At California’s first ACEs summit November 5-7, “Children Can Thrive,” over 200 health professionals, policy leaders and advocates gathered in San Francisco. They created a national model for a statewide dialogue on the biggest public health problem facing California today: Adverse Childhood Experiences (ACEs). They focused on programs in health, education, juvenile justice and child welfare at the local and state levels, and how national policies can support those efforts.
Also exciting, Google.org announced a $3 million grant November 3 to the Center for Youth Wellness (CYW), the clinic started by Dr. Nadine Burke Harris, organizer of the CA ACEs Summit. The grant is specifically aimed to get enough scientific documentation that childhood trauma causes adult onset diseases, to actually make toxic stress a diagnosis code billable for insurance: http://www.sfgate.com/bayarea/article/Google-gives-3-million-to-Nadine-Burke-Harris-5865372.php
Dr. Harris’ clinic “focuses on what is known as adverse childhood experiences and toxic stress — issues like neglect, abuse, exposure to violence and household dysfunction that can damage a child’s developing brain and body. Burke Harris said that 1 in 10 of the children she sees has experienced not just one of those traumas, but four or more,” the San Francisco Chronicle reported November 3. “Even though Burke Harris’ work has been lauded by former Secretary of State Hillary Rodham Clinton — who featured the doctor in a video for her Too Small to Fail philanthropic campaign last year — it has been a challenge raising enough money….
“/’This grant is built on science,’ said Google’s Justin Steele. “If they prove it works in Bayview, we’d love to see it scale up across the country.’ …Burke Harris said the grant will enable her team to develop a clinical protocol to address toxic stress. That will be key to making the issue into something that insurance companies can understand — and cover. Now, insurers don’t.”
Summit on Adverse Childhood Experiences
by Jane Stevens and Staff of ACEsConnection.com
ACEs are traumatic experiences, such as abuse, neglect and household dysfunction, which can result in toxic stress and have a profound effect on a child’s developing brain and body. Research shows that nearly two-thirds of Californians have reported at least one adverse childhood experience.The Center for Youth Wellness videoed the main conference sessions November 5-7, and will post those videos, including a presentation about ACEs by Burke Harris, a conversation between her and Dr. Vincent Felitti, one of the co-founders of the ACE Study, and Jamie Redford showing the trailer from “Paper Tigers”, a documentary about Lincoln High, a trauma-informed school in Walla Walla, WA.
ACEs 101 FAQs – What are ACEs? by Jane Stevens, founder, ACEsConnection.com
ACEs are adverse childhood experiences that harm children’s developing brains so profoundly that the effects show up decades later; they cause much of chronic disease, most mental illness, and are at the root of most violence. Read more: http://www.acesconnection.com/blog/aces-101-faqs
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Kathy’s news blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.
“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 isabout 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
Let’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.
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.
For 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.
I 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.
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?
——————————– 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.
Ruth is starting a new series October 15 by interviewing Steve Porges live, and yes there is a fee to subscribe if you’d like transcripts and recordings to keep. And yes there’s also a free version of the series (detailed links at bottom).
And no, I’m not getting a cent for posting this. No one asked me to; I just wanted to “pay it forward.”
Why? Hey, that story I always tell of how I clicked the wrong link in a friend’s email, and ended up on a brain science website that saved my life? That was Dr. Buczynski’s March 2011 webinar, “The New Brain Science Series – Barrier-Breaking Interviews with the Experts.” [FN1]
And she, and they, did save my life, and I do hope you check this out.
Dr. Porges even brings in Bach, Beethoven and music in general as the most powerful healing there is — after live in-person human support, of course.
Ruth adds: “What trauma therapy owes to Beethoven and Bach… According to Stephen Porges, PhD, classical composers knew something hundreds of years ago that could be so helpful in trauma therapy . . . in today’s webinar, he outlines how playing and listening to music, and even the design of the rooms where we deliver services, can shift the physiology of our patients. Stephen also goes into how to work with neuroception, the “personal risk detector” in the nervous system, as well as powerful, concrete suggestions for incorporating Polyvagal Theory into clinical work.”
We can watch or listen free in real time (schedule below). These free broadcasts reach many more than can afford subscription (to me, an insanely reasonable fee, considering what I got out of it). Transcripts, video, mp3s of all speakers, and more extras come with subscription.
Schedule: Wednesdays at 5pm EST & 6:30pm EST
Wed Oct 15th: Stephen Porges, PhD: Beyond the Brain: Using Polyvagal Theory to Help Patients “Reset” the Nervous System After Trauma
Wed, Oct 22nd: Sebern Fisher, MA: Neurofeedback: Soothe the Fear of a Traumatized Brain: How a New Intervention Is Changing Trauma Treatment
Wed, Oct 29th: Bessel van der Kolk, MD: How to Help Patients Rewire a Traumatized Brain – Applying the Latest Strategies to Speed Healing and Reduce Symptoms for Even the Most Traumatized Clients
Wed, Nov 5th: Pat Ogden, PhD: Why A Body-Oriented Approach Is Key for Treating Traumatized Patients (and What It Looks Like in Practice)
Wed, Nov 12th: Daniel Siegel, MD: The Neurobiology of Trauma Treatment: How Brain Science Can Lead to More Targeted Interventions for Patients Healing from Trauma
Wed, Nov 19th: Peter Levine, PhD: Getting to the Root of Trauma: Why It’s Critical to Understand the Role of Memory in Trauma Therapy
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.
This guest blog by Dr. Laura Kerr, PhD, Stanford University, really struck me. For Americans as people, and our government, she notes, “unconscious dreams and unresolved traumas influence our defensive reactions to threat, much like the child that suffers chronic traumatization is altered by conditions of abuse and neglect.” Dr. Kerr is a mental health scholar who writes about trauma, grief and loss — and the social cost of our often not knowing they exist, or how to heal them.
“Dreaming of a Safe America,” by Dr. Laura Kerr
The airstrikes against the Islamic State, a decidedly violent and oppressive group, are deeply unsettling, bringing forth memories of 9/ll and the Iraq and Afghanistan Wars, along with fears that America will never extract itself from this region of the world, or be safe from revengeful terrorist groups. At such times, it’s natural to become defensive, fearful, and even hopeless.
One of the things that makes America a wonderful place to live is that we feel entitled to freedom and safety and feel others are entitled to freedom and safety too. Yet rarely do airstrikes like the ones on Syria feel like a simple exercise in the protection of human rights. America has too many unresolved traumas, too many unspoken desires, for the public to trust a motive as simple as the preservation of freedom and safety.
In this blog post, I try to understand how unconscious dreams and unresolved traumas influence our defensive reactions to threat, much like the child that suffers chronic traumatization is altered by conditions of abuse and neglect. I believe we are at a time in our nation’s history when we must examine the disparity between what we have dreamed of becoming and deal with the reality of what we are: stressed, even traumatized, increasingly fragmented, yet also passionate, resourceful, and capable of honest evaluation. But first we have to let go of our defenses. Even during times of war.
American Dreams
The United States, perhaps like all nations and all people, is caught in unconscious, conflicting drives and denied vulnerabilities. In Dreaming Up America, historical novelist Russell Banks identified three dreams at the heart of America’s unconscious conflicts, dreams that originally drew people to America:
“There was El Dorado, the City of Gold that Cortez and Pizarro dreamed of finding. And then there was Ponce de Leon’s dream of the Fountain of Youth, where you could start life over again, and the New England Puritan dream of God’s Protestant utopian City on a Hill, the New Jerusalem…. We can think of there being three braided strands, or perhaps three mutually reinforcing dreams: one is of a place where a sinner can become virtuous, free from the decadence of the secular cosmopolitanism of Old Europe; another is of a place where a poor man can become wealthy; and a third is of a place where a person can be born again.” (2008, pp. 6-7)
The three conflicting impulses of these dreams — renewal, materialism, and spirituality — shape the nation, its institutions, social life, and the American psyche. They determine the myths Americans attempt to live, the fantasies that grab our imaginations, the ideals we hold, and our expectations for the future. These dreams also have a shadow side. They contain the unresolved traumas of past generations, and thus also perpetuate fear, shame, addictions, and disavowed needs. Without healing the shadow side of these dreams, the United States has no other option than to play out its conflicting state of impulses in unhealthy and destructive ways.
These disparate dreams of wealth, rebirth, and redemption have been with the American people since the country’s inception, although according to Banks, they became a source of internal tension after the Civil War. The United States emerged from this conflict as a nation state, which implied, at least in principle, the resolution of internal conflicts for the purpose of creating an integrated and interdependent nation. However, as we know all too well, this was not the case.
Following the Civil War, the United States was incapable of true integration. For one thing, the Civil War was particularly gruesome. Over 620,000 people died — far more Americans than in any other US-involved conflict. (About 1,264,000 soldiers have died in the nation’s wars.) And although the Civil War ended slavery, it did not end racism or inequality, and thus failed to uphold the ideal of universal, inalienable rights laid out in the Constitution, the doctrine intended to unite us all as equals.
Thus, after the Civil War, there was a false sense of integration. To use psychological parlance, we could say the US created a false self. The creation of a false self is common to trauma survivors. It hides the split off aspects of experience and identity that either the survivor is unaware of, or fears retribution for, if others were to know the traumatized parts and the memories they hold. And Americans have suffered many traumas — including the numerous wars, slavery, oppression, racism, sexism, as well as family violence — and all reveal the failure of democracy to create a country of safe and equal citizens.
When caught in a habitual cycle of denying or dissociating parts of ourselves, event the faintest reminders are susceptible to unconscious projection onto others. When traumatic memories are particularly offensive, and contain overwhelming feelings of shame or helplessness, the need to rid oneself of the offending and unacceptable traits and emotions can lead to a search for a scapegoat, someone or something to contain the overwhelming feelings that otherwise might shatter the fragile persona that keeps them at bay.
And indeed, the United States often functions much like the trauma survivor who projects the wounded parts of itself onto scapegoats rather than risk the uncertainty of facing a traumatized past. Scapegoating happens in relation to other countries and peoples when we demonize them, and in our own country when people are devalued or brutalized due to their ethnic origins, their gender or their sexual orientation, the region of the country they live in, or their lack of resources. And often those who have been victimized later become the ones seeking scapegoats.
Kathy’s news blogs expand on the ideas in her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as Kathy and her guest bloggers write about attachment disorder in adults, trauma, grief and loss, adult attachment theory, and the Adult Attachment Interview.
Neuroscientist Dr. Stephen Porges explained in my Sept.19 blog that when a survival threat pushes humans back into the ancient reptilian mechanism of freeze, that’s how trauma happens. The autonomic nervous system (ANS in diagram below) just does this automatically; we don’t have a say; it’s not cognitive. Porges says that for humans to be out of trauma, mammalian attachment must happen.
For that, Dr. Porges says, we need what he calls “the social engagement system… in which we listen to intonation in voice and use facial engagement. When a person has vocal intonation, an expressive face and eyes open when we talk to them, this expressive individual is also contracting middle ear muscles that facilitate the extraction of human voice from background sounds,” he says. [FN]
“When people are smiling and looking at us, they are better able to pull out human voice from back ground sounds.
“We also use ingestive behaviors; the baby nurses. Adults use the same systems. We go to lunch or we go for a drink, as a way of socializing. Ingestive behaviors use the same neural mechanisms we use for social behavior. We use ingestive behaviors to calm and to develop social engagement. And when that is done, the physical distance between people can be modulated and we can come close…
“Safety modulates our ability to develop secure attachments. Whether an individual feels safe with people during early development might modulate individual differences in vulnerability to trauma.”
Dr. Porges’ 1994 “Polyvagal Theory” says the autonomic nervous system is not a balance of two circuits, but instead “a hierarchical system” of three circuits, “in which newer circuits inhibit older circuits. And when we get challenged, those systems degrade to older and older circuits, in an attempt to survive.” We mammals start out trying to use our “social engagement system” to look at each other and resolve things warmly; that’s our first, myelinated vagus parasympathtic circuit.
If that fails, we devolve into more primitive fight/flight animals, where our sympathetic circuits take over and juice up our adrenalin.
And if that fails, our ancient reptilian unmyelinated vagus circuit takes over and knocks us out into immobilization, called dissociation in humans.
Play and Mammalian Attachment
One way to get people back out of dissociation, aka freeze — aka trauma — says Porges, is to surround them with friendly mammals, and stimulate their mammalian social engagement systems to come back on line. He gives the fascinating example of play.
“Real play, is not playing with a ‘Game Boy’ or computer; it is not solitary,” Porges says. “Play requires social interaction using face-to-face. ” Notice how the two dogs above are looking each other in the eye.
“Play requires an ability to mobilize with the sympathetic nervous system and then to down-regulate the sympathetic excitation, using face-to-face social interaction and the social engagement system. I have two little dogs; they chase each other, and nip. Then one will turn around to look at the other, a face-to-face interaction to ensure that biting was play and not aggression.”
In play, he says, we practice using our fight/flight systems properly – but we also practice to “diffuse them with social engagement. So play requires face-to-face interactions. We see this in virtually all mammals.”
“I use video clips of Dr. J. and Larry Bird, a clip in which they are friends.doing an advertisement for sneakers,” Porges notes. “Then I show them playing basketball, bumping and hitting each other. Dr. J. hits Larry Bird in the face, knocks him to the ground and walks away. By walking away, he didn’t diffuse the mobilization behaviors from fight/flight. So Bird goes after him and they have a fight.
“When we play, we mobilize physiological state changes that support fight/flight behaviors, but then we down-regulate defensive reactions by looking at each other – so that we learn to repair If we hit each other by mistake, we say ‘I’m sorry.’
“Other forms of adult play have similar features – such as dancing. Most forms of team sports involve face-to-face interactions that include communication via eye contact.
“Play is actually a neural exercise of using the social engagement system, a uniquely mammalian system, to regulate our fight/flight behaviors, to be able to down-regulate this older defensive system. Note that individuals with a variety of clinical pathologies often have difficulty playing.”
Heal Trauma by Acceptance – Not Stigma
So when we don’t receive attachment — which allows us to use our mammalian myelinated vagus parasympathetic — then, we feel endangered. Then our bodies are triggered to devolve into our second, more primitive fight/flight response (mobilizing our sympathetic system).
Further, if we are overwhelmed and fight/flight doesn’t get us to safety, our neurological system hijacks us and forces us back into our third, most primitive response: freeze, aka immobilization or dissociation (using the reptilian unmyelinated vagal system).
Almost all trauma occurs when we are overpowered just like that, by dangerous environments or people.
Polyvagal Theory also shows that our nervous system just does these things – trauma is simply not a voluntary decision. “Outside the realm of our conscious awareness, our nervous system is continuously evaluating risk in the environment,” and shoving us into bodily actions that are just not subject to thought, Porges shows.
So Dr. Porges is asking doctors and therapists to realize that tramatized people can best be healed if everyone accepts and respects what their bodies have done – instead of stigmatizing them for it.
“Try something different with clients,” Porges tells clinicians. “Tell clients who were traumatized that they should celebrate their body’s responses, even if the profound physiological and behavioral states they experienced in past, are now limiting their ability to function in current social situations. Those bodily responses enable them to survive under the trauma, often as children. It reduced some of the injury. If they were oppositional during an aggressive traumatic event such as rape, they could have been killed.
“So tell them to celebrate how their body responded — instead of making them feel guilty that their body is failing them when they want to be social –and see what happens.
“Therapies often convey to the client that their body is not behaving adequately. The clients are told they need to be different. They need to change. That kind of therapy in itself is too judging of these individuals. And once we are evaluated, we are in defensive states. We are not in safe states.
“Mindfulness requires feeling safe because if we don’t feel safe, we are, in a sense, neuro-physiologically evaluative of our setting which means we can’t be safe, and we can’t engage. We can’t recruit the wonderful neural circuits that enable us to express the wonderful aspects of being human. So if we are able to create safe environments,” starting with clinicians who make us feel respected and safe, “we have access to neural circuits that enable us to be social, to learn, and to feel good.”
Once the professionals accept reality, next traumatees can start to respect themselves, and stop judging and evaluating themselves negatively – usually for the first time since the trauma hit them.
That creates a “mammal to mammal” social engagement state inside the traumatized person, where their internal voices are kind and compassionate to them, rather than self-condemning as is the norm in traumatees.
“There is no such thing as a ‘bad’ response; there are only adaptive responses,” says Porges. “The primary point is that our nervous system is trying to do the right thing — and we need to respect what it has done. And when we respect its responses, then we move out of this evaluative state and we become more respectful to ourselves — and we functionally do a lot of self-healing.”
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Kathy’s news blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.
Footnotes
FN Porges, Stephen, PhD, “The Polyvagal Theory for Treating Trauma,” 2011, http://stephenporges.com/images/stephen%20porges%20interview%20nicabm.pdf
—“Body, Brain, Behavior: How Polyvagal Theory Expands Our Healing Paradigm,” 2013, http://stephenporges.com/images/NICABM%202013.pdf
—“Beyond the Brain: Vagal System Holds the Secret to Treating Trauma,” 2013, http://stephenporges.com/images/nicabm2.pdf
—”Polyvagal theory: phylogenetic substrates of a social nervous system,” International Journal of Psycho-physiology 42, 2001, Dept. of Psychiatry, Univ. Illinois Chicago, www.wisebrain.org/Polyvagal_Theory.pdf
————- Commentsare encouraged with the usual exceptions; rants, political speeches, off-color language, etc. are unlikely to post. Starting 8-22-16, software will limit comments to 1030 characters (2 long paragraphs) a while, until we get new software to take longer comments again.
Dr. Stephen Porges discovered in 1994 that trauma in humans comes from our most ancient “reptilian” freeze reflex. He calls it the Polyvagal Theory, as I wrote last week. But Porges also says we can use our mammalian attachment system to heal this.
This week I have a few short (and two long) Porges
videos to share with you, which since Polyvagal is
pretty darn complex, are really wonderful to have.
I really like “The Science of Compassion,” his talk
at the Stanford University conference of the same
name. Here they are:
“Polyvagal Theory: Trauma from a New Perspective” — Stephen Porges, PhD, inventor of the Polyvagal Theory, shares his insights with Dr. Ruth Buczynski of NICABM on the treatment of trauma. He explains how treating trauma or treating PTSD is not always straightforward; 4 minutes at https://www.youtube.com/watch?v=MKkDAOW2yd4
“The Science of Compassion,” by Stephen Porges, PhD, at the Stanford University conference “Science of Compassion: Origins, Measures, and Interventions.” This was the first large-scale international conference of its kind dedicated to scientific inquiry into compassion; 25 minutes at https://www.youtube.com/watch?v=MYXa_BX2cE8
William Stranger interview Dr. Stephen Porges.
The Polyvagal Theory introduced a new perspective relating autonomic function to behavior that included an appreciation of autonomic nervous system as a “system,” the identification of neural circuits involved in the regulation of autonomic state, and an interpretation of autonomic reactivity as adaptive within the context of the phylogeny of the vertebrate autonomic nervous system; 40 minutes at https://www.youtube.com/watch?v=8tz146HQotY
#090: Adam Carolla and Dr. Stephen Porges September 30, 2013 Podcast – Dr. Stephen Porges returns to The Dr. Drew Podcast and this time we are also joined by special guest Adam Carolla. Dr. Porges and Dr. Drew attempt to investigate Adam’s behavior and identify some patterns; 57 minutes at http://drdrew.com/090-adam-carolla-and-dr-stephen-porges/
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Kathy’s news blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.
Footnotes
FN Porges, Stephen, PhD, “The Polyvagal Theory for Treating Trauma,” 2011, http://stephenporges.com/images/stephen%20porges%20interview%20nicabm.pdf
—“Body, Brain, Behavior: How Polyvagal Theory Expands Our Healing Paradigm,” 2013, http://stephenporges.com/images/NICABM%202013.pdf
—“Beyond the Brain: Vagal System Holds the Secret to Treating Trauma,” 2013, http://stephenporges.com/images/nicabm2.pdf
—”Polyvagal theory: phylogenetic substrates of a social nervous system,” International Journal of Psycho-physiology 42, 2001, Dept. of Psychiatry, Univ. Illinois Chicago, www.wisebrain.org/Polyvagal_Theory.pdf
Neuroscientist Dr. Stephen Porges appeared in my last few blogs; let’s explore his 1994 discovery of the Polyvagal Theory. Dr. Porges runs brain-body research at top psychiatry departments (University of Chicago and University of North Carolina Chapel Hill).
And he always says he wasn’t looking for a polyvagal theory. He was just researching ways to measure the vagus nerve, the 10th cranial nerve running between the brain stem and most of the body.
Until 1994, textbooks said there are two parts to the autonomous nervous system (ANS). First, the sympathetic system mobilizes us for fight and flight, but is harmful if it stays on too long, making us tense, anxious and prone to disease. Second, the parasympathetic inhibits mobilization, so it was believed to be calming and healthy. Textbooks taught that “the net result was a balance between a pair of two antagonistic systems,” Porges says. The vagus nerve makes up a chunk of the parasympathetic; “it functions like a brake on the heart’s pacemaker.” [FN]
This two-part model broke down “as I was conducting research with human newborns to measure heart rate, assuming vagal activity was protective,” Porges says. “If newborns had good clinical outcomes, they had a lot of vagal heart rate going up and down with breathing. Babies with flat heart rates were at risk. So I wrote a paper in the journal Pediatrics to educate neonatologists.
“Following publication, I received a letter from a neonatologist who noted that… the vagus could kill you, and that perhaps too much of a good thing was bad. His comments startled and motivated me to challenge our understanding of the nervous system.
“I immediately understood what the neonatologist meant. From his perspective, the vagus can kill, since it is capable of life threatening bradycardia and apnea — massive slowing of heart rate and cessation of breathing. For many pre-term infants, bradycardia and apnea are life threatening. I now framed the ‘vagal paradox.’ How could the vagus be both protective and lethal? For months I carried the neonatologist’s letter in my briefcase.”
Poly Faces of Vagus
Porges went back to the evolution of anatomy, and saw that in fact there are two different vagus circuits — a total of three ANS circuits, not just a pair. The two circuits “come from two different areas of the brain stem, and they evolved sequentially,” one far earlier.
“This motivated me to develop the polyvagal theory, which uncovered the anatomy and function of two vagal systems, one potentially lethal, and the other protective,” he says.
“Immobilization, bradycardia, and apnea are components of a very old, reptilian defense system, ” Porges says. “If you look at reptiles, you don’t see much behavior — because immobilization is the primary defense system for reptiles… it’s an ancient vagus nerve.” This pre-historic nerve has no myelin, a nerve coating of protective protein and fat.
Porges found mammals have this unmyelinated vagus, on the dorsal (top) side of the nerve, which immobilizes us, too — “and that immobilization reaction, adaptive for reptiles, is potentially lethal for mammals.”
Porges also saw that among the “firsts” which began with mammals, a new vagus with myelin develops on the ventral underside of the nerve. “So mammals have two vagal circuits,” he found. ” The myelinated circuits provide more rapid and tightly organized responses. The new mammalian vagus is linked to brain stem areas that regulates the muscles of the face and head. Every intuitive clinician knows that if they look at people’s faces and listen to voices, controlled by muscles of the face and head, they know the physiological state of their client.”
Neuroception: It’s Just Not Cognitive
Porges adds that our more primitive neural circuits operate by “neuroception” — totally involuntarily. “Neuroception is not perception,” he says. “Neuroception does not require an awareness of things going on. It is detection without awareness. It is a neural circuit that evaluates risk in the environment… When confronted in certain situations, some people experience autonomic responses such as an increase in heart rate and sweating hands. These responses are involuntary. It is not like they want to do this.”
The polyvagal theory emphasizes that our nervous system has more than one defense strategy – and whether we use mobilized flight/flight or immobilization shutdown, is not a voluntary decision. Outside the realm of our conscious awareness, our nervous system is continuously evaluating risk in the environment, making judgments, and prioritizing behaviors that are not cognitive.
Next, he says, “humans and other mammals, as fight/flight machines, only work if they can move and do things. But if we are confined, if we are placed into isolation, or if we are strapped down, our nervous system reads those cues and functionally wants to immobilize. I can give you two interesting examples: one is a news clip I saw on CNN and the second from my own personal experience.
“I saw a CNN news broadcast with a video clip of a plane whose wings were tipping up and down as the plane was tossed by the wind. The plane did land safely and the reporter went to interview the people. He asked one of the passengers how it felt to be in a plane that looked like it would crash. Her response left the reporter speechless. She said, “Feel? I passed out.” For this woman, the cues of a life threat triggered the ancient vagal circuit. We don’t have control over this circuit.
“Many people who report abuse especially sexual abuse, experience being held down or physically abused. These abused clients often describe a psychological experience of not being there. They dissociate or pass out. The abusive event triggered an adaptive response, to enable them not to experience the traumatic event.”
Porges’ second example, noted in my Aug. 22 blog, was his own attempt to have an MRI – in which his body flat out overruled his powerful thinking brain. “I wanted the MRI. But something happened to my body when I entered the MRI that triggered my nervous system into…wanting me to mobilize to get out of there.” So the nurses let him out.
Porges was asked by one interviewer, “What would have happened if you called to be let out — but no one came?”
“Now we’re talking!,” said Dr. P. “So now I am stuck in there, I can’t get out; I am in this confined area. That would be totally like being physically abused, being held down, going through all these same things.” Like the plane passenger who defaulted back in evolution to her most primitive system, he might have dissociated or passed out.
“The problem, of course, is how do you get people back out of that?” Porges asks. ” If a life threat puts a human into this state, it may be very difficult to reorganize to become ‘normal’ again.”
Friday Sept. 26: Videos and audios on Polyvagal Theory
Friday Oct. 3: Dr. Porges on how to “get people back out of” the reptilian freeze of trauma.
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Kathy’s news blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.
Footnotes
FN Porges, Stephen, PhD, “The Polyvagal Theory for Treating Trauma,” 2011, http://stephenporges.com/images/stephen%20porges%20interview%20nicabm.pdf
—“Body, Brain, Behavior: How Polyvagal Theory Expands Our Healing Paradigm,” 2013, http://stephenporges.com/images/NICABM%202013.pdf
—“Beyond the Brain: Vagal System Holds the Secret to Treating Trauma,” 2013, http://stephenporges.com/images/nicabm2.pdf
—”Polyvagal theory: phylogenetic substrates of a social nervous system,” International Journal of Psycho-physiology 42, 2001, Dept. of Psychiatry, Univ. Illinois Chicago, www.wisebrain.org/Polyvagal_Theory.pdf
“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.
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.
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.
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
Dr. Stephen Porges writes in his groundbreaking “Polyvagal Theory” that mammals like us aren’t made for trauma. We’re made primarily to attach to other mammals, which makes us feel safe, secure and good. When that fails, we’re also made to go into a secondary fall-back option of fight/flight; we get aggressive or at least defensive. And it feels bad; we know something’s wrong.
But we’re not made to be in fight/flight for a long time, so when we’re caught in fight/flight and can’t get out, mammals are forced back into a third, even more primitive system: reptilian freeze, aka immobilization or dissociation.
“If you go to a pet store and look at the reptiles, you don’t see much behavior, because immobilization is the primary defense system for reptiles,” says Porges. “But if you look at the small mammals, hamsters and mice, they are running around. They are socializing.”
“Some reptiles can shut down and go underwater for several hours and be fine. The shut-down system works well if you are a reptile, because reptiles don’t need much oxygen and don’t need to support a big brain…
“But this immobilization reaction… is potentially lethal for mammals. If a life threat triggers a biobehavioral response that puts a human into this state, it may be very difficult to reorganize to become ‘normal’ again,” he warns. [FN]
I talked about that kind of trauma last blog. I was suddenly thrust into a medical system that ignored all these mammalian basics. No matter to whom I turned for communication and information, nobody saw me, nobody heard my questions, nobody seemed to care what happened. No mammalian response.
So instead of being about to simply sit and be “Present” with the sudden survival threat of a surgical knife coming at me, I had to take all the perfectly normal fight/flight feelings which that causes, and “stuff it.” Because I had to push myself into hunting and gathering all that info alone. Which threw me into reptilian freeze, just as my body was designed by the Manufacturer to do. That’s trauma.
Mammals Should Be Seen – And Heard
But, good news: I got out of that trauma in under a week, thanks to Dr. Porges’ primary state: mammalian attachment.
The first thing that happened was I took a step myself, to get myself “seen” and “heard” – I wrote that blog. It went out to almost a thousand readers, and the response was terrific. In particular, lots of nice warm mammals in my Life Team support system started to call and write to me, and wow did that feel good.
“Dearest Kathy,” wrote one reader, “I just read your latest blog post, and it sounds rough. I hope things are calming down and straightening out, and I wish I could be there to help. Do call if you want. – A big, warm, long hug….”
Now this gal and I go way back decades, though she’s on the east coast where I haven’t seen her since 2009. But we were attached mammals for so long, that in 2011 I woke up one morning dreaming I’d been singing Handel’s Messiah, things went terribly wrong – but suddenly there at the foot of the stage, she appeared – to give me a big hug. “Oh! It’s her! She knows me. She seesme — the real me, the me who really is.”
And about three hours later that same day in 2011, my cell phone rang and…. it was her. Across 3,000 miles.
“The evolution of the nervous system starts with the un-myelinated vagus nerve, which does immobilization. Reptiles have this oldest defensive system,“ says Porges.
“With mammals, a newer circuit, a uniquely mammalian vagus which is myelinated, comes online. So mammals have two vagal circuits, which originate in different areas of the brain stem. The new mammalian vagus is linked in the brain stem to areas that regulates the muscles of the face and head. Every clinician knows that if they look at people’s faces and listen to their voices, which are controlled by muscles of the face and head, they will know the physiological state of their client.
“If we are protected with the newer mammalian vagal circuit, we do fine. When our mammalian social engagement system is working, we feel calm, we hug people, we look at them and we feel good.
“These mammalian part of our nervous system enables social interactions to calm our physiology and to support health, growth, and restoration. When a person is facially expressive, has vocal intonation, has an expressive face and whose eyes are open when we talk to them,” then we feel seen, heard, and connected.
“Thank you for actually ‘seeing’ me and knowing me,” I wrote back to my gal pal last week after she saw my blog. “It’s got everything to do with plain old simple mammalian attachment, in which we just ‘be with’ each other, and feel safe.
“And just this morning, it hit me: Oh, Mom again. I was under survival threat as an infant because I was raised in a glass box, which is interpreted by the infant brain stem as a survival threat. Google ‘Still Face Experiment’ – it shows how infants go nuts when nobody sees them, nobody hears them – nobody responds.
“So today, survival threat (surgical knife) will cause me to over-react. ‘Of course’ says my wonderful attachment-based psychotherapist, ‘it’s baked into your brain stem. Give yourself some grace, have your reaction, and then do the reality check.’ So when the doctors exhibit the same reptilian behavior as Mom: nobody hears me, nobody sees me, nobody responds? ‘Of course’ — bam, it triggers the whole infant deep neurological experience.
“The minute I put that together, I had a good cry, then started to feel absolutely fantastic. Because suddenly I knew: it’s not about the doctors or the surgery — it’s about my mammalian attachment system. No matter what happens with the surgery or the doctors, it won’t matter – as long as I get with mammals. And what a relief.
“Because now I do have mammalian attachment to my friends, my therapist, and a few other important people – like God – now I do have “Safe People.”
“So suddenly now the surgery is no big deal because the doctors will do a great technical job like well-trained reptiles, and back to what really counts, my mammalian support system is taking care of my mammal needs big time. Which brought me an enormous relief of tension, and feeling of support.”
And no sooner did I figure this out, than my email dings – and it’s her again.
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Kathy’s news blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.
Footnotes
FN Porges, Stephen, PhD, “The Polyvagal Theory for Treating Trauma,” 2011, http://stephenporges.com/images/stephen%20porges%20interview%20nicabm.pdf
—“Body, Brain, Behavior: How Polyvagal Theory Expands Our Healing Paradigm,” 2013, http://stephenporges.com/images/NICABM%202013.pdf
—“Beyond the Brain: Vagal System Holds the Secret to Treating Trauma,” 2013, http://stephenporges.com/images/nicabm2.pdf
—”Polyvagal theory: phylogenetic substrates of a social nervous system,” International Journal of Psycho-physiology 42, 2001, Dept. of Psychiatry, Univ. Illinois Chicago, www.wisebrain.org/Polyvagal_Theory.pdf
The Adverse Childhood Experiences (ACE) Study showed that for 17,337 patients, childhood trauma correlated to serious adult medical conditions. “Contrary to conventional belief," says co-Director Vincent Felitti, MD, "time does not heal all wounds, since humans convert traumatic emotional experiences in childhood into organic disease later in life.”
FEATURED BOOKS – QUOTES
"Too many Americans are spurred to achieve, rather than to attach." --A General Theory of Love
"Trying to fix the heart using the head, is like trying to paint with a hammer - it only makes a mess."
"You can be strong - or you can be human."
-- Grief Recovery Handbook
"Gosh, I shoulda checked the milligramage! Oh, well, Live and Learn." -- Working Girl
"Any book you haven't thrown across the room at least once because it smashed your world view, probably isn't worth a long shelf life." -- Kathy
"Mental health. For everything else there's MasterCard." -- Kathy
At California’s first ACEs summit November 5-7, “Children Can Thrive,” over 200 health professionals, policy leaders and advocates gathered in San Francisco. They created a national model for a statewide dialogue on the biggest public health problem facing California today: Adverse Childhood Experiences (ACEs). They focused on programs in health, education, juvenile justice and child welfare at the local and state levels, and how national policies can support those efforts.
The ACEs Connection Network team participated and reported on the breakout sessions, which weren’t videoed. On the first day, Elizabeth Prewitt covered health (CA ACEs Summit: Overall health depends on much more than healthcare, pediatricians and other public health specialists agree).
