Tag Archives: Frontal Cortex

Psychotherapy and Love

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

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

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

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

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

But now it hits me like a ton of bricks:

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

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

Emotional Investment

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

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

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

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

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

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

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

 “General Theory” on Therapy and Love:

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

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

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

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

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

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

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

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

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

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

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

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

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

Limbic Revision

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

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

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

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

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

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

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

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

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

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

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

Footnotes

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

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The Body Keeps the Score – Bessel van der Kolk

Bessel Book bodykeepsscore “The Body Keeps the Score” by Bessel van der Kolk, MD, will “permanently change how psychologists and psychiatrists think about trauma and recovery,” as trauma scholar Dr. Ruth Lanius writes.  She was the first to call developmental trauma a “hidden epidemic,” source of my book’s subtitle “Silent Epidemic.” Dr. van der Kolk repeats this in his new book.  [FN1]

And it is about the body. “Infants are psycho-biological beings, as much of the body as of the brain,” writes Prof. Ed Tronick, author of the Still Face Experiment. “Without language or symbols, infants use every one of their biological systems to make meaning of their self in relation to the world.  Van der Kolk shows that those same systems continue to operate at every age, and that traumatic experiences, especially chronic toxic experience during early development, produce psychic devastation.”

I reported van der Kolk’s work on developmental trauma and on getting the military to recognize PTSD in March 2014.  When the New York Times damned van der Kolk’s insistence on body work in June 2014, I roasted them.  In this book, van der Kolk makes his case much better than anyone else could.

I’m having trouble reading the book; I keep starting to sob. That started on page 3 where Dr. van der Kolk describes his heart-breaking childhood experience in bombed-out post-war Holland, with his father prone to violent rages, and his mother acting out her childhood trauma on him. I could feel that little boy, what he’s been going through all these years, and see the depths of what he has accomplished by giving his life so passionately to heal himself and all the rest of us.

These are “good sobs;” they feel good, because once again van der Kolk has told the truth about reality where few dare. Half the human race has had significant childhood trauma, and most of them are in complete denial and live in a state of dissociation, aka freeze or numbness. People in trauma, he writes, feel “numb” to most of life. One patient felt “emotionally distant from everybody, as though his heart were frozen and he was living behind a glass wall. He could not feel anything except his momentary rages, and his shame.”

Dr. Stephen Porges calls van der Kolk’s book a “courageous journey into the parallel dissociative worlds of trauma victims and the medical and psychological disciplines.” As van der Kolk and Porges have said before, medical and psychological experts have been just as much in denial and dissociated regarding the serious nature of trauma as are the traumatees.  “As our minds desperately try to leave trauma behind, our bodies keep us trapped in the past with wordless emotions and feelings,” Porges says. “Van der Kolk offers hope by describing treatments and strategies that have.. helped his patients reconnect their thoughts with their bodies.”

Why all the denial?  “We don’t really want to know what soldiers go through in combat,” writes van der Kolk. “We do not really want to know howe many children are being molested and abused in our own society and how many couples – almost a third –engage in violence at some point…. We want to think… of our own country as enlightened civilized people. We prefer to believe that cruelty occurs only in faraway places like Dafur…”

Solutions for Recovery

Bessel van der KolkLet’s get right to what everyone wants to know.  Here are Dr. van der Kolk’s “Paths to Recovery,” which I think of as  “body solutions” :

— Healing starts with owning our “self,” 100% total acceptance of our self, exactly as we are today, no guilt, no self condemnation. It means developing pride in who we are; only by accepting ourselves as we are now, do we become free to change. We must respect our body for putting us into trauma freeze; it was the only way to defend us, as Stephen Porges says at the end of my blog last week.

– Recognize that language is a “miracle and tyranny,” van der Kolk says. “Telling the story doesn’t necessarily alter the automatic physical and hormonal responses of bodies that remain hypervigilant, prepared to be assaulted, or violated at any time. For real change, the body needs to learn that the danger has passed.” At some point we must let go of all the verbiage as yackety-yack largely in the conscious frontal cortex and logical left brain.

Instead, we must grasp that there is something more fundamental underneath all that, lead by our body sensations, non-verbal subconscious, and non-logical right brain. The body literally needs to have many, often thousands, of new, good physical experiences, such as being taught to physically move or defend itself, just where it could not during the original trauma. Only these can create a “visceral” certainty of safety, to race the old experiences of danger.

EMDR (Eye Movement Desensitization and Reprocessing) is van der Kolk’s next step, to integrate the right and left sides of the brain. In trauma often neural pathways between them have been frozen; in developmental trauma from infancy, these pathways may not have developed well and must be developed now.  By moving the eyes back and forth, we simulate Rapid Eye Motion (REM) sleep, which the brain uses to take events of “now” (today) out of short-term memory, where feelings like fight-flight and trauma reside, and put them into long-term memory.  Instead of feeling as if our trauma is happening again now, it begins to feel like an old story that loses its sting.

Yoga then teaches us how to inhabit our bodies right here, right now; that’s why it’s been used as a path to enlightenment for thousands of years.  Easy to say, but the challenge is to actually practice it rigorously and regularly; only then comes the benefit.

Neurofeedback programs done by trained neurofeedback specialists really help.  Dr. van der Kolk also recommends the computer (and smart phone) -based electronic feedback system EmWave by HeartMath, which trains users to synchronize breathing and heart rates, known as heart rate variability (HRV). In good HRV, heartrate speeds up when we breathe in and slows when we breathe out.  But in trauma we lose HRV coherence; breathing is very rapid and shallow, and heart rate de-synchronizes from the breath, also hazardous to physical health.

Finding Your Voice:  As Bruce Perry says, “Patterned, repeated rhythmic activity”  can re-tune a traumatized brain stem.   Dr. van der Kolk likes  “communal rhythms” such as drum circles and dance.  He particularly likes theater work because it gives the players a substantial voice and a character they can use to express all their feelings in a way everyone can accept.

Trauma Experts Praise “Body Keeps the Score”

“This is an absolutely fascinating and clearly written book by one of the nation’s most experienced physicians in the field of emotional trauma. Equally suitable for primary care doctors and psychotherapists wishing to broaden their range of helpfulness, or for those trapped in their memories, ‘The Body Keeps the Score’  helps us understand how life experiences play out in the function and the malfunction of our bodies, years later.
– Vincent J. Felitti, MD
Chief of Preventative Medicine Emeritus, Kaiser Permanente San Diego;  Co-Principal Investigator, ACE study

“Breathtaking in its scope and breadth, ‘The Body Keeps the Score’ is a seminal work by one of the preeminent pioneers in trauma research and treatment. This essential book unites the evolving neuroscience of trauma research with an emergent wave of body-oriented therapies and traditional mind/body practices. These new approaches and ancient disciplines build resilience and enhance the capacity to have new empowered bodily (interoceptive) experiences that contradict the previous traumatic ones of fear, overwhelm and helplessness. They go beyond symptom relief, and connect us with our vital energy and here-and-now presence. A must read for all therapists and for those interested in a scholarly, thoughtful, tome about the powerful forces that affect us as human beings in meeting the many challenges of life including accidents, loss and abuse.
– Peter A. Levine, PhD, Author, In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness.

“This book is a tour de force. Its deeply empathic, insightful, and compassionate perspective promises to further humanize the treatment of trauma victims, dramatically expand their repertoire of self-regulatory healing practices and therapeutic options, and also stimulate greater creative thinking and research on trauma and its effective treatment. The body does keep the score, and Van der Kolk’s ability to demonstrate this through compelling descriptions of the work of others, his own pioneering trajectory and experience as the field evolved and him along with it, and above all, his discovery of ways to work skillfully with people by bringing mindfulness to the body (as well as to their thoughts and emotions) through yoga, movement, and theater are a wonderful and welcome breath of fresh air and possibility in the therapy world.”
– Jon Kabat-Zinn, Professor of Medicine emeritus, UMass Medical School, Author of “Full Catastrophe Living.”

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

Footnotes

FN  Van der Kolk, Bessel, MD., “The Body keeps the Score: Brain, Mind, and Body in the Healing of Trauma,” Peguin Press Viking, New York, 2014  http://www.amazon.com/The-Body-Keeps-Score-Healing/dp/0670785938#reader_0670785938

Bessel van der Kolk, M.D. is the founder and medical director of the Trauma Center in Brookline, Massachusetts. He is also Professor of Psychiatry at Boston University School of Medicine and Director of the National Complex Trauma Treatment Network. When he is not teaching around the world, Dr. van der Kolk works and lives Boston, Massachusetts.

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“General Theory of Love” on Mammals

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Footnotes

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

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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).

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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

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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Dan Siegel on Explicit Memory

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

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

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

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

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

Four Ways to Turn Off Hippocampus

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

——————-

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

Footnotes

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

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

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

FN4   op cit  FN1  Siegel, “Domains of Integration”

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

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

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

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Dan Siegel on Re-Membering Trauma

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

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

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

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

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

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

Implicit Memory

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

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

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

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

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

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

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

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

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

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

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

——————————

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

Footnotes

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

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

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

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

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

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

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

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

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Readers Defend Van der Kolk

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

 

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

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

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

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

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

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

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

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

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

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

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

—————————–

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

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In Defense of Van der Kolk

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

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

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

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

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

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

Dear Editors,

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

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

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

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

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

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

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

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

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

The Times doesn’t report any of that.

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

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

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

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

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

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

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

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

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

Unless there’s a reason why not?

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

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

Footnotes (provided in letter to the Times)

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

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

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

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

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

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

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“Heal trauma? Start with the body”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Bruce Perry: No Empathy, No Survival

Dr. Bruce Perry, MD, “Born for Love:
“Why Empathy is Essential – and Endangered”
Address to The National Council for Behavioral Health
Washington, DC, May 4, 2014  – Click link or photo for video
https://www.youtube.com/watch?v=M6kDeBaJi0M

“Empathy is what makes us human,” says brain scientist Dr. Bruce Perry, MD  –  but this has not sunk in for Americans.  If simple kindness isn’t enough, what about the minor fact that it’s brain science?  Or that by ignoring this basic fact, we’re violating biology, so we’re dying as a species?

To let Dr. Perry make his point, today I’ve just got a few quotes from his May 4 Washington DC address, to provoke you to watch the video kindly posted by the National Council for Behavioral Health.

”From birth, we seek intimate connections, bonds made possible by empathy — the ability to love and to share the feelings of others,” Perry begins. But “our  policies routinely violate the biological reality of empathy, and that’s destructive…

“For example, we pass on to the next generation explicit choices that we’re going to teach math — but not music…We don’t care if everyone learns to read and perform music or not, but they’ve got to do arithmetic…  We have extensive rules for all the things everyone has to learn to drive a car… but we don’t do the same for raising a child!  We don’t make any systematic recommendations, or ensure that everybody who’s about to have a child has the fundamental knowledge of what’s necessary for the child…

“We’re exposing our children to levels of violence as a problem solving technique, at rates that are at least 50 times greater than alternate methods of problem-solving…

“We have invented ourselves into a corner with technology… into models of child rearing, education, and building communities that is fundamentally disrespectful of two of the greatest (biological) gifts our species has:  the fundamental malleability of the human brain in early life, and the fundamental relational (empathic) nature of human beings…. As a result we are much more vulnerable to mental health, social health, cognitive health, and physical  health  problems.

Humans Need Humans Around to Live

Perry another headshot“Human beings are biological creatures with genetic gifts… The only way we survived was by forming relationships, collaborative relationships…  Human beings are neurobiologically meant to be connected to others: to live, work, hunt, play, invent, and die in groups.

“We use the word ‘independent’ a lot — but the truth is there’s not a single human on this planet, ever, that’s been independent.  All of our physiology is designed to connect to others, we have huge parts of our brain designed purely to respond to the non-verbal cues of others… it’s in the way our face is oriented, our facial configuration is forward, looking at people… We have sensory apparatus on our skin that’s meant to be touched… so that we can feel somebody caress us…

“Our brain is a social organ; we are social animals. We don’t have any natural body armor, camouflage, stinging other things. We form groups!  Human beings are ‘meat on feet’ to the natural world!  The only way we survive is by forming collaborative groups, by sharing what we hunted and what we gathered with everybody else in our group.  And the typical living group was a developmentally heterogeneous, multi-family, multi-generational group: 40 to 50 people.

“And in that group…  the ratio of developmentally more mature individuals who cared for you, protected you, nurtured you…  was four to one.  But now, we think it’s an incredibly enriched early child care environment if there’s one caregiver to six kids!  That’s 1/24  the relational density the brain benefits from…

“Today, the whole organization of society flies in the face of this… In the last census, one third of American households were one person.

“On top of which, now… the typical American spends 11 hours a day interacting with digital devices, and not with fleshy objects!  And I want to talk about the consequences of this for how we end up expressing our ability to be compassionate (or not)…. You see it all the time, complaints in the psychological literature about the disconnectedness of multi-tasking constantly with our phones… but we do it ourselves…  You’re talking to someone, then your phone will vibrate — and it pulls you away from them.

” It breaks the rhythm of social contact, of empathic engagement– and the truth is: those things are physiologically meaningful.”

Again, click here for video:
https://www.youtube.com/watch?v=M6kDeBaJi0M

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

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