As all who have been in the world of trauma, whether as clinician, researcher, survivor, or some combination thereof know, the area of greatest injury to life and to function is the domain of relationship. That has certainly been the crippling pain, anxiety, shame, or simple cluelessness most likely to bring people to my therapy office door, and was certainly true for me. As mammals, attachment, connection, and interdependence are primordial, fundamental to survival. That would begin to explain the urgency and despair we experience in its absence.
As human beings, love and relatedness are at the heart of what makes life most worth living, as exemplified in our art, music, literature, and all other media of expression around the world. It is a great motivator. It is the pivotal and most often missing ingredient in childhood neglect, especially in the developmental or earliest incidence of neglect, which is so much of what I see. By early, I mean the very tender and, of course, “unremembered” infant months and years. I say unremembered cautiously, because the desolation and uncertainty of isolation are in fact on record in the nervous system and the body. We know that by now, yet it is so “easy” to forget.
For many adult children of neglect, their mechanisms of compensation and disguise may be more skilled than what is turned out by the world’s top makeup artists. The void behind the facade of high function and success may thus be elusive to the naked eye, even to the self, at least some of the time. Because solitude becomes a default and even a “cozy” hiding place, it would be easy to chalk it up as being an introvert or “highly sensitive person” until some undeniable symptom compels attention, appearing in the form of a dramatic emergency – for example, my anorexic downfall, now almost 55 years ago to the day. I literally fell crashing out of my hiding place, certainly not on “conscious” purpose. Alcohol became another good clue if anyone had had a road map, but as has been endemic with neglect, nobody did
I flailed for a long time in a punitive world that lacked the psychological, neurobiological, and clinical options that we are now increasingly beginning to have, although critically insufficient. And I had the privilege of being white, middle class, with access to good schools and libraries to hide out in, which I liberally did. Even now, I often exclaim spontaneously to my husband, “I am so glad we live indoors!” I truly am, and so grateful.
I remember thinking I only began to learn how to be a “regular person” when I got my first waitressing job and spent enough hours with “regular people” that I could learn how to talk about movies, sports, television, and mainstream activities that I felt so ambivalent and clueless about. Of course, alcohol became a great companion in the process, as not only did it make it easier to fake it, but it also made me not care as much. Later on in therapy, I (not infrequently) would ask my infinitely patient therapist “So what do people do when…?” When they are at home in the evenings with their families, or on vacations with others? I still had only the vaguest clue.
I routinely admonished myself, “I just can’t get along with humans!”Although I have bristled against the term “impostor syndrome” dismissing it as too “pop psychology-esque,” it is probably too close to home. I was undeniably aware that I felt for many decades as if I was indeed of some other, probably mostly extinct and certainly less evolved species.
Central to the experience of childhood neglect is a devastating conundrum, a Gordian knot that, for many, plagues and tortures them throughout their lives if it has not been vanquished by early and prophylactic numbing (which it all too often is). Attachment researcher Mary Main has aptly called it the dilemma without solution: when the source of infant comfort and the source of terror are the same – the essentially needed primary caregiver.
Abandonment, loss, and the absence of connection feel life-threatening which, certainly at the most vulnerable stages of life, it actually is. That is where the other side of the dilemma is congealed or constructed: the impenetrable Fort Knox of self-reliance. It is the safe house, the bomb shelter, the default survival mechanism until it breaks or fails, which it often does. The results are all too lethal both for the child of neglect themselves and for others in their wake, as we are all too often seeing these days as the disenfranchised “go off” and act out violently in the world. So many reasons that I am adamant about helping the world become “neglect informed.”
Neuroscience is forcing us to understand the profound and developmentally crucial impact of attachment on regulation.
Neuroscience is forcing us to understand the profound and developmentally crucial impact of attachment on regulation. Regulation is the management of energy in the organism, the balance between high and low-frequency electrical activation in the brain, sympathetic and parasympathetic, stress and calm, terror, rage or nameless anxiety, and a quiet return to a hopefully comfortable baseline. A flexible and adaptive flow and a reasonable level of control over life’s inevitable vicissitudes is the great blessing of secure attachment. It is the gift of the good enough caregiver, and increasingly we are coming to understand this. Even the larger, non-trauma specialized psychotherapy field is increasingly learning this (no disdain intended.) Regulation is profoundly necessary, and sadly, far too rare. The mainstream is all too slowly connecting the dots, often failing to recognize the devastating damage of the desperate attempt to find regulation somewhere to the self and others, especially when it has not been learned at the developmentally appropriate time. Discomfort, terror, rage, or sheer amorphous compulsivity fuels the search for a way to manage unbearable ups and downs.
Because the feelings and isolation are so often points of shame, people often ask, “What is wrong with me?” How many “friends” one has, certainly in the time of social media, is a measure of “value” or self-worth, so the isolated may be even more ambivalent than usual about their need.
Interpersonal need is so lethal that the child of neglect keeps it carefully locked away, often even from themselves. Because they might look good on the outside, helpers and the world at large readily miss the cues, or do not even imagine such an outwardly successful individual as being so distraught. So they slip through the cracks and remain invisible. They often defy recognition, even among therapists, if they even think to approach therapists. Suicide rates among medical students and physicians are disproportionally high. Where can people turn? And where can they turn if they do not even know what is wrong, or that something is “legitimately” wrong?
Regulation is profoundly necessary, and sadly, far too rare
In the affluent town of San Francisco, the number of deaths by fentanyl overdoses beat the number of Covid-19 deaths in 2021. I find that to be chilling and profoundly alarming. In another story, six San Francisco fentanyl overdose deaths were stopped, and several lives were saved in the space of days by passersby administering Narcan to users who most likely would have died if not for such good samaritan luck. What if those good citizens had not walked by?
I am an avid supporter of local Crisis Support and Suicide Prevention organizations. I am so grateful to them for doing the essential crisis/emergency work that I am decidedly not good at. It is so needed, and so neglected. Oy vey. Neglect upon neglect upon neglect. It is literally deadly.
It saddens me that some of the most powerful treatment modalities we now have for restoring regulation are not yet accessible on a larger scale. Neurofeedback is such a godsend, and yet too expensive (for most prohibitively so) to provide on a large enough scale. Where do we start? Well, you and I can start by helping the world become “neglect informed.” It took 30 years for the ACE (Adverse Childhood Experiences) Study to hit the mainstream, but it finally has, and it does acknowledge neglect. Educate the world, support services, and policy insofar as we can, and we can save lives, not to mention ease unbearable suffering.
I was gratified to learn that our US Surgeon General, the young Vivek H. Murthy, has identified a major public health crisis in this country: loneliness! 22% of the US population self-identifies as profoundly lonely. We are coming to understand more and more of the consequence of that. This is the subject of his book, Together: The Healing Power of Human Connection in a Sometimes Lonely World. I find that gratifying and hopeful, as it joins mental health on the incipient roster of important social and political matters. Yay!
Again, my deepest appreciation to the Trauma Research Foundation for tying political and social meaning to the epidemic of trauma. More than 40 years after the PTSD diagnosis was identified and named, the larger world is adopting the understanding and necessity of being “trauma-informed.” It is a term that people are coming to know, adhere to, and use. I would hope to do the same with neglect.
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.
Berkeley author Michael Chabon’s touching memoir, Manhood for Amateurs, begins with his declaration that his story started with the birth of his brother when he was five years old, saying: “Before that, I had no one to tell it to.” With no “other,” existence itself is questionable, which is why neglect is so very lethal. I recently heard a remarkable story underscoring this, of writer and conservationist Hannah Bourne-Taylor.
Although we don’t learn much about Bourne-Taylor’s childhood, we know that her family “moved often.” It certainly sounds bereft of attention, like a vacuum of solitary neglect. She describes herself as “bird-obsessed,” and every spring when her favorite birds, the swifts, returned to her area in the UK, she was overjoyed as if returning to life.
Bourne-Taylor did not even realize how agonizing her daily experience of OCD was. It was certainly the most debilitating case I have ever heard of, and I am no stranger to OCD. Not only was she plagued by the diagnostic, endless bouts of checking and re-checking, but she “en-souled” the objects of her checking – that is, she imbued them with a “soul.” When she rearranged a can of beans that was crookedly misaligned from the other cans, she imagined the can was suffering from being out of sync with the rest of the clan. Her most severely consuming preoccupation was when she and her husband moved into a home in the far reaches of the jungle, which had a lovely swimming pool. The first time she went to take a dip, she became aware of ants falling into the pool. “Making eye contact” with the ants put her profoundly in touch with their emotional experience, and she became obsessed with saving them from their terrifying drowning deaths. She did not want the luxury of her swim to be at the cost of their fragile lives. Not only did she build bridges of palm fronds to enable their safe rescue, but she got up repeatedly during the night to make sure they were OK. The ants occupied virtually all of her waking life. And it was a secret and solitary world. She did not even tell her husband, who was to be the first person she ever told of her OCD, until she was 31.
Although we don’t learn much about Bourne-Taylor’s childhood, we know that her family “moved often.” It certainly sounds bereft of attention, like a vacuum of solitary neglect. She describes herself as “bird-obsessed,” and every spring when her favorite birds, the swifts, returned to her area in the UK, she was overjoyed as if returning to life. As the wife of a devoted bird lover with a history of extreme neglect, it is not hard for me to imagine her primary relationships being aviary.
When Bourne-Taylor was in her early thirties, her husband (ironically named Robin!) got a job assignment in the far reaches of Ghana. They relocated, and it was then that she seemed to decline deeply, sinking into her most paralyzing depression. That is when the preoccupation with the suffering ants descended on her, consuming most of 24 hours a day. Until she met the finch.
Of course, it is my rallying cry that attachment, or lack thereof, is the source of both the most profound of injury and most profound healing. And although I have known many a survivor of trauma and/or neglect whose first perhaps only safe attachment was their own child, and plenty also whose preferred attachments are to animals rather than humans, I have never heard a healing story quite like that of Bourne-Taylor.
Finches are tiny birds, perhaps the height of Bourne-Taylor’s little finger. They are extremely reliant on the flock, being so small that when left to themselves, they are easy prey for any hungry carnivore. She describes them as “a flying snack” that will last barely minutes. The proverbial birds of a feather protectively flock together and have an elaborate communication/alarm system. The finch that Bourne-Taylor encountered was somehow lost or separated from the flock. Bourne-Taylor, knowing that was a likely death sentence for the little guy, worried desperately about him for the next 10 hours or so, checking on him repeatedly.
Ultimately she decided she better take some action. She attempted to imitate his chirp, and he chirped in reply, ultimately coming to her. What ensued was a remarkable love story that saved them both. The interested can look for her book, Fledgeling, in which she chronicles the whole thing. The little bird ends up making a nest in her waist-length hair, and for the next 84 days, until he is mature enough to be released into the wild, they spend 24/7 together, making a total of over 2,000 hours.
Bourne-Taylor never named the bird, her mission always being not to make him a “pet” but to return him to his natural habitat. When it was time to let him go, she enlisted her husband to do the “deed,” knowing she would find it unbearable. She also feared that he would not “make it” somehow, that a predator would get to him too fast. And it was a bittersweet time, of triumph and deep grief, when they parted.
Both Bourne-Taylor and the little finch were inalterably changed. What she discovered was that her OCD symptoms were gone. She concluded that the unrelenting preoccupation with care for her little buddy kept her so riveted in the present moment, it was like a compelling mindfulness practice that must have changed her brain. Her OCD did not return. She has since become an avid and prolific conservationist and author.
Of course, it is my rallying cry that attachment, or lack thereof, is the source of both the most profound of injury and most profound healing. And although I have known many a survivor of trauma and/or neglect whose first perhaps only safe attachment was their own child, and plenty also whose preferred attachments are to animals rather than humans, I have never heard a healing story quite like that of Bourne-Taylor. Again, I do not know her trauma story, but nonetheless, the little finch was as successful as any therapist I have ever seen.
It is a hard sell for survivors that relationships can be anything healing, especially as they have ever been so fraught, dangerous, and ambiguous at best. But I do know that as effective as any of the exquisitely helpful and essential modalities for trauma healing are: somatic therapies, EMDR, Neurofeedback, psychedelics, none are sufficient without the healing of the attachment wound: attachment with a sentient other. For survivors of neglect, even coming to truly believe that is a challenge and a main task of healing. It is a default to imagine it is impossible or just not worth it. I have also seen that when a client somehow breaks through to buying in, their healing takes off. A good therapist, as I like to say, is necessary and insufficient, meaning that talk therapy is not enough, but it is essential. My two cents, and I would not take you anywhere I haven’t been!
Bourne-Taylor never had the luxury to find out about the rest of the story about her beloved little finch. In a way, he was like “the one who got away.” Similarly, I often never find out what became of clients I had that I cared about a lot, and then under whatever circumstances, they flew from the nest. They might not even imagine how much I had cared, just as I could not imagine that my therapist cared about me. It was her “job,” so why would she think of me when I was not in her sight? Neglect teaches us to imagine that even when we are in view, we barely exist in the mind of the other, if at all. Bourne-Taylor reminds us that the healing bond works in both directions, which is one reason why couple’s therapy is so profound. And although a good therapist does not rely on or “use” their client for their own ends, it is an undeniable privilege to be in such an intimate and essential role. Like Bourne-Taylor, it is bittersweet when people are truly ready to fly on. I like to reassure them that when they do, the door is open should they wish to return for a single visit, a stint, or even another run together. It doesn’t happen that often, which is fine. And I don’t stop watching the horizon for a little flutter of wings.
Today’s song:
My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.
Way back at the beginning of our relationship, I remember my husband saying to me, only very slightly in jest, that there are really only three important activities to do on vacation: “eat, sleep and make love.” At the time, now over thirty years and many vacations ago, that was actually a terrifying prospect. Not only due to the apprehension of two old survivors of trauma and neglect spending 24 hours a day in the presence of another human but because all three of those activities were quite fraught and certainly not easy or fun for me.
It took a long time for us to find our way and create vacations together that “work” (play? Relax? Whatever!) It seems as if I am writing this about two strange other people, thankfully, as we wrap up a glorious week in Hawaii, USA.
My last few blog posts have been dark and pretty serious. This week, being largely unplugged and reading only the lite version of the San Francisco local paper – the weather, horoscope, food, and books sections – I thought would be a good time to lighten things up and write optimistically about sex. We may all be weary and beleaguered by recent coverage of the topic: abortion, harassment, assault and other abuse and discrimination, so I thought I would flip it and talk about a fave subject of mine: Sexual Health.
In the neglect household, things, for the most part, don’t get talked about at all, and there is no one to ask questions to about much of anything. So when kids experience changing bodies at puberty, “discover” masturbation or notice the differences between their own and siblings or other kids’ bodies, they may be confused, even scared. What might be an area of wonder and expansiveness becomes a shadowy, enclosed secret. Add to that childhood sexual abuse and all the secrecy, dysregulation and emotions that come with that, and we have a child locked in frightening and silent tabu. When I started menstruating at age 9, I did not know what that was. Aghast that something was fatally “wrong” with me, I was also horrified and ashamed of the mess, smells, and evidence. I remember being at school and being terrified to get out of my little desk and leaving a bloody puddle on the chair. And I was afraid of getting caught throwing my little undies in the trash. I don’t remember how my older sister somehow found out and helped me out of that quandary.
The larger world, sadly, is not much better. Although we are bombarded with sexual imagery, innuendo and titillation, there is a poverty of information or, certainly, information that is accurate and useful. Rather sex is commercialized, commodified, sensationalized and distorted by truly impossible role models of bodies, relationships, and functions: instantly rock hard ever-lasting erections, always feverishly wet vulvas, chandelier swinging, explosive simultaneous orgasms – at least in heterosexual couples.
And because there is no safe and reliable education to be had, kids (and adults too) get their “information” and advice from movies, porn, locker rooms and of course, Google and chat rooms of every stripe. And with sex being wildly subjective and colored by culture, values, morals, and individual and mass conscious and unconscious biases, the silent resounding question remains, “What’s ‘true’?”And for the most part, no one knows that everyone else is asking the same thing. Oy vey!
An interesting book I read maybe 20 years ago has stood the test of time even in the book-cluttered recesses of my head: When Sex Goes to School: Warring Views on Sex–and Sex Education–Since the Sixties, by Kristin Luker. It is a brief historical overview of the shapeshifting pendulations of sex education in the US. Essentially it graphically posits the obvious (but not so obvious?).
Sex education in schools historically reflects the prevailing political and moral perspective of the ruling government at any given time. In effect, “s— rolls downhill, and the available information shapes the sexual attitudes and behavior of that era. It is a worthwhile little read. Many who know my work have heard this rant many times before. So let’s talk about a happy and also unifying subject! You might ask, “unifying? did you not just get through saying that it is wildly subjective?” Well, yes, I did. But from a brilliant colleague and friend, Doug Braun-Harvey, I learned the Six Principles of Sexual Health (also to be found in his book, co-written with Michael Vigorito: Treating Out of Control Sexual Behavior: Rethinking Sex Addiction) which cast a wide enough net as to be universal, truly inclusive, even practical. Thanks Doug!
It is easy to believe that because sex is a “natural” function, we are all innately supposed to know what to “do”, and we are all essentially the “same.” After all, birds do it, bees do it. Most notably, children of neglect, living in a world of echoing silence and finding their own answers about most everything, generally tend to default to the belief that what I know about applies to everyone else too. Clearly, I am a freak if I do not know what I am supposed to do. Many a child of neglect avoids sex with a partner completely for a variety of reasons, this shameful ignorance being one of them. So let me start by proclaiming a resounding “NO!” We are NOT all the same, and sexual tastes, much like food tastes, are as widely disparate and diverse as the gourmet (or not!) palette. When you partner with someone new, do you assume you know what their food preferences, allergies, ethical or religious restrictions, or even rhythms of meals might be? Hopefully not! We need to ask! Listen and learn! Then, ultimately, we can cook and eat and if we are compatible and have enough overlap and enough common predilections enjoy a meal together.
And so it is with sex! We must similarly speak, ask, listen, disclose and learn! It seems like a “no-brainer!” No? Well, because in general, no one really talks about sex, including oncologists who fail to alert patients about possible sexual ramifications of their cancer, its treatments, and surgeries; psychiatrists who fail to inform/warn patients about sexual side effects of medications, even psychotherapists and couples’ therapists fail to inquire – it is not obvious that it is OK to ask and to speak up. It is really most “natural” if one is honest, to not know!
In all fairness, I must add that there is the occasional sex-positive exception to the gross generalization above. Let me just say, I am committed to breaking the silence by raising sometimes shocking tabu sexual subjects (hopefully with dignity, tact, and respect for all) with explicit language to model, teach and desensitize talking openly about sex. It is quite remarkable how many long, long-term couples never have! No shame in that! Talking about sex is not “unnatural”; it is just, well, unnatural! Let’s do something about that!
So, once we have “normalized” talking about sex, we must define “what is “normal” anyway?” So many individuals and couples both worry, “I am not “normal!” or my partner is not “normal,” our frequency of sex is not “normal,” etc., making for shame, criticism, blame, confusion, uncertainty, bitter recrimination, prejudice and often sexual impasses and long droughts. (Most people who are not sex therapists have no idea how many “monogamous” long-term partners haven’t had (partnered) sex in literally years!) I once heard a sex therapy expert say, “So-called ‘sex addicts’ are anyone who has sex more than me!” So, in addition to tabu busting and myth-busting being vitally important to me, so is defining our terms! As I often say, and it can be a hard sell, particularly with survivors of neglect for whom “doing things my own way” has been a means of survival, there are few absolutes about anything. Even more controversial, I am known for saying, “There are no facts in a relationship! Just your world and my world,” but we won’t debate that now.
Certainly, with sex, there is no universally agreed on “normal” for sexual feelings, preferences, and practices. There are some that are difficult for me to imagine and understand, and certainly would do anything but try! But I don’t have to do those if I am adhering to the Six Principles. What a blessing! If done well, a true democracy! So here are the Six Principles, only briefly fleshed out here (no pun intended). Assuredly, we shall return again and again to these topics!
Pretty basic, huh? Yet truly game-changing when scrupulously adhered to! And within this frame, the sky is the limit as to what we choose to do!
1. Consent
Consent is, of course, foundational and delineates the difference between trauma/neglect-ridden interaction and healthful, connected and free expression. Couples must agree that “No means NO!” and, in turn, yes means authentic yes! There must be agreement, commitment and safety to be candid, as well as precision about exactly what we are consenting to.
2. Non-exploitation
Non-Exploitation means thoughtful assessment and correction for any imbalances of power and care taken to share the responsibility to equalize and equally respect the dignity of each.
3. Protection from STIs and unintended pregnancy
Protection against STIs is a shared responsibility and endeavor, including agreement and cooperation about both “pre-existing” and newly acquired conditions or infections, agreement about methods to be utilized, and who is responsible for what.
4. Honesty
Honesty means transparency, both overtly and by omission. It also means having the humility to disclose likes and dislikes and to practice consistent and effective communication. Also agreed upon boundaries of “Privacy.”
5. Shared Values
Shared values is again the practice of good communication about what the meaning of sexual intimacy to each partner. Is it about play and fun? Intimacy? What makes me unique, special and sets me apart from everyone else in your life? Self-regulation, procreation, spirituality? Is it even interesting at all? Couples must determine are we, in fact, “in the same movie?”
6. Mutual Pleasure
Mutual pleasure is about creating an interaction in which there is room for the pleasure of both partners. What makes sex really “work” is when each partner is both present with themselves and present with the other while in the present moment. It is a commitment to that, which includes finding out what exactly brings pleasure to them.
7. Bonus Principle: Lifelong Regular Practice
Sexuality pioneer and icon Betty Dodson would add a seventh principle. She taught that regular sexual activity, with or without a partner, is as essential as food, sleep and (other) physical exercise. She joyfully practiced what she preached until she recently passed at 91.
Cursory and introductory for now, this topic will be amply addressed in my forthcoming book now in the works and, to be sure, in many upcoming blogposts. The eager might look up Doug Braun-Harvey, who offers a wealth of information about sexual health!
Sexual health does indeed mean inclusivity, elasticity, growth and acceptance, not only about the vast diversity among us but in ourselves through our lifespan. When I was growing up, categories were rigidly binary and few: male or female. Even gay or straight came later. Then we got bi-sexuality and, little by little, all the other letters coming after LGB in a growing list. Sexual health is widening our lens to include them all but also learning how to observe with acceptance and grow with the changes in our own bodies and sexual functions, including our own feelings and attitudes about sex and ourselves. So many things we might never have thought about until we got there.
Our species has only recently begun to live this long. Only a century ago, humans did not live long after their reproductive years, so the challenges of long-term monogamous sexual activity with one partner for decades post-child-bearing is a puzzle we are still working out! If you don’t have answers yet, well, join the human race.
So much more to say! As Terry Gross would say, “Let’s take a short break. And then we’ll talk some more!” And as Rabbi Hillel taught about the Golden Rule, these six (or seven) principles are all you really need to know. The rest is commentary. So now go and practice!
Today’s Song:
My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.
Like most of us in the U.S., this latest spate of mass shootings and particularly school shootings, has flooded me with every imaginable emotion: grief, rage, despair, fear, impotence and more. When I finally become able to think, my mind is like a jammed Los Angeles freeway cloverleaf at rush hour, with countless vehicles crammed with lives and destinations, competing, stacking up, and sometimes colliding. Invariably I get stalled. And I definitely have to carefully regulate how much news, how many personal accounts of devastated mothers, despairing teachers, and defensive officials I listen to. And I am not even a mother. Of course, no one knows what to “do”.
“One trick pony” that I am, I default back to a few fundamental perspectives. No surprise, of course, to anyone who knows me and/or my work. I remember some years ago, I read a novel – Jody Picoult’s Nineteen Minutes – about a young high school shooter. Tracking his whole life, like a well-crafted work of fiction would, it was a trail of isolation and failed relationships. His distress signals garnered no response, except perhaps discipline and ultimately dislike and ostracization, which made for more isolation, frustration and build-up of aggression. His eventual massacre was a culmination of that long build-up.
It reminds me of the process of ricotta-making: watching a large pot of whey slowly brought to a very high temperature. The heat drives the milk solids to the surface of the liquid, and they slowly thicken, thicken, thicken to a heavy white cap. After what might seem like a long time, it starts roiling and rolling until a powerful bubbling breakthrough boil punctures the cap. It bursts like a volcano or an orgasm. And then, quickly before it boils over, I turn off the heat and cover it. However, in this case, we end up with something delicious and nutritious, not a bloody mess of chaos.
I remember some years ago, I read a novel – Jody Picoult’s Nineteen Minutes – about a young high school shooter. Tracking his whole life, like a well-crafted work of fiction would, it was a trail of isolation and failed relationships.
As with many other varieties of terror and violence, the warning signs of a troubled child abound if one is mindful. Of course, in the world of neglect, no one is mindful. There might be awareness that there is a “behavioral problem” that is likely met with a punitive rather than a curious or sympathetic response or reaction. Or the child may continue to be invisible or blend in with ambient or worse chaos until perhaps it is too late.
For centuries, mental illness has been confounded with moral, social or legal non-conformity. I remember when I first started college and was captivated by early 19th Century Europe, and most notably Karl Marx, I read a book about the origins of the “asylum”, which corresponded to the Industrial Revolution and Marx’s “alienation of labor”. Life was bleak, and the family was giving way to mechanization and a kind of “efficiency” and economy that was increasingly disconnected from kinship and relatedness. What I remember as being most striking was the conflation of “mental health” with criminality, often with a measure of religion thrown in. Their institutions seemed almost indistinguishable—Oy vey. Looking at today’s world, that has not really changed much in many places. Even the designation of “behavioral health” seems to somehow cast mental illness as a “behavioral problem” or “bad behavior” rather than perhaps a medical condition or a social problem.
The most logical observer of “red flags”, of course, would be family, at least a family that is awake and minimally non-defensive, empathic and related. Understanding distress or dysregulation as cries for help might obviate the quest for comfort and affiliation in other directions, such as social withdrawal, substance use or gangs.
I have not worked in an “institution” in decades. I did a brief stint at the VA and a couple of drug programs before I was licensed, and I have not “had to” since. Patients who wind up in those places are hard to work with. The VA system was set up such that when people got “better”, it whittled down their benefits, so there was a clear disincentive to recovery. And the most severely afflicted will maybe not ever get significantly better. I was relieved to be free to work in settings where people improve or even get well. It is clearly a privilege that I (mostly) don’t take for granted.
And too, there is something very flawed about a “healthcare” system designed to intervene only when the “patient” is a danger to themselves or others. By then, it is too late.
What I remember as being most striking was the conflation of “mental health” with criminality, often with a measure of religion thrown in
In one of Malcolm Gladwell’s books, again, I read it long ago, and I don’t even remember which one, he cites controversial data stating that when abortion was legalized in 1973, the violent crime rate dropped dramatically. Gladwell linked the idea that the removal of unwanted pregnancy, and thereby unwanted children, resulted in less disenfranchisement, loneliness, and of course, dysregulation and criminal activity. It makes sense to me. Attachment trauma, loneliness, rejection, self-worth, and all the incumbent dysregulation accompanying these are at the root of the brain and body distortions that can eventually give rise to so much of the “craziness” and criminality we see.
It is hard to tease out substance use, genetics, poverty, race and huge disparities of justice, among many factors, and I do not, by any means, intend to engage in a debate about abortion or this ancient data. For me, however, it is food for thought, and being the one trick pony that I am, the primary attachment is where I always default to. I continue to believe that attention to the earliest attachment injury is likely as a place to “begin”, as we must choose how to approach and clean up this complex and tragic mess.
My heart goes out to the families of all the murdered children and adults, all the new trauma and attachment trauma that these devastating and senseless murders have wrought. Uvalde especially, where the children were so unbelievably young, is incomprehensible.
My heart breaks for the entire generation of school kids whose last two years of education were fractured by the pandemic, and now that they finally can, they may be scared to go to school. My heart is breaking. I fervently hope we can learn from experience.
For centuries, mental illness has been confounded with moral, social or legal non-conformity.
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.
As I was pondering what to write about this week and thinking that of late, my blogs have been perhaps too “dark”, I happened to catch a whiff of the pungent dirty gym socks-like odor coming off ME! The unmistakable smell of Breve Bacterium Linens, or what those of us in the know affectionately refer to as “B Linens.” If you have had a ripe Muenster or Port Salut, B Linens is the bacterium additive that brings the lovely coral red blush to their rinds. I particularly love those two because I somehow remember them as being faves of our mom. And although they don’t bring the Proust-like flood of recall that some foods do, they do bring some kind of smile to my memory. Inhaling the stink rather characteristically clinging to my shirt, I thought, “maybe I’ll write about cheese!”
Last week I had the thrill and honor of appearing on the world YouTube stage for the first time. No, not as any kind of trauma expert; rather, my much-loved Australian cheesemaking teacher and guru Gavin Webber invited me to participate in his special event, “Twelve Hours of Cheese.” No, not for twelve hours, but for a one-hour interview about my own little story as an artisan home cheese maker. And that story I do remember. Not without trauma, the traumatic events were more like little “insults” that ultimately were mostly edible. When people say “cheesemaking! What an interesting hobby!” I say, “No, you don’t get it. For me, cheesemaking is not a hobby. It is a diagnosis!” What an oxymoron and identity shock for this invisible old child of neglect to be out there in the public eye. But before I go on, I better change this shirt because it really is kind of unbearable.
When people say “cheesemaking! What an interesting hobby!” I say, “No, you don’t get it. For me, cheesemaking is not a hobby. It is a diagnosis!”
My favorite album of all time is the Rolling Stones’ 1972 masterpiece Exile on Mainstreet. I remember at the height (or depth) of my dysregulation, bellowing along with Keith, “Everybody goooonnna need some kind of ventilator….” He had a rough childhood, bombs falling in London, a neglectful mom, hunger, an alcoholic father. No wonder he got so hopelessly addicted to heroin for so many years. I am grateful that I dodged that bullet. I can certainly see its appeal. And he is right.
The concept still stands. All of us with dysregulated nervous systems, with stressful daily lives, whether due to personal trauma histories or being a psychotherapist to the traumatized, or both, need these relief valves; ways to recharge and re-balance or simply rest. Perchance I fell into cheesemaking as just that. It really was a kind of an accident. I have always loved cheese, and it was a remote fantasy to try making it someday, like many other little fantasies that never materialize. This time, someone innocently lent me a book about home cheesemaking, and on a whim, I thought I would give it a try. I made the beginner’s cheese that most people start and many end with: quick mozzarella. Oy vey – I was hooked. It was a royal road to regulation. A friend affectionately nicknamed me “Cheese Wiz!”
Like sex, cheesemaking requires a delicate balance between sympathetic and parasympathetic, a focused presence floating on a pulsing excitement. Gavin’s book Keep Calm and Make Cheese is well named. You have to be calm to do it, and it is summarily calming. Perfect! But I get ahead of myself.
Suspecting I had discovered a new brand of self-care, I returned the borrowed book, bought my own copy and then every other cheese book I could find. And it was an amazing vehicle of focus – calm and fun, even though my first cheeses were nothing to brag about, with a failure rate of about 60%. I scoured the internet and YouTube and searched out all the tutorial videos and courses I could find. That was when I found Gavin, who became my go-to authority. I lived for his weekly live stream and live chat program Ask the Cheeseman, and I worked my way through his how-to videos, trying as many as I could. Now in about year four or five of my journey, it seems there is no going back.
And what a great teacher it is. Cheese is a living thing. It grows and evolves, and without proper care and hygiene, it drifts awry, with runaway unwanted mold growth and bacterial hitchhikers and vagabonds floating around where they can make havoc. It is also a great teacher of patience. When I first started making cheeses that had to age three or four months before being ready to eat, I thought, “no way!! How am I supposed to wait?!” Then I discovered the cheeses that take six to twelve months and more. Like trauma healing time, it moves glacially slowly. But ultimately, transformation occurs, and out of a shapeless mess, something new and delicious emerges. It is usually worth it. Not always, of course; that is why the essential brain function of learning from experience comes in!
Cheese is a living thing. It grows and evolves, and without proper care and hygiene, it drifts awry, with runaway unwanted mold growth and bacterial hitchhikers and vagabonds floating around where they can make havoc.
For millennia, around the world, people have been making this simple food with essentially one ingredient. They all seemed to spontaneously discover that although they could not store milk long enough to span the seasons when it was less plentiful, this simple procedure made a nutritious food that lasted much longer and was also delicious. Spontaneously and cross-culturally (no pun intended!), a growing wealth of styles and varieties developed, and a whole world unto itself of methodology and even language was formed. I was amazed as I got acquainted with that new to me little world, that there was a whole new vocabulary and set of concepts to learn, just like everything else. Who ever heard of Breve Bacterium Linens, of flocculation, or Mespohillic and Thermophilic Starter Cultures, to name but a few. However, these terms all became part of my daily life and copious reading.
Even before the pandemic struck and isolation became the norm, entering this world community of cheesemakers made me feel connected to people across geography and across time. It made me feel connected to cows and goats and sheep and all the other mammals that produce milk. And something about working with milk seemed to tie back into Attachment Theory, so although cheesemaking struck like a fallen meteor that lit up the sky and then landed, it also felt somehow very consonant with who I had already been.
When the pandemic hit and we were all locked down, cheesemaking became even more important as a means of regulation. There is something very steady and plodding about a process that takes a long time and a fair amount of fuss, much like therapy, but without (most of!) the pain. And because cheesemaking requires so much sanitizing and cleaning, all the guard rails imposed by the pandemic, with the exception perhaps of face masks, were well known to me. It became an effective, regulating pandemic activity; long days, including sometimes a 90-minute or two-hour stir – a fine opportunity to watch the wealth of webinars and virtual conferences, which were, to me, a welcome spawn of the times. My greatest teachers joined me in the kitchen, and all that stirring was like a gentle afternoon of kayaking in Kona.
Most of all, however, I discovered that almost everyone loves it. Most people I knew had never eaten artisan cheese and were more familiar with mass-produced, ordinary, or even processed cheese like Velveeta or Kraft Singlets. As my product became slowly better and even gift worthy, I began to find a source of great pleasure, joy and connection in sharing it. It made me feel happy and less alone. I started sending packages to friends and loved ones all over, and having my creation go into their bodies makes me feel a kind of organicity of connection. If the pandemic can widely and perilously unite us in fear and deathly danger, perhaps this other microorganism-infused agent could organically unite us in health and love. That is how it seems to me. If nothing else, I found it makes me happy! That regulates me and keeps me going.
All my cheeses are dated on the day they are made. Keeping up with my daily affinage, all the fussy little steps that cheese requires day-to-day during aging keeps me aware of the passage of time, which in “pandemic time” might otherwise seem static, stopped or a seemingly endless Groundhog Day. Time stands still in the brain of the traumatized. Life in present time does inch along forward.
Now, when I meet someone new that I like, the perennial question they are faced with is, “Do you like cheese?” It is rare to hear “no”. “Send me your postal address!” I say, and suddenly I have a new friend. It seems to melt barriers! And it is my favorite way to say, “thank you!”
Here in the US, it used to be rather customary, when taking family photos, for the erstwhile photographer to say, “Say Cheese!” to the assembled photo subjects in an effort to get a toothy, rather gritty smile of sorts. In Madonna’s iconic 1991 movie, Truth or Dare, she updates it to “Say dildo!” I have adapted her practice when I take a group shot and usually get authentic and charming expressions! Whichever you prefer, keep calm and have some cheese! It is alive!
There is something very steady and plodding about a process that takes a long time and a fair amount of fuss, much like therapy, but without (most of!) the pain. And because cheesemaking requires so much sanitizing and cleaning, all the guard rails imposed by the pandemic, with the exception perhaps of face masks, were well known to me.
Today’s Song:
My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.
A ten-year love relationship spanned roughly the decade of my 20s. Out of ten years, I spent about four of them trying to leave this man, a dizzying switch back and forth between moving out and moving back in. I thought he was the love of my life. I finally succeeded in wrenching myself out on the morning of October 17th, 1989. In the afternoon of that already unforgettable day, the Bay Area was upended by the Loma Prieta Earthquake. My upheaval was complete. So ironic and so fitting; my whole world cracked and crumbled. But my little one-bedroom and my beloved cat were all intact and, although shaken, safely unharmed.
I remember attempting to shop for groceries the next day, feeling an odd sense of comfort and kinship with everyone as we all stumbled around the familiar store in a singular, even unifying, wordless, shell-shocked daze. It was what I heard New Yorkers felt in the aftershocks of 9/11. A part of me felt the eerie but somehow reassuring connection, yet another part felt desperately and unspeakably alone.
Yes, it had been a wildly ill-suited partnership, and yes, I gave it my all. A signature of the well functioning brain is learning from experience. I wanted to make sure and do so. Given that it took two hours every morning to cover what was previously a forty-minute commute to my job at San Francisco VA since the Bay Bridge had all but collapsed fully into the Bay, I had ample time to think. I squeezed onto the train (standing room only at 5:00am), and then the 37 bus loaded with people and often their produce and chickens, rolling into work, with luck, by 7:30am.
So ironic and so fitting; my whole world cracked and crumbled. But my little one-bedroom and my beloved cat were all intact and, although shaken, safely unharmed.
The rescue and relief efforts moved quickly in the Bay Area. Rebuilding, cleaning, tallying losses, counting blessings, and assessing the new PTSD trauma casualties of those suffering more dramatic impacts. The earthquake had hit during the hyperbolic “Battle of the Bay” World Series between Oakland and SF, which added color to the new chapter in local history.
However, my own little seismic event progressed glacially into anything vaguely like a new equilibrium. It was as if I dwelled in an avalanche of rubble, and while the world seemed to be emerging, learning new words like retrofit or “the big one,” developing new practices like the earthquake kit in the basement, and upping their earthquake insurance, I seemed only able to aimlessly root around in my “basement.”
We all have our own personal first heartbreak tragedy. Nothing special about me. So why indulge myself by recounting mine? There is certainly no pleasure in recalling it. Because as a relationship therapist and sex therapist, I often hear a question that I also had. For the first two years after the quake, I cried, initially unconsolably, every single day. For the three subsequent years, never a day passed, without thinking, even fantasizing about my long-gone ex. That is five solid years, after a ten-year coupling!
Because as a relationship therapist and sex therapist, I often hear a question that I also had. For the first two years after the quake, I cried, initially unconsolably, every single day.
I remember the day, sometime after I had met my now husband, I suddenly flashed, “Wow! I have not thought of him! A whole day!” It is always harder to discern and notice what is not happening; that is what is so confusing and insidious about neglect and its colorless story of deficits. This, I had to acknowledge, was like the like shedding the weight of a long dragging ball and chain. So here is the question, why?
I heard a talk by the renowned Helen Fisher, a celebrated anthropologist specializing in sexuality. (If you have not heard her speak, she is marvelous and riveting, and a wealth of Ted Talks and YouTubes graciously abound).
Both a sophisticated scientist/researcher and popular writer, she is accessible and even entertaining. She said a brain going through heartbreak looks identical to a brain crashing from a massive cocaine binge. No joke! No wonder it feels so bad! And although I have never crashed from cocaine, my hyper-aroused brain always preferring drugs that sedate; it is a vivid portrayal nonetheless!
A delightful artist couple we met who live deep in the outback in Volcano, Hawaii, host a variety of species of ferile animals on their beautiful rainforest land. They have rescued and made pets of many of those brave enough or hungry enough to approach their home. They tell the story of a pair of probably sibling feral dogs (probably part wolf) whom they began to see lurking around the house. One of them had the remarkable distinction of habitually looking both ways before crossing the un-trivial road where cars routinely drive well over speed limits! Where did he learn that?
The two were large and intimidating (at least to me), and our friends were later to discover, truly terrified. And they were hungry, especially as that year had been unseasonably dry and available prey was meager. Our friends, as was their custom, cautiously put out food for them. The two skittishly sidled only close enough to snatch their meal, quickly disappearing back into the tangle of green. This went on for months, during which time our friends quietly named and befriended them from the cautious distance. “It was many months before we could touch them.”
Perchance, someone gave our friends a very young puppy. That adorable little girl behaved more like a usual pet, and they happily held and played with her. A turning point came when the two big guys saw the puppy. They slowly edged up to her and sometimes even played with her. They hovered closer and closer to the house and ultimately became veritable pets! Never quite as relaxed as the puppy, who undoubtedly had had a safer start in the world, the three dogs harmoniously joined the household, living together as a family for many years. What sort of bell might the little one have rung inside her older “cousins?”
So, what does any of this have to do with my broken heart? It came to me organically out of the depths: I don’t remember how. I might say in a dream, but to be honest, I don’t dream much, so have to forego that poetic turn of phrase. Perhaps from a deep therapy experience or a deep sleep. The seemingly endless grief I had endured, now thankfully a distant memory, was not about the man whose name I quietly keep to myself. It was about my mom, my real first true heartbreak. No wonder I couldn’t get over it.
The abandonment and loss of infant neglect, unremembered in the ordinary autobiographical memory of which an infant is incapable, continued reverberating and quaking in its desperate quest to tell the trauma story. Certainly, like for many of us, the first real heartbreak. How do we shorten the seemingly endless river of grief over that first devastating heartbreak? By going to the source if we can and processing that. That is finding a way to access and work through that prehistoric attachment injury. Perhaps that will help to shorten the seemingly infinite and often humiliating journey, or at least make sense of it. And you’ll save a whole lot of Kleenex. Neurofeedback definitely helps to move things along.
Attachment trauma, and neglect, as we as a field and as a world are slowly beginning to grasp, is perhaps the most devastating trauma of all. Something about the puppy being a vehicle of healing seemed, at least to me, to illustrate that. And why breaking the intergenerational chain insofar as we can, is a personal and cultural imperative.
Some fifty years ago I made a blouse for my mother, probably for Mother’s Day. It is sky blue, and I elaborately embroidered it with a large daffodil surrounded by a vibrant rainbow. The colors have stood the test of time valiantly, and it is one of the few things I took, besides the sewing machines, when our dad released us into her closet to help ourselves after she died. Inside the little garment, on the back facing where a store-bought label might be, I had embroidered the words “I love my mom.”
I know at times I disparage our mom (and speaking ill of the dead is admittedly poor form), especially in the privacy of my darling aesthetician niece’s treatment room, where she works on my ragged old face. She tracks my progress diligently, like a good neurofeedback provider, taking pictures and showing them to me along the way. In horror, I exclaim, “Oy vey! I look like my mom!” However, somewhere deep inside, hidden like a relic, in the interior of a sacred vestment, persists the faint echo of the howling primordial longing.
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 Love Me Still by Bruce Hornsby.
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.
Sometimes a story or a movie is truly worth well over a thousand words to express and convey an often wordless experience concisely. This week I decided to do something a little different and dip into popular culture – commenting on a film and a book, both of which speak to our themes, portraying them sharply and differently; perhaps tipping a sensory nerve and providing food for thought, at least for me.
Neither of these two are great works of art I might add, at least not in my opinion. And in neither case did I feel a deep connection with the character, but both are good envoys, and there is no substitute for a good story.
Jeremiah Tower was a local treasure and cultural icon to a food-loving Bay Arean like me. I say “was” because in the movie, it is hard to know if he died or simply evaporated back into the vacuous wasteland of his neglect ridden childhood. I certainly noticed this when the film Jeremiah Tower: The Last Magnificent was brought to my attention. (I won’t say it was recommended, and frankly, I am not really recommending it either.) Nonetheless, for the curious, it is available on Amazon Prime for $2.99, and I will avoid the “spoilers.” And if you love cooking and eating, the visuals of spectacularly beautiful and interesting food is well worth the price!
The film was produced by Tower’s dear friend and self-proclaimed “fan” culinary rockstar, Anthony Bourdain, who certainly must have his own story. As you may remember, Bourdain committed suicide in 2018. Clearly, the restaurant world, even at its peaks, is cruel.
Known for being one of the early luminaries in the now exalted almost “religion” of California Cuisine, Tower was a key figure in the historic, and still after 51 years, wildly acclaimed Chez Panisse in Berkeley. Tower’s own tabernacle, Stars Restaurant, opened in 1984. I think we only ate there once, and all I really remember about it was walking down the carpeted stairs to our table. It was like entering a palatial theater and going to the most expensive seats in the orchestra section: grand. The cinematic scenes of the interior of Stars brought up that pleasurable and even exciting image. Stars Cafe, a later, more casual and reasonably priced Tower offspring where you could actually get a reservation, became a frequent go-to for us. I admit that back in the 90s, the big draw was the caramel sundae, which I am sure is what called me back almost every Friday for a good long time. I don’t remember anything else I ate there besides that sundae, although my husband could probably tell you!
I admit that for me back in the 90s, the big draw was the caramel sundae, which I am sure is what called me back almost every Friday for a good long time.
Hearing about the movie, I was startled to realize (rather like the neglectful parent who, fifty miles down the road, suddenly registers that their child is not in the car but was somehow left at the gas station) that I had not thought about the restaurants in years and had forgotten all about Tower himself. I’m certainly not intending to equate a restaurant with one’s own child, but rather that the forgettable invisibility of neglect and the clueless oblivion of his parents were the staple and persistent ingredient of Tower’s entire childhood. His seeming “disappearance” is perhaps a re-enactment of that.
Tower was the quintessential “poor little rich boy.” My flashbulb memory of Stars’ majestic, theatrical opulence perfectly portrayed his childhood “home,” although it was anything but a home. His alcoholic mother, who manifested the pinnacle of glamour and style, entertained her similarly privileged white comrades constantly and elegantly. The adorable little boy was either parked somewhere to keep him out from underfoot or forgotten completely. His only solace became the spectacular food that he came to love and took great pleasure in eating.
By age eight or so, little Jeremiah learned that when his mother became prohibitively drunk, she was unable to “perform,” so the food would not make it to the glamorous table. So, like many the child of neglect, he transitioned from complete invisibility to (still) invisible rescuer. He learned to cook to “keep the show on the road” (and shield his mother from shame as it were) and was remarkably successful. Cooking and covering for his mom gave the boy a sense of purpose, and although he continued to go unrecognized, he found that he loved it.
A similarly poignant feature of the film, barely a blip on the story’s screen, is the exquisite depiction of how vanishing in the elegant Dom Perignon sipping crowds, night after night, would make young Jeremiah an easy target for trauma. I won’t give it away; the brevity of the event is almost imperceptible. If you run to the bathroom without pausing, you might miss it, and because the hideous event never comes up again, you won’t know it happened. Again, smacking of traumatic re-enactment.
Predictably Jeremiah went to Harvard to study design and then graduate school in architecture. The spectacular visuals of the food he created reflect his imaginative aesthetic and structural brilliance. He started cooking for his peers in college, and for sure, lots of wine and other intoxicants were on the menus. Although the film does not explicitly say that this child of at least one alcoholic parent had a substance abuse problem, it is easy to wonder, and somehow, I vaguely remember his falling deeply into a serious hell of cocaine use. I could not find any corroboration of that, so perhaps I made it up, but it is easy to imagine.
The adorable little boy was either parked somewhere to keep him out from underfoot or forgotten completely. His only solace became the spectacular food that he came to love and took great pleasure in eating.
His rise as master chef is well documented, beginning with his starring role at Chez Panisse, where he bitterly claimed himself to be of equal valence to the famed Alice Waters. After a dazzlingly successful partnership, there was not enough oxygen in the place for the two of them, and Tower struck out on his own. Clearly, the world of relationships was a predictable minefield for him, as one would expect after his disordered attachment childhood. The film never clearly identifies his sexual orientation. Although it alluded to his being gay, it was hard to tell if that was “all” and he never seems to have a lasting partnership.
As a waiter in some relatively high-end restaurants back in the day, I am not a stranger to chefs blowing up and even throwing things at waiters and line cooks. Similarly, our dad had been a chef, and like a good child of neglect, I often worked in his shadow, however invisibly, to keep order while he created his “masterpieces” in our kitchen. I prided myself on being the only one able to be in the kitchen with him when he cooked. He too, was prone to outbursts and fits of rage, using the heat and delicate time pressure as his excuse. Tower, of course, was no exception to the raging chef rule, and his relationship world, like many a survivor of trauma and neglect, left a trail of wreckage in its wake.
It is lonely at the top. The film does not give us much about that, but I could clearly imagine it. The remainder of the film carefully and “protectively” portrays the collapse of the Stars house of cards. The Stars empire (like the Twin Towers), once a world avatar of wealth and power, was reduced to rubble. It is startling how to “dust he returned.” Again invisible and forgotten, I had to google to find out that he is still alive and living somewhere in Mexico.
Out of curiosity I looked up the story of the prophet Jeremiah. Here is what Wikipedia says:
As a prophet, Jeremiah pronounced God’s judgment upon the people of his time for their wickedness. He was concerned especially with false and insincere worship and failure to trust Yahweh in national affairs. He denounced social injustices but not so much as some previous prophets…
I wonder why they named him that.
Jeremiah Tower: The Last Magnificent (2016) available on Amazon Prime. 2 hours.
When I heard an interview with author Silvia Vasquez-Lavado, I was intrigued. First of all, because she is Peruvian, and somehow anything Latin American seems to pique my interest. But more, because she led an international group of women survivors of sex trafficking on a trek up Mount Everest, which struck me as heroic in every way. I ordered my copy of her new book, soon noticing that reviews of it seemed to be popping up everywhere. Eager to read it, I was mildly disappointed to find that it lacked the depth of character development and quality of “good writing” that compels me. But remember, I am an insatiable and somewhat critical reader with my own quirky tastes.
The story switches back and forth between the stories of Vasquez-Lavado’s traumatic childhood and younger adulthood and the story of the trek. For me, the more autobiographical part is most interesting. By way of warning to the vulnerable, she describes her own sexual trauma somewhat explicitly but powerfully. And her story, much like Jeremiah Tower’s, clearly illustrates how tightly coupled trauma and neglect must be. Terrible things can happen to a child who is unseen and not taken care of.
What Vasquez-Lavado does particularly well, and uniquely so, is clearly present the trauma of gaslighting. I have been amazed lately that the word has become a household term somehow. Referring back to a favorite classic movie, not Hitchcock but similar, the term, the name, and the movie that matter in my memory anyway were ancient history. Suddenly the word is everywhere. All the young people use it too. However, its portrayal as traumatic to a child trying to make sense out of the world, especially a child of neglect who has no one to ask, it is crazy-making and contributes to the confused belief endemic of neglect survivors that “nothing happened to me!” Vasquez-Lavado, perhaps better than I have seen anywhere, explicitly and effectively conveys the gaslighting experience from the inside. That in itself is worth the price.
Again, we do not get deep view into the life of the young girls, the survivors of sex trafficking. Some are Nepali, some from the US, so there are language challenges. We also see tragically portrayed how often sexual trafficking is an artifact of a galling degree of poverty and perhaps the gaslighting of well-meaning and destitute parents who believe the criminals enticing them with the promise of employment and a better life for their starving daughters. The cursory depictions of both the grimness of their traumatic experiences and their often stunningly courageous escapes are again some of the more captivating parts of the book; as is the one session when Vasquez-Lavado and all the girls gather in a group, in the chill of the mountain, and with the assistance of interpreters, share all of their trauma stories. There, the power of the group in trauma healing is vivid and moving. Many had never spoken aloud of their experiences, even with those with whom they went through them.
There, the power of the group in trauma healing is vivid and moving. Many had never spoken aloud of their experiences, even with those with whom they went through them.
Vasquez-Lavado, as planned, takes the group of girls as far as the base camp, but she herself has planned and trained to go to the 29,032 foot (8,849 metres) summit. The book continues to pivot between her “checkered past” and the climb. And although her personal history is often less than endearing, sensational and reminiscent of a dramatic AA “drunkalog”, she powerfully conveys the desperate compulsion to self-regulate. Ripping and running with alcohol, drugs and out of control sex are well known to many of us with trauma and neglect histories. She tells that story tragically and effectively, even if a bit tediously at times.
Never attracted to cold in any iteration, the prospect of being up in that kind of cold (let alone for six weeks) is truly unnerving! And myself a veteran of endurance sports, I have never cared enough about any sport to literally and knowingly risk my life for it. Many who attempt the summit do not come back. Vasquez-Lavado was the only woman in her group (as well as being the only lesbian and vegetarian, she is sure to tell us). A number of the men (including the man whose athletic resume touted completing two Ironman Triathlons in one day) turned back before arriving at the summit. Vasquez-Lavado does make it, which is an accomplishment that not many women can claim, and that is impressive. But more than that is the role of empowerment in trauma healing and experiencing the body as an undeniable ally. We cannot really reproduce this in any therapy.
All the women in the stories were transformed by both the physical integrity and empowerment proffered by the climb and the power of interpersonal connection for both staying alive and finding some peace with a previously unspeakable and shame-ridden past.
In the Shadow of the Mountain: A Memoir of Courage by Silvia Vasquez-Lavado February, 2022
Once again, although you may be sick of hearing me say it: it is all about regulation. Oy vey, there I go again. The addled organism, out of whack from over and under-stimulation, lack of or distortions of attachment and connection, is on a voracious quest: drinking, drugging, sexing, work… all to that same end. That is what Jeremiah and Sylvia most have to tell us if we are listening.
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 There Is A Mountain by Donovan.
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 an inveterate bookworm and student, I am reading all the time, and there is never enough of it—Oy vey. But what a wonderful problem to have when compared with the years of slogging to get through the day. However, with all that I read, it is not that often that I learn something that really changes my way of thinking. Not only new information, that is easy, but actually making use of it differently or relinquishing old, often long-held views. Over now close to forty years of sobriety from alcoholism, I have been entrenched in an admittedly “orthodox” 12-step rigidity. Not the “God” part, which trips up many people. I resolved that right at the start. But rather a hardcore abstinence-only program.
Of course, a severe black and white perspective readily suited me. I was always an “all or nothing” kind of girl and defaulted to a hungry “more is better.” I remember from an early age my mother trying to teach me the word “moderation.”
That’s a pretty big word for a little girl. I never quite got it and probably still don’t, or not enough. However, now I understand it more in terms of regulation versus voracious greed or wild overzealousness. Total abstinence from alcohol was infinitely easier than trying to figure out how much was enough or too much, i.e., to self-regulate, so I grabbed on to that one for dear life.
I was always an “all or nothing” kind of girl and defaulted to a hungry “more is better.” I remember from an early age my mother trying to teach me the word “moderation.”
Some people resort to entering a convent, the military, a cult or an authoritarian party or regime because all the decisions are made for them. There, they don’t have to assess or conclude what’s “just right,” like Goldilocks. I admit that some of that was in play during my political activist days when ideology was strictly prescribed, and political correctness was fundamental to having any sort of value at all. To this day, I am most comfortable in tight-fitting clothes: they seem to contain me and keep me from blowing apart from the inside. Similarly, I recently discovered that a weighted blanket has a similar “holding” effect. I continue to have a tendency to “color outside the lines.”
From the beginning, we all need a mom, not least because a good mom is regulating and teaches regulation. Comfortable in one’s own skin, one can live, love, “pursue happiness” with all that means, create, learn and take pleasure in life. A history of childhood trauma and/or neglect puts one on a relentless quest to find it. I think of the 23-year-old that I was, 98 pounds, on the couch with my cat Marti, drinking a quart of Old Crow bourbon straight each night single-handedly; it was $6.95 a quart then. Marti, named for the Cuban National Poet, Jose Marti, lived to 22. I always said she was like a mother to me. Really it was all an endless quest to find that elusive calm in the war-torn world of my body. Marti certainly helped, and so much of addiction boils down to that.
The dictum to “just” stop, or “just say no!” (a day at a time of course) was not easy but simple, and much easier than finding my way with food, which could never be relinquished entirely, or not safely.
From the beginning, we all need a mom, not least because a good mom is regulating and teaches regulation. Comfortable in one’s own skin, one can live, love, “pursue happiness” with all that means, create, learn and take pleasure in life.
I have since learned several sobering “new” to me facts about alcohol. According to World Health Organization data, alcohol is one of the world’s leading causes of death, behind tobacco which amazingly is still a great killer. Alcohol kills not only in its insidious damage to the body and brain, but DUI car accidents, behavior and crimes committed under the influence, not to mention the suicides of not only the drinker, but collateral loved ones whose lives with that person have become unmanageable.
Alcohol also causes more brain damage than any other drug, and neuroimaging shows the blackened tissue, which is the poisoning and deterioration caused by inflammation and dying cells. No other drug, neither medical nor recreational, shows that kind of wreckage.
And finally, a measure I had not actually pondered before: damage is measured not only by a substances’ impact on the individual user but on others and the world. How many children and spouses are neglected and abandoned every day due to addicted or substance-abusing parents? How many were molested, raped, beaten or in some other way violated by someone who might have much better judgment or control if not intoxicated? It goes on and on. And in this tally, alcohol wins by a landslide in terms of how widely one person’s substance use reaches. More reasons to be grateful, I was able to stop at 28 before doing more damage! Unfortunately, a hugely profitable industry holds it in place. Prohibition failed. Culture, tradition and culinary aesthetic make it essential to find a way at mass level, to regulate and self-regulate. Of course, this would have to include, at least where possible, addressing the myriad realities that would inspire an individual to “escape,” even if momentarily.
Michael Pollan’s latest book, This Is Your Mind on Plants, has a long section on caffeine. What I found most interesting was the history of how coffee affected industry, the industrial revolution, and the world political economy. Well worth reading! And we, or at least I, had not thought so much about caffeine as a “drug.” But meanwhile, in the private laboratory of my own brain, I have had to look at it as such.
One of the ways I have grappled with my complicated sleep issue (and the “challenges” of sleep will be a topic of its own blog on another day!) is with my afternoon coffee. I also began to notice that if I woke up and had my morning cup too early, by early afternoon, I would have one of those scull-cracking headaches right in the middle of my forehead, the undeniable battle cry of caffeine withdrawal. So the afternoon cup became medicinal in more ways than one—Oy vey. I am back to being that rat on the wheel, trying to stay ahead of the breathless chase. And although I don’t believe in the rhetoric of the “addictive personality”, I know all too well about the deep-seated dysregulation of early attachment trauma.
I knew that to begin to ratchet down the caffeine headache loop and ultimately eliminate it, I would have to find a much better way to manage the sleep issue (which I am constantly working on anyway) and also endure the discomfort (agony?) of weaning myself off. That is no fun at all. Although my own alcohol withdrawal is a blurry memory, not only because it was so long ago, but due to the addled brain I would remember it with, I do remember one of my very first mental health jobs in a methadone clinic. It was there, with a clearer head of my own, that I was to learn most vividly about “dope-sickness.” So, facing the prospect of enduring headaches without relief, or perhaps relieved in some other undiscovered way, was daunting. That is precisely what keeps all addicts on the wheel. And it is reminiscent of the age-old attachment theory dilemma without solution when the source of comfort/relief and the source of devastation and/or terror reside in the same package, human or otherwise. All the more reason why we need a more regulated world, in all the ways, regulated relationships, self-regulating individuals.
Here is where I began a subtle process of “changing my mind.” I heard expert drug researcher David Nutt (what a great name for a psychiatrist!) talking about “Harm Reduction”. When I first started hearing people talk about this “new” approach alternative to total abstinence, I balked, trying to conceal my skeptical contempt. My “todo o nada” all or nothing sensibility was roused. However, Nutt is not only extremely knowledgeable but personable and experienced at talking to people about delicate, often highly personal and controversial topics.
According to Nutt’s data (culled from his talk at the recent Addiction and Imagination Conference):
“…reductions in consumption gain much greater value in terms of health than you might imagine if the curves were linear. If you go from someone drinking 100 grams of alcohol a day, say a bottle of wine, to just 50 grams a day, you would lower their consumption by 50%, but you reduce their risk of death by eight times. And even if you reduce consumption at the top end by 10%, you actually reduce the risk of death almost by twice. So this is why any reduction in drug consumption is hugely important and that’s why harm reduction approaches are likely to be the most powerful ones in terms of mitigating the harms of drugs.”
As many of us know when learning regulation, harm reduction paradigms are not “pie in the sky.” But perhaps, I must also consider they are also not another money-making gimmick like the latest in an endless stream of commercial diet schemes, but rather a viable interim option. I have actually “updated my files” to incorporate them. Even this old dog can learn a new trick now and then!
In an Imago Therapy conference, I attended probably thirty years ago, I learned a quote that I have never forgotten, although I can’t for the life of me remember the name of the speaker or of the First Nation tribe that originated it. However, the words have stayed with me, and I even made a colorful wall hanging with them, which is hanging in my office: If you think you know me, you have stopped my growth in your presence. My interpretation: If you hold me to what I said or believed thirty years ago, or last week, or even yesterday, you are closing off the possibility that I may be growing all the time in our relationship. So, harm reduction is an important consideration. So there you have it: Addiction 101!
But as for me, well, I will stick with total abstinence and neurofeedback!
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 I’m So Glad by Fresh Cream. I love this song, although sadly Eric Clapton has his own story about addiction.
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 we mark the second anniversary of the seemingly endless global pandemic, let’s not allow it to eclipse International Women’s Day on March 8th, which doggedly rolls around year after year in the similarly seemingly endless march towards equality, justice and simple dignity.
Some decades ago, when cigarette advertising was still legal in the US, the specially designed “women’s” smokes had the catchy ad slogan ”You’ve come a long way, Baby…” Well, maybe some, in the First World anyway, but we still have a long way to go. As ever, I wrestle with my skepticism that “Me Too” and other momentarily epoch-making advances will disappear in the quicksand of traumatic memory, as other interests compel the public mind or sell news.
In 1970 pro tennis when male players were paid seven times (!) more prize money than their female counterparts (if women were admitted to compete at all!) and Billie Jean King fought for parity, it appeared as if female athletes were winning ground. Recent events like Chinese tennis player Peng Shuai’s “disappearance” and “silence” after speaking out about sexual abuse; or mysterious events surrounding teen Russian figure skater Kamila Valieva make me wonder.
As ever, I wrestle with my skepticism that “Me Too” and other momentarily epoch-making advances will disappear in the quicksand of traumatic memory, as other interests compel the public mind or sell news.
Perhaps Valieva’s tumble is a fitting metaphor. Yes, we have a woman vice president and women are even driving now in Saudi Arabia, but as contemporary Peruvian author Sylvia Vasquez-Lavado recounts in her recent memoir, even in her short lifetime she learned early that making herself ugly was the only defense against the relentless sexual intrusions and obnoxious attention of any random man.
Because of my own interest in “mother-lessness” and motherhood, I chose to focus on that female issue because it can have such profound meaning and impact on development, trauma and neglect. I remember when I first started therapy in my 20’s, my mother railed “It is the blame your mother generation!” That is certainly not my intent. However, Vasquez-Lavado’s mother is a vivid illustration.
In effect, “sold” into an arranged marriage at the age of 14; she had born three children while still a teen, until overwhelmed and overcome with tremendous shame and terror (and most likely dissociation), she fled. Vasquez-Lavado herself only learned her mother’s story years later, having always believed that the older relatives she thought were aunts and uncles, were her siblings. Of course, this all had a tremendous impact on her.
Deception, a mother’s disrupted development: generations of mother-lessness begetting generations of mother-lessness.
I have to wonder, with utmost compassion, what it was like for my mother growing up with my cold, upper-class intellectual grandmother. I believe there were a lot of nannies involved. And this, even before the explosion of the Nazi Holocaust.
I was stunned and horrified when I heard the story on February 5th that a Salvadoran woman identified only as “Etsy” was released after completing ten years of a 30-year prison sentence. The crime: abortion.
Well, they called it “aggravated homicide.” In El Salvador, abortion for any reason, including rape, incest, or danger to the mother’s health is strictly illegal. Still, in Etsy’s case it was an obstetric emergency that prompted her high stakes decision. Her release after ten years was a triumph of the international reproductive rights movement.
I don’t know if Etsy already had children before going to prison. If she did, they were motherless for ten years, and Etsy, besides being robbed of a decade of her life in conditions that I hate to envision, would have been torn away from them, Not to mention the grief of losing a wanted pregnancy.
This is all present tense. And as we all know, Roe v. Wade, the famous case that made abortion legal in the US in 1973, teeters on the precarious brink of survival.
Etsy’s trauma hovered right at the interface between abortion and miscarriage. In El Salvador, the line is blurry between the two, and even women who suffer miscarriages and stillbirths can be prosecuted for murder. I could not find any other countries that criminalize miscarriage, but I did learn that in some other cultures, women who miscarry are viewed as “dangerous” or possessed of some sort of spell that would make them, at the very least a threat and thereby unwelcome at baby showers and the like.
How very sad! Their likely grief and loss is then compounded by social isolation and ostracization – rejection. All too often, women are blamed or stigmatized for miscarrying, and certainly, this trauma is poorly understood by most who have not experienced it.
I have seen numerous examples in my practice of women who lost wanted pregnancies grieving with profound and vacuous loneliness upon these traumatic losses, especially when their reproductive window may appear to be soon to close. Somehow our culture is clueless about miscarriage, not understanding it as the death of a beloved other. I guess perhaps we don’t know what to say.
All too often, the grieving mother will hear something overly cheery like “you can try again…” or a quick jump to the joys of adoption, which may sound to the grieving “not-to-be-mother” like “this is no big deal,” or “there is nothing here to talk about,” or simply ”I don’t want to hear it.” The grieving one may then wonder if she is pathological or if her depression is exaggerated or self-indulgent.
There may also be medical complications or hormonal shifts that make healing slow, difficult and again lonely. There are no sympathy cards. There is no funeral, in most cases no spiritual or religious marker, public or private—a lonely and poorly understood road. And when grief is complicated and traumatic, and there is a subsequent pregnancy, that child spends its early months of development in a womb still lost in grief, stress hormones and fears that it might happen again. We could certainly help those children and later, adults, by developing an understanding of how to support miscarrying mothers-to-be and also make it a safer and kinder world in which to talk about miscarriage openly.
I was troubled to learn that in Spanish, or certainly in El Salvador, there is no word for miscarriage. The same word is used to refer to miscarriage as to abortion: aborto. So the mother of miscarriage is categorically likely to feel like a “sinner.” My recommendation to those who learn that a loved one or friend has lost a pregnancy and who don’t know what to say, is to just say that! Just say, “I don’t know what to say, but my heart goes out to you.” That is what I always recommend when we don’t know what to say, as it is a way to communicate that my silence is not because I don’t want to talk about this. I simply don’t want to make it worse. And it may serve as an invitation to let you know what would perhaps help.
I knew when I was five that motherhood was not for me. I was such a profoundly sad and lonely child, I knew I did not want anyone to ever come into the world and feel like that, and I feared I could not do better. I did not speak of it, but I always knew. As I got older, and my mother would refer to couples we knew who chose not to have children as “too selfish.” So, I concluded that my undisclosed plan for myself was another indication of my badness or defectiveness, it was probably true about me too. I was all the more compelled to be “unselfish.”
As I got older and saw how excited others and later my friends were about having families, I grew to believe that there was perhaps something monstrous about me and unnatural in my preference. In my thirties, as my window of possibility was narrowing, I had the good fortune to have a consultant, Mardy Ireland, who had recently written a book on the subject. All these years later, I still highly recommend that book: Reconceiving Women: Separating Motherhood from Female Identity.
Both Mardy and her book helped me tremendously to make my peace with my decision, which I have never regretted. I was also fortunate to partner with a man who was on the fence about children and therefore left it up to me. I am blessed with a wealth of nieces and nephews whom I adore, and the one thing that really endeared me to Tim Cook, the CEO of Apple, is when I read an essay he wrote on the joys of being an uncle. Being an aunt is one of the great pleasures of my life. I am good with that.
Admittedly I can slip into feeling that motherhood is an act of heroism and courage that I lacked. I must be mindful that when a client is grieving what she has not “accomplished” in other areas, that I do not miss the mark or intrude with my own formulation. And we all live or wrestle, like George Floyd in his final breaths, with a deep memory of the at least then, most important person in the world. In that spirit, I do say, thanks mom.
In the 1970’s Women’s Movement, we used to say Women Hold Up Half the Sky.
Happy Women’s Day to all.
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 Madre by Silvio Rodriguez.
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.