The first time I heard Bessel speak must have been in 1988 or 89. It was at the grand rounds of a small, local hospital in Berkeley, open to the public. As ever, I went to everything I could find about trauma. There was so little information in those days. Nobody in my community knew anything about it or cared. Granted, I was in a largely psychodynamic world, so I was already kind of a dark horse being interested in somatics. Well, this was a panel of doctors, and this one young guy looked wet behind the ears, and as if his necktie was too tight, but when I heard his heavily Dutch-accented comments (and admittedly I was still somewhat reactive to Germanic accents back then), I listened. He was definitely onto something.
In those days, what I knew of, was primarily the International Society for Traumatic Stress Studies (ISTSS) conference, which I began going to every year as soon as I learned of it. It was stuffy and academic, as far as I was concerned, mostly white men with complicated research. Not my idea of a friendly gathering, and I always felt like something of an invisible impostor there. Later we got the International Society for the Study of Dissociation (ISSD), which later became ISSTD (adding Trauma into the title) which was decidedly more female, and more comfortable for me.
It was probably in 1990 that my friend Marie told me about the Boston Trauma Conference. I guess it was the second year after it began. She asked me if I wanted to go with her. I had never gone to a conference with another human, so that in itself was extraordinary, and I even shared a room with her which was even more radical for this self-reliant, hermetic child of neglect. Admittedly it has never happened since, (except on the rare occasion when my husband accompanies me to a conference.)
The Boston conference as it turned out, was that guy Bessel’s production, and I loved it. There was plenty of research but there were also references to literature, history, art and music, and speakers spanned a wide swath. It rapidly became a staple of my year, to the point where every January, almost immediately after the turn of the year, I would start eagerly scanning for the announcement of that year’s conference, almost always in the first week of May. And I was probably the first to sign up every year because I could not wait.
I loved flying to Boston, I loved the town. And I loved the conference. I was however so timid and shy, and shame-ridden, that I never spoke to a living soul but drifted silently, rather like a ghost, or even a billow of smoke, that could dissipate and vanish. I floated saturated off to my room with my full notebook at the end of the session days, settled down with my room service and a book, and read quietly. Got up at the crack when the hotel gym opened, this was before the days of the 24-hour gym, which I occupied alone, and made sure to hit the conference room early so I could score my front-row center.
I was introduced to brilliant minds, people I would never have heard of like James Gilligan, Seamus Sinclair, Jaak Panksepp, and Jessica Stein. And heard luminaries like Judith Herman, author of the first important trauma book I remember, Trauma and Recovery, which has stood the test of time. And I could always say, “You heard it here first…” when EMDR, Sensorimotor Psychotherapy and Somatic Experiencing, Pesso-Boyden Psychomotor Therapy, Model Mugging, IFS, Neurofeedback and then Psychedelic Assisted emerged in the trauma recovery world. That conference was always cutting-edge and always pointed me in the direction of my next important treatment tool. It became a mainstay of my professional development, and of my year.
When I trained in Sensorimotor Psychotherapy, I had the privilege of being in a group taught by Pat Ogden herself, and with the assistant instructors, of no less than the illustrious Janina Fisher and Deirdre Fay. Can you beat that? And it was in Boston, which really delighted me. I had an excuse to fly to Boston, each month for the four-day training, which lasted almost five years through certification. I loved that Every time I landed in Boston, my heart would leap, feeling myself to be in this hotbed of trauma healing ferment. Once back in the San Francisco Bay Area, typically ahead of the curve in so many ways, I continued to be a lone voice. But I kept at it, writing and talking about trauma as much as I could in the local community, and gradually felt a little less alone.
It is hard to believe this year will be the Boston International Trauma Conference’s 35th year! I think have been to most of them, and with immense gratitude, (and some pride I might add.) Many wonderful healing modalities, not to mention much of my treasured trauma and neglect library would not have been known to me, or not known to me until much later. I am so grateful. And so much better for it. Over time, I have gained much recovery, often through the methodologies I learned of there, not to mention studied and practiced with generations of clients who moved through my hands. Who would have imagined that I might materialize from the lurking, slinking ghost who first landed dizzily in Boston, to an outspoken, interactive and contributing, even social trauma and then neglect-informed therapist?
In our healing journeys, it is so hard to imagine or believe that things will change. In the world of neglect, it seems like time rather freezes. Emptiness is so static and unmoving, especially for the very young. I remember cold, lonely winters sitting by the window, nose pressed against the chilly glass, fogging it up a bit, counting cars, and waiting for Daddy to come home. I don’t know why I looked forward to his walking in the door, with his jovial “ho ho!” I don’t know why he said that! I guess it meant “I’m home!” That was always what he said when he came in. And it was not as if he had any time or attention for us, of course. Simply some semblance of a grand entrance. But I waited for it. Hours yawned cavernously, emptily, bleak, glacially slowly. Like most neglect survivors I had a terrible time with those long days of depression. I remember the endless agony of getting through the day. Depression was like quick sand, movement seeming impossible, except for being heavily sucked downward. Anorexia made the days even longer. I would hungrily track the hours when meals “should have” been, like mile markers on a long steep bicycle grind uphill, surmounting them one by one, putting each small increment behind me. I hate to remember it.
So besides the tremendous despair and loneliness that are the inevitable consequences of failed, absent and withdrawn attachment, for many if not most, is the accompanying barren hopelessness. No one has ever cared enough to change out of love for me. Anything that changes, will only be because I make it happen. And I can’t move…
I go into such detail about the darkness of the past, because I can be incredulous that it has in fact changed so much. I remember sitting in groups and hearing someone who was out of the tangled woods of her eating disorder and was talking about the simple joy of eating one small slice of cake, and that being it, no drama, no more, no agonizing about it for the rest of the day or the next few. I thought, “Wow that will never happen to me…” And now, I eat whatever I want, and can barely imagine those decades where that was all I thought about. Now I have much bigger fish to fry! I guess I tell these tiring stories, to show that with our dogged work, these things change, and life can be pretty darn wonderful!
Here we are coming up on 35 years of Boston. Marie had said to me since the beginning, “You should speak here,” especially as I was hatching my work about neglect. I laughed longingly, “yeah, right…” Well lo and behold, it has come to pass. On May 1 (which happens to be International Workers’ Day and an old lefty like me can’t help but notice that!) I will be presenting my model of Neglect-Informed Psychotherapy. Perhaps you will join us!
Sadly, I lost track of Marie. I tried to find her so I could tell her, but for whatever reason failed to locate her. My sister is so good at tracking people down using social media, finding people from all walks of her life. I should ask her to help me. I want to say, “Thanks, Marie!” Meanwhile, I hope to see you in Boston!
Today’s song:
It was the end of 2019, I was awash in all the mixed emotions of my father’s death. And boom, enter the Pandemic of COVID-19. Abruptly, the entire world was invaded, shrouded by this strange new and seemingly unreal force. Suddenly we were all learning a new language of “shelter in place,” “social distancing”, “don’t touch your face!”, “don’t touch anyone!” Obsessive hand washing… When the mayor of San Francisco announced the first stay-at-home order and predicted two weeks., I thought she must be kidding! I wasn’t going to do that, stay home for two weeks?! I was a “health care provider,” an “essential worker.” Little did I know… The next morning when I was one of almost zero cars on the bridge heading for the office, I paranoically flashed my attention back and forth to the rearview, scanning for KGB-like cops who would pull me over for being “out.” All the things we all had to do, like stay home, stay away from other people; and people dying by the thousands and then millions each day, all inspired my conspiracy suspicions at least at first.
Struggling at that time, to finish the book I was working on… I was seriously dysregulated. My therapist of many decades had recently retired, and I was not about to search for someone else. Besides, the very idea of virtual therapy sessions, our only option now, was seriously out of the question. I remember calling neuroscience-of-trauma researcher and expert, Ruth Lanius, to consult about something or other, and I don’t remember how it came up; she told me perchance about a new-to-me treatment modality she was researching: Deep Brain Re-orienting (DBR), developed by Scottish psychiatrist Frank Corrigan. I had not heard of him before. Ruth directed me to a couple of YouTube videos (https://www.youtube.com/watch?v=wijwwMuONFg) which I promptly watched. My interest was definitely piqued.
I had not encountered a new trauma treatment, with the exception of psychedelic-assisted psychotherapy (which of course I could not practice) since I trained in neurofeedback in 2009. As it turned out while navigating a transition to a full virtual psychotherapy practice during lockdown; (not to mention the transition to lockdown itself!) and writing a book, I was realistically not in a position to study a new-to-me treatment modality (although admittedly it took a little while to achieve the frazzled humility to accept that.) But it was a relief to have my curiosity and interest awakened about something new.
I might add that the complicated grief, some version of writer’s block, and my complex challenges around sleep seemed to all have coagulated in my neck and shoulders, and upper back. It seemed I was cringing inward from all directions, with my neck perennially kinked and aching. And for the first time probably ever, I actually admitted I was bone, dead tired.
On the suggestion of Ruth L., I contacted Frank. Not yet accustomed to zooming, certainly not internationally, his Scotland and my San Francisco, USA time zones, were no small feat to coordinate then. But we managed to cobble together a schedule where I could meet with him for online DBR sessions roughly every other week, a schedule which we succeeded in keeping for some months. I feel very privileged that I had the opportunity to work with Frank, to learn about and experience this fascinating work, and no less with the Master himself! Although I made it my intention to study and practice DBR, especially because unlike neurofeedback it could in fact be practiced remotely, sadly I am unable to do that effectively until I clear the decks of my schedule, at least a bit! Sigh…
Working with Frank was like working with a gentle giant. The tall, soft-spoken man on my screen, was so kind and patient, that already was reassuring and regulating. His strong accent, even if different, reminded me of my beloved Australian YouTube cheesemaking teacher, a soothing association. And knowing my interests, he made a yeoman’s effort to be both didactic as well as therapeutic. I appreciated that even if my addled brain was hard-pressed to metabolize brain science at that time, which even in the best of times is not my strongest suit! That is why I am gratified that he has a new book, about to hit the stands, provisionally entitled Deep Brain Reorienting: Understanding the Neuroscience of Trauma, Attachment Wounding, and DBR Psychotherapy., co-authored by Hannah Young and Jessica Christie-Sands.
As I experienced the work, at least initially, it was reminiscent of the “sensorimotor sequencing” I learned in my Sensorimotor Psychotherapy training back in 2000, which was essentially a fine-tuned tracking of sensation in the body when in an activated trauma state. I always found that exquisitely helpful, and it was perhaps the most important to me of the many treatment tools I took away from SP. Especially in the closely monitored tracking, the movement in the body from moment to moment conveyed the visceral experience of time passing, and change happening constantly within time, both invaluable in the face of the strange both unmoving and lightening-speed hyperarousal of time in the traumatized body.
As in SP, Frank’s voice was a steady accompaniment, naming brain areas, that I was hard-pressed to grasp mentally then, but I think I would be more able to now. However, one of the essential innovations of DBR, is that although most of us who consider ourselves to be trauma and neglect informed, and attachment theory savvy, are familiar with the activations of the limbic brain, most specifically the right amygdala, in the traumatic fear response, few of us are well versed in the deeper more primitive brainstem regions, often somewhat pejoratively referred to as the “reptilian brain.” (I suppose some are fonder of reptiles than I!) DBR teaches us that the very earliest responses to shock and terror occur in these deep brain regions: the locus coeruleus, superior colliculi, and the periaqueductal grey (oy vey! A mouthful!). The experiences of irregularity, absence and loss of attachment, register in the infant’s brain as “shock” and strike those primitive structures first. He describes this as attachment shock, such an apt and vivid description of some of the profound attachment trauma of certainly many if not most of my neglect survivor clients, not to mention myself. Of course, the neck and shoulders, and the upper back, body areas that house or are in close proximity to those brain areas- precisely the areas that were aching in my stressed-out body, are more than likely to be activated.
Frank’s voice and steady naming of what he observed, both grounded and accompanied me as I followed the sensation moving in my body, often eliciting unexpected memory fragments from early ages. It was quite fascinating and most certainly valuable. We only discontinued the sessions because scheduling became impossible. I am sure I will go back to it when I can. Meanwhile, the research produced by Ruth L.’s lab is promising indeed, and as a neglect-informed, attachment-oriented practitioner it behooves me to learn it as soon as I can. Admittedly I suffer from FOMO, as DBR has gone viral in my neurofeedback community and is appearing to be a powerful companion treatment. Thankfully I can tide myself over with Frank’s upcoming book.
I find it validating that the framing of the terror and horror wrought by early dysregulations: of attachment: disconnections, withdrawal, absence and loss, add up to shock, especially occurring during the tender vulnerability of early life. The severity of neglect trauma, so often under-rated, ignored and minimized, is increasingly growing its neuroscience “legs,” and may come increasingly to garner the attention it requires and merits, at least gradually in the trauma field. Perhaps neglect will emerge a bit more from its “step-child” status. That is my hope. Meanwhile, I am hoping to meet the “Gentle Giant” in person next fall, when I return to Oxford. I figure Scotland will be a much smaller pond away!
Today’s Song:
Sometimes memory seems so mysterious and baffling. The other day, suddenly and seemingly quite randomly, I felt washed over by a “Maverick” wave of shame. Maverick waves I learned, in the surfing vernacular, are monster or super waves: unpredictable, suddenly appearing and potentially “extremely dangerous.” Yes, admittedly that sounds dramatic, but it felt like that. I felt the accompanying tightness in my slightly and suddenly nauseous stomach, and a sour taste in my mouth, even a little tension in my throat of either tears or screams. And then floated up the thought… “My whole life is a lie…”
I had never had that brutally honest thought before. I vividly remembered sitting diligently in my Marxist Leninist study groups, echoing the party line, “No alternative to armed struggle! Strategy and tactics, Hasta la Victoria Siempre (forever until victory!) It was a dark secret that I was in therapy. Such an individualistic and “weak,” petit-bourgeois endeavor would have been a sure cause for ouster, ex-communication. In search of meaning, purpose, and probably a way to die, I had constructed a persona to be and tried desperately to shove a square peg into a round hole. No wonder it was simply a matter of a few short years before I cracked up completely. Being a child of neglect, lacking the developmental brain and life experiences that enable an authentic self to emerge, I flailed and found what was in effect a mask, a costume and a role. That is what a child of neglect will do, although perhaps with less theatrical effects. I guess it took that much, although still failed, to quite get my dad’s attention.
But where did that memory come from? And even with new highlights or narrative. It seemed to come out of nowhere. Except that I was struggling with a perhaps lesser, but similar identity, shame episode. Perhaps it was just similar enough to be a traumatic stimulus. Hmmm. I never read Marcel Proust’s famous book about how a flood of (much more idyllic I believe) memory was unleashed by a simple bite of a certain kind of cookie. A “Madeleine”, I’ve never had one of those either. Powerful stuff. Well, I was reminded of that. And then I happened to hear an interview with a memory researcher, Charan Ranganath, about his new book Why We Remember: Unlocking Memory’s Power to Hold On to What Matters, in which he explains and describes in some detail the different types of memory.
I remember my long commutes to my job at the San Francisco V.A. (Veterans’ Administration) hospital, back in the days of cassette tapes, the late 1980s, listening to Bessel’s talks over and over again, as he talked about what happens in the brain when an organism experiences traumatic events. Overwhelmed by a stimulus greater than what the system is designed to process in its customary way, the logical, cognitive, and verbal part of the brain, the meaning-making prefrontal cortex is blown offline and effectively shuts off. The brain and body flood with stress hormones and blood flow is redirected to the extremities in the service of survival. Fight or flight. I was brand new to any information and language of science and anatomy, which is why I needed so much repetition not only to get it but to remember.
But I did readily remember the glaring visceral visuals of speechless terror. And I remembered the images of Bessel’s Rorschach ink blots, and his voice saying of the veterans, “Either they saw their worst horrors, or nothing at all.” I can still hear it. Now that is good teaching! And it also sums up the nature of traumatic memory. Some survivors are swamped by haunting ceaseless and graphic recall and can’t seem to escape it.
And as we also now know, the amygdala or alarm bell of the brain, is hell-bent against the traumatic event happening again, and even the slightest stimulus that may in some way or other resemble the original trauma, can set off survival strategies. Suddenly and often unwittingly the unrecovered survivor is in full-on fight or flight. To the dismay of partners or bystanders, and sadly often vulnerable children, it is as if the trauma is repeating itself right now. “Triggering”, or what I prefer to call activation. Nerve racking and tiring for all.
For other survivors, the prefrontal cortex having shut down, there may be only a blank empty space, and no memory at all, at least for a time. And if and when it does break through it can elicit a maverick of confusion and self-doubt about what is true. I for one, had no recall for years of my worst traumatic experiences, and when they did burst on the scene and took over my life for a time, I was hard-pressed to know what to believe.
One of my first neglect survivor clients, or I should say, one of the first whom I came to identify as being a survivor of neglect said “I have no memory of my childhood, just bushes. Bushes and a little bit of the family dog. That was probably 40 years ago. But somehow, I still remember her words, her name and the moment she said them. Why did I log that so clearly? My life is much like hers, a large and blank empty space. Says Ranganath, when we log the original filing richly, with sensory and emotional detail, that memory is likely to endure and age well. I guess I intuitively knew this, which is why I like to adorn my teaching with colorful imagery and emotional stories. (And I like to add a song to these blogs!) The brain is more likely to retain what is more multi-sensory or emotion-laden.
Similarly, as is often the case with neglect, when life is a vast desert of nothing, that is what we remember: nothing. Or perhaps what is most picturesque or memorable is the bushes or the dog. Mine are snapshots of me reading Little Women, or doing the “twist” to the Beatles’ “Twist and Shout” when it first came out in 1963.
An environment of chronic or ongoing stress, like growing up essentially trapped or confined in a world of overt abuse, and/or painfully ignored or rejected in the mind-blowingly vacuous environment of neglect, is “neuro-toxic.” Similarly, life in a war zone, where terror, threat and uncertainty are ever-present, keeps the brain bathed in stress hormones, which over time disrupts healthy memory and pre-frontal function. More good reasons to end abuse, neglect and of course war.
Ranganath also speaks of what he calls “small f” forgetting, which in effect boils down to ordinary slips or word finding. He says, and sadly I must echo his words, “My ability to remember song lyrics from the 80s far exceeds my memory for why I walked into the kitchen.” This he terms as a function of normal aging. My Achilles heels are around scheduling and bookkeeping. Oy vey! And I do hate wasting my time looking for things! Admittedly, I have grown increasingly “OCD” about where I put things, out of existential fear that I may never see them again!
Recently I had an experience where I went to use my old laptop, the one I use for traveling, and for the life of me, I could not remember the password. I banged on that poor thing probably close to a million times, trying all the various passwords I have used and could remember, so frustrated because I had recently used it on my last trip just two months ago. I also knew, because it has happened enough times, that very often, in a day or two some misbegotten, lost or forgotten item floats quietly forth from the swamp, and voila is back! Sure enough, that is what happened in about 24 hours. What is that?
Says Ranganath, information “competes” for real estate in the brain. All that banging and repeatedly trying every generation of passwords had my brain space sticky and cluttered with passwords. When I let it all settle down, the “one” emerged. A new start with fresh eyes, words to live by, no?
Finally, in these times we have come to virtually take for granted the chronic hum or backbeat of distractions: pinging texts, all manner of device alarms and interferences. Distraction of course interrupts attention and clear and accurate recall. Texting while in a meeting or class, certainly erodes explicit, accurate recall of either the meeting or the text chat. Yet all these are in the normal range.
Biden confusing the names of the Egyptian and Mexican presidents was an embarrassing but not pathological “gaff.” If he had forgotten that he had met with the president of Egypt at all, says Ranganath, if that memory was simply “not there,” that would be a cause for concern, or suggest a “memory problem.” “Word finding” and forgetting names or passwords are expectable, annoying but not pathological “small f” features of healthy aging.
But Good news! Ranganath is quick to add, there are ways that the prefrontal cortex improves with age! Compassion, optimism and emotional regulation all are strengthened as we move through the years. So there! Don’t worry, be happy! Turn off your devices, be present, and as my mom wisely said, “We have to live well. You never know what will happen!”
Today’s song (A Happier Memory):
In the early years of the Millennium, it seemed as if the world was suddenly haunted by a dreaded and insidious enemy. It kind of reminded me of the opening lines of Marx’s Communist Manifesto, which I read with great ardor in my first months of college in 1973: “A spectre is haunting Europe…” It resounded rather like the trailer of a terrifying horror movie. This spreading “evil” was so-called “Sex Addiction”, which was rapidly becoming the diagnosis du jour. My phone was ringing off the hook with panicked spouses breathlessly complaining about their partners’ rabid behavior; or the accused partner lamenting that they had been kicked out of their homes. It was a newly named “diagnosis” which had no nosology, no research, no scientific basis at all. And yet as is so often the case with a new sensation, the world was suddenly full of “experts.” Suddenly a new, high-priced treatment industry began mushrooming around it, and the nightmarish stories abounded.
Because my practice was primarily adults with sexual trauma histories, and I worked a lot with couples, I guess people thought I was a logical person to call. I didn’t think so… I tried urgently to inform myself and searched in the sex therapy conferences, information, diagnostic, scientific and clinical. I kept coming up pretty dry. For a long time, I could only find one article, which I quickly clung to like a lifeline “Compulsive sexual behavior: what to call it, how to treat it?” by Eli Coleman (2003). I knew and admired Eli from hearing him at conferences, and I remember calling him more than once. Flying by the seat of my pants, I really disliked that work, and did my best to send those couples elsewhere. The question was where? There was the panoply of pricy “specialists” and treatment programs. that I was soon hearing distressed and distressing stories about. We were barely emerging from the AIDS crisis so those were some challenging times in the sex therapy world, and in the world really.
Thankfully we have come a long way since then, and after a few years of flailing, I subsequently met my colleague and friend Doug Braun-Harvey who wrote the truly ground-breaking book, Treating Out of Control Sexual Behavior: Rethinking Sex Addiction, which was helpful and continues to be a resource about sexual health.
So, what does all this have to do with neglect? Now that I am long out of the weeds, or those anyway, I can think more objectively about that question. The sex addiction model, although I would hardly say there was one distinct “model,” generally tended to moralize and pathologize, as one of my sex therapist colleagues said only semi-tongue in cheek, “A sex addict is anyone who has more sex than me…” The fact is that my experience has shown that sex that is random, impersonal, and somewhat disconnected, may indeed be relevant to our topic.
Last week I wrote about the heart of neglect trauma, the “dilemma without solution.” After the blog went out I realized to my sheepish dismay and embarrassment, that I never articulated the precise words Dr. Main used to define it. Mea Culpa!! Thankfully, as ever the opportunity for apology and repair is available! The only thing that thankfully makes it survivable and even safe to make a dumb mistake! So, I can tell you here, because as ever it is infinitely relevant. The dilemma is defined as follows: “The source of longing and the source of terror are the same person.” The child is therefore faced with this terrible non-choice of reaching toward and pulling away, reaching toward and pulling away, and on and on until they collapse in despair. Ultimately in many cases, the adaptive default is self -reliance which is an effective if lonely strategy in many cases. We went over this last week.
In sexuality, however, self-reliance presents additional challenges. Clearly, we can do it all ourselves, but most of us would agree that it is not the same. So, we must elaborate some other creative way, to be sexual and be safe. This is what I tend to find among the vast world of neglect survivors. For me, when I was young and un-recovered, sexual compulsivity was a ready solution. Numbers, frequency, superficial distance, and a lot of alcohol, kept it impersonal and disconnected enough to be less “dangerous,” at least in the emotional sense. I could even feel proud or powerful about how many guys I could “get”. Oy vey.
As I got older and became a bit more civilized and more discriminating, alcohol became the main “safeguard” against getting too close, although I still managed to have plenty of dramatic heartbreak stories. I kept voluminous journals about it all, and I still have the shelf of them, although I can honestly say that for some reason, I don’t throw them out, I have never cracked the covers and they all remain unread! Needless to say, everything changed and became much more difficult when I got sober. By then I was 28 and in therapy. I had to begin to face the “dilemma,” which I slowly did. But admittedly it took me some time!
Among my neglect survivor clients, I have observed many creative “solutions” to the sexualdilemma. Now the internet has provided a vast world of cyber partners, where one can have erotic experiences without risking the vulnerability of authentic flesh and blood relationships. This becomes quite an issue among many couples, and even within guilt-ridden individuals, however as evidenced by a more than thriving mega-industry, it continues to be an option.
Less now, post-AIDS (well almost) than before, anonymous sex has been an option. At the corner of our block in San Francisco is a park once a famous destination for anonymous sex liaisons. I can remember when I first moved in in 1991, seeing rather guilty-looking individuals slinking out of the park, after assumably having their trysts in the bushes. That seems to have stopped, at least to my observation. There used to be bathhouses and hot tub places that were similar, and I sometimes heard about them from shame-ridden clients trying to stop frequenting them. I have not heard those stories in quite a while.
More typically, and a “solution” that I still encounter in my work, and is truly painful for both parties to work with, is what turns out to be serial infidelities, which most effectively drive a wedge between partners, which is often painfully difficult if not impossible to repair. I don’t want to say impossible, but it requires two truly committed partners willing to stay the course, to get there. And all too often another generation of neglected kids is the tragic result.
Similar and perhaps in many cases slightly less difficult to repair, is employing sex workers. And I have had a few clients who were sex workers, a rewarding way to have plenty of sex, in many cases stay “in control,” and not get attached. And many more, and this is what I see most often, neglect survivors may partner “unwittingly” with someone who is unable or unwilling to have sex, or have sex with them. They may have a miserable and cycling conflict/fight about it. Or may sink into a long and sexless partnership. It is surprising how many couples have ended up like this.
“Spectatoring” is a term used in sex therapy. It maps remarkably neatly onto the “one-person psychology.” The person is focused on their own performance and observing themselves in action almost as if watching a show, while also imagining and being perhaps fixated on their impact on the partner. Again, unrelated, detached, and ultimately solitary. All this is to say, the dilemma without a solution leaves a cavernous void or scar, that the survivor is hard-pressed to heal if truly satisfying sex is to be possible.
Sex therapy with neglect is largely relationship work. It is some of the hardest work we do. One reason why I am so crazed about talking about sex, (even to the point of sometimes shocking people with my candor, I’m afraid. Hope I have not offended you!) is because so few will talk about it, or so it seems to me. Doctors don’t warn their patients about the sexual side effects of medications, procedures and illnesses; psychiatrists don’t warn patients about the sexual side effects of some of the most popular psych meds; many therapists, sadly are tongue-tied on the subject, even many couple’s therapists don’t inquire.
Many of you have heard my rant before. My apologies. If we can’t get good quality sex education in the schools, we might start by becoming able to talk to our kids at home; and learning ourselves what is “normal”. We can do our part in raising regulated and sexually healthy children. And Doug Braun-Harvey’s book provides what I think is a wonderful model (Not necessarily for children!) for his “Six Principles of Sexual Health”, which you can also find by Googling. So much more to say on this, to be continued!
Today’s Song:
https://www.youtube.com/watch?v=1IOL-VT-WnEFor some time I’ve been meaning to write a blog about the “Dilemma Without Solution” which is a centerpiece of my work. I consider it the heart and soul of neglect trauma. The woman who first identified and named the dilemma, Mary Main, is one of my greatest heroes. I hesitate to call her a heroin, because of the identification, at least in my mind, with the lethal drug. Admittedly, for whatever reason (most likely of course having to do with my bigger-than-life dad,) she is one of the few on my shortlist who is female. Well, I went to look her up to find out how old she is now, only to find to my dismay and then great sadness, that she passed away on January 6 (a historic anniversary in the US!), 2023. I will have much more to say about the loss, and the life of Dr. Main, but for now, I want only to remember and honor her as I yet again immeasurably appreciate her massive contribution to attachment theory, trauma theory and my thinking and my work. Thank you so much Dr. Main!
In 1986, Mary Main, in conjunction with her UC Berkeley collaborator Marion Solomon identified and named a fourth Attachment Style: The Disorganized Disoriented. Because it led directly to a new understanding of dissociation, it of course profoundly affected and came to inform trauma theory and practice, as dissociation is so often a telling trauma symptom. And Dr. Main identified its roots in what she came to understand and named “The Dilemma Without Solution.”
Attachment as we now clearly know, is a survival need. The human infant is dependent on parents longer than most if not all other mammals. And the infant instinctively “knows” that without the mother they will die. I am mindful in my use of the term mother, but because the infant grows in the mother’s body and makes their first and lengthy attachment there, I use mother as shorthand. Primary caregiver is perhaps more politically and even technically correct, but it may be tedious. And even the infant themselves intuitively “knows” that anyone else is, at least in some ways, the “wrong one.”
In the hierarchy of defenses from danger, for all mammals is the attachment cry. Our first and most primal response to threat, after orienting to it, is to cry out for the mother, just as George Floyd in his final breathless gasps uttered the plaintive cry, “Mama, Mama…” which continues to haunt me. When the attachment cry fails, the sequence is to attempt fight or flight, of course, impossible for an infant. And ultimately, collapse or freeze.
In the wild, the freeze response of a cornered prey animal is ratchet down all “non-essential” bodily functions to negligible, almost nothing, feigning death or “playing possum.” Perhaps with luck, the predator will think they are dead and lose interest in eating them, as most predators do not care to eat dead prey. Or the prey animal will numb out, and freeze so completely as to not feel the pain of being eaten, what we now understand as the dissociative response. The numbing of dissociation is well known to us, many from the inside, if not from our study. So back to our neglected infant.
A baby, confined or “trapped” in a crib may look up into an angry face, a scared face, a blank face, or worst of all no face at all, and will despair, and go through the survival sequence. Of course, unable to flee, with no hope of fighting, they reach, cry and then collapse or freeze. They even cease to cry. As Ruth Lanius, neuroscience of trauma research luminary reminds us, “the withdrawal of the mother is experienced by the infant as life-threatening.” Life and death are at stake. And there begins the voiceless hopeless helplessness, and terror of dependency we have come to associate with neglect.
Very early on the child adapts with a ready stand-in, not conscious of course, but a default to “I’ll do it all myself.” It is not a solution but a life raft, a perhaps lonely means of survival. In the US and some other Western cultures, self-reliance is highly esteemed and respected. The “self-made” tough and autonomous “rugged individualist is a cultural icon to be emulated here. I was certainly a poster girl.
In ninth grade, as I slowly returned from the almost-dead of my anorexia, I had a game-changing experience. I entered a national essay contest. I competed with nationwide high school seniors. And amazingly, I won! What was game-changing about it was not the “obvious.” I wouldn’t say it helped me to feel better about myself really, or even get much attention from my parents, although there was an article and even a picture of me in the paper. I must have that old clipping somewhere. No, what really made the difference in my life was that I used the $100 prize to buy my first ten-speed, and rapidly became a distance bicyclist, I had my own wheels at 14, and could put distance between myself and my childhood home; I could become independently mobile. It was not only freedom, and my gateway to meeting older boys/men, but it gave a boost to my self-reliance. I was able to start my little housecleaning business ride to the mansions in the hills where I worked, and save money for college. Most ironic, however, was that the nationally ascribed theme for the contest, and the title of my essay was, get this: “No Man is An Island.” I have no idea what I wrote. I think that essay was somewhere in the bulging closets full of stuff to be gone through in our dad’s house when he died. I haven’t seen it. But I’d love to know what I wrote back then. All this is to say, the Self-Reliant Character is almost a caricature, the dead giveaway of neglect if we can learn to see it. The natural outgrowth of the “Dilemma” is how we can begin to discover ourselves or our clients who are children of neglect. And it is the heart of course, of why relationships are such a minefield. Attachment from the start is fraught with lethal danger.
I learned this concept from one of my few other women heroes, Pat Love (yes, her real name!) whom I consider to be the greatest couples therapist in the known world. I discovered Pat in the early 1990s through her book Hot Monogamy, when I was first trying to formally learn more about sex. She became over time a trusted colleague, consultant and friend. I wonder how Pat is doing. The duality or contradictions of the one-person psychology are also often a marker of neglect. On one hand, the person is almost obsessively “other-directed,” and focused on the other. I constantly studied my mother’s state, if she appeared anxious, scrambling to make exquisite orders in the house, to have dinner made and the kitchen all cleaned up before she could stress about it, and also to guard against her anger or impatience with me. I was much more aware of her feelings and states than my own, constantly reading her, or trying to. It was a way to be safe, to try and please, and if not get love, ward off the opposite.
The flip side of one-person psychology is that living in a universe of one, one can forget to consider or even see that there is another. When I was first with my husband and we might go for a walk, he would be nine feet ahead of me without noticing, as if he had forgotten I was there, which in fact he had. I thought “What is wrong with this person? He doesn’t know how to walk with someone!” And it was true. The “one person” is so used to doing it all and being only alone, that they can readily lose awareness of the other. I often hear this from couples where at least one is a child of neglect. A wildly confusing construct.
Neglect is a koan of confusion about self. One can be completely “self-centered” and self-focused, while simultaneously feeling “there is no me.” I was always utterly confused about existence. I forever wondered not only if I had a right to exist, but if I even did. The Dilemma is where it all begins. Sadly, the hornet’s nest of relationship begins in the cradle. It is indeed the heart of the neglect matter. We must treat it, and what may appear to be our “selfishness,” with the kind of kindness, gentleness and patience worthy of an infant.
Please receive my sincerest apology and regret for being late with the blog! It is an essential neglect issue and certainly a value and intention of mine to be reliable and consistent. I am so sorry I failed at that this week!
It is Black History Month here in the US, and I have been pondering about how to address it in at least one blog before the month is out. Now as the weeks tick away I still have yet to come up with a topic that might be interesting, relevant and fresh. All my life I have been haunted, plagued and compelled by the seamless interplay between micro and macro where trauma and neglect are concerned. Having two terribly traumatized parents, who were deeply injured by both, it is in my bones, as is some sort of mandate to act. I have always and continue to struggle about where to direct my energy and time which is never enough. And admittedly getting older does not much help. Oy vey, but I don’t stop trying even as the world seems to be getting more complicated and in some ways worse. As the Chileans say, “El mundo es al reves…” The world is spinning backwards.
Admittedly I am humbled and somewhat bewildered by my impoverished knowledge of Black history, and how badly neglected such a huge and blighted narrative could be, by my public school education. I have to hope things have improved, but sometimes I am not so sure. Much of my growing up took place where Silicon Valley has sprawled, although it certainly was very different then, with peach and persimmon orchards on hills that are now crowded with corporate skyscrapers. It was a great bicycling country. The gap between haves and have-nots was not as wildly extreme and glaring as it is today. Meanwhile, I attempt to scramble and catch up with my missing education, at this advanced age (I might recommend a spectacular new book by a local author, George McAlman: Illustrated Black History: Honoring the Iconic and the Unseen). And I have been reading the biography of basketball legend Magic Johnson, who is only a few years younger than I am, so his is painfully recent history. He was a brave ambassador of integration in his teens; and a remarkable human being endowed with brilliance and charisma of many kinds.
And I do remember a little from my own life experience. My mother who was always a champion of the “underdog” loved Harry Belafonte, and taught us little bits and pieces of history that she knew, feeling her identification with a rejected race. And I remember from when I was three and our dad had his first student cantor position at a little congregation in Manhattan, he “went to bat” for Muncie the Black custodian, who was grossly underpaid. I remember our mom being proud that he “stuck his neck out” for Muncie that way. I did not really understand what those expressions meant, but somehow, I knew it was a good thing. And I knew that Muncie was a good guy.
Following the murder of George Floyd in 2020, it seemed as if the imperative of institutional change was actually materializing at least in some ways. We saw the emergence of a new field of “DEI,” diversity, equity and inclusion, teams in many business workplaces. It seemed to even be a new specialization emerging in business schools. Having been in private practice for almost 40 years (a certified child of neglect!) It has been that long since I have had bosses and co-workers. And I have never had employees. So of course, I am clueless about workplace dynamics, at least first hand. But I heard plenty from clients both about race and DEI in the workplace. Yesterday’s paper reported that DEI programs are being cut back and even phased out in many places, or scaled way down. And there has been plenty of noise wobbling in recent years, about affirmative action in both workplaces and school admissions. How are we to correct our course? To break the chains of intergenerational trauma and neglect, and shackles of all kinds? Microaggressions are perhaps not so micro!
I learned from Ta-Nehisi Coates that race itself is a racist construct. Why should differentness be such an issue that we must create such, categories, such distinctions, and hierarchies? Why would it not be like flavors and colors, a palette of richness? I think of the worlds of art, or cheese! Among cheeses, some are hard, some mushy, some stink others odorless, some are ready immediately, and others require months or years of ageing. We may have, our personal favorites, or even no interest at all. But attributions of superiority, of power or intrinsic value, or morality? What is that? I constantly wondered as much beginning at an early age, what made me so worthless? How could I compensate or measure up, or do or be enough? Why did others seems of much “better?” As a couple’s therapist, I hear it daily., So much of the mire of daily life layered over attachment trauma and all the other kinds too, are questions and contests of differentness.
I heard an interview the other day (NPR Hidden Brain), with a psychologist named Peter Coleman who runs a program in New York, the Morton Deutsch International Center for Cooperation and Conflict Resolution, and also teaches at Columbia University. He was talking about seemingly intractable differences, both his own and also research experiences; and around finding the way. What he discovered was not really surprising, but certainly interesting and worthy of exploration and practice. He found that understanding why whatever the point of view, is so hugely important to the other, truly understanding that, can be the game changer. Certainly not necessarily quickly, but completing that process.
Admittedly I have historically been perhaps stubborn and sometimes averse to the question “Why?” I remember my therapist saying to me “Why is a 19th Century question?” And I probably associated it with orthodoxy or defensiveness. My husband being a scientist would readily ask why and I would hear it as somehow critical, or a demand to “justify” my feeling or point of view which of course infuriated me. I have certainly loosened in my views and understand that explanations, certainly scientific or developmental ones, have their place and can actually be illuminating and even calming. But this idea, that true comprehension, empathic curiosity, patience and attention, and time, can make a great deal of difference in what may seem irreconcilable. It seems at the very least a worthy experiment.
I have found hope and inspiration in the notion of turning over a new leaf. Perhaps the Year of the Dragon brings that to mind. In Chinese culture, the dragon is a symbol of supernatural power, wisdom, strength, and hidden knowledge. Perhaps ushering in this year may bring more of that. I hope so. As I slowly learn to grow my orchid plants, a new passion of mine, I am readily heartened and surprised when I see new leaves and even buds appear on plants I have almost lost hope for. A good reminder.
A hero in Black history, and certainly in my book, was Shirley Chisholm. She was the first Black woman to be elected to the US Congress in 1968 and served for seven terms until 1983. She even had the guts to be the first woman, let alone a Black woman, to run for the Democratic presidential nomination in 1972. What a role model! Chisholm was known for saying “If they don’t give you a seat at the table, bring a folding chair. We must reject not only the stereotypes that others have of us but also those that we have of ourselves.” Words to live by.
Today’s Song:
As the US winds up for another presidential election, I find myself feeling exhausted and barraged by a seemingly elaborate industry of strategy and tactics, already. Even while the actual race is not for another almost nine months. It is hard to escape the unceasing updates and commentaries: it all reminds me of a sophisticated, commercial advertising/propaganda campaign, Was it always like this? Maybe I never noticed? Or maybe now that media are so lightening quick and inescapably pervasive, it is simply harder to not notice. I don’t know.
This morning in the wee hours, I heard a political commentator reporting on research showing that “optimism sells!” Wow! That is gratifying, and perhaps a bit surprising to me, although I have always found it pretty unbearable when candidates attempt to gain their ground with increasingly insulting diatribes against their opponents. And it is hard for me to imagine that the ubiquitous doomsday predictions and threats, inspire people to vote, or even to keep listening, (let alone continue to live here!). Maybe all that negativity is still to come. I hope not. In any case, I was happy to hear this. And I found myself contemplating the whole vast subject of hope.
I remember when I was quite young, certainly not yet five, my mother scolding, even nagging me: “Do you have to walk around here with that long face, moping around all day…?” Ironically, she was not the glowing picture of cheer, nor did she seem to give me a lot to smile about. I guess she thought she did, and that I certainly had it a whole lot better than she ever did, Admittedly it is true that my outlook was often bleak. I never expected to live too long, and the prospect of dying seemed perhaps heroic or redeeming.
Obviously a dark outlook is a glaring expression of depression and it is unclear, which comes first. I remember once hearing one of my friend-mentors, Imago therapist Pat Love tell the story of an upbeat and positive little boy. Surrounded by poop, he somehow still managed to have a bright outlook. Wading through the stinky mess he exclaimed “I know there is a pony around here somewhere!” Would I have had that kind of persistent optimism? Perhaps it would have helped my mom to be happier. I can joyfully say on the other side of all this recovery, I have gotten pretty darn close! I am so grateful. I am sorry my mother was not here to see or share it.
In the case of trauma and neglect of course it is important to know it is not your “fault.” I am one who avoids blame entirely if possible. For the child of neglect, the poverty of hope is most certainly not without good cause. Abandonment trauma for the tiny organism feels lethal. And when an infant repeatedly cries, and meets with echoing emptiness and no response, they will cease to cry. What is the point? Frustration, terror and ultimately collapse, despair, and defeat. The experience of that child is “I have no impact.” “I don’t know what to do!” “There is nothing I can do.” These defaults are signature markers of neglect. At the beginning of my study of neglect, I was struck by the redundancy of these familiar refrains, and the accompanying passivity, procrastination and paralysis, the “Thre P’s.” There is no apparent reason to be optimistic. There is no incentive and thus no energy for agency, or hope. And apparently biology follows suit.
I found it interesting that in studying the Penniston Protocol, the famous and well-researched a remarkably effective 1989 neurofeedback treatment for alcoholism. Researchers measured baseline levels of alpha, the brain frequency associated with a calm, relaxed, and apparently more creative states in chronic severe alcoholics, in comparison with healthy controls. They discovered that the baseline alpha levels in the control group were significantly higher. The alcoholics were able to match it after drinking four shots. A good reason to drink, which so many of our dysregulated survivors do.
Alpha or not, for the child of neglect, there is little reason to believe things will change. And I certainly never had reason to believe that anyone cared enough about me to change out of love for me. And it is hard to believe, that anything would change for the better, period. Rather, I believed if I could only make myself better, a little more bearable, do more, help more, and be less of a bother, I might minimize to some extent the damage or the burden that was my existence.
Johne Gottman the Marriage Researcher has been formally researching relationships for some four decades now and is a prized resource of mine. He has collected and continues to collect reams of longitudinal data about what makes relationships successful, and what are the predictive factors of separation and divorce. I am delighted to add that he and his both professional and life partner, Julie Gottman, will be on the playlist for this year’s Oxord Trauma Conference! Gottman’s research shows that in order to break even, not to make progress or backslide, but to stay relatively steady, the ratio of positive to negative in a partnership, must be 5:1! This means five thank yous for every grumble, five smiles for every mopey frown, five surprises for every oversight… simply to break even. And positive begets positive.
He also teaches a concept he calls “Positive Sentiment Override” – a mouthful that means, when we have a surplus of positive, some cushion in the field, the relationship is more resilient, we have a better shot at weathering the activations, the “triggers,” without as much interpersonal upheaval. So we can, in fact, effect even interpersonal change, especially if both parties in a relationship at least attempt to stay conscious. Can we be hopeful? Well probably for a long time in recovery it is a long shot. But perhaps with intention, and our dogged commitment to trauma work, we can come to believe…
I am decidedly no fan of Lance Armstrong, (although I do believe he was unjustly used as an example of bad behavior when his laurels were stripped for doing what everyone else was also doing, much like Jim Thorpe), but he was and probably still is a brilliant athlete. I must admit I find him an unsavory person, but reading his first book (written before any of the drama that got him in trouble), I found myself hating his mother much more. I don’t even remember the stories, but I remember finishing that book, and thinking “Oh, no wonder…” Perhaps I was not more fond of him, at least I gained some understanding of why he was so mean.
I do, however, continue to cite Lance as a shining example of something which I believe is exquisitely important. In 1996, he was diagnosed with metastatic testicular cancer, which had already spread to his abdomen, lungs and brain. He was 24, and his life expectancy was about 14 months. Today he is 52 years old.
When Lance very gradually began his remarkable cancer recovery, it was of course a long time before he could climb back onto his bike. When he was finally able to ride, his very first “rides” were one-quarter of one city block! That’s right, one-quarter of a block! And he went on to win the grueling, mountainous 3,405.6km, or 2,116 mile Tour de France a record seven consecutive times, between 1999 and 2005. Say what you will about the doping, I believe it can’t possibly account for his incredible strength and drive. That part notwithstanding, here is my point: Lance started with the minuscule distances that he could, and with persistence and consistency, and unrelenting determination he slowly built up from there. If we can do that, trauma, neglect or not, we have a shot at the kind of joy and peace that I never dreamed I would find. And miraculously, gradually have!
And admittedly in the case of neglect, I do believe that the most vital ingredient, certainly the most challenging, is coming to tolerate and allow an attachment with a supportive other. That requires a similar herculean effort. But when we can do that, who can imagine what the laurels may be? As my Holocaust survivor dad routinely said, “You should always go to sold-out concerts. You’ll get in.” He did that until his final breath. Gung Hay Fat Choy! Happy Year of the Dragon!
Today’s song:
I remember when the alcoholism field was budding and there was a bumper crop of pop literature about alcoholic families, a buzzword du jour was “denial.” Of course, this was long before social media made everything viral in a hot minute, and we didn’t even use the now everyday term “viral”, so I don’t know how things buzzed around so fast, but a little joke that went around with it, was “Denial is not a river in Egypt.” Ha ha, a play on the Nile River. We all thought we were so clever. But it was a long time before I really learned what that word meant. I alluded to it in last week’s blog, but I realized that it is worth coming back to for many reasons. Most importantly I had no idea how powerful and truly tangible denial can be until I experienced it from the inside.
I might add that I learned something similar about the overused, similarly buzzy clinical term “Narcissism.” I am decidedly opposed to diagnostic labels, seeing their value primarily for getting insurance companies, to pay. Beyond that, they tend to be insults and slurs and attempts to show off. And worse, in the case of partners diagnosing and analyzing each other, something they will never get away with on my watch. I remember once hearing Bessel say “Diagnosis is a political instrument!” And I thought, “Hear hear!” But I admit that the few times I have encountered the real thing, denial was rather like a living mule with blinders. I discovered the intransigence of a person truly incapable of empathy. I mean they could not see the point of view of another person. It was as if there was a physical block or blinder that made it impossible, truly impossible. It was hard to believe. No matter what I did or said, I could not facilitate standing in the shoes of the other, even for a nanosecond. I remember once sitting with a couple struggling with healing from infidelity. The “betraying” partner was literally incapable of imagining what it would have been like had the tables been turned. It was as if it were structurally impossible. Apart from being unmoved by the tears and devastation of the other, only perhaps guilt and confusion were achievable. I was amazed. And only once in 40-plus years have I been able to help put a dent, even facilitate healing from that disability. I remember in AA they would say “Those who cannot recover are those who are constitutionally incapable of being honest with themselves.” And although I heard those words hundreds, even thousands of times, only much later did I come to truly understand them.
My own personal experience of denial was, however, an indelible learning experience that I had to have myself to really get it, and believe it. That is what I want to tell you about because I think it is relevant and perhaps useful in our larger topics of trauma and neglect. And yes, it was about alcoholism. I told you the story of my alcoholic partner. I was in love with him like only a young, romantic, lonely child of neglect can be. I was 24 when we met, and it was one of those crazy experiences of young love that really never happened again. He was like a Greek god, and everyone thought we were siblings because we looked like a matched set. We were inseparable, and we started living together almost instantly. Drinking together was a big part of our daily home life, and it was idyllic: delicious European foods, roses, and lots of wine. He loved art and when we looked at beauty, we saw the same thing. As time went on, typically, especially when there was a lot of alcohol involved, things were not as perfect anymore. And as more time went on, and my drinking got more and more out of hand, even I was forced to look at it. As I have often said, my therapist in her infinite wisdom, knew that for a long time, the alcohol was keeping me alive. We did not yet know it was keeping my trauma at bay. But she knew that without it I had probably near lethal depression, in spite of my euphoria about my partner, the alcohol was managing that. She knew it was a symptom but also a kind of lifeline, and then she also knew when it was becoming lethal in its own right. At that point, she nudged me and then sent me to AA. Grudgingly, and also ashamedly I went. And speaking of denial, my parents insisted that “Jews do not become alcoholics” and continued offering me wine for about two years into my sobriety. Thankfully I was able to decline. I had the good fortune of getting and staying sober on my first try which I consider to be grace and a gift. I have absolutely no idea why some of us can and others simply can’t. My beloved partner turned out to be in the latter group. I have no idea why.
Not immediately, but sometime after I did, my partner got sober too. And he stayed that way for a while. Unlike me he came from a Mediterranean farm family, his father was a winemaker, and he grew up drinking wine. For his family, it was even more unacceptable and unthinkable to stop. He fell off a time or two but eventually, I thought he was solidly in recovery like I was. By then I was pretty busy. I had finished grad school and was working at the VA (US Veteran’s Administration) in a dual diagnosis unit, PTSD and substance abuse, with largely Viet Nam veterans. I was saddened and outraged to see the revolving door of that system. These guys (and all of the patients I worked with there were men,) were trapped in a cycle where if they got better, they lost part or all of their benefits, so there was no incentive to recover, even if there had been any effective modalities for treating the newly named PTSD diagnosis at the time. So, most of them stayed addicted and symptomatic and many of the very same poor souls are sleeping in doorways in Haight Ashbury, only blocks away from my home, even still.
Meanwhile, there was “trouble in paradise.” My supposedly sober ex began to stay out late at night, and I didn’t know where he was. But he would come home with the oddest cock and bull explanations of where he had been, concocting truly wild and unlikely stories. But somehow, I can scarcely imagine how I believed him. They got weirder and weirder. One night the cops brought him home. When they knocked on the door, they asked me, “Does he live here?” I said “Yes.” They said “We found him passed out in a driveway…” My ex stumbled off to bed I took him to the hospital in the morning, and he explained that he had some unlikely lung diagnosis that I don’t remember. And again, I believed it! He was such a relentless tobacco smoker, that I figured it was related to that. And in a weird inconceivable way, I had some kind of blinders on. Love perhaps? Fear? I don’t know. But the truly obvious happenings went on for months longer. And I continued, blinded by whatever, to not “see”. Until one night when he didn’t come home at all. In the morning, I got a call from the county jail, where he was locked up for drunk driving. Finally, my denial was punctured. And finally, I was able to do one of the hardest things I had ever had to do: pull the plug on the relationship with this man whom I still loved so incredibly much. But not before learning an indelible and invaluable lesson. Denial is much more than a river in Egypt. It is an undeniable and serious defense mechanism, not to be underestimated. Denial enabled me to ignore and not deal with what I most did not want to see. Until ultimately undeniable events forced the issue. This did not excuse or justify my failure, but it did somehow make sense of it. We block out what is most painful, unbearable, terrifying, shameful, and impossible to accept.
Previously I had incredulously wondered, how do you not see your 13-year-old daughter vanish to 79 pounds (36 Kg) on her five foot three (160 cm) little frame? How do parents fail to “know” other kinds of unthinkable trauma happening to their children under their very roof? Now I began to have an idea. Many of us often wonder about our own neglectful parents, how can they not see? How can they close their eyes to these cruel realities? How can they go unconscious about seeing their child’s needs for all kinds of essentials? Do they simply not care? How could my mom, and my parents turn blind eyes? Did they truly not give a darn? Or were they brittle, terrified, or paralyzed by their own trauma, guilt or shame? Or did they, like me, cluelessly love “too much?” Who can know? But perhaps it gives me a bit of comfort to have a modicum of understanding about denial.
Today’s Song:
Recently I had occasion to walk through the neighboring SF Mission District. For whatever reason, the mystery of memory, I found myself remembering a distant past I had not thought about in ages. It was 1984, I was one year clean and sober. Back then the Mission was a Mexican/Latin American ghetto. Carlos Santana went to Mission High, and one of my favorite haunts was Discolandia, a long-gone Latin Record store, and one of the few places I could find my beloved Pablo Milanes. Now the Mission is a barely recognizable tony, upscale neighborhood, where a parking space is almost as hard to find as Pablo was then. I used to walk through the neighborhood every day, from the BART subway station on the daily commute from my Berkeley apartment to my job. I worked in a small agency called Latino Family Alcohol Counseling Center. I was proud to have a job there and “in the field” especially as a young, Jewish gringa woman. But my Spanish was pretty darn good.
It was a challenging job, as most of the poor clientele were court-ordered for some reason or another, usually drunk driving, and almost exclusively men. In those days the punishments were so different, generally, some modest number of counselling sessions. Perhaps the most challenging part of my job, was that once a month I had to teach the mandatory drunk driving school, which was one full weekend, two eight-hour days, and in Spanish of course. Oy vey. Thinking back on it now, I can’t imagine how I did it. I did my best to make it interesting, lively and interactive. I don’t remember what we did. Back then there was no AV gadgetry. I had a few films I could show, I tried to create activities that the guys could do and/or do together. I don’t remember much, except that we were all doing our best to get through it. They seemed to like me, I guess it meant something to at least some of them that I had my own history and was open about it, and not punitive like their probation officers and often their wives. I also familiarized myself with Spanish language AA which I found pretty awesome in that the program seemed to extend internationally and not become corrupt in one way or another like so many things international did. The addiction field was in its infancy then. I hung in there for that year until I started graduate school. Now forty plus years sober, it all seems like a distant dream, and I am so grateful.
Although AA still has a decidedly moral tone, those of us who studied trauma and neglect understand it as a symptom. And for me, although I never bought into the higher power part, my time spent in those at the time blindingly smoke-filled rooms, was life-saving. I walked devotedly around the corner to my Berkeley Fellowship meetings twice a day: 6:00 AM and 7:00 PM. In conjunction with my then four times-a-week psychotherapy, they saved my life. Thankfully neither my drinking nor the clouds of tobacco smoke seem to have had any lasting damage on my brain that I know of. It was my good fortune and my therapist’s wisdom that got me to quit young enough. By the last of my drinking career, I was consuming a quart, roughly a litre of straight bourbon by myself every night, Old Crow, $6.95 a quart. On my small frame, how did I do it?
We now know that coming out of trauma and neglect, we do what we must to survive the pain and fear. I started out with my near-fatal eating disorder, anorexia that nearly took me down at age 13. Eating disorders were considered the “good girls’ addiction,” although I have always rather baulked at the classification of eating disorders as an addiction because it is unclear if they fit the precise scientific definition. Drinking and bicycling, however, became a ready alternative or addition, depending on the times. And they were at least more social and brought me out of my utter and certainly not unique isolation.
Thankfully the alcoholism field has advanced a lot in the last 40 years. In my early recovery time, AA was all we had, and in eating disorders sadly even less. To my mind that field is still pretty impoverished although perhaps you know more than I do. I am grateful to be I would say fully recovered, although it took a painfully long time.
Within the first four years of my sobriety, my beloved partner, who at the time I thought was the love of my life, was tragically caught in the web of alcoholism himself. I got to see up close what it looks like when someone simply cannot stay sober. We had originally gotten sober together, but he seemed never to be able to make it for long, and there was repeated deception and heartbreak, as well as my learning to my own shock and dismay, the humbling and mystifying phenomenon of denial. The incredibly obvious evidence in plain sight, I was able to somehow ignore and not see. It does help me to be perhaps more compassionate and empathic, at least sometimes, with neglectful parents who are uncannily able to not see, like my parent with my near-fatal starvation.
It took me four years to “successfully” leave that man, four years of a 10-year relationship. The child of neglect riddled with profound interpersonal ambivalence can scale the tightrope for years. And even after getting out, my grief was relentless for another five, and it took years to resolve. I guess this is my way of pitching for patience tolerance, and kindness around relationship loss, whether it be our own, or someone else’s. The important takeaway is that addictions are a symptom, a desperate attempt at regulation, or relief, however momentary.
Admittedly as a therapist, I avoid working with addictions and even eating disorders when I can, which of course is often quite impossible. I know I run short of compassion, especially when there is lying involved, which is of course there usually is, as it is one of addiction’s undeniable symptoms. Although I cannot lie to save my life, especially in my anorexic years, I was a phenomenally creative, chronic liar, and have profound shame and remorse about it now. It is no wonder that AA’s most challenging Step 8 is about making amends, which has in general, become a vitally important practice to me.
In the case of those addictive people who do slip through the cracks into my practice, it is clear that their healing from trauma and neglect is stalled by their use, much as mine was. My trauma recovery really took off when I both got sober and then left the alcoholic relationship. I have not kept pace with advances in the addiction/recovery fields, because I have known that I was not well suited for that work. I am grateful to those of you who are and for leaders like Gabor Mate Johan Hari, David Nutt, and others who I do not even know about because I have not kept up. And for those who have apparently hopelessly addicted partners, my heart goes out to you. And we are indeed powerless. My ex did stay in touch for quite a few years, and I would get long, blubbering messages on my office answering machine, usually on my birthdays or his, although I never returned the calls. I don’t know if he ever quit, or even if he is still alive.
I do not know of any good routes to recovery, other than AA. Perhaps you do. There is good research about neurofeedback; and also perhaps ironically Ketamine Assisted Psychotherapy (KAP) which I find intriguing but have not yet attempted. I did attend a first-level KAP training but realize I still have a long way to go. Meanwhile, I struggle with my ineptitude with the handful of clients I do have who continue to wrestle in the grips of addiction, although I am gratified when they tell me candidly what is really going on. My suspicion is not always as gentle as I would like. Remembering that this tragic symptom is another essential reminder of how important it is to break the intergenerational chains of trauma and neglect, is the best route that I know. However clearly, it is not enough. As AA exquisitely reminds us, it is one day at a time.
Today’s Song:
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