Weekly | "Don't Try This Alone"

Is Our Medical System Traumatizing Us?

Posted on August 22, 2014 by Kathy

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

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

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

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

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

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

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

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

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

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

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

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

No Time to Think – Let Alone Feel

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

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

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

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

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

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

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

Involuntary Reaction to Survival Threat

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

——————

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

Footnotes

FN1 Barrett, Mary Jo, MSW, “Addressing PTSD: How to Treat the Patient without Further Trauma,”
NICABM Webinar, June 29, 2011. Dr. Barrett’s latest book is “Treating Complex Trauma: A Relational Blueprint for Collaboration and Change,” orders are here: http://goo.gl/SEiWVD and http://www.centerforcontextualchange.org/publishedworks.html

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

Posted in Attachment Disorder, Brain Science, Fight-Flight | Tagged ACE Study, Adult Attachment Disorder, Adult Attachment Interview, Adult Attachment Theory, Adverse Childhood Experiences, brain science, Brain stem, Daniel Siegel, Mary Jo Barrett, Medical Trauma, Stephen Porges | 8 Comments

Pediatricians Screen for Child Trauma

Posted on August 15, 2014 by Kathy

“To prevent childhood trauma, pediatricians screen children and their parents…and sometimes, just parents…for childhood trauma”
— guest blog by Jane Ellen Stevens, Editor, ACEsTooHigh.com and ACEsConnection.com

When parents bring their four-month-olds to a well-baby checkup at the Children’s Clinic in Portland, OR, Drs. Teri Petersen, R.J. Gillespie and their 15 other partners ask the parents about their adverse childhood experiences (ACEs). [Tabitha Lawson of Portland, OR with her two children, who greatly benefited from the new program; more below]

When parents bring a child who’s bouncing off the walls and having nightmares to the Bayview Child Health Center in San Francisco, Dr. Nadine Burke Harris doesn’t ask: “What’s wrong with this child?” Instead, she asks, “What happened to this child?” and calculates the child’s ACE score.

In rural northern Michigan, a teacher tells a parent that her “problem” child has ADHD and needs drugs. The parent brings the child to see Dr. Tina Marie Hahn, who experienced more childhood trauma than most people. Instead of writing a prescription, Hahn has a heart-to-heart conversation with the parent and the child about what’s happening in their lives that might be leading to the behavior, and figures out the child’s ACE score.

What’s an ACE score? Think of it as a cholesterol score for childhood trauma.

Why is it important? Because childhood trauma can cause the adult onset of chronic disease (including cancer, heart disease and diabetes), mental illness, violence, becoming a victim of violence, divorce, broken bones, obesity, teen and unwanted pregnancies, and work absences.

The CDC’s Adverse Childhood Experiences Study (ACE Study) measured 10 types of childhood adversity: sexual, physical and verbal abuse, and physical and emotional neglect; and five types of family dysfunction – witnessing a mother being abused, a household member who’s an alcoholic or drug user, who’s been imprisoned, or diagnosed with mental illness, or loss of a parent through separation or divorce. (There are, of course, other types of trauma, but those were not measured in this study. Other ACE surveys are beginning to include other types of trauma.)

Each type of trauma — not the number of incidents of each trauma — was given an ACE score of 1. So, a person who has been emotionally abused, physically neglected and grew up with an alcoholic father who beat up his wife would have an ACE score of 4.

The ACE Study found that childhood trauma was very common — two-thirds of the 17,000 mostly white, middle-class, college-educated participants (all had jobs and great health care because they were members of Kaiser Permanene) experienced at least one type of severe childhood trauma. Most had suffered two or more.

The more types of childhood trauma a person has, the higher the risk of medical, mental and social problems as an adult (Got Your ACE Score?). Compared with people who have zero ACEs, people with an ACEs score of 4 are twice as likely to be smokers, 12 times more likely to attempt suicide, seven times more likely to be alcoholic, and 10 times more likely to inject street drugs. Compared to people with zero ACEs, people with an ACE score of 6 have a shorter lifespan – by 20 years.

Twenty-two states and Washington, D.C., have done their own ACE surveys, with similar results.

The ACE Study is part of a perfect storm of research emerging over the last 20 years that is revolutionizing our understanding of human development. Brain research shows how the toxic stress of trauma damages the structure and function of children’s brains, which can explain their hyperactivity, inattentiveness, angry outbursts and other behavior. This affects their ability to learn in school, and leads them to use drugs, alcohol, thrill sports, food and/or work as coping mechanisms.

Biomedical researchers discovered that toxic stress experienced as a child can linger in the body to cause chronic inflammation as an adult, resulting in heart and auto-immune diseases, such as arthritis. And epigenetic research shows that the social and emotional environment can turn genes on and off, and childhood trauma can be passed from parent to child to grandchild.

Let’s put this another way: A huge chunk of the billions upon billions of dollars that Americans spend on health care, emergency services, social services and criminal justice boils down to what happens – or doesn’t happen — to children in their families and communities.

The pediatricians mentioned in this article know that, and they also know that if they intervene early enough to stop or prevent childhood trauma by building resilience factors in children and families, children won’t suffer, and they’ll have happier, healthier lives as adults.

Pediatricians aren’t just about sore throats and ear infections anymore, says Gillespie. “This is a culture shift. We’re here to support families.”

The profession is moving away from looking solely at healing a child, to healing a family and a community. For the last several years, the American Academy of Pediatrics has been helping pediatricians create medical homes where all needs of children and their families are met, including “specialty care, educational services, out-of-home care, family support, and other public and private community services that are important for the overall health of the child and family.”

Two years ago, the AAP encouraged pediatricians to also address adverse childhood experiences and toxic stress in early childhood. Last month, AAP President Dr. James Perrin launched a new initiative, the Center on Healthy Resilient Children, to “coordinate the academy’s response to the issue of adverse childhood experiences, the promotion of healthy development, and the prevention of toxic stress.”

Feeling overwhelmed…and someone to turn to

When Tabitha Lawson brought her four-month-old son in to the Children’s Clinic in Portland, OR, they both were having a hard time. Unlike her 6-year-old daughter, he wasn’t an easy baby. He had colic, and Tabitha and her husband were under stress from his long bouts of crying.

“I was feeling overwhelmed,” she recalls. “I had no breaks. I work full time. From my job to my house is five minutes, where I’d go into my other life mode, and every evening, the scream-outs.”

She filled out a survey with 10 questions about her adverse childhood experiences (ACEs)… click here to READ MORE…

Posted in Attachment, Attachment Disorder, Attachment Theory, Brain Science | Tagged ACE Study, Adult Attachment Disorder, Adult Attachment Theory, attachment disorder, brain science, Child Trauma, Developmental Trauma, Emotional pain, Toxic Stress | 1 Comment

Fire Up the Right Brain

Posted on August 8, 2014 by Kathy

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

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

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

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

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

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

Fire the Right Brain Neurons

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

——————

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

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

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

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

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

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

Posted in Attachment, Attachment Theory, Brain Science, Dissociation | Tagged Adult Attachment Disorder, Adult Attachment Interview, Adult Attachment Theory, brain science, Daniel Siegel, Dissociation, Jill Bolte Taylor, Left Brain, Mindfulness, Neuroplasticity, Right Brain, Tara Brach | Leave a comment

Dan Siegel: Creating a Joyful Brain

Posted on August 5, 2014 by Kathy

I’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).

——————

Footnotes

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

Posted in Attachment, Attachment Disorder, Attachment Theory, Brain Science, Dissociation | Tagged Adult Attachment Disorder, Adult Attachment Interview, Adult Attachment Theory, brain science, Brain stem, Daniel Siegel, Developmental Trauma, Dissociation, Frontal Cortex, Limbic brain, Mindfulness, Neuroplasticity, Secure Attachment | Leave a comment

Dissociation Nation: Half a Brain

Posted on July 25, 2014 by Kathy

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

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

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

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

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

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

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

Living with Half a Brain

And Stewart drew the biggest blank when Siegel asked him about his emotions during childhood.

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

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

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

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

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

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

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

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

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

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

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

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

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

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Footnotes

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

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

Posted in Attachment, Attachment Disorder, Brain Science | Tagged Adult Attachment Disorder, Adult Attachment Interview, Adult Attachment Theory, brain science, Daniel Siegel, Dissociation, Frotal Cortex, Limbic brain, Mindfulness, Mindsight, Neuroplasticity, Secure Attachment | 1 Comment

Dan Siegel: Re-Wire Your Brain

Posted on July 11, 2014 by Kathy

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

In August 2010 I heard psychologist Dr. Henry Cloud on CD saying, “we can now do scans of the brain of older kids who were… not held, comforted or soothed, and there are parts of the brain which are dark. There’s nothing growing in there — because nothing was planted; neurologically there’s literally no brain activity.”

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

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

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

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

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

Re-Wiring with “Mindsight”

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

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

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

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

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

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

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

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

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

——————

Footnotes

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

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

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

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

Posted in Attachment Disorder, Attachment Theory, Brain Science | Tagged Adult Attachment Disorder, Adult Attachment Interview, Adult Attachment Theory, brain science, Brain stem, Daniel Siegel, Developmental Trauma, Henry Cloud, Meditation, Mindfulness, Mindsight, Neuroplasticity | 3 Comments

Dan Siegel on Explicit Memory

Posted on June 27, 2014 by Kathy

Dr. 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

First 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]

——————-

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.

Posted in Brain Science, Dissociation | Tagged Adult Attachment Disorder, Adult Attachment Interview, Adult Attachment Theory, brain science, Brain stem, Daniel Siegel, Developmental Trauma, explicit memory, Frontal Cortex, Hippocampus, implicit memory, Limbic brain | 6 Comments

Dan Siegel on Re-Membering Trauma

Posted on June 20, 2014 by Kathy

Dr. 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

Check 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.

——————————

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)

Posted in Attachment Disorder, Brain Science, Dissociation | Tagged Adult Attachment Disorder, Adult Attachment Interview, Adult Attachment Theory, brain science, Brain stem, Daniel Siegel, Frontal Cortex, Hippocampus, implicit memory, Limbic brain, Richard McNally, Stephen Porges | 7 Comments

Readers Defend Van der Kolk

Posted on June 13, 2014 by Kathy

I 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?

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Kathy’s news blogs expand on her book “DON’T TRY THIS ALONE: 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.

Posted in Attachment Theory, Brain Science, Dissociation, Emotional pain | Tagged Adult Attachment Disorder, Adult Attachment Interview, Adult Attachment Theory, Attachment Theory, Bessel van der Kolk, brain science, Brain stem, Child Trauma, EMDR, Frontal Cortex, New York Times, PTSD | Leave a comment

In Defense of Van der Kolk

Posted on June 6, 2014 by Kathy

The 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 innuendos against the science of how the human
organism deals with trauma, and denial that trauma is as widespread as it is, in fact.

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 the Times. Nor should their abuse of their authority go unaddressed.

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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 ‘.”

I 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]

The 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

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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Posted in Attachment Disorder, Attachment Theory, Brain Science, Emotional pain | Tagged Adult Attachment Disorder, Adult Attachment Interview, Adult Attachment Theory, Attachment Theory, Bessel van der Kolk, brain science, Brain stem, Child Trauma, EMDR, Frontal Cortex, New York Times, PTSD | 12 Comments

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