” then lean against a tree to “see whether she’d sit on my lap.”  But I still could find no child inside me; trying just created more anxiety.

Next Dr. Rita said “Let’s ask the child some questions. Respond without thinking, from the gut. What’s your first memory of Father?”  “A pair of slacks going behind a closed door,” I mumbled.  Spontaneous, yes, and I’d never said that before, but that was me talking.  No child involved.

“What’s your first memory of Mother?”  “I got a B in kindergarten and I was afraid to go home.  So I hid in the class bathroom trying to erase it.  I wrote an A over it, but I got caught and it was really awful.” Again it came spontaneously, but this was me talking, and it was an incident I’d remembered all my life.  I can still see the inside of the class bathroom door and feel the fear.  But I’d just tried to forget it since Mom was a fact of life, like the weather.

“You had to put on a front because they didn’t accept the real you,” Dr. Rita announced.  Me, I never would have thought of any of this.  She, however, had a whole analysis: “Both your father and mother abandoned and rejected you.” Gosh I never would have thought of that, that sounds really embarrassing!

“You have ‘repetition compulsion’- you’re compelled to find men who abandon, so you can recreate the problem ‘on stage.’  So you can go back and fix it,” Rita went on. “But you didn’t break it – you don’t have to fix it.” I wrote that motto on a large 5 x7 file card and it’s still on my desk today.  It sure sounded like plausible and useful data.

But where was the Adult Attachment Interview, needed to diagnose anyone starting therapy?  It’s been around since 1996. Why didn’t she tell me about Attachment Disorder in adults like me, as well as in children? That might have given words to my terror at my lack of bonding. [FN2]

Instead it was all head talk, and the solution was even more head talk.  Dr. Rita, my second therapist, concluded with the same advice verbatim that my first therapist gave at the end of my Oct. 11 blog: “Just let it go,” she said.

“Just stop trying to fix it with men, and let the past go. It’s an act of will.” Just think your way out of it.  But “trying to fix the heart using the head, is like trying to paint with a hammer—it only makes a mess,” as I later learned – much later. [FN3]

Isolation Again

Then Rita lowered the isolation boom—again. “You are the one who has to do it,” she intoned. “You have to feel the little girl in your heart and comfort her, love her, and heal her.  She wants you to be the one to make her feel safe and be the Mom she never had.

“You have to do it alone, that’s the whole point. If you go to other people, she’ll be frightened, because she’ll think you don’t love her, if you’re running to others. You’ll scare the little girl away if you go to anyone else. A child will always run from anyone other than Mom.  Especially from men.  If you go to men she’ll be terrified.”

Forza-zinka-milanovStill, there was absolutely nothing that felt like a child inside me.  I tried and tried; I was paying good money for all this! I listened to Rita’s “Garden Path” imagery over and over on a tape I’d made of her, and did all the exercises; no result but despair.  It was more like “down the Rabbit Hole.”

I got out Verdi’s epic “La Forza del Destino” in which Leonora is consigned to live alone in a monastery cave unto death, to repent of her ill-fated love affair. I sang her farewell aria until I sobbed. I took it all very seriously, and Zinka Milanov (right) rocks as Leonora. But I felt worse and worse.

“I can’t do any of this if I can’t find a child!  Is there any way to put a structure on this process?!” I actually said the following week.

What I meant was “Have you no methodology?  I’m drowning over here!” The more I look at my notes, the less I can understand why no one could understand my protest.  It was a really loud call for help.

My emotions may have been shot, but my thinking brain could still perform.  My notebooks show it all.  I had just worked 30 years to restructure the global monetary system, build rail and water infrastructure projects, and launch billion dollar satellite systems.  So if Rita’s RX made sense, I could get it.  If I could find an inner child, I would. My predicament was bizarre, but no one listened.

Where were the diagnostic tools – or any diagnostic method? Where was the Adult Attachment Interview, I ask again? Hadn’t she read any adult attachment disorder books or anything on adult attachment theory or adult attachment disorder?  But no.

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This is from Chapter 2 of Kathy’s forthcoming book DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.  Watch for the continuing series of excerpts from the rest of her book each Friday, as she explores her journey of recovery by learning the hard way about adult attachment theory, attachment disorder in adults, and the Adult Attachment Interview.

Footnotes

FN1  Taylor, Cathryn L. MFCC, “The Inner Child Workbook,” Penguin Putnam, New York, 1991

FN2  Main, Mary,  “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,” Journal of the American Psychoanalytic Association, 2000, 48:1055-1095. At: http://70-40-200-36.bluehost.com/documents/Main.pdf
–This is a very difficult topic to research, so I did it for you; check my blog on it, with more footnotes at the end: http://attachmentdisorderhealing.com/adult-attachment-interview-aai-mary-main/

FN3  James, John W., Friedman, Russell, “The Grief Recovery Handbook,” Harper Collins, New York, 2009 (original 1998)

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

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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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When Family Doesn’t Get It, Recovery Partners Will

#4 in the news blog series; original post on ACEsConnection, September 26, 2013

When we’re hurting, we all want and need those closest to us to “get it,” but please take comfort from the statistic that it usually does not happen that way.  Why?  Therapist and scholar Jack Kornfield says, “Even Buddha and Jesus had a lot of trouble with their families when they went home!  So did Mother Theresa.  Holding up the ring nuns wear as brides of Christ, she told a journalist: ‘ I’m married, too, and He can be very difficult… ‘  ”

That’s because when we humans get close, to those closest to us, that proximity turns on the fight-flight paranoia in all concerned (in everyone, not just in me).  Why? That’s where humans get the most vulnerable, so that’s where (our bodies and paranoid brain stems feel) we could potentially get really hurt.  There is a lot of literature on this problem – please don’t feel alone on this!  You are exactly normal.

Henry Cloud & John Townsend

Henry Cloud & John Townsend

This is why we have support groups and that is why therapists exist.  In my experience it’s instead my recovery partners, my trauma-informed therapist, and trauma-informed folk such on ACEsConnection who get it.  And that’s a life-saver.

Dr. John Townsend says: “There will be people who are marked, at the same time as you.  Find them.”

Find people who are in the same boat, who are not in denial, who do get it– and spent a lot of flight time sitting with them, face to face.  That’s where the real healing is.

When I did that work, I didn’t know about ACEsConnection, the  private Facebook  of the ACE Study.  ACE is the top research on childhood emotional pain and health;  it shows Adverse Childhood Experiences (ACE) actually create most medical, mental health and emotional issues in adults.

What I did in 2009 was to get relief by piling on many extra hours of “flight time” sitting with my Recovery partners, one whose parents were dying, and another whose spouse committed suicide.  The emotional pain was excruciating, but the process worked — because we were in the same boat.

We used the “Grief Recovery Handbook” by John James & Russell Friedman and wrote “Grief Letters” as the book assigns. It’s an arduous method and they do caution:  Don’t do this alone!

So arduous, we were advised by the pros to “schedule in the flight hours” with a Grief Partner — and we met in pairs every single Wednesday night for 3 hours and Saturday afternoons for even longer — for three years.  We just read our Grief Letters to each other.

Grief Recovery Handbook,+20th+Anniversary+Expanded+EditionWe shared everything, and I do mean everything, the deepest of grief.  One hour sharing by each of us of our letter of the week, sharing in turn, while the other sat with mouth shut (that’s why “Hello Kitty” has no mouth) and practiced compassionate listening.  After sharing 1 hour each (no one can take more than that in a day!), we’d have a snack and chat, or go walk on the beach on Saturdays.

I can not possibly say in mere writing how deeply healing that was – it saved my life!

This can not be done by email or telephone.  It’s the eye contact that heals the brain; ask Dr. Bruce Perry:  the eyes literally carry the image of the soul from one human into another. That’s how mothers co-create their babies’ brains, and that is the only thing that can heal us for the rest of life.  “It’s all about the face time.”

But our family members were just not in the same boat (or in denial; they might be in the same boat but couldn’t face it; denial harmful to all concerned).  So trying to get from them, something they simply do not have, was just not the best use of our truly valuable time.  Sooner or later, they will get it — but probably later.  I had one family member in denial who lives 3,000 miles away, and that was all the family I had;  I had to wing it from scratch.  That was a big ouch by itself.  It still stings.

Then I “accidentally” met my recovery partners in choir.

If no recovery partners appear magically in your ‘hood,  join ACEsConnection.com — nation-wide and world-wide– and go to or form an ACE meeting.   Or find or form a support group at your local house of worship or county health organization.  I’ve tried all the groups from DivorceCare to GriefShare, Codependents Anonymous, Celebrate Recovery (aka CR, Pastor Rick Warren’s national group), and even Al Anon.

It was incredibly painful because so many just do NOT get it — but I became a gold mine of ideas on how to find recovery partners.  Message me, I’ll help you — I found them, I did recover — and now I feel great most of the time.

If all else fails there are weekly Al Anon meetings in every city in America and they are not just for families of addicts. They will be there for anyone who is hurting and needs loving acceptance; just walk in and admit to that tiny streak of co-dependency that lurks in all of us.

Plus: Here is an incredibly fruitful link I just found on http://acestudy.org/faqs
Q:  I’m a survivor and/or perpetrator of child abuse in search of help; what should I do?
A:  Talk with your physician, and ask for a referral.  No matter what your age, if you do not currently have healthcare coverage, contact the nearest children’s hospital or children’s advocacy center and ask for help. This jumps to the National Children’s Advocacy Center at http://www.nationalcac.org/locator.html and to illustrate, I put in my zip and got 5 matches within 50 miles such as:
1. Child Abuse Services Team (CAST), 401 The City Dr., Orange, 92868  (714) 935-7599
2. Miller Children’s Abuse and Violence Intervention Center, 2865 Atlantic Ave., Long Beach, 90806  (562) 933-0590
3. Children’s Advocacy Center for Child Abuse, 363 S. Park Ave. Ste. 202, Pomona, 91766  (909) 629-6300
4. Riverside Child Assessment Team, 26520 Cactus Ave., Lower Level Moreno Valley 92555  (951) 486-4345
5. Palomar Pomerado Forensic Health Child Abuse, 121 N. Fig St., Escondido 92025  (760) 739-2156

Building a Life Team

I’m no stranger to emotional pain so bad it can lead to suicide. My new book “Don’t Try This at Home: The Silent Epidemic of Attachment Disorder” notes the pain was so intense, it nearly did.

Rick & Kay Warren, Matthew 9-28-13In fact this blog resulted from a Sept. 17 interview with Pastor Rick Warren on his son Matthew’s suicide this year. Pastor Warren told CNN, “Matthew was not afraid to die.  He was afraid of pain.”

Pastor Warren and his wife Kay have been passionately calling for a change in our mental health system to recognize and deal with the fact that this happens too often, starting with a July 26 statement calling for complete mental health system reform.

Among the comments I received after posting this warning about how bad the pain can get, were these:

“Thank you for sharing.  I have Major Clinical Depression myself and I can totally relate to what his son went through. Many times, even the people who say they love you the most, don’t really get what it’s like to go through such intense emotional pain that you want it to just stop no matter what the cost.  Then, those you have no choice but to turn to for support–actually work against your recovery by saying and doing things that are counter productive.  It’s the worst ‘Catch 22’ I can imagine being in.”

The next comment was:

“So very well stated! And when folks don’t get that they are acting in a counter-productive way, the person in need is getting re-traumatized again; it’s a mini-re-traumatization. Not unlike a micro-aggression or micro-inequity.

“Micro-aggressions/micro-inquities are usually attributed to minority experiences.  There is a ‘dose-response effect’… a cumulative effect of these and other traumas that create a heavier burden for the person in need as time goes by.  The fundamental essence is that the person is alienated from ‘the group.’  Being a part of one’s social group is a biological need of all mammals ! ”

I replied, “No, most people can’t get what it’s like ‘to go through such intense emotional pain that you want it to just stop no matter what.’  It’s so hard, that Catch 22 you talk about.  Many times in 2008-2011 I was in Matthew Warren’s shoes.  But I had to see a friend every day whose spouse had committed suicide, so I had to look the results in the eye. That is the only reason frankly I survived.

“I’ve been thru micro re-traumatizations like that for decades. This is why I so appreciate ACEsConnection.  Because there, I can be 100% my real self, trauma and all, and everyone ‘does get it;’  you get the real me.   So no re-traumatizations.  Priceless!”

Feel like you’re at the End of the Line?  Here’s the proverbial bottom line:

It is SO important for us to simply be heard saying the truth of what we feel, the whole truth, and nothing but the truth – and then to , receive a totally accepting response.

As in “you belong, no matter what you are feeling. ” And it’s just very difficult to get family to do that;  it’s too intense for them.  It’s just human nature; let’s accept it.

That’s why Dr. John Townsend also advises that we all create a “Life Team” of seven people who are not family – Seven “Recovery” team partners – so we can call someone every day and share how we really feel, no bull, and be accepted and validated.

He says it’s only by bringing our “bad parts” into relationship with other humans, that we can heal them. Amazing. You should see what his list of “bad parts” includes, it’s astonishing.  He’s for sharing every not-good thing we feel under the sun.  Even horrid sexual impulses.  Talk about the emotions, so that we can feel it and heal it – then we dissipate the impulse and don’t act out.

Make the Call !  Get Your 5 Supplements…

Dr. Townsend says everybody, every day, requires — as a physiological need — what he calls the Five Supplements:

Grace, Empathy, Validation, Acceptance, and Encouragement.

Can you imagine that?  As an ACE survivor, the first time I heard him say this, I thought:  “This shrink is out of his mind.”  I’d never had such a wonderful experience in my life – let alone every day of my life — and as a doctor-certified requirement of the human soul.

OK, so we need a list of seven people who will do this for us – because obviously, we are also going to be there for them and do it for them!  That’s what “General Theory of Love” calls “100%-100%” agape. I’ve been doing this and it really works.

But then: we have to make the call. That’s usually the worst part, we are so mortified.

harlow-monkey-getty sm, better ResolutionI once told my therapist: “Last night I felt like the Harlow’s monkey shown in ‘General Theory of Love’. ”  It’s a baby monkey huddled up in a ball of agony like a spider about to die — after it was removed from even the terry cloth mother monkey and left in a cold bare wire cage.

But I had called a recovery friend the night before, and simply told them that.  And got accepted telling it.  My doctor replied:  “That’s the point.  The monkey couldn’t make the call.  YOU made the call!”  And I felt better.

To which our team of commentators responded:

“Saying one’s truth and being ACCEPTED as in “belonging” is just spot on! Again, it’s a biological need.  Mammals NEED to belong.  Dr. Gabor Mate states this often.

“Sadly, an excellent example is bullying.  It’s why so many young kids take their lives when bullied.  Being ostracized from the group is to inject disease (or as some would point out “dis-ease”) into the victim; denying one from BELONGING. Then one looks at Dr. Daniel Siegel’s work and understands that individual biology is modulated by interpersonal experiences (click the link).”

And:

“I REALLY appreciate what you’ve both shared with us.  It has a ring of truth to it (resonating loudly within me) and I wish there was a way to TEACH that to every single person on the planet.  It’s as basic a need as food, water, clothing, shelter.  Our society suffers when WE suffer — rejection and isolation are such HUGE barriers to self-esteem, feeling loved, being accepted.”

So that’s it:  Everybody, every day, requires, as a physiological need, Dr. Townsend’s Five Supplements:

Grace, Empathy, Validation, Acceptance, and Encouragement.

Then, let us build our Life Teams, and let us keep working together here in dialogue.

And remember: the monkey couldn’t make the call – but we can make the call.  So make the call!

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How Your Brain Works 101

#2 in my News Blog series; original post September 13, 2013

BrousBlog9a Perry head shotDr. Bruce Perry just put out his latest on “How Your Brain Works 101,” in his September 5 webinar for the National Council on Behavioral Health. Perry’s revelations at Dr. Daniel Siegel’s March 8  (2013) UCLA Conference “How People Change” hit me in the solar plexus.  Now you can hear him and download his slides, (Click here and scroll all the way down to September 2013). [FN1]

You know how your car works – don’t you want to know how your brain works? Click here for an introductory  video on how Attachment Disorder causes brain trauma  [FN2]  Click for Dr. Perry’s YouTube channel with educational videos in depth: https://www.youtube.com/channel/UCf4ZUgIXyxRcUNLuhimA5mA?feature=watch

I first heard of Bruce Perry in August 2010; not his name, but his substance. I was commuting to another high-pressure defense job on the 91 freeway outside Anaheim, CA, worrying about how to pour concrete at Seal Beach Naval Base.  It didn’t look to my clients, or to me, as though I had anything wrong with my high-performance business brain.

On the car stereo was a CD by psychologist Dr. Henry Cloud. “Humans are neurologically designed, physiologically designed, psychologically, spiritually, emotionally, and cognitively designed, to be in a relationship where you are loved,” Cloud said to my shock. “You are designed to take aspects of that relationship inside of you, and they actually become a part of who you are.  My 17-month-old came into the world with nothing in her head.  A lot of need, not a lot of words, didn’t read.  Babies are all need and they cry. Adults must calm them, and the minute we put them down, they start crying again.

“But after we do that a million times, the gap for how long they can tolerate not being held gets wider and wider. They take our love from the outside, and it becomes part of them on the inside… Love becomes actual equipment that you take in and walk around with.” [FN3]  I felt sad; I couldn’t identify.

But watch how my body reacts to the right research:

Cloud went on, “We can now do scans of the brain of older kids who were in institutions and were not held, comforted or soothed, and there are parts of the brain which are dark. There’s nothing growing in there — because nothing was planted; neurologically there’s literally no brain activity. But the kids who were held and loved, those parts of the brain are physiologically growing.”

I nearly drove off the 91 overpass at 70 MPH. It hit me in the gut the minute he said it. “Oh, S#$%”, I thought, “parts of my brain are dark!”  (Go tell that to the Marines at Seal Beach.)

It wasn’t until 2 1/2 years later when some guy named Perry put up his slides at UCLA in March 2013, that I saw the pictures. It was brain scans of two children aged 3, a normal brain in grey, and one labeled “extreme neglect,” parts of which were black. In that moment, I knew Cloud had referred to Bruce Perry’s work. [FN4]

As I’ve shown in previous posts, maybe 50% of Americans have some degree of attachment disorder, neurological areas which didn’t get Dr. Cloud’s “love on the inside.”  We don’t want to go around with parts of our brain dark.

Most Primitive  Brain Develops First

BrousBlog9c Perry Slide1 Brain 4 PartsDr. Perry says we’ve got to learn about the neuro-biological growth of the brain in order of time sequence from  conception to later development in infancy and childhood.

He calls this the Neuro-sequential Model of Therapeutics (NMT).  Dr. P’s “Four Part Brain” slide above shows the time sequence from the bottom up: first the brain stem develops (pink); then the diencephalon cerebellum (yellow); they make up our primitive reptilian “survival” brain.  Next develop the emotional limbic brain which only mammals have (green), and finally the thinking cortex (blue).

Why time sequence? Our entire big Einstein brain is an outgrowth of its most primitive part: the brain stem (the knob at the top of the spinal chord), and its spin-off, the cerebellum.

This “reptilian brain” is in the back of your head at the level of the ears. It maintains rock bottom survival such as body temperature, heart rate, sleep, and breathing – all the functions you never think about which if they didn’t happen you’d be dead. Not only reptiles have the same apparatus but so do pre-bony fish like sharks. That’s humbling: our whole brain starts with something that primitive.

“During development, the brain organizes from bottom to top, with the lower parts of the brain developing earliest,” Dr. Perry says. Reptile brain better hit the ground running at birth or infants don’t breathe; the rest of the brain can and does grow in later. “The majority of brain organization takes place in the first four years of life,” he says. “Because this is the time when the brain makes the majority of its ‘primary’ associations and core neural networks organize as a reflection of early experience, early developmental trauma and neglect have disproportionate influence on brain organization and later brain functioning.” [FN4 Op cit]

What goes wrong from “conception to 36 months” can fry our reptilian brain and put it in permanent fight-flight or freeze (dissociation shutdown). Then the entire brain can be thrown out of whack starting from its first cell divisions.

As the ACE Study has shown, this results in heart, gut, and many other chronic physical diseases throughout adult life.

“The brain is an historical organ,” Perry said.  “The NMT Core Assessment’s first step is a review of the key insults, stressors, and challenges during development. Intrauterine insults such as alcohol or perinatal care disruptions (such as an impaired inattentive primary caregiver) alter the norepinephrine, serotonin, and dopamine systems of the brain stem and diencephalon that are rapidly organizing. These early life disruptions result in a cascade of functional problems in brain areas these neural systems innervate.”

Think your thinking brain’s in charge? “Think” again – we’re arrogant about how much our thinking brain can do. Fact is, it’s the new kid on the block in the brain. It has a lot less influence than we imagine on the roiling instincts and feelings in the subconscious or “downstairs” brain, as Dan Siegel calls the rest of the brain below the cortex.  Siegel says the “downstairs brain” also  includes thick clusters of neurons associated with the brain stem that form around our viscera (heart, lungs, gut etc.).  Development of all that can go wrong from the hour the sperm hits the egg. It did with me.

“When a child has experienced chronic threats, the brain exists in a persisting state of fear,” Perry says. This “makes the stress response oversensitive, over-reactive, and dysfunctional due to over-utilization of brain stem-driven reactions. Such reactions become entrenched over time, and the ‘lower’ parts of the brain house maladaptive, influential, and terrifying pre-conscious memories that function as a template for the child’s feelings, thoughts, and actions.” [FN4]

“Cognitive behavioral therapy (CBT) is great if you have a developed frontal cortex – but we’re talking about a five year old kid who’s so scared to death most of the time that it’s shut down his frontal cortex ’cause he just saw his mother get shot,” Perry told his UCLA therapist audience March 8. “You’re going to do 20 sessions of CBT and expect change?  B#$$%&! (expletive)  That’s a fantasy.”  (Wild applause).

Listening to him talk, I can feel things inside me resonating, probably things that didn’t develop right in the womb, and I can feel it healing because, finally, here is compassion for my situation. It’s a remarkable experience.

When I hear Dr. Perry and his colleagues identifying these issues, it hits me in the solar plexus and the gut. I feel like someone is telling me “You’re not crazy, this actually happened deep inside you, you don’t have to conceal the pain anymore. You can be understood, you can be accepted as who you are.

“You can say exactly how you feel for the first time in your life and we are not going to run screaming from the room. We are going to accept you, because we can say scientifically that this is the way your cells developed in the environment you were in.”

Once I feel accepted in this profound way, I literally feel the problem begin to heal.  Dan Siegel reports that it’s been proven by brain scans that this feeling of acceptance and belonging produces re-growth of damaged brain tissues. It simulates the missed environment of love, acceptance and “we’re glad you’re here” which the infant was designed to experience at birth.

“Born for Love”

BrousBlog9d Perry Slide2 Attachment,StressBruce Perry and his Attachment Theory and trauma specialist colleagues like Bessel Van der Kolk, Daniel Siegel, Allan Schore, and Mary Jo Barrett, are also overturning the American Psychiatric Association (APA) apple cart by calling this “developmental trauma.”  It starts in the womb and is continuous from there, going on in the pre-conscious years.

It differs completely from incident-by-incident based trauma such as assault, rape, school violence, or combat stress, which can hit at any age. These later “PTSD” traumas have been assumed to what trauma is, yet horrible as they are, they are just not all there is.

Many (like me) take a lot of damage in wrong therapy which treats developmental trauma as if it were incident trauma. The APA’s latest “what’s my disease” bible, the “Diagnostic and Statistical Manual of Mental Disorders (DSM-5),” just out June 2013, doesn’t even recognize the existence of developmental trauma.

How to heal? Dr. Perry lays out the brain science behind Dr. Cloud’s idea of “getting love on the inside.”

“Attachment is when the baby learns by thousands of good experiences that stress is tolerable because it leads to reward opiates such as dopamine in our body, and that this pleasurable outcome is cathexsized to a person, Mom, who consistently attunes to it about this,” Perry said at UCLA. “When the baby feels distress, the attuned Mom feels distress and gets her own pleasure rewards by responding to the baby. So the infant brain weaves together the neurobiology of what interaction with another human being is, and connects it to stress relief, pleasure and safety, when this happens repeatedly. Ultimately, just seeing or hearing Mom makes you feel safe and pleasurable. Let a wounded combat soldier talk to his mom, and he’ll require 45% less pain meds.”

“Patterned, Repeated, Rhythmic Activity”

“Because the brain is organized in a hierarchical fashion, with symptoms of fear first arising in the brain stem and then moving all the way to the cortex, the first step in therapeutic success is brain stem regulation,” Perry said.  “An example of a repetitive intervention is positive, nurturing interactions with trustworthy peers, teachers, and caregivers, especially for neglected children who have not had the neural stimulation to develop the capacity to bond with others.

“Others are dance, music, or massage, especially for children whose persisting fear state is so overwhelming that they cannot improve via increased positive relationships, or even therapeutic relationships, until their brain stem is regulated by safe, predictable, repetitive sensory input.” An hour here and there of even sensitive therapy is rarely enough, he says.

“Children with relational stability and multiple positive, healthy adults invested in their lives improve; children with multiple transitions, chaotic and unpredictable family relations, and relational poverty do not improve even when provided with the best ‘evidence-based’ therapies. The healing environment is a safe, relationally-enriched environment,” he says.

“The only way you can move from these super-high anxiety states, to calmer more cognitive states, is rhythm,” Perry emphasizes.  “Patterned, repetitive rhythmic activity: walking, running, dancing, singing, repetitive meditative breathing.  You use brain stem-related somato-sensory network regulation, which make your brain accessible to relational reward and cortical thinking.”

Dr. Perry’s ChildTrauma Academy in Houston offers courses such as “Somatosensory Regulation Plan for Dysregulated Children” and “The Power of Rhythm: Music, Movement & Language.”  Somatosensory rhythmic programs at Dr. Bessel van der Kolk’s Trauma Center in Boston feature yoga, drama, drum circles,  trampoline work, and more.

“If you want a person to use relational reward, or cortical thought,” he says, “they’ve got to be emotionally regulated first!  We must regulate people, before we can possibly persuade them with a cognitive argument or compel them with an emotional affect.  All our contingency-based models do nothing but merely escalate their negative arousal!”

Sound stupid, like your doctor saying “Scram and go cool off at the gym” ?  I thought so – until I tried it.  It works, big time. But what happened was so explosive, it’s another blog for another day.

The take-away is 1: Listen to Dr. Perry; figure out how your brain does work; see if anything he says resonates.  Call up the ChildTrauma Academy and get their materials and training on Somatosensory Regulation and the power of rhythm.

Or if you can’t wait, as I’ve said before, find a really empathic, loving therapist who knows trauma inside out, and bring him that Peter Levine book. [FN5]  That’s what I used to do somatosensory work before I heard of Bruce Perry.  You’ll need professional supervision when you do the exercises on the CD in the back of Levine’s book, and look out world.

Even if we’re 92, we can grow parts of our brain. Daniel Siegel did it with a 92-year-old lawyer using mindfulness practice. [FN6]

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Excerpts from Kathy’s forthcoming book DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment DisorderHow I accidentally regressed myself back to infancy and healed it all and related research of attachment and brain science are posted here every Friday. Watch for the continuing series of excerpts from the rest of her book, in which she explores her journey of recovery and shares the people and tools that have helped her along the way.

Footnotes

FN1  Perry, Bruce D. MD, PhD, “Helping Children Recover from Trauma,” National Council LIVE, National Council on Behavioral Health, September 5, 2013; http://www.thenationalcouncil.org/events-and-training/webinars/webinar-archive/  Scroll down to September 2013.

FN2  Bruce Perry, Daniel Siegel, et.al, “Trauma, Brain & Relationship: Helping Children Heal,” (25 Minutes) www.youtube.com/watch?v=jYyEEMlMMb0 – an introductory video on Attachment Disorder. A new understanding of how trauma effects the development of the mind-body system, and how it affects children’s behaviors and social relationships. Copies at www.postinstitute.com/dvds.

FN3  Cloud, Henry, PhD, “Getting Love on the Inside,” Lecture, April 2002 (CD), Mariner’s Church, Newport Beach CA, www.Cloud-Townsend Resources.com, [Coauthor with Townsend, John, PhD, of “Boundaries,” Zondervan, 2004]

FN4  Perry, Bruce, MD, PhD, “Born for Love: The Effects of Empathy on the Developing Brain,” Annual Interpersonal Neurobiology Conference “How People Change: Relationship & Neuroplasticity in Psychotherapy,” UCLA, Los Angeles, March 8, 2013 (unpublished).
Dr. Perry’s latest research and key slides (otherwise hard to obtain)  are in his National Council speech in FN1 above.
Key videos, articles on Interventions, Trauma, Brain Development/Neuroscience, etc. are at: https://childtrauma.org/cta-library/
“The Neurosequential Model of Therapeutics” by Perry, B.D. and Hambrick, E. (2008)  is  at: http://childtrauma.org/nmt-model/references/

FN5  Levine, Peter A., PhD, “Healing Trauma: A Pioneering Program for Restoring the Wisdom of Your Body,” Sounds True, Inc.,  Boulder CO, 2005; ISBN 1-159179-247-9

FN6  Siegel, Daniel J., MD, “How Mindfulness Can Change the Wiring of Our Brains,” National Institute for the Clinical Application of Behavioral Medicine, www.nicabm.com,  March 2011.  Check for the passage on a 92 year old lawyer code-named “Stewart.”

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