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.
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.
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.
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?
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.
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!
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!
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!
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!
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.”
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.
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.
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:
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.
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.
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.
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.
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!”
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.
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.
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:
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.
In June in San Francisco, the city is more colorful than ever, with rainbow flags billowing gaily in the wind. We live blocks from the famed Castro District, which is community and home to a large number of LGBTQ inhabitants.
June is Pride Month, and for the last two years of the pandemic, festivities of all kinds have been toned down or cancelled, like everything else. As with all other re-openings, restoring some sort of “normal”, even if it is a “new normal”, brings a wash of feelings and memories. For some reason, I found myself drifting back to thoughts of my childhood friend, Jimmy (not his real name).
I was in 6th grade, and Jimmy was in 7th. He was a gangly, goofy smiling blond, and I was a too-sensitive, introverted bookworm. We were a pair: two invisible misfits who found each other and somehow became best friends. I would join Jimmy on his paper route, and we would spend hours pedaling our clunky three-speed bikes around the neighborhood long after the deliveries were done. We could joke, and Jimmy also had the depth that we could talk about serious things. And that we also endlessly did.
As ever, my memory is spotty, and I don’t remember how we lost touch with each other for many years. I was in my middle 30s when I heard from Jimmy again. He had become a top fashion model in Milan. He was gorgeous; well, the glossy magazine photos of him were. But now it was the 1980s, the height of the AIDS epidemic, when it was a most terrifying and a pretty inevitable death sentence for those infected. When he contacted me, Jimmy was very sick. Once back in touch, I spent as much of the short time he had left with him as I could.
Jimmy wanted to talk about dying, and he said no one wanted to talk about that. We talked and talked, just like we always had. I don’t remember much at all, except how soon he died and how tragic it was. A tragedy sadly shared by many, if not all of us in my generation here in SF.
Most tragic of all, perhaps, Jimmy’s very religious parents, who had always seemed like such “nice” people and who had not known he was gay until after he got sick, distanced themselves and disowned him. They just could not accept it. He had always been invisible and disconnected from them, and now in his final days, more than ever. And then he died. Terribly neglected as a child, he was completely abandoned in his darkest and final hours. I am so sad about this and also deeply sad that my memory is so raggedly incomplete. I wish I could honor Jimmy with fuller recollection, and I wish I had it for myself.
Jimmy wanted to talk about dying, and he said no one wanted to talk about that. We talked and talked, just like we always had. I don’t remember much at all, except how soon he died and how tragic it was. A tragedy sadly shared by many, if not all of us in my generation here in SF.
What kind of weird “otherism” would make a parent hate and reject their own flesh and blood? Self-hatred? More likely a legacy of feeling unseen and hated themselves. And yet it seems to be a horrible multi-cultural mutation.
This morning I heard a program about spirituality and religion in the LGBTQ world. There were speakers from Muslim, Jewish, Hindu, First Nation, and Christian backgrounds, some still searching for a way to remain in faith, describing being shunned, outcast and worse by family, community and seemingly God. It seemed their only best consolation was in sharing experiences and understanding with their diverse compatriots around the world.
Nonetheless, the primordial attachment bond (we share it with all mammals) is the source of our deepest and most persistent longings and reactions. Clients often wonder why their vulnerability and stubborn endurance of mistreatment seems so intransigent; why their futile strivings for approval from the elusive parent endure, even often long after they have died. The “quiet” and invisible, seemingly subtle injuries of being ignored, not known, abandoned, forgotten, or as with Jimmy and many like him, disowned, are perhaps the most insidious, devastating, and under-rated trauma stories of all. And sadly, they are all too often the stories that, in effect, “have no story.” Often lacking concrete form, the experience of, in effect, “missing experience” having vanished from view disappears into non-existence, and the sufferer feels guilty or baffled about “feeling so bad.”
Another wave of attachment trauma is in the offing, with historical changes now unfolding in China. For decades, in an effort to manage burgeoning population expansion, the government issued a one-child mandate. Rapidly, baby girls became beyond worthless, a liability, and boys were inherently more valuable. Now it has caught up with them, and as the population shrinks and ages, there is a “shortage” of girls and women. With a shrinking population, how will the economy keep up? Parents worry about who will their sons marry. How can they afford the competition for suitable mothers for their heirs? And we have to wonder about the impact on attachment bonds of all this “conditionality.”
When couples talk about “unconditional love”, I must disclose my bias. I believe the one time in our lives we can reasonably hope to be loved “unconditionally” – meaning regardless of what we do or don’t do – is in infancy. It is an honorable goal but not always possible or even adaptive. I certainly would not expect Johnny Depp and Amber Heard, for example, to love each other unconditionally and similarly in less dramatic cases. But in infancy, that is the one time we can rightfully and realistically hope to be loved and valued with no expectation to perform or somehow merit, earn or win that love. When that is lacking, it is an unspeakably terrible lack.
And sadly, they are all too often the stories that, in effect, “have no story.” Often lacking concrete form, the experience of, in effect, “missing experience” having vanished from view disappears into non-existence, and the sufferer feels guilty or baffled about “feeling so bad.”
Passionately involved in the Latin American solidarity movement for many years and being a music lover, the then “‘New’ Latin American Song” was an ever-present back beat or accompaniment. It was a beautiful hybrid of traditional folkloric and indigenous music and instruments, more modern folk music, and revolutionary lyrics. I was a tireless listener. Its “founder” or mother, was Chilean singer-songwriter Violeta Parra, most famous for her song, “Gracias a la Vida,” – thanks be to life – and acclaimed as the song that kicked off the new song movement. We all loved her.
I was surprised and dismayed to learn that Parra’s 1967 death was from suicide. She was 50. As it happened, Parra was invited to Europe to accept a high-level international music award. She agonized over the decision to travel and be away from her beloved nine-month-old daughter. Ultimately, she decided to go and accept the award, concluding that the harm of being away from her baby for two weeks was outweighed by the good she might contribute to the world and to Chile by receiving the great honor. Shortly into her trip, Parra learned her daughter had contracted pneumonia and was terribly sick. Seized by fear of her daughter’s fate and racked with guilt for leaving her, Parra rushed to return to Chile. She found when she arrived that it was too late. Her little daughter had died. Parra was inconsolable, and ultimately this mythical lover of life killed herself by gunshot.
It is nature’s design for a mother to be as deeply attached as the child and to be as profoundly affected by attachment rupture. The same was true of mothers still in deep grief about the deaths of their murdered children in the massacre at Sandy Hook, now a decade ago. The interviewed mothers have never gotten over it, and we must anticipate something similar among the growing numbers of parents experiencing such losses.
The inhale to George Floyd’s gasped exhalation “Mama, Mama…” with his last breaths. This is why we suffer so from the absence, loss, or never having had secure and loving attachments. Indeed, secure attachment is our inalienable birthright and the most natural and enduring of longings.
To end on a more positive note, we do now have same-sex marriage. A relatively new historical development and change. It is evidence that, even at a glacial pace, there is movement on the historical map, which reminds us to not give up: that all our efforts at change are not in vain.
Happy Pride.
The inhale to George Floyd’s gasped exhalation “Mama, Mama…” with his last breaths. This is why we suffer so from the absence, loss, or never having had secure and loving attachments.
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.
Last week I had a (for me) truly strange experience. While sitting quietly and alone in my psychotherapy office, out of nowhere, I had a wild dizzy spell. I say “wild” because the room was whirling at such a speed as to be but a blur of splattered color. I had never experienced anything like that before. I quickly tried pressing my feet hard into the floor, a grounding practice I had learned in my first somatic trainings decades ago. I could feel my feet, but the spinning did not slow. I heard a bellowing voice in my head saying, “this is real.” It kept repeating those words.
I held onto my chair, and eventually, the gyration quieted and ultimately stopped. Stunned and somewhat rattled, I called my husband to tell him. He asked me if I wanted him to come and pick me up. I said I thought I was OK and would let him know if I changed my mind, and then I proceeded to work my day. By the end of the workday, when it was time to drive home, I felt OK, and although I called him to let him know I was getting ready to drive, I felt pretty much back to my usual self. I was careful, and the drive home was unremarkable.
Reflecting with some bafflement, what perhaps struck me the most about this little event, were the words “this is real.” They got me to thinking about my childhood experiences of feeling unwell in any way. Whatever untoward bodily state I might be experiencing was either my “fault”, or it was “nothing.” If I caught a cold or the flu, it was from doing something or being with someone I shouldn’t have, staying out too late, or not wearing enough clothes. If I felt queasy, it would be from eating something I shouldn’t have, eating too much, it being unwashed, etc. If we did not feel well in the morning, our dad would say, “Get all ready for school and see how you feel after breakfast.” By that time, unless I was actively vomiting, which was rare to virtually never, I did not even know how I felt anymore.
One of the few times I do remember vomiting was in first grade. I didn’t feel well, but I did as I was told and went to school, PS 152, my large New York City public school. At recess, I threw up on the blacktop, and someone drew a chalk circle around it and wrote “Ruth Did This” in large juvenile caps. I was mortified, and the trauma I remembered was that.
When I was almost lethally anorexic, and it was finally impossible to ignore because I collapsed in a public place, it was not viewed as an “illness” but rather “bad behavior”. The response was, or felt to me to be just punitive, with an accusation of stressing my parents out.
Interoception is the brain’s ability to sense and feel the body. It is a survival function that dictates action. If something is “wrong”, there might be some sort of correction or antidote required for equilibrium or healing to be restored. With a lack of mirroring and care, it is inadequately, outright inaccurately, or simply not learned. Perhaps I got so completely disconnected from my body’s sensations that anorexia might later be more “tolerable.” Perhaps I myself could not quite feel the difference between a “normal state” and a state of starvation. I honestly don’t remember. I do remember that alcohol felt good when I discovered it at around age 14, but mostly because it made everything else “go away.”
I used to boast that in 35 years of private practice, I only missed two days of work due to illness. It was kind of a joke until, in 2015, I was stricken with a nearly septic systemic infection which landed me in the hospital for a week, followed by a week at home lying around watching bread baking YouTube videos. The first time I humiliatingly took a “DNF” (Did Not Finish) from a 200-miles-in-a-day (“Double Century”) bike ride, at mile 163, I was bitterly ashamed. I was utterly freezing. Too cold to keep riding. Sheepishly, I called my husband to tell him and was annoyed that he was relieved and “proud of me” for, perhaps the first time, not forcing it and harming myself in the process. I was ever after sickened by the memory of that ride: a 163-mile embarrassing failure.
There are so many ways that the child’s body experience, whether it be illness, weight, injury, substance use, sexual abuse, or innumerable other iterations, are another insidious form of neglect, and the consequence to the child and later adult’s sensory life, and self-care can be dramatically altered in ways that are long and trying to correct and/or heal. It is not unusual for the body to express the unknown trauma/neglect story in somaticizations that do not fit in any diagnostic box. All too often, survivors of any age are neglected or mistreated by a medical system, ignorant to these symptom constellations or syndromes, and patients are again blamed or told it is “all in their heads.” I have wondered why the way the Pandemic forced the entire world to be focused on the body, health and medical care was somehow a comfort to me. Perhaps this is why.
Reflecting with some bafflement, what perhaps struck me the most about this little event, were the words “this is real.” They got me to thinking about my childhood experiences of feeling unwell in any way. Whatever untoward bodily state I might be experiencing was either my “fault”, or it was “nothing.”
Some children grow up with a sick or disabled primary parent, even starting from their very birth. Obviously, by no “fault” of their own, the parent’s attention and capability are compromised. Short of more help than most mothers or parents can muster, the child will pay. Pain, by its very nature is consuming, and illness self-focused. A sick or disabled parent will categorically be inwardly focused, and the infant, baby, small or growing child confused about how to get care or even who the caregiver is. For many a child of neglect, the caregiving role begins very early: taking care of the self, the parent, and even younger siblings. Self-reliance may seem like a “genetic” or inborn trait, and caretaking of others an inherent, default, perennial role. It may be the one source of attention they get. I remember how acknowledging my mother was when at the age of three, “Ruthie was organizing the’ little ones’ in play.” It seemed to be a help to the mothers and created some sort of value or modicum of visibility or existence for me.
Parental compromised physical or mental health, or disability or both, beyond consuming attention and energy, creates a confusion of roles. Who is the caregiver? Who really even needs care? If the parental disability is “subtle” or “invisible,” or something the child perceives but cannot quite name or identify, such as depression or chronic fatigue, even more so. The child might become accustomed to ensuring the parent’s wellbeing, to safeguard the parent’s survival in the hope of “getting” any attention or care at all, or simply out of love, compassion, sympathy or fear of loss. If there is anger or longing, it may be shrouded in shame or guilt or simply be imperceptible. And, of course, it disconnects the child from their own bodily experience, like me.
Pain, by its very nature is consuming, and illness self-focused. A sick or disabled parent will categorically be inwardly focused, and the infant, baby, small or growing child confused about how to get care or even who the caregiver is.
I know numerous adults with long histories of neglect and great loss because of it who find themselves in the position of caring for aging parents. At a certain point of the trajectory toward death, a parent might seem to exist in some sort of neurological limbo. I remember when our dad was in that state, I had to wonder if anything was firing in his brain anymore: if he focused inward, or if, like the neuroimaging scans I have seen of the brain in a freeze state, nothing was online. Toward the end, the only thing that made him appear minimally alive was when he proudly walked his laps up and down the hall, displaying with his fingers how many. He seemed not to know me anymore; I don’t recall him speaking my name ever in his final year. Often, he barely seemed to look up or register when I came in or even when I touched him, although he did seem to like the kisses on the forehead and would smilingly say “thank you, thank you.” He lost his mother way too young and suffered great deprivation throughout his childhood, adolescent, and teen years.
I did not live with him in those final years. He had a second wife with whom he lived, and a truly angelic hired caregiver, whom I believe he loved more than anyone. She blessedly performed all the unsavory hygiene tasks that he was no longer able to do for himself with exquisite gentleness and love. We were all lucky to have her.
Children of neglect who find themselves in the position of live-in primary caregiver to the elderly parent who by now is as absent as the unlit brain scans may find themselves trapped in a tussle between duty, resentment and guilt, perhaps even love, and sympathy and compassion, all having it out inside of them. Meanwhile, quantities of resources, financial, time and social opportunity are expended, compounding the lifetime of loss due to neglect. Sorting the morass of feeling may be a Sisyphean and ever-changing task. The absentness of the vacuous aged brain may be a living reminder of the absent, vapid childhood parent. They are back in the “belly of the monster” with all the incumbent grief. Oy vey. All the objectives of healing from neglect collide as they find their way to a sustainable ending to the parent’s life that will allow the survivor to live with themselves most comfortably after the parent’s passing.
There is no simple “fix” for all of this. We all find our own way. The best I can offer are the timeless words of the Dalai Lama, who is known for saying, “Be kind whenever possible. It is always possible!” I add, “to yourself, that is!”
Children of neglect who find themselves in the position of live-in primary caregiver to the elderly parent who by now is as absent as the unlit brain scans may find themselves trapped in a tussle between duty, resentment and guilt, perhaps even love, and sympathy and compassion, all having it out inside of them.
Todays 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.
My course with Quantum Way is now available for registration!