Tag Archives: Daniel Siegel

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

Scary Parents

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

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

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

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

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

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

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

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

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

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

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

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

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

The Adult Attachment Interview (AAI)

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

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

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

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

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

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

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

Astonishing Results You’ve Never Heard

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

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

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

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

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

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

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

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

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

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

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

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

Footnotes

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

FN2  Felitti VJ, MD; Anda RF, MD, et. al, 1998, “Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study,” American Journal of Preventive Medicine 1998;14:245–258.  Detailed article on the ACE Study: http://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/

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

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

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

FN6  Bowlby, John, “The Nature of a Child’s Tie to His Mother,” British Psychoanalytical Society, London, 1958; “Attachment and Loss,” New York, Basic Books, 1969

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

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

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

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

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

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

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

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

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

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

FN17  Main 1985; Main & Goldwyn 1984

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

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

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

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

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

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

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

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

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

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

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

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

 Strange Situation  Experiment

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

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

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

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

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

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

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

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

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

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

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

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

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

Footnotes

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

FN2  Felitti VJ, Anda RF, et. al, 1998, “Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study,” American Journal of Preventive Medicine 1998;14:245–258.  Detailed article on the ACE Study: http://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/

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

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

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

FN6  Bowlby, John, “The Nature of a Child’s Tie to His Mother,” British Psychoanalytical Society, London, 1958; “Attachment and Loss,” New York, Basic Books, 1969

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

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

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

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How to Use My Website

OLYMPUS DIGITAL CAMERAFor new readers signing up, bless you for your patience. I’m new to Attachment Disorder Healing, too — and it’s my website.  A note on “How to Use” AttachmentDisorder Healing.com is overdue.

I fell into all this entirely by accident, when attachment disorder hit me upside the head.  Just as the latest brain science on how it works and how to heal was flooding in.  So I’ve been going a bit ape (above), multiplying content here like rabbits — faster than I’ve been able to index it so you can find what you need. (Click on pics for clear shots; my software’s glitched.)

My webmaster finally spanked me (metaphorically speaking, of course) and said “There’s too much good info on here, with no way to find it!  Re-index the place so that people can find your book, your Featured Topics, and your News Blogs of the Week.”  So here’s a new page to help you find stuff:

Book:  The first 30%  of my psychiatric autobio “Don’t Try This at Home” is posted on the New Book page here.  I’ve got 60% of it written, but all this trauma and brain science news has kept me tied up blogging, instead of “book-ing.”  I feel so much better now than I did during the events in the book, events which got me where I am.

Dr. Peter A. Levine talks about how prey like an impala, running in full fight-flight, will suddenly go into freeze, pass out and keel over — an instant before a predator such as a cheetah gets a claw in. Any mammal’s vagus nerve will deck us like that when the nerve “neurocepts” overwhelming danger in the environment  — no thinking involved.

Kathy w. Cheetah SignI used to feel like that impala; the world was a dangerous place and I’d go into freeze…  Not anymore!  So who wants to write about 2011 when all this great news is happening in 2014?  OK, ok, I’ll crack down and get the book onto Amazon soon.

Featured Topics (find info by topic):
Adult Attachment Disorder, Adult Attachment Interview (AAI)
Attachment-based Psychotherapists Directory and Referrals
Brain Science
Developmental Trauma, Infant Development
Grief Recovery Handbook (GRH) and Method

Healing with Body Work, Rhythmic Regulation
Mammalian Attachment, Limbic Brain, “Fur”

Meditation, Being Present, Radical Acceptance
Music and Attachment, MP3 audios, Sheet Music

News Blogs: Click here for News Blogs; there are too many to list on this “How To” page, but here are the main themes:
Latest on the Brain
How We Develop
Did I Attach?
50% Suffer from Trauma
On Healing: Body Work
Being Present, Now
Watch Out for More Trauma

What is Addiction?

Resources: For Seminars, check now for the latest Brain Science of Trauma Webinar series live on line October 15 – November 19, at Now Live: Oct-Nov 2014 Trauma Webinars
Other resource tabs include:
Books & Reviews
Find a Support Group
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Key Articles
Videos & Audios

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If you find the site useful, do remember:  I’m not a PhD studying “those people” with attachment disorder. I’m just a paramecium writing about how it feels to be a paramecium.

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

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Is Our Medical System Traumatizing Us?

StethoscopeHey, it happens to us all. I’m healthy as a horse, but a body part was bugging me, so at my annual check up I asked to see a specialist.  I love my family doc, er I mean “primary care,” and I love this specialist.  They’re the best there is.  And they’re victims of the system as much as we.  I’m grateful they’re here just when I need them, with all their years of training and miraculous skills. I don’t want to cause them trouble, so let’s call it “body part X.”

It took months to get authorization for the specialist, thanks to insurance lunacy. Meanwhile X got worse, but still I expected just a routine new prescription.

The new doc walked in, took one look, and said, “You’ve got [deleted] here, and also there. You can go on like that for a while, and  I could just write you another prescription for Y [as it’s been handled before].  But you’ll be back in a year because it will get worse.  It’s not for me to tell you what to do, but we can replace [body part X] with an implant…

“Outpatient surgery takes 20 minutes, insurance pays for it all because it’s legally classified as  ‘medically necessary’ since otherwise you’re going to lose your Z [essential function]. Then you can forget about the problem, you’ll be done.”  (And no, it wasn’t prostate cancer.)

“Outpatient surgery”?  So professional.  Me?  I’ve just been told, “you’re getting a knife in a real scary place.”

The specialist (I do like him) told me later that at that first meeting, he then proceeded to outline my options for the different available types of inplants, and following surgery, what functional abilities each implant type would give me. I was with him less than 20 minutes. Next he sent me on to his medical assistant to be checked by one more machine, who sent me to their lady “surgery coordinator.”  By which time I was hit by a barrage of panic from my belly.

I’ve never had more than a tooth pulled in my life, and OK, I’ve always been a “fraidy cat.” And all I could think of was “Surgery. Surgery? Surgery — there?

From the first mention of “surgery,” clearly I was in trauma. But why did this occur to no one, with so many professionals there?  They seemed so oblivious that anything upsetting could possibly have occured, I was afraid to show it.

“We’ve discovered in our work in trauma that going to the gynecologist, pediatrician, social worker at school, any of the helping professions, can be traumatic,” says trauma expert Dr. Mary Jo Barrett (below right). “People with prior trauma, especially, experience their attempts to get help from the medical system as traumatic – because they experience it as a threat to their bodies.”  [FN1]

Mary Jo BarrettAnd according to the ACE Study, roughly 50% of us suffer one or more types of Adverse Childhood Experience (ACE) trauma. That means half of us are going to experience such a medical issue as trauma.  Including clearly me.

But in fact any human who’s a mammal will experience something like this as trauma, science is just starting to show.  And even the most well-meaning, kindly medical personnel have never gotten the memo on what is trauma and how their system contributes to it.

Not to mention the legions of pretty much heartless medical personnel who have had their humanity forcibly ripped out of them by their training. Psychiatric expert Dr. Daniel Siegel, MD, says he almost quit med school when he realized he was being deliberately trained to destroy his emotions and view patients as machinery to be fixed, in the name of better performance.

No Time to Think – Let Alone Feel

Not to mention the insurance companies who now force doctors to stay glued to a stop-watch while seeing patients. Docs are forced to spend no more than X (pardon the pun) minutes per patient, no matter what, or they won’t be paid, can’t pay their staff or their astronomical malpractise insurance premiums, and must close their doors.

Upset?  Shove it.  Suddenly there I was with the “surgery coordinator,” and I had no time to panic, feel any emotion, or even to think. Wham, she hit me with a barrage of wildly complex surgery insurance questions involving a five-way tangle between my HMO, the specialist, the primary doc, the doctors’ “medical group,” and the hospital– made more complex by the fact that my insurance was about to change radically in three months. Worse, she was the type who quickly rattles off a list of in-house acronyms that only an insurance exec could understand, then says “OK?”

No, it was most definitely not ok.  In fact with all my experience handling insurance companies over many years, 15 years experience interviewing engineers about rocket science, a BS in Math and 3 foreign languages — I still couldn’t understand a word she said.  Surely she’s good at what she does, but her ability to explain what she does to another human being was sub zero.

As I began to drown under her spiel, that internal voice just got louder: “Surgery. Surgery? Surgery — there?

On she went with questions about my meds, vitamins, lifestyle, and complicated instructions about new meds they were going to give me before surgery, and when to take what in a detailed month-long schedule. The level of detail would have overwhelmed anyone who’d just been given good news. By the time she was done rattling, the office was about to close at 5 pm and I was ushered out.

No more than two minutes of the entire two hour ordeal had been allowed for discussion of, or even for me to think about, the real Square One decision at hand:  Surgery? Go for surgery, or not?

“Surgery. Surgery? Surgery — there?”  It seemed like a nightmare from which I’d soon wake up. As it turned out, that feeling lasted about ten days.  I kept thinking, “Oh, this is just a bad dream. I’ll wake up any minute.”  No such luck. Somehow I made it through an evening of appointments straight until 9 pm, drove home and collapsed at 11 pm.

Involuntary Reaction to Survival Threat

Stephen Porges mages“Medical procedures send many of the cues to the nervous system that physical abuse has,” warns Dr. Stephen Porges (left). “We need to be very careful about how we deal with people and whether or not even medical practices trigger some of the features of PTSD…

“Our clothing is taken away. They remove your glasses. We’re left in a public place and all predictability is gone. Many of the features that our nervous system uses to regulate and feel safe are disrupted,” says Porges. [FN2]

“And one of the most potent triggers of neuroception un-safety, is low-frequency sounds which the neurological system interprets as ‘predator.’ In ‘Peter and the Wolf,’  friendly characters are always the violins, flute, and oboe. Predator is always conveyed via lower frequency sounds. Medical environments are dominated by low frequency sounds of ventilation systems and equipment. Our nervous system responds, without our awareness, to these acoustic features and shifts physiological state.”

Medical pronouncements about what’s going to happen to our bodies, and medical environments generally “trigger ‘neuroception’,” Porges explains, “the neural circuits regulating the autonomic nervous system” tell our bodies that we are under threat. The news goes straight to our brain stem which takes action, without ever involving our thinking brain. Something entirely involuntary happens.

“Neuroception is not perception. It does not require an awareness of what’s going on,” says Porges. “Throw away the word ‘perception.’  Neuroception is detection without awareness.  It is a neural circuit that evaluates risk in the environment from a variety of cues. When our mammalian social engagement system is working and down-regulating defenses, we feel calm, we hug people, we look at them and we feel good.  But in response to danger, our sympathetic nervous system takes control and supports metabolic motor activity for fight/flight.  But next, if that doesn’t get us to safety, the ancient unmyelinated vagal circuit shuts us down,” says Porges, literally describing shock.

He gives an example: himself.  “I had to get an MRI. Many of my colleagues conduct research using the MRI, and I thought, ‘This will be a very interesting experience.’  You have to lay down flat on a platform and the platform is  moved into the magnet. I enthusiastically lay down on the platform for this new experience. I felt really good. I was not anxious…

“Slowly the platform moved into a very small opening of the MRI magnet. When it got up to my forehead, I said, “Could I get a glass of water?” They pushed me out and I took my glass of water.  I lay down again and it moved until my nose was in the magnetic.  I said, ‘I can’t do this.’  I could not deal with the confined space; it basically was putting me into a panic attack…  And an MRI produces massive amounts of low-frequency sounds…

“My perceptions, my cognitions, were not compatible with my body’s response.  I wanted to have the MRI.  It wasn’t dangerous. But, something happened to my body when I entered the MRI. There were certain cues that my nervous system was detecting and those cues triggered a defensive of wanting to mobilize to get out of there. And I couldn’t do anything about it. I couldn’t think my way out of it. I couldn’t even close my eyes and visualize my way out of it. I had to get out of there! Now when I have a MRI, I take medication.”

I could go on.  I could tell you how I dealt with the question “should I have this surgery” the very next day, by getting a second opinion in my area, and was told “Yes, and soon.”

I could tell you how after a few days, I realized that the next looming question was what type of implant to choose, how long it would take each type of implant to get approved through the insurance maze, and where each type would leave my body functions after surgery.  So I put out queries to the second specialist, and to three personal friends in Maryland, New York, and Illinois who are doctors, who all polled their colleague specialists in body part X.   All of them came back with conflicting advice.

I didn’t ask my first specialist because I’d been told by the surgery coordinator to wait for a packet by mail, believing it would tell me how to select implants.  But when it came a week later, it didn’t mention implants.

As noted, the specialist said later that at our first meeting, he did outline my options for the different types of implants. I was with him less than 20 minutes, half of which was a physical exam with a lot of machines.

Perhaps he gave a good briefing, but I was in “Surgery!?!” trauma, and my brain was out to lunch — like Dr. Porges in the MRI.  If so, didn’t he realize I might be too preoccupied by the word “Surgery” to hear all those critical complex details immediately?

Perhaps he just read me an incomprehensible list in under a minute.  I’ll never know; I simply can not remember even a single mention that first day of this issue, which is still tying up many of my waking hours at this writing.

Because now, nine days later, I have his read-out, and read-outs from the other four specialists – and none of them agree on the implants.  Some of them even imply that the type my specialist is recommending could be a health hazard long term.  And none of them have the remotest idea there might be a bit of trauma after all this at my end.

It’s 1 am and time to post this blog — so I can get up tomorrow and try to get this straightened out in time to select the correct implants, in time to get them authorized by insurance, in time for —  surgery.

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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 Barrett, Mary Jo, MSW, “Addressing PTSD: How to Treat the Patient without Further Trauma,”
NICABM Webinar, June 29, 2011. Dr. Barrett’s latest book is “Treating Complex Trauma: A Relational Blueprint for Collaboration and Change,” orders are here:  http://goo.gl/SEiWVD  and http://www.centerforcontextualchange.org/publishedworks.html

FN2 Porges, Stephen, PhD, “The Polyvagal Theory for Treating Trauma,” 2011, http://stephenporges.com/images/stephen%20porges%20interview%20nicabm.pdf
—“Body, Brain, Behavior: How Polyvagal Theory Expands Our Healing Paradigm,” 2013, http://stephenporges.com/images/NICABM%202013.pdf
“Beyond the Brain: Vagal System Holds the Secret to Treating Trauma,” 2013, http://stephenporges.com/images/nicabm2.pdf
—”Polyvagal theory: phylogenetic substrates of a social nervous system,” International Journal of Psycho-physiology 42, 2001,  Dept. of Psychiatry, Univ. Illinois Chicago, www.wisebrain.org/Polyvagal_Theory.pdf

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Fire Up the Right Brain

Dan Siegel Website PicWhen we last left Stewart the 92-year-old lawyer in Dan Siegel’s office June 25,  “the presenting problem was:  his wife got sick, and he became more socially withdrawn… losing himself in his books,” Siegel said. “Rather than confronting what the illness of his wife of 65 years brought up in him, this unbelievable sense of vulnerability which he wasn’t prepared to sit with, he withdrew into his law books.”  [FN1]

Stewart could handle and remember lots of facts, like his or others birth dates, a left brain function.  But he had little or no emotional response, nor could he recall much about his fleshed-out lived experiences, like what he did on his son’s first birthday, a right brain function.  Pure dissociation.  “I think you’re living with half a brain,” Siegel told him.

So Dan set out to grow Stewart’s right brain.

“Our right human hemisphere is all about this present moment,” says brain scientist Jill Bolte Taylor. “Information, in the form of energy, streams in through all of our sensory systems, then it explodes into an enormous collage of what this present moment looks like, what this present moment smells like and tastes like, what it feels like and sounds like.” [FN2]

Here’s what Dan did: “I told Stewart that I thought if we could drive energy and information flow through the right hemisphere of his brain, over a three to four month period, I believed we could stimulate neuronal activation and growth: we could get new synapses to form in the right brain that had never formed before.”

Dan gave Stewart a series of exercises which only the right brain could handle, so the neurons in Stewart’s spectacularly developed logical left brain would have to just stop firing awhile.  His right brain would have to step up. [FN3]

Fire the Right Brain Neurons

Brain_superior-lateral_viewFirst, Siegel said, the right hemisphere specializes in non-verbal responses, facial recognition and imitation, and other mammal to mammal relational expressions and body language – as distinct from verbal language and logic which are left brain actions.

So Dan started miming emotions with his face and body, only — no words. And Stewart had to try to mimic back his face and body motions — no words. “I would make a face, and he would imitate it—not name it because that would be bilateral integration, ” said Dan. “We wanted to get his right hemisphere going, and the right specializes in non-verbal response and facial recognition.”   Stewart watched while Dan demonstrated an emotion non-verbally, with face, with hands and body, and gradually Stewart found he could make his own face, hands and body imitate Dan — all without logic or speech.

Then Dan reversed it, having Stewart mime something without words, while Dan tried to imitate him. “It kind of became fun actually, like a game,” Dan said. “For homework, I would have him watch television with the sound turned off, so that his left hemisphere, which does language, wouldn’t get stimulated. The right hemisphere had to start watching the shows, and he had to get his right hemisphere to work.”

Second, Dan knew that emotions, as the word implies, arise  first as bodily sensations — motion in the body parts — which is communicated as raw data via body nerves to the brain, and finally analyzed and interpreted by the mind as “feelings.” But emotions, like most bodily data, are shunted to the right side of the brain for interpretation, as Dr. Jill Bolte Taylor describe the way incoming sensory data goes to the right brain, above.

Dan thought Stewart didn’t have that right brain function of assembling a map of how his body felt — which was why he didn’t have emotions. So he taught Stewart to create in his mind, an integrated map of his body, which only the right brain can do.

Dan taught Stewart to do “body scans,” in which attention is focused strongly and willfully (“mindfully”) on what is going on first in our head, then our face,  neck, chest, belly, legs, and so on, for prolonged periods of time — something Stewart had never spent 10 minutes on in 92 years. “He couldn’t check into his body to say, my heart is pounding, my stomach is churning, I’m breathing fast,” said Dan, so how could he know he was feeling an emotion?

Third, Dan gives Stewart autobiographical exercises. “I asked him, ‘before you came to the office, you woke up. How did you wake up?’  He said he got up, he had breakfast, and he got in the car. I said ‘Let’s back that up, which foot got out of the bed first?’  He had to go from factual memory, to having a sense-of-self in time. That’s a right hemisphere specialty. Obviously your sense of self, if you don’t have an autobiographical sense of self, is pretty thin.

“Now you would say: hold on, my left foot got up, and then I had breakfast. How? You didn’t fly to the kitchen…Well I went to the toilet first, then I washed my face, then I took a step, etc…  Then he would start making a map of what he experienced that morning…

“And over time, with autobiographical memory exercises, non-verbal exercises, bodily exercises, and starting to then name feelings, we would put on facial expressions of these feelings — and then he started to change.  It was actually quite startling.

“One moment is telling…  He had mentioned that his brother had lost his leg in a skiing accident, but it didn’t matter, you know, because of his dismissal of relationships. He knew the facts of it, but not the feelings of it. A few months later, he was saying something about his grandchildren going skiing, and I thought there was something related to his brother, so I brought it up and he started to get tearful. I asked him if it was about his brother, he said no.

“I asked him what he was feeling and he looked at me and said that he couldn’t believe that I had remembered what he’d said, and that I really knew him. He said, ‘I can’t believe you remember who I am.’  And there was this shift of the feeling of his presence in the room.  He began to be able to articulate that he felt sad, that he could feel heaviness in his chest, that he was aware of his body in new ways.

“It was a moment of connection with him that didn’t exist before. And from that time onward the feeling in the room was like I had a whole person with me. There was this natural unfolding.  Once you allow these areas to be differentiated and honored, they can naturally find a linkage often.  And that’s what happened with Stewart.

“Empathy became something he did. With the right hemisphere focused on his interior, it also naturally began to focus on the interior of other people — me, his wife, his friends.  And that Presence you have when you’re interested in the interior world of other people, is a totally different way of being on the planet.

“His son reported that his presence around his grandchildren really changed. There was even one time Stewart came in and told me that I wasn’t going to believe what happened. He said they were saying goodbye to some people, and his wife put her hand on his shoulder, and he told her it felt good. Then she asked him if he wanted a back massage because in 65 years of marriage, he never let her do that. So she gave him a shoulder massage, and he said it felt fantastic. I asked why he’d said no for 65 years, and now at 92, he said yes.

“He said that he had been so terrified his entire life of needing anyone because he was never able to need anyone in his childhood, and that now he felt as if he could be that vulnerable to his wife and he could say that he needed her.

“His wife actually called me and asked me if I had given him a brain transplant because he had become a different person.  It wasn’t just that he was more present with relationships; internally, he felt this sort of playfulness. So, that’s how we could tell that something shifted with him.

“It was incredible and I have to say if it were just Stewart, I’d feel really nervous about reporting such a thing in a book, but I’ve worked with a lot of people with avoidant attachment histories, who as adults have dismissed attachment with the same paradigm, and it comes out the same way almost every time. [FN5]

“Now I get these beautiful cards from Stewart every winter. The last one said, ‘Dan, you cannot believe how much fun I’m having. Thank you’.”

——————

Next Friday August 15:  Special guest blog on how the ACE Study is finally being put to good use in pediatrics

——————

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
Bio, website, and more of Dan’s books in Footnotes at end of http://attachmentdisorderhealing.com/Daniel-Siegel-3/

FN1    Siegel, Daniel J., MD, “The Developing Mind,” National Institute for the Clinical Application of Behavioral Medicine (NICABM), Apr 6, 2011 p.20-22   www.nicabm.com Apr 6, 2011 p.20-22

FN2   Jill Bolte Taylor,  “My Stroke of Insight,” Ted Talk of Feb. 2008,  http://www.ted.com/talks/jill_bolte_taylor_s_powerful_stroke_of_insight

FN3   Siegel, Daniel J., MD, “How Mindfulness Can Change the Wiring of Our Brains,” NICABM, www.nicabm.com; 2010 Webcast; my first NICABM webinar, downloaded March 31, 2011; rebroadcast October 11, 2011. http://www.nicabm.com/nicabmblog/meditation-medication/ and http://www.nicabm.com/mindfulness-2011-new/

FN4   Siegel, Daniel J., MD, “The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are,” (Guilford, 1999).  How attachment in infancy and childhood creates the brain and the mind.

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Dan Siegel: Creating a Joyful Brain

Dan Siegel Quote on EmotionI’ve got some great short videos here by Dr. Dan Siegel, MD  — and even his friend comedienne Goldie Hawn makes an appearance.

I’ve also had a lot of demand for my book — but it’s not done. I’ve been too wrapped up in my fascination with brain science and lots of great networking resulting from that. Now I need to chain myself to my book files, so I’ll be blogging only every other Friday.

As reported the last few weeks, Dr. Siegel details how often we feel lousy because actually our brains are wired wrong from childhood. And now Siegel has shown we can actually heal that and rewire our brains. A fun and heartwarming video by Dan which elaborates this theme “How you can change your brain” is here: https://www.youtube.com/watch?v=i4tR5Ebc4Mw&index=22&list=PL1A32ED7EF5F192F2

We often get sad-wired with attachment trouble as kids while the brain’s forming, due to implicit — body-only — memory created before we reach age 3, before we can think and remember. Two videos by Dan on this topic are here:
https://www.youtube.com/watch?v=zovtRq4e2E8&list=PL1A32ED7EF5F192F2
and here:
https://www.youtube.com/watch?v=nGhZtUrpCuc&index=1&list=PL1A32ED7EF5F192F2

In coming weeks, I’ll be blogging on how Siegel actually healed the split-up brain of a 92-year-old lawyer.  The gentleman had great cognition, but couldn’t feel anything at all. It’s an amazing story.   To prepare, check out this video by Dan called “On Integrating the 2 hemispheres of our brains”  at https://www.youtube.com/watch?v=xPjhfUVgvOQ&index=24&list=PL1A32ED7EF5F192F2

Dan on “Being” Versus “Doing” With Your Child – This video really helps show how poor Stewart the lawyer got so messed up as a child, because of lack of emotional connection in his birth home.  My blog introducing Stewart is at http://attachmentdisorderhealing.com/daniel-siegel-4/

Stewart was taught as a kid to think about facts, but he couldn’t feel a thing.  It’s all in the development of our right brain vs our left brain.  Click here for Dan’s video: https://www.youtube.com/watch?v=PGUEDtGSwW4

Dan Siegel & Friend Explore the Brain: Mindfulness and Neural Integration at TEDx.  Dr. Siegel shows more on how mindfulness and meditation can help rewire our brains. Then a school kid walks on camera, and you’ll love what happens next.  Click here: https://www.youtube.com/watch?v=LiyaSr5aeho

Dan Siegel with Goldie Hawn at TEDMed 2009:  The comedienne explains her hunt for the “science of happiness” and how she teamed up with Dr. Dan.  Now they make school kids happy by helping them harness their brain power and grow mindfulness. It does turn out to create great joy — and better grades.  Click here: https://www.youtube.com/watch?v=1OdBXGHwNCk&index=19&list=PL1A32ED7EF5F192F2

Mindfulness meditation has become an increasingly popular way for people to improve their mental and physical health…New research from Carnegie Mellon University shows even brief mindfulness meditation practice – 25 minutes for three consecutive days – alleviates stress.  Go here for more:  http://medicalxpress.com/news/2014-07-minutes-mindfulness-meditation-alleviates-stress.html

I promised to blog on how Siegel actually healed poor Stewart’s split-up brain; I will, in Dan Siegel Part 5 (available here on Friday Aug. 8).

——————

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

For Dr. Dan Siegel’s biography, website, books and more: see Footnotes at bottom of  http://attachmentdisorderhealing.com/Daniel-Siegel-3/

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Dissociation Nation: Half a Brain

Dan Siegel Podium w. BrainDan Siegel’s webinar “How Mindfulness Can Change the Wiring of Our Brains,” which I found by accident in March 2011, insisted that we can re-wire our brains. Siegel actually used neuroplasticity and “mindsight” (see July 11 blog) to re-wire the brain of a ninety-two year old lawyer code-named “Stewart.” [FN1]

Stewart was an extreme case, but it’s how most of us live these days.  We live in “head talk” in our frontal cortex, pretty much in dissociation from the emotions in our mammalian limbic brain. Stewart existed entirely in his thinking brain, but said he didn’t know what feelings were.  He had almost no use of his emotional brain.  “He’s a good example of a need for bilateral integration,” as Siegel put it.

Emotions?  We think the objective is to get rid of ‘em, just “grow up” and be rational like Spock on Star Trek.  “Too many Americans are spurred to achieve (business, academia, etc.) rather than to attach (to other human mammals), warn three top psychiatrists in the key book “A General Theory of Love.”  We’ve been taught that our performance is our identity, so we over-perform, thinking non-stop. That leaves almost no hours for “face time” to simply “be” with and be present with live human beings.

Yet in fact emotions are sanity and mental health, not the reverse.  And that’s not an endorsement of road rage.  But we need secure attachment as kids, while our emotions first develop, to learn to govern (regulate) emotions by sharing them with our human mammal living group so we don’t go nuts.  Yet sharing emotions is far out of style these days, and  in the last census, “one third of American households were one person,” as Dr. Bruce Perry notes.  Having no social option, we dissociate from our emotions.

Stewart began acting strangely when his wife of sixty five years took ill, so his son brought dad to see Siegel. “Stewart comes in and his son says that he thinks his dad might be depressed,” Siegel said. “Stewart was withdrawn and cantankerous, but the feeling I got wasn’t that he was sad or depressed, but that there was something just kind of vacuous and disconnected about him.  When I got to talk to Stewart alone, he still didn’t seem depressed.  He seemed more aloof than anything else.”

Stewart’s thinking brain was in great shape; “his cognition at ninety-two was totally intact—excellent memory for facts,” said Siegel, and his legal business was  successful.

But when Siegel checked on Stewart’s emotions, the gent drew a complete blank.

Living with Half a Brain

Jill Bolte Taylor Brain Halves Crop, Ted 2-08And Stewart drew the biggest blank when Siegel asked him about his emotions during childhood.

“I did a brief Adult Attachment Interview (AAI) assessment, which I do with most of my patients,” Siegel said. (See my all-new blog on the AAI here; finally got the story.) The AAI shows how emotionally close the adult interviewee got to their parents as a child.

But that just annoyed Stewart. “He thought it was absolutely a moot point that I was reviewing his relationship with his parents almost 90 years ago…

“ ‘You’re out of your mind’ Stewart said,” Siegel laughed. “He insisted that ‘relationships didn’t matter,’ his son said; ‘he’s always had that attitude.’ ”  Stewart’s wife had more data.  “She said that his parents, as Stewart had also factually stated, were ‘the coldest people on the planet.’ They lacked the ability to see the internal world. Everything was about managing Stewart’s behavior and his physical externals—his food, his shelter, his schooling — but nothing was focused on feelings or thoughts, or the meaning of  things.”

Siegel pushed back, telling Stewart that they had to look into his childhood because “synaptic connections get formed early in life.” And then it came out that Stewart couldn’t remember much about his childhood experiences at all; he only remembered logical facts such as dates. This showed “a big difference between the left and right hemispheres of his brain,” said Siegel. Stewart could handle lots of facts with his left brain, but lacked recall of fleshed-out experiences, which are more an emotional phenomenon in the right brain.

Then Siegel gave Stewart the bottom line; he said that likely Stewart’s wife’s illness “had made him go more into withdrawal from relationships.”  He also said that his tests of right and left hemisphere functioning showed that Stewart’s right brain “wasn’t very developed.”

“I said, ‘I don’t think you’re depressed. I think you’re living with half a brain.

“And… I just want to offer you the idea that you did the best you could in childhood, but the lack of focus on you internal world didn’t develop that part of your brain, so you’ve lived a life dominated by one side and not the other.”

The photo above shows the actual normal separation of the two halves of a human brain, connected only at bottom by the corpus callosum, displayed by Jill Bolte Taylor in “My Stroke of Insight” on Ted Talks in February 2008.

“And when I asked how it felt when I said that, he paused and said he didn’t know what that question meant. He said that for his whole life, people have asked him how he felt, and he had no idea what they were talking about,” Siegel went on.

“Then, he paused again and said, ‘Maybe before I die, I can learn what that question means.’

“So then we went on a journey together,” Siegel said, “and the idea is this: if a part of your brain is underdeveloped, not destroyed, but underdeveloped, it can be changed. And even if it’s destroyed maybe you can sometimes get around that, as in abuse. I want to make sure to say that. Neuroplasticity, as you’ll see in Stewart’s case, exists throughout the lifespan.”

Next Friday August 1: More current news and videos from Dan Siegel and his collaborators.

Next blog Friday August 8:  Siegel and Stewart’s journey… not forgetting Jill Bolte Taylor.

——————

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

For biography, website, books and more: see Footnotes at bottom of  http://attachmentdisorderhealing.com/Daniel-Siegel-3/

FN1   Siegel, Daniel J., MD, “How Mindfulness Can Change the Wiring of Our Brains,” National Institute for the Clinical Application of Behavioral Medicine (NICABM), www.nicabm.com; 2010 Webcast and my first NICABM webinar, downloaded March 31, 2011. Rebroadcast October 11, 2011.  http://www.nicabm.com/nicabmblog/meditation-medication/ and http://www.nicabm.com/mindfulness-2011-new/

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Dan Siegel: Re-Wire Your Brain

91 Overpass-2 006Like I say, Dr. Dan Siegel introduced me to brain science, and I write about brain scientists like him ‘cos they saved my life.  It was all an accident… or a God-send.

In August 2010  I heard psychologist Dr. Henry Cloud on CD saying, “we can now do scans of the brain of older kids who 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.”

That was me, and it hit me in the gut: “Oh, s#$%!  Parts of my brain are dark!”  I thought it was fried for life.  I was commuting and almost drove off this I-91 overpass near Anaheim, CA at 70 mph (view from my car, above).  It was no trip to Disneyland.

Later I learned what I had was  “developmental trauma.”

But in March 2011, Dr. Dan Siegel taught me that we can re-wire our brains. It was literally an answer to prayer.  I clicked the wrong link in a friend’s email and ended up by mistake watching a webinar by some guy named Siegel titled  “How Mindfulness Can Change the Wiring of Our Brains.” [FN1]

He announces with characteristic excitement (I do love him) : “We’re in a moment now of making one of the most revolutionary findings from neuroscience: neuroplasticity.

“Neuroplasticity is the way we can study how the connections in the brain… continually change throughout the life span… we’re now learning  that the brain doesn’t stop growing after childhood or adolescence; it continues to grow throughout the entire life span.”

Re-Wiring with “Mindsight”

Dan Siegel Mindsight cover1 “Experience drives those changes by activating the firing of neurons, and then as neurons fire, they can rewire their connections to one another,” and make new synaptic connections, Siegel said. We can even grow more myelin coating on the neurons involved in the new thought patterns where we want to focus our attention.

That leaves the bad old brain patterns we don’t want to repeat, the ones which cause us emotional pain, not so myelinated.  And as our new brain patterns create more myelin on the cells we’re deliberately firing in new ways, our new neural patterns  become supercharged to fire faster and at way higher efficiencies, he continued.

We can use mindfulness meditation, therapy, and even brain exercises, he said, to “focus attention, which is basically harnessing the power of the mind to focus energy and information flow through the substance of the brain. As you do that, you can change synaptic connections, you can stimulate the growth of new neurons” and develop mental skills which grow myelin. “In all those ways, we can change the physical structure of the brain to the focus of the mind.”

Plus, Siegel said, we can specifically use a technique he invented called “Mindsight” to become mindful of all our mental activities, and reorganize them, to re-wire our brain even more efficiently.  We can recognize that whatever happens to be mechanically flowing through our brain is not really “us.”  It’s just the mechanical patterns of neurons which have been firing on autopilot (brainlessly!) without our wanting or needing them to fire, often since infancy, and most of them since adolescence.

“Mindsight is the capacity to sense that those mental activities are, in fact, not the totality of who you are, “ he said. “So in that sense, it overlaps with mindfulness… but it goes beyond mindfulness because once you have this ability to sense that these mental activities are just part of your identity, you then specifically can move the way your energy and information flow is happening in your mental life, in your relational life, or even in your neuronal life….”

For more, get Dr. Siegel’s book ”Mindsight: The New Science of Personal Transformation,” (Bantam, 2010) (see http://www.drdansiegel.com/books/mindsight/ ).  Also check out his Mindsight Institute at http://www.drdansiegel.com/about/mindsight/.  [FN2]

What immediately blew me away was how Siegel used mindsight to work with a  ninety-two year old lawyer who came into Siegel’s office with half a brain (Lawyer? Was that a no-brainer?)  Siegel completely rewired the man.

Details in my next post — in two weeks, on Friday, July 25.  I’ve got to bear down on completing my book, so I’m moving to a new schedule to blog every other Friday.

Next Friday July 18,  I’ll send you current news from Dan Siegel.

——————

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

Footnotes

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

FN1   Siegel, Daniel J., MD, “How Mindfulness Can Change the Wiring of Our Brains,” National Institute for the Clinical Application of Behavioral Medicine (NICABM), www.nicabm.com; 2010 Webcast and my first NICABM webinar, downloaded March 31, 2011. Rebroadcast October 11, 2011.  http://www.nicabm.com/nicabmblog/meditation-medication/ and http://www.nicabm.com/mindfulness-2011-new/

FN2  Siegel, Daniel J., MD, “Mindsight: The New Science of Personal Transformation,” Bantam Books, 2010

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

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

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Dan Siegel on Explicit Memory

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

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

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

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

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

Four Ways to Turn Off Hippocampus

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

——————-

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

Footnotes

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

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

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

FN4   op cit  FN1  Siegel, “Domains of Integration”

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

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

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

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Dan Siegel on Re-Membering Trauma

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

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

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

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

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

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

Implicit Memory

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

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

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

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

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

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

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

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

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

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

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

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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

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

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

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

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

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

FN5  Porges, Stephen, PhD, 2013: “Body, Brain, Behavior: How Polyvagal Theory Expands Our Healing Paradigm,”  NICABM Webinar, http://stephenporges.com/images/NICABM%202013.pdf
— On Trauma, 2013: “Beyond the Brain: How the Vagal System Holds the Secret to Treating Trauma,” http://stephenporges.com/images/nicabm2.pdf
—  Academic background, 2001: “The polyvagal theory: phylogenetic substrates of a social nervous system,” International Journal of Psychophysiology 42 Ž, 2001, 123 146, Department of Psychiatry, Uni ersity of Illinois at Chicago, http://www.wisebrain.org/Polyvagal_Theory.pdf

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

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

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