Although I am committed to zero tolerance, no rushing, I am rarely successful. I am always trying to do too much in a day; the time gets away from me. I wind up feeling disappointed about all that I did not get done and wondering, where does the time go? I have no idea where it went, and there is never enough. It is hard to remember the long, lonely years when the time weighed so heavily on my hands as to be unbearable. Getting through the day was like pushing Sisyphus’ leaden boulder, invariably feeling it refuse to move. I thought there was something wrong with the clock. Now I know the amygdala has no time.
Neglect is a bleak, empty cavernous void. I imagine an infant lying alone in a darkened room, helpless, with no way of “knowing” if anyone will ever come, let alone when. I am often visited by that image when sitting with a client who describes their days as interminable, desolate, powerless, and hopeless. I have no doubt that is how it was. What is so insidious about trauma healing is that experience is not remembered but relived. The neglect story being one of absences, holes in time, empty space, and no story to remember, is a reliving of that. Often accompanied by a panoply of somatic mystery symptoms, it is puzzling. People often ask me, “Why do I feel so much worse than ever? When is this going to end?” The very musing of the young child, I imagine, who, of course, does not have the words.
I remember watching out the window, counting cars; I must have been six because that window was at the house in South Bend, and I knew how to count. Counting and waiting for Daddy’s Chevy to pull in and for him to bound in the door, calling out, “Ho ho!” Why did I look forward to that? I don’t know… I know it was invariably a long wait. I remember one time when I fasted for two weeks, with only a bit of water now and then. I called it “the Long March.” I would count the hours as “meal times” would come and pass. There was lunch, check. There was dinner, check. Day one, day two, up to fourteen. How did I do that? I don’t remember. I remember watching the clock not move, waiting to get to the magic hour of 4:45 when I could crack my bottle of Old Crow, $6.95 a quart rotgut bourbon. But it worked. Getting through the day. I remember that old song by John and Yoko, “Whatever gets you through the night, is alright, alright…”
It is true, the healing years can be slower, longer, and arguably even worse than the original trauma experience, especially because it makes no sense. “I am worse than before! Is this therapy making me worse?” I wondered, and people ask me. It is hard to provide an answer that makes any difference. The best I can do is hold the certainty that I know it will. And I do. That is why I always say everything I have ever been through serves me.
Trauma and neglect are like a childhood of wild scribbles, not the orderly coloring book of a safe childhood.
I have always loved art. I love pretty things, I love looking at art, I love making things, and I love beauty. I can say I love visual beauty more than music, maybe. Like many of my era, I idealized the iconic Frida Kahlo. She had terrible trauma and physical pain, but she managed it most successfully by painting prolifically, mostly graphic and dramatic self-portraits. Bright, primary colors, realism and symbolism, tragedy but also the beauty of nature, flowers, birds, animals, even hope. She found her way, and even with the ongoing trauma of her brilliant and cheating husband, she prevailed. Her life never ceased to be hard, but her powerful work is a legacy and an inspiration to many, especially women.
During the worst of those interminable years, probably after I finally surrendered alcohol to start trudging the rugged road of recovery, I don’t remember how it happened. I started to draw – I used colored pencils, never having the patience for unwieldy media and needing to feel a sense of control. I drew myself, largely rendering from old photos of many ages, but my family members too. I had my own symbology of icons and monsters that recurred. I sat, and I drew and drew and drew, and it gobbled up the time. There was no clock, there were no meals to track. I was in what that famous Hungarian guy with the unpronounceable name called “flow.” And I was amazed. My artistry was very good. It has never been that good since.
So much story was unearthed and even processed in those long hours at the kitchen table. Then I would roll up the large sheets and take them to therapy to review them with the “witness,” my therapist. I wonder how much quicker things would have moved if I had had neurofeedback then. Quite a few years later, when EMDR came on the scene, and I was studying and practicing that, I had an EMDR therapist who was also an art therapist. I can’t remember how she combined them, but it was a good idea. I am sure it was good, at least at the time. I don’t remember much. However, nothing was again like those hours at the kitchen table.
I still have the drawings, sheaves of them in large, now ragged brown cardboard portfolios. They trailed with me through all of my vagabond moves over decades. I don’t look at them often, but they are a record of where I was, that long slog. They certainly keep me grateful. My best friend was in film school at that time, and made a movie with my drawings, about the power of art for healing. She recently had the VHS converted to DVD. Now, if I could just find my DVD attachment, I’d like to have another look!
I agree with John and Yoko, whatever gets you through the night, is alright…. Well, as long as you don’t do any harm to yourself or another. Colored pencils are definitely better than bourbon or starvation.
This was actually intended to be a missive of hope. I am not sure if it came across that way! Trauma and neglect are like a childhood of wild scribbles, not the orderly coloring book of a safe childhood. Of course, healing will be largely outside the lines, sometimes wildly so. My artwork was not cheery, but the colors are strong and have stood the test of time, as has the rocky but persistent healing work. Sometimes I feel as if my main task is a hope monger, to keep the faith somehow. I still occasionally have days where I have to be that for myself. That’s OK. Now I know that the clock is not broken; time does not really stand still, or at least not for long. And I agree with John and Yoko, whatever gets you through the night, is alright…. Well, as long as you don’t do any harm to yourself or another. Colored pencils are definitely better than bourbon or starvation.
Cheese is an excellent teacher. The Monterey Jack I made last week required 70 minutes of stirring. That’s right! I stand on my little stool, stirring my 8-gallon pot for that long. I get to watch a whole lot of great webinars! The aging time is another story. I remember when I first started making cheese, and the idea of waiting four months before it was ready seemed like a cruel joke. Now four is a short time, and a good Parmesan or cheddar will take a year or more. Gardening is the same way. I used to grow roses when I lived in Berkeley. I read that when you grow asparagus, it takes eight years before you get a crop! The waiting is part of the protocol, part of the deal. Hard to metabolize that some of these invaluable processes are simply not to be hurried. Some of those cheeses really stink! But we find them delicious.
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.
We saw so few movies when we were growing up that the ones we did see stick in my mind, like the 1968 film, “Oliver!” a musical adapted to screen, based on the classic Dickens novel, Oliver Twist. The bits I remember about it were how the boys, victims of child slave labor, shared beds, where one slept during the other’s 12-hour work shift, and then they switched, and the song “Food, Glorious Food!” The boys were so hungry they dreamed of food and sang joyously about what they craved. I remember a bittersweet feeling about that song. Although food was certainly plentiful enough in our house, it was, to me, anything but glorious. It was more on the order of a protracted, hideous, recurring nightmare.
I was always “dickkopf” (fathead) and a “bad eater.” Right from the start I did not like meat, which made for an ongoing power struggle. Now I am not a “formal” vegetarian, meaning I have no ethical, political or spiritual rationale, simply my age-old distaste/preference to avoid meat.
Meal times were not much fun, anyway. Our dad, who had been a chef before becoming a cantor, repeatedly told Mom with a smile, “I did not marry you for your cooking,” but really, it was no joke. When he cooked, he required a fair measure of adulation for the uppity French dishes he made, which were never my taste, apart from the meat issue. There was also a truly unsavory period of at least several years that I think of as the “Kosher wars.” Our dad wanted to keep a kosher kitchen, and Mom wouldn’t do it. He lived on nightly Hebrew National hot dogs until she finally relented with “OK, I will cook what you buy.” I don’t remember how they resolved the part about two sets of dishes. Mostly I remember the long and bitter tension that hung heavily over our family table. No great surprise when my trauma expressed itself via, among the many other symptoms, a near-fatal anorexia that spanned my adolescence, but really much more. In 1967, anorexia and eating disorders in general were even less understood than they are now. There was no treatment to speak of, and I was simply viewed as a “bad girl”, creating headaches for my parents. I somehow got to a healthy-ish weight eventually, but the agony of obsession persisted for decades.
After many years and all sorts of somatic approaches alongside my depth psychotherapy, I can say food is one of the truly glorious and great pleasures of my life. I love it and am grateful to say I eat whatever I want. I love making food, too. I am a home cheesemaker, a sourdough baker, and I aspire to grow vegetables when I can make the time. On a particularly bad day at the office, I might rant to my ever-patient partner, “I’m done! I am going to retire, be a cheesemaker!” until I calm down. We do, however, love our food.
After many years and all sorts of somatic approaches alongside my depth psychotherapy, I can say food is one of the truly glorious and great pleasures of my life. I love it and am grateful to say I eat whatever I want.
When I was in the throes of my eating disorder, our dad would rail at me that the word “companion” emerged from the Latin com panis, sharing bread. Eating together was a natural and human way to connect. Ideally, that would be true. My not wanting to was somehow “inhuman.” For so many who grew up in a household of trauma and neglect, this was sadly far from true, and disordered eating is a not-so-uncommon expression of dysregulation.
I was interested to learn that, in a strange way, the whole category of “com panis” and food culture became a mechanism of social control and an attempt at cultural change in the Soviet Union. I heard an interesting story, “Dissident Kitchens”, on one of those wonderful late-night Public Radio programs. After the revolution in 1917, food was scarce. The new Stalinist government set about industrializing food, essentially dictating what was to be eaten by everyone. The new housing, small apartments where everyone lived, was built without kitchens. Rather, there were large communal kitchens, and people broke their bread in dining halls with 500 comrades. The Bolsheviks were not interested in the tradition or the aesthetic of food. First, food shortages devastated all that, but further, private kitchens were considered “bourgeois.” The foods to be eaten were determined by the government, and everyone ate the same. Apparently, and understandably, the people hated that and sorely missed cooking and the ritual of sharing intimate family mealtimes.
When Kruschev replaced the Stalinist regime in 1953, in addressing the housing shortage he had apartments built once again with small kitchens, which became a place for families and friends to gather. Now, cookbooks and programs reflect the slow and steady revival and reclamation of traditional Russian foods. And although Russia is currently alienating many of us, its food story is informative, and reminds us how very elemental the family table is. Eating together in harmony is on the order of a birthright. And the way it is corrupted in micro and macro forms of trauma is a crime against nature as far as I am concerned!
The dysregulations of trauma and neglect that manifest as disordered eating are some of the most persistent and challenging to heal.
One of my favorite books of all time is Michael Pollan’s epic Omnivore’s Dilemma, which approaches food from myriad directions: psychological, emotional, nutritional, environmental, political, cultural, ethical, aesthetic, historical… what else? Long before he became a harbinger and champion of psychedelics, Pollan wrote brilliantly and prolifically about food and its many meanings, which span quite a universe. There is even now an emerging sub-field of “culinary medicine,” which makes a lot of sense to me. Here in San Francisco, food is virtually on the order of religion, which can be both a pleasure and an embarrassment.
The dysregulations of trauma and neglect that manifest as disordered eating are some of the most persistent and challenging to heal. I have worked with survivors who suffered disordered eating of every stripe, not to mention my own. I do not pretend to know how to treat eating disorders effectively, and I have yet to see programs that do. Please prove me wrong! The best thing I know, which is the best thing I know for trauma in general, is the combination of depth, attachment-oriented psychotherapy, and neurofeedback. If I had had that 50 years ago, who knows if my own healing would have required less than the multiple decades it did?
Whatever we can do to get the shame out, even better. And whatever we can do to break the intergenerational transmission not only of trauma, but also the agony of interference with the natural development of food and eating tastes and habits, better still. It is my wish that “enlightened feeding,” becomes an aspect of “enlightened parenting.” Although I am not a mother, I am indeed a proverbial “Jewish mother” in that I love to make and give food, although certainly not to foist unwanted food on anyone ever! Far be that from me! But for me, it can be an exquisite show of love and care, as long as (like with any gift!) the recipient is truly seen, known, and considered.
Our mom used to say “Mahlzeit!” before we ate. I never knew what it meant, thinking it was “mouse-ite.” I picture a little family of mice enjoying their dinner (maybe cheese?) It is a form of greeting and celebratory marking of mealtime. We later evolved into singing a Hebrew grace before meals. Although I have long since given that up, I do like the ritual of feeling and acknowledging with gratitude before we eat. My husband graciously does all the grocery shopping, buying those things that I am not able to make for us myself. My little ritual has become a hug and a loud exclamation, “I love you! Thanks for the food!” What’s yours?
Enjoy your dinner!
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.
I remember once, I had a garbage can-sized bin full of old papers, tax records, client files much older than the seven-year legal time requirement, junk mail, newspaper clippings, and who knew what else. The very idea of shredding and disposing of them completely overwhelmed me. I would walk into the room with the closet housing that bin, open the closet door, see it there and run, not quite shrieking from the room, flinging the door shut behind me. I just could not face it. The insurmountable pile; the task seemed truly interminable.
One day I had the flashbulb thought, “what if I just did ten minutes a day? I dragged our old shredder into the room thinking “let’s just see what ten minutes is like. So, I fired up the shredder and loaded it for ten minutes. That wasn’t so bad… enough to give me a kind of rhythm with it. The timer went off after ten, and I calmly left the room. “I can do that.” Amazing. So, each day, I set the timer for ten minutes and fulfilled my quota. It became routine, until one day, it was all gone, the pile had gone away! In AA they figured this out years ago. Thinking of a lifetime barren of drinking is too much to imagine, even for a minute. But twenty-four hours? Well, I can probably do that, so a day at a time becomes my now 39-year sobriety.
I have a vague visual memory from when I was very young, probably not much more than two. We used to go to the Catskill Mountains every summer, and our dad worked in one of those fancy resort hotels to get us out of the City in the unbearably hot and humid New York summers. Our dad worked about sixteen hours a day, waiting tables and singing in the lounge at night. We stayed in a little bungalow on the grounds. On this particular afternoon, I woke up from a nap to find myself in the darkened bungalow alone. Where was everyone – where was my mom? It was of course wordless, like a bottomless pit of dark terror. It may have been only minutes. I don’t know. For that tiny child it was eternity. Sometimes when I am sitting with a client who seems to have no story, I am visited by that image, an iconic symbol of early neglect. I imagine something unremembered, that is perhaps communicating itself in some unspoken language from the client’s brain and body to mine.
I first started thinking about neglect, now over thirty years ago. It now boggles my mind to find myself remembering things that happened thirty, forty, fifty, even sixty years ago. These are such big numbers, years that passed a day at a time, some of them interminable. Back in the beginning, all my “data” about neglect was anecdotal observation of clients. I had no science then. The brain was nowhere near my radar yet. I noticed that these clients found things like boredom and insomnia excruciating, even lethal. I remember one man in couple’s therapy with me, who when he got too bored in a session, would lob a known inflammatory remark sure to get a rise from his hapless wife, just to get energy moving in the room. Waiting in lines for things, lying sleeplessly in bed at night, were like dying. I could only imagine a child left alone too much or too long.
I remember reading the trauma story of a political prisoner in a book once. I don’t even remember what book or what country it was about. One of the tortures used to deprive the man of sleep was playing the song Sultans of Swing by Dire Straits, really a quite good song, over and over again for nine days. Time was interminable. I can never hear that song without thinking of him. And trauma knows no time. In both incident trauma and developmental trauma like neglect, time stands still and does not move, which makes it that much more deadly. I have since learned that all the somatic therapies have some component of noticing “What happens next? What happens next?” The idea being to become aware of change or time moving and passing.
Again, when I was first collecting observations and compiling what I later came to call the “Neglect Profile”, I identified the “Three P’s of Neglect: Passivity, Procrastination and Paralysis.” I wrote about it in my first book. At the time, I was simply aware of the pattern, that survivors of neglect seemed to have a hard time initiating and completing purposeful action and then collapsing into despair about it. I assumed that it was due to the absence of the life-sustaining other, who first demonstrated and, in effect taught, and also rewarded such behaviors. If no one is there to teach me, how will I learn? And without feedback, how will I know I am on track? The child is adrift in a sea of lonely uncertainty. Crying, reaching, lashing out into the empty space is all futile at best, if not devastating. Ultimately collapse, passivity, freeze, become a default, even a baseline.
Both sense of time and agency are prefrontal brain functions: they are mediated by the most “highly evolved” executive neocortex areas of the brain. This area is where the initial resonance between infant and primary caregiver brains is supposed to occur in the earliest weeks and months of life. When that does not occur, or not enough, the little developing brain is under-stimulated, under-aroused. This later can coagulate into three P’s, and then all the shame, self-blame and self-hatred that accompany it. “Of course it is my fault; who else is there?” The prefrontal cortex is also the brain area that goes offline when the brain is overwhelmed by stimulus greater than what it is designed to process in its customary way. That by definition constitutes traumatic experience, such as the infant overwhelmed by drowning in a solitude of abandonment way too early.
Ironically, attention issues also have the origin of under-stimulation. Even though the brain flitting from thing to thing might feel like hyperarousal, it is faster brain firing that creates focus and ability to concentrate, and under-firing that makes for the clutter of attention deficit. Again, the early under-stimulation of the infant brain, the lack of attention received makes for the subsequent deficit. I used to think that ADD and ADHD were neglect markers, as I saw them so often in neglect survivors. We now know that these diagnostic categories are far from precise or diagnostic. They are rather a collection of observed symptoms that might have a variety of origins, like many of the other codes. What to me is compelling is that some of the most brilliant, creative people I know or know of have struggled with these issues and also developed the most ingenious workarounds to compensate for them.
Before March 20, 2020, I used to fill my Prius with gas every week. Commuting from my San Francisco home to my Oakland office every day, and whatever extraneous other driving I did each week, did not use up nearly a whole tank, but I always felt most secure with the car on full. In August of 2021, I found myself at the gas station. I barely remembered how to put gas in the car, it was the first time I had done so in seventeen months! (It hadn’t been washed either, oy vey!) My hair was ragged, my husband had a ponytail now. I had been hunkered down day after day, as we all had, in the house with my husband, then two (now sadly just one) dogs, and my on-screen clients. How did this happen? Time had somehow evaporated like the old time-lapse photography. Groundhog Day. The repetition, the sameness, made for a strange complex of endless time and split-second vanishing. Suddenly it is gone, where did it go and what do I have to show for it? Depression is like this; this intolerable slogging, getting through the day, and then looking back on an embarrassing expanse of “nothing?” Very strange.
I think early neglect had to be like this, which is why the child becomes so expert at dissociation: numbing out, “going away,” and is also traumatized by emptiness. Waiting in a long line can evoke that hideous traumatic sensory memory that is coupled with what the child often comes to associate to rejection. Of course, time and its passing or not become a sort of enemy, and altering one’s state is a welcome relief. And this blurry relationship to time or to “nothingness,” has become a window and often an indicator of early neglect – or at least something to wonder about when considering whether one might be a child of neglect.
“The repetition, the sameness, made for a strange complex of endless time and split-second vanishing. Suddenly it is gone, where did it go and what do I have to show for it? Depression is like this; this intolerable slogging, getting through the day, and then looking back on an embarrassing expanse of “nothing?” Very strange.”
Don’t ya hate it when well-meaning people (like therapists) say rather glibly or cheerily, “this too shall pass…”? But you know what? It does. It turns into history and might even become interesting. As a home cheesemaker, I continued making cheese every weekend through the Pandemic years. With all the wheels of aging cheeses dated in the caves, I would suddenly be astonished to find that wow – this cheddar is a year old already! Healing is like that too.
When I first went to therapy at the age of 23, my therapist literally seemed like a blur of colored fog in the far corner of the room. It took some years before she actually coagulated into human form, even though I went to multiple sessions per week. Early sobriety was the same way, I have no memory of sitting in meetings, except the clock on the wall, and the billowing of tobacco smoke, as in those days, people smoked openly everywhere. And now, looking back, my relationship to time and to life is like, well, night and day. There is never enough, certainly for all I want to do. And I have to keep reminding myself, “No! Sleep is not a waste of time!”
“And now, looking back, my relationship to time and to life is like, well, night and day. There is never enough, certainly for all I want to do.”
As we age, now in my advancing years, the passing of time seems to be a kind of foe, if I am not careful. I slip into animosity with nature. I hate the wrinkles, the undeniable physical pains that I never had before and always rather had contempt for, limitations of fatigue, losses that will not be returned. It is something to befriend if one is wise or in harmony with nature’s design.
Admittedly I am not there yet. And there is no getting back that time that slogged unbearable, emptily, and then was gone. But at the risk of being annoying, I can say it does pass. Hang in there!
Each time I write a blog, I always try to think of a song that I love that goes with what I’ve written. Today’s is All Things Must Pass by George Harrison.
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.
When I first heard of Chef Jose I felt a surge of excitement, awe and longing. Jose Andres, born in Spain, and immigrated to the US as a young man, soon made a name for himself as a celebrity chef, opening several highly acclaimed restaurants and winning prestigious awards in the highly lucrative world of gourmet food. Certainly, in the Bay Area, food is almost at the status of a religion. In 2010, perhaps having his fill of money and adulation, he founded the World Central Kitchen, established to feed masses of people left hungry or displaced by some sort of large-scale disaster, be it a natural or political one. He sets up traveling kitchens providing free meals to large numbers who need it. Hunger itself is a form of trauma, let alone the trauma of hurricanes, wildfires, war or crazy immigration policy. My longing was to grab my husband, drop everything and go join his team. I even found he has a local team right next door to me here in Oakland. Of course, I wouldn’t do that. But the idea of helping the traumatized in that way grabbed me hard for a minute. Admittedly, one of the things that makes me happiest, is making food for people I love. I realized that only in the past few years, and probably it has not been true much longer than that.
Like many survivors of childhood trauma and neglect, I have a long and troubled history with food. Starting when I was a little girl, for whatever reason I did not like meat, and it became a power struggle between my mother and me, with my occasionally being spanked with a serving spoon. I was known early on as a “bad eater,” and I was. My parents had their own wartime history with food. I remember our dad talking about when he first came to this country and saw the bounty at Safeway, he could not believe how much food there was in the store! He simply could not stop drinking milk, because he could. My mom used to always say “Mahlzeit” before we ate. (My little sister thought it was “mouse-ite” or something rather cute!) That is German for “Enjoy the meal,” which I really never could. To this day I feel a little spark of anger in my belly when someone says “Bon Appetit” or some such, remembering the regular unpleasantness of mealtimes.
By the age of 12 I had a full-on eating disorder, being severely anorexic. At 5 feet 2, I weighed 79 pounds, and in typical neglect fashion, no one really noticed. By then I had taken over much of the cooking for the family which was a way to control what we ate, and also gave me an excuse to be jumping up and down from the table during mealtime, so what was going on with my own plate might be less obvious. It was 1967 so anorexia was not recognized, nothing like the household word it is now. When I finally collapsed and could not even walk to the bathroom, I got attended to, but mostly with anger, blame and coercion. The nightmare that went on for decades ensued.
As with many survivors of trauma and neglect, food becomes another form of the “dilemma without solution” identified in attachment theory, where the source of comfort and the source of terror are the same, be it the parent or the food – most likely both. In reality the comfort sought by the child in both forms, and in general, is regulation. The desperate attempt to calm the agonizing hyperarousal of the nervous system. Ironically there was something calming about the numbing of starvation. I do remember the mild state of euphoria and power I had when I was 20 and embarked on what I called “the Long March” which was a 14-day fast where I literally took in nothing but water. I felt somehow super or sub-human, but definitely different if not special. That is one I remember, but I am sure I felt it long before that.
I have always bristled when I heard people who struggled with their weight, envying anorexics. First because it is such a relentless and devastating tyranny. But also because my 12 year old anorexia slid amoeba-like into a new form, I am not sure when. Suddenly I became compulsively driven to eat. It was terrifying. I began a routine where I ate sparsely through the day, but after dinner and washing the dishes, when everyone in the family was in bed, or where were they? I consumed between half a gallon and a gallon of ice cream, standing up and straight out of the cartons. I guess my parents kept me supplied, I don’t remember. But I could not stop. Each night, completing my routine, completely numbed out and bloated, I stumbled off to bed. In the mornings, I would get up and secretly run twenty miles in the dark, also a compulsion. The peril of gaining weight being the whip. I stayed on that merry go round, probably until I discovered alcohol which had a similar numbing/regulating effect. So, anorexia was no free ride to thinness for me.
“As with many survivors of trauma and neglect, food becomes another form of the “dilemma without solution” identified in attachment theory, where the source of comfort and the source of terror are the same, be it the parent or the food- most likely both. In reality the comfort sought by the child in both forms, and in general, is regulation.”
I became a waitress as a way to earn money for college and graduate school. I was really good at it, discovering that if I got a lot of saliva in my mouth, and a sparkle in my eye when describing a pricey special, I could get people to order whatever I wanted them to. In that way food was an ally. In my activist days I became a cook in a community cultural center and restaurant that supported refugees and exiles from Latin American dictatorships. I cooked ten-gallon pots of soup, and learned all kinds of Latin specialties that I still love to make. And it was an opportunity to lend my preoccupation to something socially useful.
At a young age I became very interested in the interface between body and mind. I knew my terrible eating obsession was a confused tangle of both. I just had no idea what to do. The simple recipe of “eat less and exercise more” was surely not the answer. And the worst of it, was how my mind was always crowded with thoughts, worry, anticipation, terror, hope, fear and self-hatred about food and weight. It really was 24/7, and so boring, not to mention the shame and loneliness, and utter waste of time of the secret world, and of being constantly “on the run.”
“And the worst of it, was how my mind was always crowded with thoughts, worry, anticipation, terror, hope, fear and self-hatred about food and weight. It really was 24/7, and so boring…”
So what is the answer? I will start with the “ending.” I can joyfully say I have a wonderful, pleasurable, healthful and spacious relationship with food today. I only think about it when I am deciding what kind of cheese to make this weekend or appreciating something delicious I just ate. I am grateful that I can eat whatever I want and it is not a struggle to know how much is enough or too much. I remember seeing people like that with envy and despair, and thinking “that will never be me.” Kind of a “homestead girl” I make all the bread and butter and cheese in our house. I aspire to grow vegetables but I have not quite cleared the time for that.
How did this happen? As with every other aspect of trauma and neglect healing, the magic is regulation. I believe the winning elixir is a healing attachment relationship, in my case with a truly wonderful therapist, and regulating modalities of therapy also. I did “everything” but I do like neurofeedback best. I am not saying neurofeedback is a “cure for eating disorders” nor would I tout any non-evidence-based solution for anything. I know there are some neurofeedback providers who specialize in eating issues. They are an often-seen component of the constellation of trauma and neglect symptoms, so one must search out the trauma therapists that have a somatic modality to offer, (but one should do that anyway!)
The third major ingredient, I must add, is time. Because most of these conflicts go back so far, and neglect often goes back to preverbal ages, this rewiring does not happen in twenty sessions, unfortunately. My healing journey took maybe four decades? Oy vey, I don’t want to tell you it will take that long. Most of what we now know about the brain and about regulation emerged since the 1990 decade of the brain. And I know I am not the only one devoted to speeding up the process of healing.
I discovered cheesemaking at the ripe age of 63. I am 66 now. It bit me like a bug, out of nowhere. I found it to connect me to people all over the world, and across time, all of whom discovered that letting milk “rot” in effect, makes a glorious, nutritious food that enables fresh milk to last longer. I feel connected to cows, goats and sheep, and all milk producing females. And cheese is a living thing, requiring regular attention and care like a pet.
Perhaps most valuable of all, is that it has taught me to wait. Not passively. But taking the time, doing the daily practice of care, and waiting months for it to be ready, or at its best is the lesson. It is a hard sell, but like the work of healing, it is well worth the wait.
Meanwhile, I think I will go send Chef Jose another donation!
Each time I write a blog, I always try to think of a song that I love that goes with what I’ve written. This is a favorite of mine, a Cuban song sung by Silvio Rodriguez.
When I complained that other kids got money for doing chores or even getting good grades, I remember our dad used to say, “I want you to be good for nothing!” He thought it was funny. I didn’t think so and soon started going out and finding babysitting jobs. In those days the going rate was 50 cents an hour. I think a lot about “nothing” when I ponder and write about neglect.
The early world of neglect is a desert: an empty, cavernous and howling loneliness where nothing seems to happen. When I was anorexic and eating nothing, I would take note of the passing of each “meal time that wasn’t, as a way of knowing that the vacuous time had elapsed. The more I think about it, the more meaning “nothing” seems to have. And as I often say, one of the greatest myths surrounding neglect is that “nothing happened to me, so I have no business feeling so bad.”
I recently heard an interview with a successful young South African textile artist named Billie Zangewa, a Black woman who grew up in Apartheid. As I began to pay attention, I heard that her medium is patchwork, making collages out of bits of silk. She was presently working on a commission, a portrait of the fashion icon Christian Dior. She was pleased to point out the irony, or the synchrony of creating a “painting out of silk, of a man famous for his work in silk.” Looking up her work, brought back a flood of memories for me, about sewing and patchwork.
I have few happy memories of my mom, my favorite one is from when I was nine, and my mother taught me to sew. I loved to sew, it became a godsend, a way of regulating myself: focusing my attention on very fine and precise movements, and creating beauty. I was of the belief that “ugly people need to compensate by making beautiful things.” So, I made a project of that, and I was making clothes for everyone before long, with my mother’s vintage 1950 Singer “Featherweight.” My other happy memory, was my 15th birthday when my mom gave me the best gift ever: my own little sewing machine, a tiny little portable thing called a “Lotus.” I still have both my mom’s Featherweight and the Lotus. Thanks Mom!
I accumulated so much leftover fabric that I too discovered patchwork. Having little money, it was a way of creating something new and beautiful without having to buy anything, in effect it felt like “making something out of nothing.” I made my parents a large patchwork bedspread with an elaborate design that I made up, which they had on their bed for many years. I now have it in my home office, and you can see it below.
I did notice since I have been a trauma therapist, that I have had many clients who work in patchwork, as if trying to organize all the fragmented parts of themselves into a coherent, even beautiful and colorful whole. I have received several as gifts over the years, and I love them. Sometimes I think my mind is like a patchwork quilt, a random smattering of different shaped and colored thoughts, stitching themselves together into designs that may be interesting to me. Being a lonely child of neglect, most of my life it was a solitary bunting. I could hardly imagine that anyone would want to see it.
It was a way of creating something new and beautiful without having to buy anything, in effect it felt like “making something out of nothing.”
I have always loved ricotta, its simple fresh and light flavor and cool, both smooth and course texture that can lend itself to both sweet and savory. I was fascinated when I learned how to make it. Most people know that the biproduct of cheesemaking is the whey. The curd or milk solids that set and become cheese, separate, and the liquid that remains is the whey. It is amazing to me that when I make an 8-gallon batch of cheese, and end up with an approximately 8 pound wheel, I still somehow wind up with a good six gallons of whey. Many people, and probably most manufacturers just toss it, although there are many things you can do with it. Certainly, body builders know this. Well one thing you can make with whey is ricotta.
I learned that slowly heating up the whey, causes a cap of residual milk solids to rise to the top of the pot, becoming gradually thicker. It is an adventure to watch it form, the pressure of the rising heat, driving the thickening mass up. Smooth and bulgy, it takes its time, rising, rising. You don’t add anything to it, it is the simple whey. Watching the energy build, to my sex therapist mind, is reminiscent of the building energy of an orgasm. It begins rolling and roiling, and the finale is when the bubbling, mass breaks through into a boil. Then you quickly turn off the heat, cover it and leave it overnight. In the morning, I uncover it and skim off a thick layer of ricotta, drain the remaining liquid through cheesecloth and there is another layer in the cloth lined colander. Nothing added, just the simple whey that many discard: a good pound or so of ricotta. Again, like something out of nothing. I now have a treasure trove of recipes of delicious things to make with ricotta: cookies, muffins, scones, as well as all the most known uses like lasagna.
Taking it even further, I sometimes use the second generation of whey, after draining the ricotta, for bread baking, or even for boiling bagels. And I am told that tomato plants and lemon trees love it. So, there is great value in what seems like “nothing.”
I learned that slowly heating up the whey, causes a cap of residual milk solids to rise to the top of the pot, becoming gradually thicker. It is an adventure to watch it form, the pressure of the rising heat, driving the thickening mass up. Smooth and bulgy, it takes its time, rising, rising. You don’t add anything to it, it is the simple whey. Watching the energy build, to my sex therapist mind, is reminiscent of the building energy of an orgasm. It begins rolling and roiling, and the finale is when the bubbling, mass breaks through into a boil.
Clients often lament about all the “wasted” time. There is no denying the loss, and there is tremendous grief involved. The loneliness and vacuousness are no joke, nor are the many years lost to addiction, suicidality, depression, and the like. During the seeming eternity, required to heal, others appear to be getting on with career and family. There is no justice in it. However, I cannot deny that everything I have ever been through serves me, the supply of ricotta seems endless. Something valuable and beautiful can emerge from “nothing.” Zangzewa added in her interview, that the caterpillar works long and hard to create the cocoon in which it sleeps. The grand transformation is when the butterfly emerges. The cocoon is then cast off, tossed away like trash. The cocoon. however, she reminds us when spun apart, provides the thread from which silk is made. My ricotta chocolate birthday cakes are the best that its recipients have ever had! And I now know not to waste time, because I have a choice.
The song I have chosen to accompany this blog is:
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.
“Two country people were fishing in a river. As they fished and talked, they saw a child floating down the river dangerously close to the rushing waterfall. Fearing the child would drown, one of them jumped in the river and brought the child safely to the bank. But soon there was another child floating down the river, then another, and another. Soon the river was filled with children all heading toward the whitewater and waterfall.
Both of them rushed to save as many children as they could, but there were too many children, they would never be able to save them all. One of the two jumped out of the river and started running upstream along the bank. The other yelled “hey where are you going? we need to save these children.” The first yelled back “I’m going upstream to stop whomever is throwing them in.”
– Prevention Parable
For three decades the voices of #MeToo have echoed off the walls of my psychotherapy office. What a long overdue and welcome relief to hear them resound at long last, even be believed in the larger world outside. Gratified and hopeful though I am that the issues of exploitation, abuse and sexual injustice are getting wide mass and mainstream attention, I find myself thinking more deeply about its causes and prevention. Policy and punishment appear to be beginning and changing, and much more is needed than that, to interrupt a pandemic that is daily proving to be even more ubiquitous than we may have thought. I am interested in adding to our responses the major categories of education and treatment for perpetrators and all boys and men; and locating sexual health in all of its ramifications as a public health issue for all children and adults in our country. I for one, am old enough to remember the “false memory” movement where victims and their therapists were blamed and villainized for “fabricating” stories and symptoms of sexual trauma, attempting to drive it back into darkness and silence. We must all work hard to keep that from happening again, and prevent this devastating reality from slipping back under its cloak of denial into hiddenness and complicity.
A new perspective is emerging in the larger sexuality field. There is a budding movement to redefine the concept of sexual health from one that is value, moral, culture and pathology laden, toward a more thoughtful and subjective criterion that emphasizes consent, pleasure and self-regulation.
As awareness grows, we see the beginnings of progress toward changing attitudes, policy, and education about gender, power, sexual harassment and abuse. That is heartening. However, while the #MeToo movement shines a much-needed spotlight on gender and power inequality, it is also an aspect of a far more complex web of problems. By looking a little wider, at more of the issues in play, casting a wider net may garner a better shot at success. Awareness of exploitation and abuse of women and children is imperative, as are sanctions and consequences for perpetrators and sexual opportunists of all kinds. I propose that we also guard against solutions that are too simple, or become a contest that further divides men and women. Perhaps this pandemic of out of control sexual behavior, reflects a cultural crisis involving sexual health, that we may have a public health crisis on our hands. As in yet another parable, of the blind men and the elephant, viewing the parts in isolation, does not convey an accurate enough big picture, and will certainly fall far short of our goals. We need to sort and study in depth the various issues, integrate them, and then put the mosaic together. While with certainty for many men who exploit, abuse and intimidate women, sanction and punishment are the only appropriate response, I also see a fundamental imperative to put sexual education and sexual health through the lifespan on the national public health agenda.
Still, however, sexuality in the larger world, and even in the relatively progressive Bay Area, continues to be sensationalized, commodified, pathologized, mystified and globally titillating, with there being a poverty of information. Although it has become routine to see advertising for sex enhancing medications and other products, most people have a limited understanding of what is sexually realistic or “normal.” I am repeatedly dismayed by clients’ reports that the oncologist treating their cancers; the psychiatrists treating their depression; even their couples’ therapists do not educate, inform them, or do not inquire about sexual function and satisfaction. Because their helpers do not initiate the dialog, they conclude either that it is wrong to ask, or that they are simply supposed to know.
My career began in the 1980’s when the Women’s Movement had recently given voice to violence against women and children. My work with sexually traumatized women took me down an unexpectedly winding road. Realizing how difficult a relationship was for my clients, I became a busy couples therapist, then sex therapist. Sexuality was so difficult for so many of these traumatized women, that it became a focus of my attention and my work.
The advent and rise of the Internet brought with it what every “new” technology and medium of communication historically had: it became a vehicle and a new commercial avenue for sex. Pornography in every imaginable and unimaginable iteration appeared, and it became a widely discussed and often sensationalized topic in the world and in the field of sex therapy. It certainly began to show up in my office, with partners or spouses wondering or worrying about what it might mean. Is porn use cheating? Is it patholological or damaging? How much is too much? Due to “Accessibility, Affordability and Anonymity” people could spend inordinate amounts of time watching it and many did. A literature and treatment industry soon mushroomed around pornography in both professional and mass public realms, with little agreement or data supporting it. In my office, I witnessed the pain, suffering, shame, humiliation, confusion anger and despair of couples, where one partner, (in my practice usually male) repeatedly hurt and betrayed a spouse he truly loved. Both were baffled and desperately dismayed that he would not or could not stop. Then I began hearing about other activities: affairs, sex for money, anonymous sex with strangers, empty “hook-ups” and all taking place without explicit agreement between the two who sat in front of me.
The specifics of the sexual behaviors varied, but the consistent element was what came to be described as a kind of split Self. Essentially the sufferer (or perpetrator) was of two minds: there was a part of the Self that did not want to engage in the behaviors in question, were even repelled and ashamed of them; and another part that irresistibly did. I saw this often in my practice, and it is an experience known to most of us where the warring pull of temptation versus a commitment, value system or priority seem to agonizingly tear the individual apart. The battleground of the two parts in this case was the body and sexual behavior in question, be it infidelity, or some other variation on betrayal. I have seen a broad range. The problem was often less the specific behavior per se, than the drive to repetitively do something in spite of its impact, its consequences and against one’s better judgment. Often these individuals were betraying their own deeply cherished values and morals, and rather shocking themselves. For myself, I struggled and searched for an understanding and an approach that would help both clients and their partners make sense out of what seemed incomprehensible, and maybe even find a way to navigate through it together. No small feat, especially as often the impact on the betrayed partner is many faceted and profound.
2015 brought the seminal work of Doug Braun Harvey, who with his co-author and collaborator Michael Vigorito wrote a groundbreaking book on what they termed Out of Control Sexual Behavior or OCSB. They brought a different lens to the problems of sexual harassment, opportunism, exploitation and abuse, building a coherent and dignified conceptualization, and a treatment approach. The centerpiece of their work is a concise definition of sexual health, which is also its heart and soul.
Sexual health consists of a framework of six essential and non-negotiable principles. Within the frame of those principles, individuals and couples determine for themselves what their sexual activities are to be. For many individuals and couples, these concepts are astonishingly new and they have never thought about them or discussed them. In fact it is remarkable how many couples have barely if at all talked about sex, or their sexual relationship. We live in a world where we are bombarded with sexual stimulation and sexual myth, and information is at a minimum. Doctors and surgeons, prescribing physicians and psychiatrists, teachers and even therapists more often than not fail to speak or educate about sexuality. The majority of clients I have seen over the decades, if they have had any relevant sex education at any time in their early or adult lives, it was pitifully lacking. So I found the six principles to be a surprisingly useful teaching tool.
First and most important of the six principles, is Unambiguous Consent. By unambiguous consent we mean, beyond “No means No!” that unspoken “deals” must be spoken about. If he buys me an expensive dinner, what do I “owe” him? Is it true that revealing attire means “I am available?” Is it “fair” to change my mind? What is the impact of mind altering substances on consent, even if the substance use itself was consensual? And power differentials are a game changer. “What will it cost me if I don’t do what you want?” And “What do I want to do about that?”
Consent is a huge, complex and multidimensional topic, and I view it as a vital component and expression of care and empathy. I teach couples to practice “informed consent” about most anything; as a way that we acknowledge, honor and create equality around differentness. Even something as fundamental as when we discuss any difficult or personal matter, is a point for consensual agreement. In the larger world, consent is complicated by many factors, the most obvious of course, is power.
The other five principles are:
Non-exploitation: This of course means a commitment to being ethical, thoughtful and respectful of the integrity, rights and preferences of all parties to the interaction. It also considers what might be a power inequality between the two parties that could complicate the question of consent. I have also found that as with so many concepts, definitions of what constitutes exploitation, vary widely. Some individuals view pornography and paid sex as categorically exploitative of the sex worker. Others do not. Again, individuals and couples must elaborate and agree on their terms.
Protection from HIV, STI’s and Unwanted Pregnancy: Shared responsibility for safety and equality in all its forms.
Honesty: A commitment to transparency. So often the worst injury in sexual predation and betrayal stems from deceit, of intention, motivation and meaning. I have certainly also seen couples disagree on “lying by omission,” which also needs to be explicitly negotiated.
Shared Values: Sexuality is tied to a vast range of diverse philosophical, moral and religious meaning systems. Gender, exclusivity, sexual frequency, even preferred sexual acts for example, are all personal and subjective, and must be known, negotiated and compatible.
Mutual Pleasure: Not to be forgotten, with the emphasis on mutual.
If the whole world operated on these principles, OCSB as well as the entire #MeToo phenomenon and all its abusers, would pass into grim history.
Beside the Six Principles, the authors detail the problem of “split Self,” of being of two minds, which can result in unwanted sexual behavior, and the emotional and relationship difficulties and disasters that it can bring. Numerous devastating examples of have flooded into my office over the years. Braun Harvey and Vigorito developed an approach consisting of individual, group and couples education and therapy, emphasizing accountability, self regulation and relational integrity. I found their framework to be of great use to me, and many of my struggling and suffering couples.
Self regulation is a concept that is becoming more and more a part of the mental health lexicon as we finally come to better understand the role of the brain and nervous system in human psychology and health. It would seem like a “no brainer” that the brain profoundly shapes the mind, but it has been a long time coming. Self regulation boils down to maintaining balance and control, a fundamental ability that is most noticeable in its absence.
Regulation is the balance between energy and rest, intensity and ease, excitement and calm, sympathetic and parasympathetic: the ability to rev up when appropriate and then settle down. As children we rely on caregivers to oversee or manage these functions. Under the best of circumstances, children are soothed and comforted by parents, their fears and worries are eased, their frustrations and anger tempered or contained by a good parent. As children, we need first to be taught to identify, name and effectively express impulses and feelings. With maturity, we ideally learn to manage our energy, our activation, our impulses, ourselves, to self-regulate. A “regulated” nervous system, is one wherein individuals can control and choose how to behave. Rather than rely on external rules, we ideally become able to trust an internal mechanism of control. Of course none of us do it perfectly. We all have the occasional emotional outburst we regret, the impulse to overspend, the one too many brownies.
The same is true for sexual feelings. Pioneer sexuality educator Betty Dodson teaches that parents’ normalization and acceptance of children’s sexual feelings, and helping them to understand and manage them, are the fundamental building blocks of later sexual health. In the world of sexuality what can feel like a runaway train to an adolescent, becomes manageable to a regulated adult.
In a world where couples rarely talk about sex with each other, let alone their children; and sex education in schools is minimal at best, this is all too rare. However regulation, within a solid sexual health framework, provides a foundation for individuals and couples to thoughtfully, honestly and intentionally evolve and negotiate their arousal and their own erotic palette. That would be a worthy goal.
Bill Clinton rose out of a matrix of parental alcoholism and violence to become a Rhodes Scholar and Yale Law School graduate. He went on to become the youngest governor in the nation at 32, an age when I was barely emerging from drugs, sex and rock ‘n roll. Elected president in 1992, at just 46, he was arguably the most powerful man in the world, a success story at the pinnacle of success. Why would he risk it all on scandalous, wanton sexual behavior with someone who apparently meant little to him?
Bill Cosby has dominated the sexual predator stage for some years, with one after another of his alleged victims speaking out before his conviction this month on three counts of aggravated indecent assault. But before that downfall, Cosby was also another great American success story. “The Cosby Show” was TV’s biggest hit of the 1980s, earning him the moniker “America’s dad.” He also earned a doctorate in education from the University of Massachusetts, and became a widely followed civil rights activist. Popular, rich and famous; with a beautiful family, he appeared to have it all. Why would someone like this have to drug women to have sex with them? Or why would he want to have sex with unconscious women?
Al Franken, Kevin Spacey, Anthony Weiner, Charlie Rose, Eric Schneiderman, Woody Allen… What is wrong with these men? And how many men, famous or not, powerful or not, “good souls” or “good spouses” or not, are fractured by split selves, and out of control? With the statistic that one in three women are victims of some kind of abuse, harassment, rape and other unwanted sexual attention, it is clear that these men are but a fraction of those who perpetrate.
As a trauma therapist, I have seen the gamut of wildly dysregulated sexuality, from frozenness in seemingly endless sexual impasses, to erotic extremes of every imaginable and unimaginable ilk. I see plenty of “split self” sexuality in the traumatized. Braun Harvey and Vigorito, agree that trauma may be a factor in Out of Control Sexual Behavior some of the time, but certainly not in all cases.
I asked Braun Harvey, “What do you think about this #MeToo phenomenon from an OCSB standpoint?” He replied that sadly, for the most part men do not talk about sexual health, unless they have either been victimized or have themselves already perpetrated. Men’s conversations about sex tend to be limited to what our president referred to as harmless “locker room banter:” competitive, posturing, vapid. Beyond that, even though bombarded with Viagra advertising, most men know very little about what is really “normal” and what other people are doing. Couples commonly don’t talk about sex in any meaningful way. It is time to begin a national discourse about sexual health.
Braun Harvey continued that consent as a concept is largely not broached until it becomes part of a conversation about sexuality, and even then not nearly enough. The broader implications of mutuality, consideration and equality are weak at best in our culture, which was been built largely on the motifs of self-reliance and rugged individualism, not to mention slavery.
In 2001 our then Surgeon General, the enlightened David Satcher issued a “Call to Action to Promote Sexual Health and Responsible Sexual Behavior.” Not that different from Braun Harvey’s formulation, it went as far as to place sexual health among both our nation’s values and rights. Education, policy and accessible services must make sexuality as safe, just and dignified, as all other matters of health.
“A major responsibility of the Surgeon General is to provide the best available science based information to the American people to assist in protecting and advancing the health and safety of our Nation,” Satcher’s call proclaimed. “This report represents another effort to meet that responsibility… These challenges can be met but first we must find common ground and reach consensus on some important problems and their possible solutions. It is necessary to appreciate what sexual health is, that it is connected with both physical and mental health, and that it is important throughout the entire lifespan, not just the reproductive years. It is also important to recognize the responsibilities that individuals and communities have in protecting sexual health. The responsibility of well-informed adults as educators and role models for their children cannot be overstated. Issues around sexuality can be difficult to discuss because they are personal and because there is great diversity in how they are perceived and approached. Yet, they greatly impact public health and, thus, it is time to begin that discussion… We need to appreciate the diversity of our culture, engage in mature, thoughtful and respectful discussion, be informed by the science that is available to us, and invest in continued research. This is a call to action. We cannot remain complacent. Doing nothing is unacceptable. Our efforts will not only have an impact on the current health status of our citizens, but will lay a foundation for a healthier society in the future.
Dr. Satcher cited in his 2001 report:
A 2007 federal study on abstinence education found that these programs had no impact on the rate of teen sexual abstinence. Rather, teens in states that prescribe abstinence education are actually more likely to become pregnant. 1 in 4 teens in the US receives information about abstinence without receiving any information or instructions about birth control. Among teens aged 18–19, 41% report that they know little or nothing about condoms.
The chilling rates of child sexual exploitation have not changed much. In a 2015 report:
Clearly it is time to dust off and revisit Dr. Satcher’s call, and resuscitate sex education that will enable boys and men to make sense out of, and speak about confusing sexual feelings; or desires and impulses they don’t know how to manage before they perpetrate. Girls too, besides learning about consent and equality need to learn about what problematic and out of control sexuality look like. In others and in themselves. Identifying a problem and ready access to help that would not be shaming or stigmatized might prevent a lot of damage to self and others. These discussions might begin in the elementary grades.
None of this is in any way intended to let #MeToo offenders off the hook, or excuse sexual harassment, abuse or violence. Quite the opposite. I believe we must continue to make the policy and legal changes that will stop the Harvey Weinsteins, and Larry Nassars (the Physician who abused generations of young gymnasts entrusted to his care,) and protect and prevent children and adults from any unwanted and/or exploitative sexual attention or activity. Parenting classes might expand to include sexuality and sexual health as important parenting responsibilities. And besides making it safe and effective for children and adults to report their experiences, we need sexuality education that covers both wanted and unwanted sexual activity, and the nature of out of control feeling and behavior. Rather than hide and continue it, those afflicted will be able to recognize it; and know that help is available before they do harm, or more harm. And we need to make sure that help is readily available. This means training health care and mental health professionals including school counselors and other key adults at schools, about diagnosis and treatment that are positive, sex positive and effective.
When the infamous pussy grabbing video burst on the scene in 2015, I thought for sure candidate Trump was finished. As a professional, a woman and a civilized human being, I just could not fathom that a man who did and said such a thing could become the president of the United States, there was simply no way he could continue to advance toward the White House after such an affront.
I was shocked and horrified to see how wrong I had been, and that men still impress and amuse each other with “conquests,” and not only in locker rooms. That furor died down. Other shock and horror has followed. And I am concerned about the real change that needs to take hold. I don’t want our cat-eared pussy hats to migrate to the back of the drawer. I don’t want the cries of #MeToo to fade again into silence without the essential response: a response that will include sanctions and reparations for wrong-doing.
The renowned neuroscientist Antonio Damasio, in his most recent book, tracks human evolution back to the earliest bacteria. He posits that it is feeling, the experience that something is “wrong,” something is out of balance with well-being and preservation of the species, that impels the organism to find the correction that will restore health. That, in conjunction with natural selection, brought us from our forebears – those early bacteria that were even without nuclei – to the conscious, complex-brained, and hopefully self-aware beings that we have become. Damasio seeks to create more respect and value for feeling as being fundamental to the advance of healthful life. We need to teach young children to recognize the feelings associated with “good touch” and “secret touch;” older girls to recognize and understand the feeling of unwanted or exploitative attention; and sufferers of dysregulated arousal and sexuality to identify the feeling that something is awry in their bodies. All of this before injury and shame has calcified in these young, and older bodies. It is my fervent hope that we can use the outrage of the #MeToo movement in that direction. This would include parents, teachers, coaches, employers, managers, employees, chefs, bloggers, celebrities, policy makers and of course all health and mental health professionals, all speaking up for sexual health. I guess that is most of us really.
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 the recurring devastating dynamic between a couple I work with, a memory from my own life bubbled up. For those of us who have the minimal and spotty memory of early life, typical of neglect, these little forays into memory are rather like wandering through a curio shop. Much of what is there is uninteresting “junk.” But occasionally there is something surprising, or worthy of a closer look. Out of nowhere I found myself reflecting on a joke my father used to tell.
Our dad had a very quirky way of telling jokes. He thought he was pretty funny, but I remember also seeing a book by Henny Youngman a Jewish comic of that generation, and sometimes other joke books lying around, so he must have studied a little bit to make himself a more entertaining singing-waiter back in the day, and later in his profession as a cantor. When he told a joke, the “body” of the joke was unremarkable. But as he approached the punchline, he would burst into peels of laughter, to the point that he could hardly get the words of the punchline out. It would take a few tries. By the time he actually told us the punchline, we were all doubled over with contagion laughter and barely heard it. Then he would repeat the punchline maybe six times, and we would all be in stitches. In “ordinary consciousness,” it may not have been funny at all, but these moments of family hilarity now seem somehow sweet.
I remember one joke however, well I don’t remember the joke, I just remember the punchline, which was an emphatic “Ernest, Answer me!” And for some reason I just did not think it was funny. Ernest Ansermet (pronounced like “answer me”) was a world-class Swiss conductor of our dad’s era, a contemporary of Debussy and Stravinksy, so it was a play on words. But to me, a wife being desperate for her husband to just speak, was anything but amusing. I found myself remembering with a chill, the urgency, even terror I felt when the loved other would clam up, withdraw, or appear in a word, to abandon me.
Even before we got the PTSD diagnosis, neuroscience and psychology, and ultimately all the rest of us, were familiar with the “fight-flight” response to fear and trauma, even when we had little understanding of what trauma was. Later we learned that there was an additional adaptation or reaction to danger or fear: the “freeze” response. (We have since learned of a number of others, but those will be for another day). The freeze is the response to the “inescapable shock” situation, when fight and flight are simply impossible, like in the case of chronic torture, or abuse in the home where the nightmare does not stop, and the child cannot leave; or a prey animal being cornered and trapped by a larger, stronger, or faster predator. It also may be a kind of “death feigning” where the prey animal pretends to be dead so the predator will lose interest and just go away. Most predators don’t want to eat dead prey.
In the case of early neglect, the child learns early, that there is no point in crying or protesting, because there is no response, certainly not a favorable response. So withdrawal into the self is an understandable adaptation, and most likely becomes a default. If I know I have no impact, why bother? I might make myself more of an irritant or a blight than I already experience myself to be, or just simply call attention to myself which may not be such a good idea. Of course these are not “cognitions” or thoughts per se, as the cognitive apparatus is not nearly developed for a long time. But they are “procedural” or bodily, emotional or sensory modes that are installed rather like software, through experience. And they are stimulated in sensory ways at points later in life, so not experienced as “memory”.
One of the most devastating experiences that a young child can have, is what I refer to as the tragic poverty of “mirroring”. Mirroring is where the child experiences being seen, heard, and known, and in effect, “felt.” “Feeling felt” or an empathic reflection back to me, of what is accurately and receptively “me” is how I come to know who I am, and also how I learn to recognize and express feelings. The child of neglect has little or no experience of being mirrored. And without that, there are gaping holes and blank spots. As a cheese maker I object to these holes being likened to the holes in cheese. In the cheese-making world, those highly desirable, elegant markers of a good “Alpine” cheese, are referred to as “eyes”. In neglect, they are more like ravenous caverns of emptiness and hunger. They might be experienced as dull flatness, physical hunger, or some other misguided attempt at getting “filled up”.
As a result of the failure of mirroring, the child misses out on an emotional “education”. The capacities to perceive, identify and express one’s own emotions, and the emotions of others is minimal at best, as is a comprehension of why that would matter anyway. If the child is male, US and western culture will re-enforce a cognitive or “logical” default, and possibly devaluation of emotion. Although neuroscience has taught us that emotion is an important aspect of cognition and even coherent thought, that can be a very hard sell. Meanwhile if my partner is unexpressive of their own emotion, or rather oblivious to mine, if they are a child of neglect, it may be, not because they don’t care, but literally that they can’t – or not yet.
Powerful change is possible in psychotherapy. In a well facilitated couple’s therapy, a child of neglect can experience strong emotion safely and learn to comprehend and process it. Through experience some of the important brain areas are helped to develop later in life. Neurofeedback is another royal road to emotional intelligence, as it might bring relevant brain areas into connection with each other. None are a quick fix, and like working out, take consistency and practice to sustain change.
Of course, it can be very confusing when there is both early shock trauma, or incident trauma and neglect, which is most often the case. A child most likely cannot be assaulted, beaten, or somehow ravaged, with an attentive, caring protector present. Or if they are, there is a caring and comforting response process that can make a world of difference in impact of the injury. Often the failure of having a place to turn with the traumatic event is even more traumatic than the injury itself. When there is a history of both: incident trauma and attachment trauma/neglect, often the default for that child is fight-flight.
In the couple we opened with (a heterosexual couple although that need not be the case;) she had a tragic history of both. When he seemed to go silent and withdraw, she would vociferously protest. Her loud cries would awaken in him a helpless overwhelm, that left him speechless. When he did not speak, she would panic, and get louder and more shrill. He would withdraw farther. She would by now be semi-hysterical, running from a tiger, unaware of how both extreme and critical her screaming was. He felt so ill equipped to do anything to make it stop, that sometimes he would leave the room, the house, even leave her somewhere. I have seen couples mired in this dynamic where one partner was left on a dark street in an unfamiliar town, and the other drove off. They persisted a long time in their agonizing pattern. When this unbearable dynamic would constellate in my office, as it could on any topic, I could feel the sense of life-threatening emergency of both in my own body. It could begin with either partner. (And that was a hard sell indeed!). Both felt terribly victimized by the other. It might take weeks to recover. Both were desperate to learn what to do. These two were not unique by any means.
So, what is to be done? Well, there is little hope of convincing anyone that no one is to blame! At least not while activated. I always tell people, “The reason why you have me, is so there is one person in the room who is in present time! Everyone else is deep in their traumatic history. But there is no way to say that when we have two brains deep in trauma. So, what to do?
First of all, quiet the nervous system enough so the thinking brain comes back online. I might as well be “passing gas” in the wind, so to speak as to try and teach anything to anyone in that state. It is even hard to do this much, but I try to teach them: “stop action!”.
Take a break and breathe. Your breath is your best friend. Your inhale is ‘sympathetic’ or stimulating. Your exhale is ‘parasympathetic,’ or calming. So looooong exhale. I recommend closing the eyes, breathe in on six counts, out on nine, and do that, ten times. No one leaves the room.
It is hard to teach this, but as we learn to revisit the tragic stories of those two little kids, it eventually becomes easier. If from the quieter state, either one is able to say, “please talk to me…” or the other is able to say simply “I don’t know what to say,” or “I was afraid if I said anything I would make it worse…” a gentle truce may become possible. That is our goal.
I always wondered why I loved that old song by Peter Gabriel, “Please Talk to Me!”.
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.
Driving to work one day last month, I heard a snippet of news about a young man named Spencer Elden, now 30 years old, suing Nirvana and Kurt Cobain’s estate for a 1991 photograph of him, taken and used without his consent. He was a four-month-old infant then, he was naked, and the photo was displayed on the cover of a Nirvana record album. “What if I wasn’t OK with my freaking penis being shown to everybody? I didn’t really have a choice.” Elden’s father received $200.00 at the time for the photo. No papers of any kind were ever signed. The album ironically called Nevermind, sold thirty million copies. It is still in circulation, with the photo. When I went to Amazon to have a look at it, admittedly, I was nauseated.
I remember when I was pretty young, probably not much more than 8. My dad got certified to be a “Mohel” in Yiddish pronounced “Moyel.” The moyel is the religious officiant at a “Bris” or circumcision. I remember being shocked at the time that an 8-day old infant was subjected to “that”. And my memory from that the time, is that no anesthesia was administered, with the rationale that an infant would not remember. We now know that although the brain’s anatomical capacity for autobiographical memory is not developed yet in an infant, and certainly not an infant of 8 days old, the emotional and physical imprinting may very well be. We certainly see experienced in therapy “procedural” and emotional memory from many ages where the cognition is missing.
With survivors of childhood neglect who often remember so little from their often very empty childhoods, that is much of what we have to go on, to re-construct a narrative of their lives. At the time that I first learned of this, I was horrified. I did not understand what difference it makes whether the child does or does not remember the pain. Would that mean it does not matter? The agony is real NOW! My 8-year-old mind was confused and shocked, and I didn’t get it. Apparently now, according to Wikipedia, anesthesia is recommended. I also could not understand why my dad would want to do that. Never mind the dignity, safety, or comfort of that little being.
As the research progresses about trauma and developmental trauma, we are coming to understand that the injury of being ignored, unconsidered, forgotten, not known, neglected, may be the most profound injury there is. Although I am not one for “comparing” trauma, i.e., who has the “worst worst?” because of our evolutionary design where attachment is so fundamentally wound in with survival for our species, it makes sense. Of all mammals, humans remain dependent on the primary caregivers perhaps the longest. We are hard wired to be connected, and when we are not, or not in a way that we can feel, the suffering and the deficits are profound.
I remember perhaps forty-five years ago I read a book called Hope Under Siege: Terror and Family Support in Chile. It is interesting to me how certain things stick in memory when so many of the countless good books I have read over my long book-worm years, are long forgotten. I read it before I came to psychology as an area of study, long before I knew anything about attachment or trauma. It was during my impassioned anti-imperialist years, a book about political prisoners held in the horrific prison camps during the months and years immediately following the fascist Pinochet coup in Chile on September 11th, 1973. The prisoners were brutally tortured, often with electric shock. I won’t go into specifics here, but I remember being haunted by the accounts and often literally kept awake by the images that lingered from reading about them. The prisoners of course were desperately isolated and alone. For all their families knew, they had “disappeared” and many of them in fact were never seen again.
What the book described, which made so much sense to me even then, was that the prisoners who had strong family ties, who could feel the connection and support inside of themselves, even when they were far away, even when perhaps the family had no idea where they were, those were the prisoners who did not “break” under torture. Those were the ones who did not give away any information that betrayed or compromised a comrade. Certainly not all of them, but the premise of the book, was that strong family connection, that is deeply internalized, can be sustaining under even the most dire of conditions. Although PTSD was not yet understood, let alone named or defined then, I am guessing that those who survived, of the securely attached, fared better in PTSD terms. That is just a guess.
We do know however, that certainly childhood trauma in the family, and often even outside of the home, cannot happen when someone is paying attention, watching, noticing, protecting, and taking care of that child. And the response of the parent when the child does tell, if that were to occur, is critical to the outcome. If the parent is minimizing, dismissive, unconcerned, or denies the child’s experience, that compounds the trauma, or may even be worse than the original traumatic event. And that happens way too often. “Oh, never mind” is an attitude. We want to forget or deny the unbearable.
Mr. Elden disappeared from the news. Who? Forgotten almost immediately after he made “interesting” news for a minute. The cycles of news are fickle and quick. We are distressed or moved by something for a minute, until another sensation comes along to take its place. Michael Brown, Eric Garner, Spencer Elden, out of sight, out of mind. It is the essence of neglect.
Hope Under Siege is long out of print. I finally found a copy on eBay for $72.00. I will be interested to read it again.
My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” is now published. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.
Early in my career, when I was in a post-graduate training program and just beginning to see clients, I remember when one of my first clients gushed hyperbolically about how wonderful I was. I was dazzled and delighted. “Maybe, just maybe I will be good at this!” I thought. When I proudly told my supervision group what she had said, a woman in my group, a year ahead of me in the program sarcastically retorted, “Isn’t transference grand?!” I went silent, feeling deflated and ashamed. And although at the time I thought she was snotty and mean, I never forgot her words.
Transference is the projection onto the therapist of feelings for a real or longed for important other, commonly but not exclusively a parent. What my colleague was reminding me, or telling me, was “It’s not about you, Dummy!” Also, we invariably come crashing down from the proverbial pedestal, to become worse than scum. I have since come to understand, how these projections can be some of the richest sources of information about a client’s often unremembered past. Neglect leaves such gaping holes in interpersonal memory, that other media of communication than the spoken word become the requisite vehicle for the telling and reconstructing of personal narrative.
I remember one client telling me, “I really don’t remember anything about other people. When I try to remember my childhood, I just see bushes, and maybe our various dogs.” We slowly began to learn her story by studying her present relationships, and dynamics she did remember.
It is curious to me, that as I find with many of my neglect clients, although I have blank or spotty memory about my childhood, I have vivid memory of books. I remember from second grade Sunday school a picture from a Bible Story picture book of Abraham smashing the idols. We were learning the Ten Commandments and the concept of “One God.” In Jewish synagogues there were to be “no graven images” meaning no images or statues of human subjects who might be attempting to upstage the One God. Abraham, in the picture, a young boy, not that much older than me, in his little toga with a stick thrashing the white marble statues to the sanctuary floor. I remember thinking this was very strange. The lesson was, we were not supposed to worship idols. Somehow I did not quite get it.
I was always a hero worshipper. I could not seem to find real people to connect to, I just did not know how. But I would create them out of some raw material that I found in the environment, and invent the relationships I did not know how to have. When I was about 12, my “first love” was Thomas Wolfe. He was an author who wrote mammoth 500-600 page novels, known to be autobiographical, where the protagonist was depressed, intense, insatiable, creative and desperately alone. Wolfe the writer died at 39. So even though he was dead, I believed I had found my match, he was like me, I was not the only one. Wolfe was from Asheville, North Carolina. It was on my bucket list to go to Asheville, see his home and the birthplace of all these stories that filled my world.
In 2012 I had the opportunity to go to Asheville for a Neurofeedback training. I was delighted! By now it was 45 years later. I had a different brain and a completely different relationship landscape, thankfully. I booked a hotel across the street from the Thomas Wolfe House, the boarding house Wolfe’s mother ran, that featured in all the books; and where the real people had lived. I spent a day taking pictures of everything there.
In the gift shop I bought a little miniature of the marble angel made famous in the title of his book Look Homeward Angel; and a 560-page biography. After the training I eagerly devoured the biography in the same devouring way that Thomas Wolfe the man had related to most people and things. I learned from the biography, that he was a misogynist, he was an alcoholic, he was antisemitic, he was racist. What was I thinking? Who was that young girl?
I recently heard Bessel van der Kolk say, “idealization is a defense against terror.” I was terrified that I was a different species, that there was never and never would be anyone like me. In my quest for a partner or twin, I had to make someone up. Wolfe was the clay. The void left by neglect is so gaping, it terrifies. We have to fill it with something besides bushes or book illustrations.
In my twenties I became politicized. By then I had given up on being seen or known by my parents. My father’s suffering and his hero story or overcoming his suffering and making a successful life, became the model. But I also was angry and rebellious. I wanted to get his attention and approval, but I also disavowed that wish. So, I chose something that would perhaps outrage or anger him. At that time democratic governments were tumbling all over Latin America, smashed by military dictators not unlike Hitler. I adopted an identity as freedom fighter, out to overthrow fascist rulers, and perhaps even die doing it. The ideal was Ernesto “Che” Guevara.
Originally from Argentina, Che grew up with privilege and became a doctor. But he sacrificed everything to be an internationalist fighter, who led the Cuban people to freedom and died doing it. Perfect! That was who I wanted to be. The new female version of Che. Ever trying to fill the empty void left by neglect, find an identity, a way to be like my father, but not too much. To be seen and known, respected and loved. And with luck to die doing it, a noble way to end the pain. I tried to do this and had a terrible psychological crash doing it, which ultimately led me to psychotherapy.
The child of neglect, lacking a mirroring other, has no self to be. I have shown Ruth Lanius’s shocking brain scans of the child of neglect, whose brain is firing faintly if at all. The default mode network which is the home of the sense of self, is virtually missing entirely. “Without a self” as Lanius reminds us, there is no other. So we continue to create some version of relationship, but being distorted and alienating, they don’t last. Like many survivors of neglect, I left a trail of relationship wreckage behind me, until I finally attached to a therapist, and stayed for many, many years. I am happy to say I now have very fulfilling and mutual relationships, a partner of 35 years, and dear friends. But I did not grow the circuits in the way we were designed to. That is the task that neglect leaves us with. And that is why we must learn to become the therapists that can heal this.
In Cuba I saw a billboard that said “Seremos Como Che,” This means we shall be like Che. The emphasis is mine. We will aspire to emulate, but not to be him. The void of self is devastating. The tragic impact of neglect. Getting a spine, getting a voice, big tasks. And big tasks for the therapist to learn all the possible access routes to assist. We must also resist the temptation to buy into the inevitable projections, positive and negative, or even to recognize them when they occur. Another reminder of why the therapist who works with neglect, perhaps even more than any other therapist, must do their own personal work. We don’t want to miss that boat like our clients’ parents did!
My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on the 31st August. 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!