Berkeley author Michael Chabon’s touching memoir, Manhood for Amateurs, begins with his declaration that his story started with the birth of his brother when he was five years old, saying: “Before that, I had no one to tell it to.” With no “other,” existence itself is questionable, which is why neglect is so very lethal. I recently heard a remarkable story underscoring this, of writer and conservationist Hannah Bourne-Taylor.

Although we don’t learn much about Bourne-Taylor’s childhood, we know that her family “moved often.” It certainly sounds bereft of attention, like a vacuum of solitary neglect. She describes herself as “bird-obsessed,” and every spring when her favorite birds, the swifts, returned to her area in the UK, she was overjoyed as if returning to life.

Hannah Bourne-Taylor

Suffering

Bourne-Taylor did not even realize how agonizing her daily experience of OCD was. It was certainly the most debilitating case I have ever heard of, and I am no stranger to OCD. Not only was she plagued by the diagnostic, endless bouts of checking and re-checking, but she “en-souled” the objects of her checking – that is, she imbued them with a “soul.” When she rearranged a can of beans that was crookedly misaligned from the other cans, she imagined the can was suffering from being out of sync with the rest of the clan. Her most severely consuming preoccupation was when she and her husband moved into a home in the far reaches of the jungle, which had a lovely swimming pool. The first time she went to take a dip, she became aware of ants falling into the pool. “Making eye contact” with the ants put her profoundly in touch with their emotional experience, and she became obsessed with saving them from their terrifying drowning deaths. She did not want the luxury of her swim to be at the cost of their fragile lives. Not only did she build bridges of palm fronds to enable their safe rescue, but she got up repeatedly during the night to make sure they were OK. The ants occupied virtually all of her waking life. And it was a secret and solitary world. She did not even tell her husband, who was to be the first person she ever told of her OCD, until she was 31.    

       Although we don’t learn much about Bourne-Taylor’s childhood, we know that her family “moved often.” It certainly sounds bereft of attention, like a vacuum of solitary neglect. She describes herself as “bird-obsessed,” and every spring when her favorite birds, the swifts, returned to her area in the UK, she was overjoyed as if returning to life. As the wife of a devoted bird lover with a history of extreme neglect, it is not hard for me to imagine her primary relationships being aviary. 

     When Bourne-Taylor was in her early thirties, her husband (ironically named Robin!) got a job assignment in the far reaches of Ghana. They relocated, and it was then that she seemed to decline deeply, sinking into her most paralyzing depression. That is when the preoccupation with the suffering ants descended on her, consuming most of 24 hours a day. Until she met the finch.

Of course, it is my rallying cry that attachment, or lack thereof, is the source of both the most profound of injury and most profound healing. And although I have known many a survivor of trauma and/or neglect whose first perhaps only safe attachment was their own child, and plenty also whose preferred attachments are to animals rather than humans, I have never heard a healing story quite like that of Bourne-Taylor.

Fledgling, Hannah Bourne-Taylor’s book.

Flock

Finches are tiny birds, perhaps the height of Bourne-Taylor’s little finger. They are extremely reliant on the flock, being so small that when left to themselves, they are easy prey for any hungry carnivore. She describes them as “a flying snack” that will last barely minutes. The proverbial birds of a feather protectively flock together and have an elaborate communication/alarm system. The finch that Bourne-Taylor encountered was somehow lost or separated from the flock. Bourne-Taylor, knowing that was a likely death sentence for the little guy, worried desperately about him for the next 10 hours or so, checking on him repeatedly.   

     Ultimately she decided she better take some action. She attempted to imitate his chirp, and he chirped in reply, ultimately coming to her. What ensued was a remarkable love story that saved them both. The interested can look for her book, Fledgeling, in which she chronicles the whole thing. The little bird ends up making a nest in her waist-length hair, and for the next 84 days, until he is mature enough to be released into the wild, they spend 24/7 together, making a total of over 2,000 hours.

      Bourne-Taylor never named the bird, her mission always being not to make him a “pet” but to return him to his natural habitat. When it was time to let him go, she enlisted her husband to do the “deed,” knowing she would find it unbearable. She also feared that he would not “make it” somehow, that a predator would get to him too fast. And it was a bittersweet time, of triumph and deep grief, when they parted. 

     Both Bourne-Taylor and the little finch were inalterably changed. What she discovered was that her OCD symptoms were gone. She concluded that the unrelenting preoccupation with care for her little buddy kept her so riveted in the present moment, it was like a compelling mindfulness practice that must have changed her brain. Her OCD did not return. She has since become an avid and prolific conservationist and author.

The finch, nesting in Bourne-Taylor’s hair.

Care

 Of course, it is my rallying cry that attachment, or lack thereof, is the source of both the most profound of injury and most profound healing. And although I have known many a survivor of trauma and/or neglect whose first perhaps only safe attachment was their own child, and plenty also whose preferred attachments are to animals rather than humans, I have never heard a healing story quite like that of Bourne-Taylor. Again, I do not know her trauma story, but nonetheless, the little finch was as successful as any therapist I have ever seen.  

     It is a hard sell for survivors that relationships can be anything healing, especially as they have ever been so fraught, dangerous, and ambiguous at best. But I do know that as effective as any of the exquisitely helpful and essential modalities for trauma healing are: somatic therapies, EMDR, Neurofeedback, psychedelics, none are sufficient without the healing of the attachment wound: attachment with a sentient other. For survivors of neglect, even coming to truly believe that is a challenge and a main task of healing. It is a default to imagine it is impossible or just not worth it. I have also seen that when a client somehow breaks through to buying in, their healing takes off. A good therapist, as I like to say, is necessary and insufficient, meaning that talk therapy is not enough, but it is essential. My two cents, and I would not take you anywhere I haven’t been!

     Bourne-Taylor never had the luxury to find out about the rest of the story about her beloved little finch. In a way, he was like “the one who got away.” Similarly, I often never find out what became of clients I had that I cared about a lot, and then under whatever circumstances, they flew from the nest. They might not even imagine how much I had cared, just as I could not imagine that my therapist cared about me. It was her “job,” so why would she think of me when I was not in her sight? Neglect teaches us to imagine that even when we are in view, we barely exist in the mind of the other, if at all. Bourne-Taylor reminds us that the healing bond works in both directions, which is one reason why couple’s therapy is so profound. And although a good therapist does not rely on or “use” their client for their own ends, it is an undeniable privilege to be in such an intimate and essential role. Like Bourne-Taylor, it is bittersweet when people are truly ready to fly on. I like to reassure them that when they do, the door is open should they wish to return for a single visit, a stint, or even another run together. It doesn’t happen that often, which is fine. And I don’t stop watching the horizon for a little flutter of wings.

Today’s song:

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

From an early age, I harbored both fascination and perhaps preoccupation with the body. Certainly my own, but really everyone’s. I was curious about sex, obsessed about food and weight, athletics, healing, all of it. I did not think I was smart enough to be a doctor, but I thought about it. In graduate school, I chose a specialization in somatics, even though back then, somatic psychotherapy did not have nearly the foundation of science and neuroscience it has now. I pored over Wilhelm Reich’s Function of the Orgasm because it integrated the essential worlds of psychology, sexuality, and politics in a way that profoundly resonated with me, those being three areas of exploration that consumed me and still do. I am gratified that the body has come to occupy center stage in the field of trauma, and even in a weird way, how the pandemic has forced us all to be mindful of the body and of health. It has also illustrated how profoundly matters of the body affect our mental health and even vice versa and worldwide.

Admittedly, I neglected the vast population of disabled or “differently abled” people. I don’t know if out of fear, denial, or simply oblivion. Another population that is invisible and forgotten, abandoned or cast out. I remember telling my husband early in our relationship, “if ever I can’t move, please shoot me.” I simply could not imagine being able to live if not fully “able-bodied.” (I am ashamed to remember it.) Our office has an elevator and a “disabled” parking space. I figured I was “doing my share.” Oy vey.

I recently heard an interview with a young woman introduced as a blind, queer, African American hip hop artist, Young Ant. She was talking about disability in the music industry, and what it is like to be a blind performer – something I had never thought about. Watching her rap and dance on YouTube was eye-opening. I had never considered how a performer finds their way gracefully onstage, dances, and looks cool moving, not to mention the accessibility issues of most or certainly many venues. Ant is on a mission to awaken the world to this.

I was impressed by the recently released movie, Box of Rain, a movie not about the Grateful Dead, but about the culture of Dead Heads, by the mention that way back in the 1970s, the Dead had a little platform in the audience at their shows for wheelchairs. That was radical in its time: the same era in which then-President Nixon killed what would have been the Americans with Disabilities Act. Many species destroy or abandon their “imperfect” young, and sadly, many human parents and fellow citizens are not much better. I am humbled to find another “blind spot” in my awareness, another big point of neglect and injustice.    

A man featured in Box of Rain, a longtime Dead Head, was Jim LeBrecht, who worked as the sound engineer for the Dead for many years. He is also a longtime friend of my best friend. Of course, I was excited to tell her about seeing Jim in this new movie. She asked me if I had ever seen another movie he had produced, Crip Camp, about a summer camp in the Catskill mountains of New York, specifically for disabled kids. I was intrigued.

Rarely have I seen a more moving and graphic depiction of the power of affiliation, what it is like to be in a group of others with a similar experience to one’s own. In the world of trauma and neglect, we are well aware of the power of the group: what it is like to be in the company of others with some sort of similar experience who understand without any words. Some of us have had the good fortune to have been in such a group and found it indescribable. I am not much of a movie person, as I always say, “I am way too stingy with my reading time,” but this one is a must-see (and it is available on Netflix).

The film also makes a powerful point of how (yes, we ever return to it) the original attachment with primary caregivers so profoundly affects the sense of self. The film opens with Jim narrating, 

“When I was born,” he says, “they did not expect me to live more than a couple of hours.” In the visual footage, a grainy old black and white home movie, we see little Jimmy as a toddler, blissfully happy, laughing and ambling, climbing and tumbling on his plump little arms. Although we do not see his parents, it appears that he feels secure and safe enough to explore widely, move and grow, even to become the teenager who has the gumption and grit to imagine and aspire, hope, and actually become the sound engineer for his favorite band. And those parents obviously got him to Camp Jened, lovingly referred to as “Crip Camp.”

At camp, everyone had one or another disability, and for the first time ever, felt free and accepted. They did what all kids do at summer camp: sports, art, music, experiencing nature and the outdoors, and communal living. With a culture of non-judgment and helpfulness, they pushed each other’s wheelchairs, carried those that needed it, and understood each other’s sometimes strained or challenged speech.   

In the larger world, apparently, there is a definite hierarchy or pecking order of disabilities, with the “Polios” at the top rung and the “CP’s” (those with cerebral palsy) at the bottom. Not here. It was moving to see how carefully and thoughtfully the “CP’s” difficult verbalizations were both listened to and comprehended, sometimes “translated” or summarized by a comrade. And my memory was jogged.

I remembered a time, the one time in my long and sweaty waitressing career, that I waited on a really famous person. I worked in a fancy place not far from UC Berkeley and had the honor of serving a large dinner party celebrating the luminary physicist, Stephen Hawking. I watched the tiny man in his wheelchair, fitted out with many super-high-tech devices to help him communicate with the throng of scientists and other intellectuals fawning over him, myself included. What a rarity in today’s “ability-supremacist” world.

My favorite part of Crip Camp was when a “CP” named Judy laughingly told the story, in her somewhat garbled speech, “I was getting older, and I did not want to die a virgin! With a twinkle she declared, “So I had an affair with the bus driver! A week or so later, I had a terrible abdominal pain. I went to the doctor and turned up a diagnosis of gonorrhea. The doctor was flabbergasted, incredulous! He could not imagine that anyone would want to f— me! As soon as I got well, I went back to school and got a master’s degree to become a sexuality educator.” Judy became an activist and vocally championed the cause of disabled sexuality. She also married happily, although she laughingly added, “my in-laws accepted me, but they said to their son, ‘couldn’t you have at least married a ‘Polio?’”

anybody

Admittedly, I neglected the vast population of disabled or “differently abled” people. I don’t know if out of fear, denial, or simply oblivion. Another population that is invisible and forgotten, abandoned or cast out. 

Acceptance

Our dad, when he had throat cancer, required a complicated surgery where they had to break his jaw and build a new one, out of steel. Always vain and proud of his strapping good looks, he was now disfigured. He was 50. Amazingly it did not seem to phase him (the insulation of narcissism?). Years later, I even asked him about that. He said it never bothered him. By then, he was fond of saying, much like Keith Richard, “I’m happy to be here! I’m happy to be anywhere!”

I once had a client who finally accepted his history and the idea of being a survivor of childhood neglect. He said, “I want a disabled placard for my car that says “Child of Neglect!” It is a blessing and a daily challenge to accept who we are.

Have a look at Young Ant rapping and dancing with her white cane. And thanks Jim!

Today’s Song:

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

For me, a dark secret, fiercely off limits to anyone, even my therapist (until very recently,) has been the silent but fraught world of sleep. Although I remember sadly little about my childhood, I do remember the welcome, early discovery of masturbation as a way to get to sleep and thinking that was its purpose. I remember hating and dreading slumber parties because I woke up hours before anyone else and agitatedly waited for the other girls to finally get up and continue the party. 

In my early teens, I remember my much older, “drug informed” boyfriend giving me some kind of little pills (valium perhaps? I don’t remember). I kept them stealthily locked away in my bedside pink jewelry box. When I was anorexic, I loved the power and control I felt from not eating for seeming eons but dreaded and feared the guaranteed anguish of gnawing hunger keeping me awake. The rumbling night seemed to go on forever.

In more recent decades, after the eating disorder was blessedly and fully resolved, I seemed to develop a different version of “anorexia,” if you will, or a parallel self-deprivation. It took me years to recognize and admit to myself what I was doing. Much as I had renounced and disavowed the need or desire for food in the past, now I was doing the same with sleep. 

Virtually identical to what I had believed about food, it was as if I were a different species. I did not need, and/or I did not deserve what “regular people” had or got to do: to sleep. Was I monstrously inferior and not entitled to rest, too busy justifying my sorry existence? Or was I superhuman and could get away with it? It was some combination of both. The result was a kind of hubris, whereby I slept four hours a night for years and proudly, if quietly, had 20 hours a day to be “productive.” For a long time, it was a well-kept secret. Only my husband knew, familiar with my long absences from the bed, and the cohort of kindred insomniac gym rats or night workers, who also frequented 24 Hour Fitness at 1:30am. Later our dad and my therapist somehow knew; I must have told them. I don’t remember. But they all knew from whatever their unpleasantly failed attempts were that the topic was not up for discussion. I was highly defensive and definitive about that! I ultimately made light of it, concealing it less. It was simply another of those quirky anomalies about me.

We have a now elderly little gray Miata, we affectionately refer to as “the Mouse.” During the final years of my father’s life, the one-hour weekly drives to our otherwise difficult visits seemed to be the redeeming feature. Something about the Mouse had a quick-acting sedative-hypnotic effect. Its hum like a lullaby, its drive rocking me like a cradle; as soon as I climbed into the passenger seat, I was out. My husband was delighted to see me sleep! And I silently, slowly had to admit it to myself. I was so, so tired. It had all been a lie about not needing the sleep. I was bone tired.

Humility

For many a survivor of trauma and/or neglect, sleep is a minefield. It may be the desperate quest to get to sleep, or the problem may be staying asleep long enough to get rest. It may be the movie-like screening of haunting nightmares. It may be a memory relived, with or without awareness, of traumas that invaded or upended the childhood bed. It may be the fear of the insomnia itself. Young parents, medical professionals with 24, 48, even 72-hour shifts, emergency responders… how do they do it?

It took me a long time to remember some of my worst experiences in bed. But I always did remember waking up alone in the dark cold of my hospital room when I had my tonsils out at age 3. In those days, I guess mothers (or a parent) did not stay by the bedside of a tiny child. Waking up alone and terrified, with a painful raw throat, no one around, and it was so dark. Where was everyone? Anyone? And they had promised there would be ice cream. Where was the ice cream? 

I remember another time, waking up alone from an afternoon nap in the little bungalow where we summered in Fleischmanns while my father waited tables in the luxury resort. I was again, about 3. And again, terrified. Where was everyone? And I remember always being so scared of the dark that when I went to the bathroom in the night, I ran like hell back to the bed, not knowing who or what might be chasing me. 

The mythical “good night’s sleep” can become a torturous quest, certainly, for the hyper-aroused nervous system of survivors of whatever the trauma. And although our world is now glutted with remedies, pharmaceutical, over-the-counter, legal and illegal, “alternative,” not to mention the wide world of apps, devices, and mindfulness practices. Many have tried them all. Many continuing in exhausted despair.

For me, the first step, as is all too often the case, was having the humility to face that this is a problem; and a problem that could be dangerous to my health. What might be the impact of at least a decade of four-hour nights? Maybe I am simply a human organism after all, an ordinary mammal, not superhuman or subhuman, bionic or undeserving.

Maybe, as they say in AA, “I am just one more Bozo on the bus.” It was time to work on this before it became too late.

Regulation

As ever with trauma, the problem is generally dysregulation. Sleep requires that the body achieve some modicum of calm to be able to enter the blissful state. Samantha Harvey’s 2020 book, The Shapeless Unease: A Year of Not Sleeping, although it is a rather bleak description of her own insomnia, is spectacular writing and an avid portrayal of the anguish of the elusive shut-eye. And it is not uniform in its nature. For Harvey, it was related to a dark fear of death, haunted as she was by family members’ passing. For others of us, it is rooted in attachment trauma. After all, the earliest and most vulnerable time of human life we spend mostly asleep, so the developing human brain, designed to be in resonance with another, flounders to find its rhythm if left alone or if its sleep is fractured by dissonance, conflict or confusion.

The parasympathetic or calming function of the autonomic nervous system is certainly a factor in sleep, of course. When a particular pattern of insomnia appeared as my single symptom of menopause, I learned about that. My menopause iteration was a repetitive cycle of 90 minutes of sleep interrupted like clockwork by an abrupt rude awakening, persisting stubbornly for hours. I learned from a somatic therapist that the parasympathetic nervous system connects the brain with the body at two locations: the occiput or base of the skull, and the sacrum, or base of the spine. Stimulating those two spots by lying on slightly deflated rubber balls each time I awoke put me right back to sleep. 

It was a miracle and resolved the insomnia of my menopause. I became a missionary with the little balls, keeping them by my own bedside and in my travel suitcases and ordering cases of them that I gave away to friends and clients. They took me through menopause. However, my sleep challenges returned, and I discovered them to be tied in with other trauma and psychological hurdles about doing “enough,” being enough.

Neurofeedback and psychotherapy in concert, for many of us: regulation and trauma healing, are the royal road. And I am making progress! I’m averaging about 6 hours! Happy dreams to you!

Today’s Song:

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

(This article contains content about suicide. If you or anyone you know experiences suicidal thoughts or impulses, please call your local suicide hotline or emergency services.)

“…the thought of suicide is a great consolation: with the help of it one has got through many a bad night.” – Fredrich Nietzsche 

The renowned existential thinker and Philosopher Fredrich Nietzsche wrote liberally about themes related to death. I never read him, philosophy never being my taste, nor in the wheelhouse of my long trauma fogged mind. I don’t know where I first heard that quote, but somehow it stayed with me. Years later, when I can think and read, I am curious about him and the life of the brilliant and epoch-making man. But probably not enough to slot him into my ever-higher, sky-scraping tower of books waiting to be read. Oy vey. I guess books, at least sometimes, were the way to get through bad nights and days for me. 

I remember long ago reading somewhere that the only thing that got him, Nietzsche, through his pain and anguish was that escape hatch he left open for himself, although he never used it. Suffering from unrelenting migraines beginning in childhood and later beset by debilitating dementia that left him unable to care for himself in even the simplest ways in his early forties, he died of pneumonia at age 55, leaving to the world an erudite inheritance.

 

Like Van Gogh, whom I have always been able to appreciate and love, his pain somehow benefitted us all.

Glory?

Death always seemed to me an avenue to glory and, ironically, long sought-after attention. My favorite character in Luisa May Alcott’s  famed staple for every little girl of my generation’s reading list, Little Women, was Beth. Her early and precipitous childhood death of Scarlet Fever pitched her three sisters and her parents into the kind of consuming grief, love and value that I did not know how to get but endlessly craved. I remember Tom Sawyer feeling similarly, looking down from the clouds and seeing himself sadly missed by those who in his ordinary life seemed barely to know where he was. I don’t remember where in Twain’s famed book I read it, but again it stayed with me.

I sometimes wonder if our dad carried a weight of ambivalent guilt, shame and inferiority for not being one of the six million who perished in the Holocaust. Although his suffering was massive, and we heard quite enough about that too, it was somehow not quite “enough” to merit that ultimate badge of courage. I don’t know how I got the idea.  

Somewhere, I similarly got the idea that dying a martyr’s death, in the line of altruism, heroism and/or macro-level self-sacrifice, would provide not only Nietzsche’s proposed solution for pain but also forgive a debt, paying for my sorry existence and unearned right to take up space on the planet. 

Che Guevara, the heroic and brilliant internationalist revolutionary leader of then-successful guerillas movements in embattled countries not even his own, became my role model. His fiery, dramatic death at 39, in tireless pursuit of justice and freedom, somehow personified glory to my young and desperate psyche. Was this another manifestation of “the intergenerational transmission of trauma?” My attempt to be “enough” in the way our dad never could? Another contorted attempt to win his attention or esteem? All of the above?


suicide

Visiting Cuba for the first time in 2015, I saw the now 55-year-old “graffiti” (older than Che was when he died) still on an old brick wall: “Seremos como el Che!” We shall be like Che. At this point, I still struggle with how to do that, perhaps without dying.

For about six years in my twenties, I was beset by persistent suicidal thoughts throughout pretty much every day. I never made an actual attempt (if we can except anorexia which was early and unconscious, but almost achieved it), but I could not shake it. 

The only respite in those dark days came when I finally reached AA: my twice-daily Alcoholics Anonymous meetings. Those two daily hours, 6:00am and 5:00pm, sitting in those (then) smoky rooms, were my only islands of peace. I couldn’t explain it. I certainly had no use for God or any sort of higher power. Rather, I now think it was being part of a group, a loose amalgam of vastly varied folk, connected by “something”. That seemed stabilizing, containing, comforting. 

Perhaps even more importantly, as I think on it now, was some largely unspoken sense of a future. The nature of trauma and neglect is a pervasive ennui of futurelessness. In the course of traumatic events (or non-events), time stands still or appears to. We now know that this has to do with aberrations in brain function during overwhelming experiences. Paralysis of not only movement but the proverbial clock are hallmarks of the trauma experience. 

This motley “community” where I never made friends with anyone, barely spoke, and even had trouble keeping a sponsor, became not only an affiliative group but a symbol or representation of the possibility of dynamic change. I am sure I did not register this in awareness, but I kept going back. And sometimes, there was even humor.

Group therapy seems something of an endangered species in our area now, which is a terrible loss. The potency of connecting with a group, which so many survivors never have, is no joke. I probably never consciously got it, how powerful that was for me, but in the first decades of my incarnation as a trauma therapist, I offered multiple weekly groups until it became just too hard to work so late into the evening.

 In January, I read of the death by suicide of 2019 Miss America Cheslie Kryst. She was the proverbial “rockstar”, beauty pageant gorgeous, an accomplished attorney with a degree from a fancy school, and social justice leader bringing African American women into the frontlines of the fierce and racist, sexist beauty industries. She was 30. 

Often these celebrity suicides stun: these people who appear to “have it all”, Anthony Bourdain, Kate Spade, and Robin Williams, to name but a few. (In the cases of Amy Winehouse or some of the many head-injured football star suicides, some of the possible “causes” may seem more transparent). What was wrong? I have to wonder how many suffer from primal attachment wounds, given that what I know to be most effective for bringing sufferers back from the edge is a sustaining attachment. In my case, besides the AA group was my brilliant therapist, whom I had the good fortune to fall in with in the nick of time.

In her recent memoir In Love, Amy Bloom takes us through her personal story of first noticing distressing “changes” in her beloved husband, which led them to learn of his diagnosis of early Alzheimer’s. He was 66, the age I am now. For him, it was a “no-brainer” that he was unwilling to go through and drag his wife through the predictable sequence of mental and physical degeneration. He simply and adamantly refused. So, they set about finding a way to forestall and abrogate such an outcome. 

In the US, where very few states have legal assisted suicide, the regulations surrounding it are tight. One must have a terminal illness with a medically predicted six months to live while, of course, being fully competent to make one’s own decision. 

Bloom’s husband, like many doomed by degenerative illnesses, did not make the six months cut. So the couple undertook a quest to find one of the almost only programs in the world – Dignitas in Forch, Switzerland, a scenic town in the high Alps close to the French border. For a hefty sum, a peaceful and timely death with dignity for which Bloom’s husband qualified became available to them. Although the book does not take us deep enough into the character’s felt experiences for my taste and therefore left me feeling less moved than I would have expected, it is a fascinating and worthwhile journey through what, to me, seems a comprehensible decision. Always in support of assisted suicide, I was unaware before of how stringent and exclusive the rules are.

Hope

In Delia Ephron’s recent memoir, Left on Tenth, she details her recent experience with a rare and aggressive blood cancer. She describes, much as I imagine Nietzsche felt, physical pain so relentless and untreatable in its time that she fully intended and begged for help with ending her life. 

Pulling through it with valiant help from her husband and doctor, she has been unspeakably grateful for help in surmounting that hump and regaining the truly wonderful life she now has. Still, she describes the desperate moments in a way that makes so much sense. My story, less dramatic, has a similar “moral.” Hang in.

I once had a client who, before she came to me, had made a suicide attempt that not only “failed” but left her with a crippling disability. Although she had had a change of heart and called 911 midway through the attempt, she was ambivalent and racked with shame about having tried, and also the living evidence, not to mention pain and frustrations, of her regretted impulse. 

I think in my suicidal moments, that might have been another, if faint deterrent, not only the guilt of causing more nuisance to my already overburdened parents but that I might somehow bungle it.

The most impressive scenes in Michael Pollan’s recent Netflix series, How to Change Your Mind, is the interview with a police officer. News to me was that “suicide claims more law enforcement lives than felonious killings or accidental deaths in the line of duty”. This, to me, however, was not the most compelling part. What impressed me was that the one treatment that stopped his unrelenting suicidal ideation was MDMA-assisted therapy for PTSD, which not only resolved his suicidality but changed some of his other misbegotten law enforcement attitudes and impulses as well. Most hopeful of all was his decision and recommendation for the complex problem of police brutality, to himself become a guide for MDMA-assisted psychotherapy for Police Officers. That is the first suggestion for our hugely tangled and conflict-fraught challenge of police violence and racism, which has inspired a flicker of optimism for me. As FDA approval of MDMA edges ever closer, I almost dare to hope. 

As in the old Spencer Davis Group refrain, “I’m so glad we made it!”  I am infinitely grateful that I did not “do it.”  Although, like Ephron and Nietzsche, I do profoundly understand how it could seem to be the only way out. Trite but true, that suicide is a permanent solution for (most often) a temporary problem; my truly great life is living proof of that. And hey, I wouldn’t be around to write these blogs!

Thankfully only once in my life have I experienced the “completed” suicide of someone I knew, if not well. He happened to do it, certainly unwittingly, on my birthday. In his memory, every year on my birthday, I make a sizeable donation to San Francisco Suicide Prevention. I profoundly appreciate the therapists and volunteers committed to work, which I know I am unsuited for. Thank you!

Today’s Song: Bautista von Schowen, a German-born internationalist revolutionary fighter, died under torture by the Chilean Dictatorship in December 1973.

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

Way back at the beginning of our relationship, I remember my husband saying to me, only very slightly in jest, that there are really only three important activities to do on vacation: “eat, sleep and make love.” At the time, now over thirty years and many vacations ago, that was actually a terrifying prospect. Not only due to the apprehension of two old survivors of trauma and neglect spending 24 hours a day in the presence of another human but because all three of those activities were quite fraught and certainly not easy or fun for me. 

It took a long time for us to find our way and create vacations together that “work” (play? Relax? Whatever!) It seems as if I am writing this about two strange other people, thankfully, as we wrap up a glorious week in Hawaii, USA.

My last few blog posts have been dark and pretty serious. This week, being largely unplugged and reading only the lite version of the San Francisco local paper – the weather, horoscope, food, and books sections – I thought would be a good time to lighten things up and write optimistically about sex. We may all be weary and beleaguered by recent coverage of the topic: abortion, harassment, assault and other abuse and discrimination, so I thought I would flip it and talk about a fave subject of mine: Sexual Health.

In the neglect household, things, for the most part, don’t get talked about at all, and there is no one to ask questions to about much of anything. So when kids experience changing bodies at puberty, “discover” masturbation or notice the differences between their own and siblings or other kids’ bodies, they may be confused, even scared. What might be an area of wonder and expansiveness becomes a shadowy, enclosed secret. Add to that childhood sexual abuse and all the secrecy, dysregulation and emotions that come with that, and we have a child locked in frightening and silent tabu. When I started menstruating at age 9, I did not know what that was. Aghast that something was fatally “wrong” with me, I was also horrified and ashamed of the mess, smells, and evidence. I remember being at school and being terrified to get out of my little desk and leaving a bloody puddle on the chair. And I was afraid of getting caught throwing my little undies in the trash. I don’t remember how my older sister somehow found out and helped me out of that quandary. 

The larger world, sadly, is not much better. Although we are bombarded with sexual imagery, innuendo and titillation, there is a poverty of information or, certainly, information that is accurate and useful. Rather sex is commercialized, commodified, sensationalized and distorted by truly impossible role models of bodies, relationships, and functions: instantly rock hard ever-lasting erections, always feverishly wet vulvas, chandelier swinging, explosive simultaneous orgasms – at least in heterosexual couples. 

And because there is no safe and reliable education to be had, kids (and adults too) get their “information” and advice from movies, porn, locker rooms and of course, Google and chat rooms of every stripe. And with sex being wildly subjective and colored by culture, values, morals, and individual and mass conscious and unconscious biases, the silent resounding question remains, “What’s ‘true’?”And for the most part, no one knows that everyone else is asking the same thing. Oy vey! 

An interesting book I read maybe 20 years ago has stood the test of time even in the book-cluttered recesses of my head: When Sex Goes to School: Warring Views on Sex–and Sex Education–Since the Sixties, by Kristin Luker. It is a brief historical overview of the shapeshifting pendulations of sex education in the US. Essentially it graphically posits the obvious (but not so obvious?). 

Sex education in schools historically reflects the prevailing political and moral perspective of the ruling government at any given time. In effect, “s— rolls downhill, and the available information shapes the sexual attitudes and behavior of that era. It is a worthwhile little read. Many who know my work have heard this rant many times before. So let’s talk about a happy and also unifying subject! You might ask, “unifying? did you not just get through saying that it is wildly subjective?” Well, yes, I did. But from a brilliant colleague and friend, Doug Braun-Harvey, I learned the Six Principles of Sexual Health (also to be found in his book, co-written with Michael Vigorito: Treating Out of Control Sexual Behavior: Rethinking Sex Addiction) which cast a wide enough net as to be universal, truly inclusive, even practical. Thanks Doug! 

Nature

It is easy to believe that because sex is a “natural” function, we are all innately supposed to know what to “do”, and we are all essentially the “same.” After all, birds do it, bees do it. Most notably, children of neglect, living in a world of echoing silence and finding their own answers about most everything, generally tend to default to the belief that what I know about applies to everyone else too. Clearly, I am a freak if I do not know what I am supposed to do. Many a child of neglect avoids sex with a partner completely for a variety of reasons, this shameful ignorance being one of them. So let me start by proclaiming a resounding “NO!” We are NOT all the same, and sexual tastes, much like food tastes, are as widely disparate and diverse as the gourmet (or not!) palette. When you partner with someone new, do you assume you know what their food preferences, allergies, ethical or religious restrictions, or even rhythms of meals might be? Hopefully not! We need to ask! Listen and learn! Then, ultimately, we can cook and eat and if we are compatible and have enough overlap and enough common predilections enjoy a meal together.

And so it is with sex! We must similarly speak, ask, listen, disclose and learn! It seems like a “no-brainer!” No? Well, because in general, no one really talks about sex, including oncologists who fail to alert patients about possible sexual ramifications of their cancer, its treatments, and surgeries; psychiatrists who fail to inform/warn patients about sexual side effects of medications, even psychotherapists and couples’ therapists fail to inquire – it is not obvious that it is OK to ask and to speak up. It is really most “natural” if one is honest, to not know! 

In all fairness, I must add that there is the occasional sex-positive exception to the gross generalization above. Let me just say, I am committed to breaking the silence by raising sometimes shocking tabu sexual subjects (hopefully with dignity, tact, and respect for all) with explicit language to model, teach and desensitize talking openly about sex. It is quite remarkable how many long, long-term couples never have! No shame in that! Talking about sex is not “unnatural”; it is just, well, unnatural! Let’s do something about that!

Norms

 So, once we have “normalized” talking about sex, we must define “what is “normal” anyway?” So many individuals and couples both worry, “I am not “normal!” or my partner is not “normal,” our frequency of sex is not “normal,” etc., making for shame, criticism, blame, confusion, uncertainty, bitter recrimination, prejudice and often sexual impasses and long droughts. (Most people who are not sex therapists have no idea how many “monogamous” long-term partners haven’t had (partnered) sex in literally years!) I once heard a sex therapy expert say, “So-called ‘sex addicts’ are anyone who has sex more than me!” So, in addition to tabu busting and myth-busting being vitally important to me, so is defining our terms! As I often say, and it can be a hard sell, particularly with survivors of neglect for whom “doing things my own way” has been a means of survival, there are few absolutes about anything. Even more controversial, I am known for saying, “There are no facts in a relationship! Just your world and my world,” but we won’t debate that now.

Certainly, with sex, there is no universally agreed on “normal” for sexual feelings, preferences, and practices. There are some that are difficult for me to imagine and understand, and certainly would do anything but try! But I don’t have to do those if I am adhering to the Six Principles. What a blessing! If done well, a true democracy! So here are the Six Principles, only briefly fleshed out here (no pun intended). Assuredly, we shall return again and again to these topics!

Pretty basic, huh? Yet truly game-changing when scrupulously adhered to! And within this frame, the sky is the limit as to what we choose to do!

The Six Principles

 

1. Consent

Consent is, of course, foundational and delineates the difference between trauma/neglect-ridden interaction and healthful, connected and free expression. Couples must agree that “No means NO!” and, in turn, yes means authentic yes! There must be agreement, commitment and safety to be candid, as well as precision about exactly what we are consenting to.

2. Non-exploitation

Non-Exploitation means thoughtful assessment and correction for any imbalances of power and care taken to share the responsibility to equalize and equally respect the dignity of each.

3. Protection from STIs and unintended pregnancy

Protection against STIs is a shared responsibility and endeavor, including agreement and cooperation about both “pre-existing” and newly acquired conditions or infections, agreement about methods to be utilized, and who is responsible for what.

4. Honesty

Honesty means transparency, both overtly and by omission. It also means having the humility to disclose likes and dislikes and to practice consistent and effective communication. Also agreed upon boundaries of “Privacy.”

5. Shared Values

Shared values is again the practice of good communication about what the meaning of sexual intimacy to each partner. Is it about play and fun? Intimacy? What makes me unique, special and sets me apart from everyone else in your life? Self-regulation, procreation, spirituality? Is it even interesting at all? Couples must determine are we, in fact, “in the same movie?”

6. Mutual Pleasure      

Mutual pleasure is about creating an interaction in which there is room for the pleasure of both partners. What makes sex really “work” is when each partner is both present with themselves and present with the other while in the present moment. It is a commitment to that, which includes finding out what exactly brings pleasure to them.

7. Bonus Principle: Lifelong Regular Practice

Sexuality pioneer and icon Betty Dodson would add a seventh principle. She taught that regular sexual activity, with or without a partner, is as essential as  food, sleep and (other) physical exercise. She joyfully practiced what she preached until she recently passed at 91.     

Cursory and introductory for now, this topic will be amply addressed in my forthcoming book now in the works and, to be sure, in many upcoming blogposts. The eager might look up Doug Braun-Harvey, who offers a wealth of information about sexual health! 

Nexus

Sexual health does indeed mean inclusivity, elasticity, growth and acceptance, not only about the vast diversity among us but in ourselves through our lifespan. When I was growing up, categories were rigidly binary and few: male or female. Even gay or straight came later. Then we got bi-sexuality and, little by little, all the other letters coming after LGB in a growing list. Sexual health is widening our lens to include them all but also learning how to observe with acceptance and grow with the changes in our own bodies and sexual functions, including our own feelings and attitudes about sex and ourselves. So many things we might never have thought about until we got there.

Our species has only recently begun to live this long. Only a century ago, humans did not live long after their reproductive years, so the challenges of long-term monogamous sexual activity with one partner for decades post-child-bearing is a puzzle we are still working out! If you don’t have answers yet, well, join the human race.

So much more to say! As Terry Gross would say, “Let’s take a short break. And then we’ll talk some more!” And as Rabbi Hillel taught about the Golden Rule, these six (or seven) principles are all you really need to know. The rest is commentary. So now go and practice! 

Today’s Song:

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

June 26th marked 25 years since the “handover” of Hong Kong back to its motherland, China. What an odd term, “handover”, as if what is home to millions is but a puck or a ball in some larger-than-life sporting game. I am largely ignorant about the history of China, my knowledge being limited to the bleak stories our dad told us throughout childhood about his seven years in the Shanghai ghetto, part of his multidirectional flight from Hitler Germany.

I remember the frightening descriptions of opium dens and the tragedy of his mother’s death there when he was 12 when Jews were not admitted to the hospitals. My college roommate was a vociferous Maoist, and a larger-than-life poster (not Warhol!) of the Chairman filled most of a wall of our dorm room making him almost a third roomy. That was most of my familiarity with that massive country and its equally massive history.

As part of the observance of this anniversary, BBC played an interview with a woman born in Hong Kong when it was still a British colony in the late 1950s and early 60s. Besides its own bulging population, the territory was flooded with refugees from the mainland in flight from a historically horrific famine. The population became so dense, and the people so poor, that there was a catastrophic scarcity of food and space, with three million people squashed together and occupying 62 square miles (160.579 square km). As many as 3,500 people occupied some single blocks, and families were hard-pressed to keep their children.

As a result, countless babies were being “disposed of” in various ways. Newborns were routinely dumped in garbage bins, graveyards, in the gutter, on doorsteps – anywhere they might be stumbled over by a magnanimous passerby. The interviewee was one of them, abandoned at 14 days old on the staircase of a public square. Although there was a record of the specific location and address, even the date she was found, her birthdate was unknown, and she had no name.

Police retrieved her and delivered her to an English-run orphanage, where she spent her first couple of years (there, the ratio of abandoned girls to boys was 76:6). The girl foundlings were all given the same name, Tsin: the name of a Chinese region.

When this Tsin was almost 2, a British couple came to the orphanage looking to adopt. They were a mixed couple which in Britain was largely unacceptable in those days, the husband being of Chinese descent, which complicated adoption in the racist UK. They figured in Hong Kong, they would have more luck. After touring several orphanages they selected our Tsin rather randomly. “My father tickled me, and I laughed, so I was the one.”

homeless

In her adoptive country, Tsin felt like the alien that she, in fact, was. She was somehow expected to emerge from the cocoon a fully English child. She didn’t know a word of English, and no effort was ever made to introduce her or support her around her cultural identity. Her parents gave her the domestically pronounceable name of “Debbie”, but that hardly helped her to fit in, let alone be accepted by the other children. She was teased and mocked with racist “jokes” and faces. Sadly and silently, she longed to wake up in the morning with white skin and round eyes. Her well-meaning parents exercised “benign (or simply clueless?) neglect,” leaving her to flounder in a lonely existence of feeling invisible, lost, and not understood.

It was many years later when the internet had shrunken and connected the world, that Debbie discovered others like herself; in fact, she found a group of women all lost and found on the streets of Hong Kong, with their own iterations of her story. She was dazzled and awed by the new experience of feeling kindred and feeling seen, and she felt in a way she never had. She had hardly known how numb, bereft, and lifeless she had been until then. Finding these women was truly a kind of birth for Debbie. When the little international group finally decided to meet in person, it was indescribable for her and all of them and a testament to the well-known healing impact of relationships and groups.

Perhaps the most poignant point in Debbie’s story was when she and a few other women visited the Hong Kong public square where she had first been disposed of as an infant. She sat on the cold stone of the steps, feeling a swirl of nameless emotions and emptiness. Being with the other women helped to ground her as she looked around at passersby, wondering, like the lost baby bird in the old children’s book, “Are you my mother, my aunt, my cousin, my near or distant relative?” 

The quest and hunger for affiliation and attachment are as boundless and timeless as are their healing properties.

Super

Interestingly in London, there is a “Foundling Museum.” Who knew?

Apparently, we have a fascination with mother-lessness (or parent-lessness, to be more correct) and an understanding largely outside of awareness of the primariness and immense power of that first and most essential attachment. On some level, we must know that attachment trauma, with or without bodily scars, constitutes the deepest and most stubborn of the injuries we endure. Although research is slowly bearing this out, developmental trauma and, most specifically, neglect, are slow to garner attention, let alone research, treatment, and education dollars to mediate and eradicate it. Absurd! What is neglect, but obliviousness to the centrality and salience of this bond, or lack thereof? On some level, we know.

The current exhibit at this Foundling Museum is about Superheroes. Admittedly, I have never been well versed in comic book lore. Although our family lost everything in the Holocaust, Oma on my mother’s side continued to be proud and even somewhat “uppity” about her Oxford education, which they could not steal, and that attitude permeated our family. We were raised to be bookish and “scholarly.” So, the characters of comic books were absent from my childhood reading education.

I was curious to learn from the description of the museum exhibit that all the Superheroes are, in one way or another, orphans. Superman, Batman, Spiderman, Black Panther… others of whom I have never even heard, in other languages and of other stripes. How very curious!

Say the exhibit designers: “Marvel’s X-Men experience both discrimination and social ostracisation… The superheroes’ early life experiences impact on their roles and the stance they take over good and evil in their comic lives.” 

On some level, we must know that to endure the loss of the primal bond requires a strength that is superhuman. And the quest to connect to the world in some way, if not via an authentic self, and make that larger world safer for all, would be a super drive. That, in fact, does make sense. And looking at myself and countless children of neglect and disconnection that I know, it’s what drives many of us.

Neurofeedback

I have the good fortune to study with and be mentored by the greatest neurofeedback-of-trauma expert in the known world, Sebern Fisher. By some stroke of genius, I approached her and asked her to mentor me back in 2009 when I first trained in neurofeedback. Back then, there was a spot to be had on her weekly appointment calendar, which I have greedily clung to ever since. Two tenets that I learned from Sebern are trained indelibly into my brain. She has taught me immeasurably more, but I find these two little statements I repeat to myself and others more than any other:

  1. Whatever the positive or negative, large or small change we observe in the client’s brain, we NEVER rule out the possibility that neurofeedback is a factor. This requires not only scrupulous attention but also non-defensive responsibility, humility, and flexibility.
  2. Perhaps most importantly, Neurofeedback is NOT a standalone treatment. This means in our approach, it is not a mechanical procedure that we perform “on” or “to” the client, but rather it is a shared process undertaken by a dyad, or a triad really: the client, the therapist, and the computer. The psychotherapist/client relationship and the (well “trauma-informed” and “developmental trauma-informed”) psychotherapy are the context, the amniotic fluid within which the healing unfolds. The two are, as the Cubans say, “de un pajaro las dos alas,” two wings of one bird. Both necessary, neither sufficient.

This is why I prefer not to practice neurofeedback with other therapists’ psychotherapy clients and why I schedule sessions that are long enough to do both. The neurofeedback creates the regulation that often makes more and deeper material accessible and manageable for psychological processing, or so it appears.

On some level, we all know it, even if we are not awake to it. The litter of neglected attachment must be scooped up, transformed, healed, and prevented, even if one brain at a time.

Today’s Song: Talking Heads: People Like Us:

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

Alarmed by the barrage of horrifying mass shootings in the US of late, we are all shaking our heads and wondering, “what is happening to us? What is going on here? What does this mean?” Researchers have been looking into what, to me, are “new” places in an effort to comprehend what appears to be a not only alarming but growing trend. The most recent run of rampages, apparently neither politically, racially, nor ideologically motivated, have sent some researchers to the internet to track shooters’ “online footprints” in search of warning clues or explanations. 

In studying the most recent suspect in the “Highland Park” mass shooting, experts discovered a trail that I certainly had no awareness of. I, of course, am no paragon of savvy about what goes on in the online or social media worlds. Tracing the 21-year-old shooter’s recent activity, including his online activity, revealed a startling, dramatic, and relatively new cyber sub-world or underworld. Emerging in the last couple of years, it was certainly new to me. 

This new genre of online communities consists of blood, gore, nihilism and the creation of fictional identities exhibiting and glorifying those traits. Particularly jarring, according to researchers, is the way they appear to blur reality and fantasy, creating a psychotic-like confusion of Self. An opportunity to “be” someone else, and then an obscuring of identification of who I am “really.” Designed to be immersive, “viral”, or result in prolonged and repetitive hours of “play,” apart from whatever the psychological impact of such horror might be, combines with the still not fully understood brain impact of protracted screen time, on especially developing brains. And these sites tend to be most frequented by young people between 13 and 21 years of age. We see, in effect, a scrambling of alarming content with a potential for brain damage, precisely in prime years of identity formation and brain development. Where I might be inclined to exclaim “oy vey!” that would seem trivializing here. Throw in the context of climate change, and any vision of the future may seem apocalyptically blighted.    

Trauma simmers (and potentially ultimately boils) with confusion, conflict or simple lack of identity at the heart of neglect. So, a child of neglect might be particularly vulnerable and susceptible to the offer of an alternative and powerful identity and even a loose posse of similarly searching and lost souls like themselves, all lacking distinction, purpose, connection or even something to do

“Analog” Footprint

Apart from this troubling digital footprint, what about the concrete and observable signals that something is terribly amiss? Who is even watching? The young Highland Park suspect was hardly subtle in scattering his clues: suicidality, homicidal threats to family members, violence-laden artwork, even a chilling mural-sized painting he left on an outside wall of his mother’s home of a sinister smiley-faced figure brandishing an assault rifle. Somehow, he remained stunningly invisible in the days, even years leading to the massacre. What was this young man’s story? Attempting to track his actual history did not turn up too much.

Living with his father and a paternal uncle, he was quiet and withdrawn, tending toward depression. The men thought he was a good kid,  but to be honest, it appeared no one was really looking. When his father helped him obtain his weapons, he claimed the boy was going to use them for target practice, or so he “believed.” Some neighbors commented that his “parents worked long hours.” Perhaps he was left unsupervised too much? In 2002, his mother was convicted of leaving him alone in a hot car when he was two years old. These are the stray crumbs of childhood material I was able to find. His father matter-of-factly and non-defensively said, “I want a long sentence; that’s life. You know you have consequences for actions. He made a choice. He didn’t have to do that.” 

To my lens and sad eyes, this adds up to another story of deadly neglect; in this case, deadly for so many more than the original “child” in question.

graffiti gunman

 

Invisible

So often, I hear clients say – at least those new to me or my work – “—-But nothing happened to me!” If one isn’t using the familiar and perhaps “valid” triumvirate of sexual abuse, physical abuse and more vaguely defined “emotional abuse,” they come up empty. They may even come from significant privilege, pointing to paid-for fancy educations, plentiful food, money and creature comforts. Or, in the cases of less plenty, they may point to hard-working parents doing the best they could to provide, often with their own traumatic backgrounds. This may make for additional layers of shame and guilt for “complaining, suffering, or inexplicably feeling so bad.” Layer on top of that, the “protective lenses” of denial or even gaslighting that much of the larger world wears, and individuals feel that much more despicable and unworthy for feeling bad.

The field of psychological trauma has known for years about the pivotal and decisive impacts of early attachment relationships (the primate researchers have known even longer.) Trauma experts decades ago coined the term “developmental trauma” as catchment perhaps for all these uncategorized or unacknowledged micro or even macro-injuries. The DSM (Diagnostic and Statistical Manual of Mental Disorders – the diagnostic “dictionary” relied upon by clinicians for insurance coverage) has yet to include them, despite well-documented field trials. 

In 1995-97 the ACEs (Adverse Childhood Experiences) Study was admirably undertaken, turning up reams of hugely valuable data about the relationship between “small” and “large” childhood experiences, linking them to medical and mental health outcomes. Only in the last few years, a quarter of a century later, has this information penetrated the larger medical and mental health fields, let alone  the field of education and the public at large. Neglect in its various iterations is, of course, included. Childhood neglect is not nothing! Perhaps everyone is tired of hearing this from me. And maybe my emerging from my own invisibility is to wave this flag.

Again, as the attachment researchers began to document and teach us long ago, mirroring or not has profound developmental impact. Many of us are very familiar with the famous ‘Still Face” research on this. It is impressive if you have not seen it and well worth the quick watch. Being seen, mirrored and understood are like food and shelter for the growing and developing organism. They are foundational building blocks to knowing who we are; to coherent identity formation.

Connection

The shootings leave a whole new population traumatized: families and loved ones of those murdered, witnesses to the atrocities, and the larger world. Meanwhile, how many young and old are still glued to their screens, or unaware, as I was, of an additional variety of internet infections and potentially magnetic or “bingeable” content. As essential as connection is, babies to caregivers, communities, nations, is the mandate to connect the dots. Twenty-five years later, families of the Columbine dead still grieve. They will never get over it, nor really will any sufferer of traumatic loss. It behoves us to connect the dots.

Increasingly I am compelled by the interconnection of social, social justice and individual psychological trauma. It can seem to be a Gordian knot of complexity to tackle it all. That is another reason why we need each other. You have skills and inclinations, creativities and ideas that I don’t have, and universally vice versa.

Let’s work together.

Today’s song (an all-time favorite of mine!): 

 

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

The other morning I woke to the tragic news of a catastrophic earthquake in Afghanistan. By the time I tuned in, 1000 people were already dead, and 1500 more were injured and/or trapped under avalanches of rock and rubble. Of course, earthquakes are a fact of life here in the San Francisco Bay Area, and I have lived through one big one (and our house is a valiant survivor of the really big one in 1906!) But we now have the infrastructure and the luxury of being schooled and supplied in preparedness. The Afghans seem in so many ways godforsaken and, of course, have none of that. 

My first thought after imagining the anguish and terror, the dead and dying, the orphaned and widowed, and those starving out in the countryside where supplies and food don’t reach, the terrible loss and devastation; was this question: Now that the Afghans are dominated by the Taliban will the international humanitarian world help them? Will anyone even trust the Taliban to deliver the aid where it is intended? I am already hearing a mixed response to that, which makes my heart break. 

Quickly my mind went to the ragged morass and scramble about mixed emotions and the collisions between the compassionate impulse to help with bitter and righteous anger and hurt. A complicated dilemma indeed. My thoughts raced.

I remember in 2015 when I was in the hospital with a massive, nearly septic infection. It was a sudden and shocking event that brought me closer to death than ever before. It was my first time ever being in the hospital, and I was there for over a week. One arm was in traction on IV antibiotics, and the other blessedly mainlined to a morphine drip. I could not move, let alone think or manage any other bodily functions. I hovered in a very strange liminal state for the first few days. During that time, I had a lovely hospital roommate, a woman about my age who had adult kids and young grandkids who came to visit her and were friendly to me, as were my loved ones and visitors with her. It was warm and family-like among us, and I had mixed feelings when she was released to go home. I was happy for her but saddened: I hated to see my new friend leave.

That very afternoon, not surprisingly, given today’s health care system (and this was well before COVID), I got a new roommate. This one was a 40-ish homeless woman with a broken leg, among other problems. She moved in with her bags of stuff and had nothing to say to me. She seemed to be on speed or some kind of amphetamine and incessantly talked loudly on her phone. She also called for the nurse every few minutes, complaining about something or with some other demand, usually around pain relief. My nerves were already jangly; I was irritated and on edge. Desperate to simply rest, I no longer could. But perhaps worse than that, I was scared. She was a “shady” character in very close quarters, who lacked for everything and had already demonstrated a complete lack of regard for me. Not only was I annoyed, but I was afraid she would steal my things: my laptop and my phone – which were most of what I had there but also my lifeline – and I could not move, let alone defend myself. (Of course, neither could she, but my addled and traumatized mind was not quite grasping that.)

Worst of all, I was gripped with guilt and shame. I am blessed with everything: I live indoors, have all the accoutrements of a comfortable life, a partner who loves and cares for me etc. She had nothing but the seedy people on the other end of the phone, whom I could only imagine, presumably a raging addiction to something, and a broken leg, in addition to the other health problems I did not know about. I just wanted her GONE! Not unlike so many privileged San Franciscans, who want the unsightly and smelly homeless encampments removed from their “back yards.” 

So, while I felt furious and impatient with my unsavory roommate, I was torn apart by shame about San Francisco’s homeless problem and my petty discomfort in comparison with her sorry life. I tossed and turned to the steady backbeat of her incessant phone conversations all night long, mostly gossip and apparent drug deals. (I feel compelled to add, if perhaps defensively, that my new and recently departed friend was of a mixed-race family, married to an African American and with family members of various colors and stripes, and my new roommate was white as snow like me. So thankfully, there was no racial component to my complicated guilt trip.)

After a horrendous first night with her, finally, 5:00am rolled around, and clutching my IV pole, I slowly hobbled to a corner of the quiet and deserted ward and called a friend and angel on the US East Coast, where the time zone was such that it was no longer an ungodly hour. Blessedly, she picked up and stayed on the phone with me for a full hour while I sobbed uncontrollably with guilt, shame, and insomniac confusion. I could not believe I was so petty. But I was also enraged, scared, under whatever was the influence of my condition and also ravaged by sleeplessness. I have no idea what my friend said to me in that lifesaving hour, but the experience of our conversation was unforgettable—and validating. It spoke to the lifelong dilemma of mixed emotions and the age-old battle between my own discomfort, sense of personal injustice, and, god forbid, even anger when it collides with sympathy or compassion for the other. Whatever she said somehow flew in the face of my long-held belief that I must always consider the other first. I was well trained to believe there is no me! Or, at the very least, I don’t matter. Self-sacrifice is the ultimate virtue and decisive factor.

Neglect is a thorough training in selfless responsibility and sainthood. The experience of “there is no you”, in combination with parental trauma histories, their medical and mental diagnoses, parental substance abuse etc, creates an environment where the parent’s need is paramount and what the child is most aware of.

Twilight

All this brings me to the similarly ambiguous topic of aging parents. A number of clients and some friends too, with stories of childhood trauma and/or neglect, have aging parents fading into twilight years. I remember when our dad was in his last year or so, being in that liminal state that I could not distinguish as inattention, dissociation, or a brain with ever diminishing numbers of live neurons actually firing anymore. He did not seem to recognize me anymore, and although he remembered songs and we could somewhat connect through singing, he was mostly quite absent. Ironically, he was quite like the neglectful, absent father I remembered, who often seemed to not know me, especially in public when he was in a role of being very important. So, this invisibility was not new and would have been quite activating if not for the decades of work I had done around trauma and neglect. And of course, I did not live with him, nor was I one of his hands-on caregivers like some of my clients. Living, some in the very houses where their original traumas occurred and caring for aging parents, they make huge sacrifices. There in the belly of the monster, they live in a virtually chronic state of trauma activation, and many are fractured and torn by gnawing ambivalence and guilt, not unlike my hospital guilt.

Neglect is a thorough training in selfless responsibility and sainthood. The experience of “there is no you”, in combination with parental trauma histories, their medical and mental diagnoses, parental substance abuse etc, creates an environment where the parent’s need is paramount and what the child is most aware of. That, coupled with a seemingly futile longing and a quest for attention, care, and love, make for a perennial impulse to care-take. I know I endlessly tried everything with both parents virtually until the end, and I catch myself even now translating an occasional impulse into an effort to win my father’s love and approval, even after he is long gone! Oy vey! 

As the Boomer generation ages, more and more of us contend with aging and dying elders and very mixed emotions about how much to sacrifice to help them now. Those that I know who have actually moved in with their aged parents may grapple with resentment, impatience, or guilt about the (sometimes) occasional wish that they would just GO already. There is an old Cuban song I used to love called La Vida No Vale Nada (life is not worth anything) that I used to quietly sing to myself in our dad’s twilight months and year or so. I simply could not understand why he was so adamant about living, still hell-bent on survival. But I had the luxury of going home quietly singing my song and with time and space to recover from the cascade of varied emotions.

How to handle the tug of war between resentment, responsibility, longing, love, guilt, grief and revived traumatic memory all swirling around at once? Working through trauma alone seems to be the work of a lifetime, and then once again, these parents intrude and compound the already incomprehensible injustice. How to resolve the conflict? I only know of one answer to this conundrum, and it is easier said than done. Always return to the question: “If I do A, how will I feel about myself when they are gone? Or if I do B, how will I feel about myself when they are gone?” Then I decide what to do. So ultimately, it is for me and for my own peace of mind and soul. That, to me, seems like healing. That is the best I can come up with. 

Some of my clients and friends go much further than I can imagine. Some I admire, and some I fear go too far in my estimation. I wonder if they will suffer from lasting resentment, loss, bitterness and worst of all, regret. But we all must make our own decision and then live out our own remaining days with that. I am sorry I cannot be of more help! 

 

Today’s Song: Once again, the immortal Rolling Stones say it aptly: “You’re not the only one with mixed emotions.”

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

As I was pondering what to write about this week and thinking that of late, my blogs have been perhaps too “dark”, I happened to catch a whiff of the pungent dirty gym socks-like odor coming off ME! The unmistakable smell of Breve Bacterium Linens, or what those of us in the know affectionately refer to as “B Linens.” If you have had a ripe Muenster or Port Salut, B Linens is the bacterium additive that brings the lovely coral red blush to their rinds. I particularly love those two because I somehow remember them as being faves of our mom. And although they don’t bring the Proust-like flood of recall that some foods do, they do bring some kind of smile to my memory. Inhaling the stink rather characteristically clinging to my shirt, I thought, “maybe I’ll write about cheese!”

Last week I had the thrill and honor of appearing on the world YouTube stage for the first time. No, not as any kind of trauma expert; rather, my much-loved Australian cheesemaking teacher and guru Gavin Webber invited me to participate in his special event, “Twelve Hours of Cheese.” No, not for twelve hours, but for a one-hour interview about my own little story as an artisan home cheese maker. And that story I do remember. Not without trauma, the traumatic events were more like little “insults” that ultimately were mostly edible. When people say “cheesemaking! What an interesting hobby!” I say, “No, you don’t get it. For me, cheesemaking is not a hobby. It is a diagnosis!” What an oxymoron and identity shock for this invisible old child of neglect to be out there in the public eye. But before I go on, I better change this shirt because it really is kind of unbearable.

When people say “cheesemaking! What an interesting hobby!” I say, “No, you don’t get it. For me, cheesemaking is not a hobby. It is a diagnosis!”

Why Make Cheese?

My favorite album of all time is the Rolling Stones’ 1972 masterpiece Exile on Mainstreet. I remember at the height (or depth) of my dysregulation, bellowing along with Keith, “Everybody goooonnna need some kind of ventilator….” He had a rough childhood, bombs falling in London, a neglectful mom, hunger, an alcoholic father. No wonder he got so hopelessly addicted to heroin for so many years. I am grateful that I dodged that bullet. I can certainly see its appeal. And he is right.

The concept still stands. All of us with dysregulated nervous systems, with stressful daily lives, whether due to personal trauma histories or being a psychotherapist to the traumatized, or both, need these relief valves; ways to recharge and re-balance or simply rest. Perchance I fell into cheesemaking as just that. It really was a kind of an accident. I have always loved cheese, and it was a remote fantasy to try making it someday, like many other little fantasies that never materialize. This time, someone innocently lent me a book about home cheesemaking, and on a whim, I thought I would give it a try. I made the beginner’s cheese that most people start and many end with: quick mozzarella. Oy vey – I was hooked. It was a royal road to regulation. A friend affectionately nicknamed me “Cheese Wiz!”

Like sex, cheesemaking requires a delicate balance between sympathetic and parasympathetic, a focused presence floating on a pulsing excitement. Gavin’s book Keep Calm and Make Cheese is well named. You have to be calm to do it, and it is summarily calming. Perfect! But I get ahead of myself. 

Suspecting I had discovered a new brand of self-care, I returned the borrowed book, bought my own copy and then every other cheese book I could find. And it was an amazing vehicle of focus – calm and fun, even though my first cheeses were nothing to brag about, with a failure rate of about 60%. I scoured the internet and YouTube and searched out all the tutorial videos and courses I could find. That was when I found Gavin, who became my go-to authority. I lived for his weekly live stream and live chat program Ask the Cheeseman, and I worked my way through his how-to videos, trying as many as I could. Now in about year four or five of my journey, it seems there is no going back. 

And what a great teacher it is. Cheese is a living thing. It grows and evolves, and without proper care and hygiene, it drifts awry, with runaway unwanted mold growth and bacterial hitchhikers and vagabonds floating around where they can make havoc. It is also a great teacher of patience. When I first started making cheeses that had to age three or four months before being ready to eat, I thought, “no way!! How am I supposed to wait?!” Then I discovered the cheeses that take six to twelve months and more. Like trauma healing time, it moves glacially slowly. But ultimately, transformation occurs, and out of a shapeless mess, something new and delicious emerges. It is usually worth it. Not always, of course; that is why the essential brain function of learning from experience comes in!

 

Cheese is a living thing. It grows and evolves, and without proper care and hygiene, it drifts awry, with runaway unwanted mold growth and bacterial hitchhikers and vagabonds floating around where they can make havoc.

Nourishment

For millennia, around the world, people have been making this simple food with essentially one ingredient. They all seemed to spontaneously discover that although they could not store milk long enough to span the seasons when it was less plentiful, this simple procedure made a nutritious food that lasted much longer and was also delicious. Spontaneously and cross-culturally (no pun intended!), a growing wealth of styles and varieties developed, and a whole world unto itself of methodology and even language was formed. I was amazed as I got acquainted with that new to me little world, that there was a whole new vocabulary and set of concepts to learn, just like everything else. Who ever heard of Breve Bacterium Linens, of flocculation, or Mespohillic and Thermophilic Starter Cultures, to name but a few. However, these terms all became part of my daily life and copious reading. 

Even before the pandemic struck and isolation became the norm, entering this world community of cheesemakers made me feel connected to people across geography and across time. It made me feel connected to cows and goats and sheep and all the other mammals that produce milk. And something about working with milk seemed to tie back into Attachment Theory, so although cheesemaking struck like a fallen meteor that lit up the sky and then landed, it also felt somehow very consonant with who I had already been.

 

Love

When the pandemic hit and we were all locked down, cheesemaking became even more important as a means of regulation. There is something very steady and plodding about a process that takes a long time and a fair amount of fuss, much like therapy, but without (most of!) the pain. And because cheesemaking requires so much sanitizing and cleaning, all the guard rails imposed by the pandemic, with the exception perhaps of face masks, were well known to me. It became an effective, regulating pandemic activity; long days, including sometimes a 90-minute or two-hour stir – a fine opportunity to watch the wealth of webinars and virtual conferences, which were, to me, a welcome spawn of the times. My greatest teachers joined me in the kitchen, and all that stirring was like a gentle afternoon of kayaking in Kona.

Most of all, however, I discovered that almost everyone loves it. Most people I knew had never eaten artisan cheese and were more familiar with mass-produced, ordinary, or even processed cheese like Velveeta or Kraft Singlets. As my product became slowly better and even gift worthy, I began to find a source of great pleasure, joy and connection in sharing it. It made me feel happy and less alone. I started sending packages to friends and loved ones all over, and having my creation go into their bodies makes me feel a kind of organicity of connection. If the pandemic can widely and perilously unite us in fear and deathly danger, perhaps this other microorganism-infused agent could organically unite us in health and love. That is how it seems to me. If nothing else, I found it makes me happy! That regulates me and keeps me going. 

All my cheeses are dated on the day they are made. Keeping up with my daily affinage, all the fussy little steps that cheese requires day-to-day during aging keeps me aware of the passage of time, which in “pandemic time” might otherwise seem static, stopped or a seemingly endless Groundhog Day. Time stands still in the brain of the traumatized. Life in present time does inch along forward. 

Now, when I meet someone new that I like, the perennial question they are faced with is, “Do you like cheese?” It is rare to hear “no”. “Send me your postal address!” I say, and suddenly I have a new friend. It seems to melt barriers! And it is my favorite way to say, “thank you!”

Here in the US, it used to be rather customary, when taking family photos, for the erstwhile photographer to say, “Say Cheese!” to the assembled photo subjects in an effort to get a toothy, rather gritty smile of sorts. In Madonna’s iconic 1991 movie, Truth or Dare, she updates it to “Say dildo!” I have adapted her practice when I take a group shot and usually get authentic and charming expressions! Whichever you prefer, keep calm and have some cheese! It is alive!

There is something very steady and plodding about a process that takes a long time and a fair amount of fuss, much like therapy, but without (most of!) the pain. And because cheesemaking requires so much sanitizing and cleaning, all the guard rails imposed by the pandemic, with the exception perhaps of face masks, were well known to me.

Today’s Song:

And for the curious, here’s the link. I’m at Hour 3:

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

My course with Quantum Way is now available for registration! 

The Trauma of Neglect: Identifying and Treating it in Therapy