People sometimes ask me, “How do you come up with something to write about every week?” I used to wonder the same thing about local treasure Willie Brown, whose weekly column was my reason for reading the Sunday paper. When Willie quit, we turned off that paper. Well, for me, it has become something I can’t quite turn off. I might be listening to Public Radio, or half listening, or even one-eighth listening, and I will hear something that rousts me out of my kitchen task reverie. And then my mind starts whirring with words and thoughts and, of course, songs.
That is what happened yesterday, when I absently tuned in to an interview with author Henry Hoke, of whom I had never heard, about his new book, Open Throat. Intriguing as it is, narrated by a cougar, the book did not quite sound to my taste in spite of the interviewer’s raves. However, hearing that one of the towns in the book was called “Scare-City,” which, of course, is a brilliant play on scarcity. I thought, “Wow! I wish I could claim that brilliant turn of phrase!” And it got me to thinking about the terror of not enough, which is a scar on the soul, body and brain of the neglected child. I, for one, was born and raised in Scare-City.
I began to think about the nameless quaking terror of not enough. It is no wonder that I chose anorexia. Better to eat nothing than feel the rumbling panic of insufficiency. And, of course. I was insufficient, inadequate, not enough, always driven to do more, do more, do more, vestiges of which still somewhat dog me. And no wonder it never felt safe to share or lend. Sharing, I was convinced there would not be enough for me. Lending, my things would come back diminished, wrecked or not at all. It was safer to kiss it off and only lend what I might be ready to part with or never see again, hide behind a pretext of generosity and give it instead, or buy the prospective borrower their own of whatever it was. Other people could not be trusted where “enough” for me was concerned. I remember my therapist’s enduring patience with trying to convince me that perhaps, in fact, there is enough to go around. Our family was ruled by “zero-sum.” Wherever possible, I opted out of the competition.
Neglect is, in fact, an impoverished city. No wonder so many neglect survivors I know are scrupulously thrifty, sometimes even appearing needlessly stingy, at least with themselves. Or family finances, division of labor and other resources are a challenge for relationships. Of course! Poverty is no fun at all. Is self-reliance a kind of hoarding? Or an insurance policy to huddle around myself against the danger of famine?
Lately, I have had occasion to dialog with grief expert Edy Nathan. I had never thought explicitly about the apparent sisterhood between neglect and grief. The two are united by loss. Neglect is about the loss of what most likely never was, what should have been, or maybe what was for a while, and then no longer. I realized long after the fact that my protracted grief about the loss of my first love was in fact, the boundless and nameless grief of “motherless-ness.” Other than that, or until then, loss simply evoked numbing. I felt nothing. Even though I was not literally motherless, I felt such a void of loneliness, an inexplicable quaking broken heartedness, that only found expression, if for a long time misdirected, reeling from another lost love. Grief is a hard sell! Recovering from romantic heartbreak is so dramatic, especially the first time, it is next to impossible to think of it as something else.
In therapy and in parenting, the task is regulation. That is the royal road to sufficiency, to equilibrium, to balance, to “enough,” whether it be, doing or getting enough. Although I have thought of myself, perhaps flattered myself? Thinking I am pretty darn emotionally intelligent. Perhaps about some emotions or some people’s emotions, I am. But about grief, which lies at the heart of neglect, not so much! I have a lot to learn. And unprocessed grief, where does it go? As we know all too well, it will show itself somewhere.
I have never heard anything even vaguely endearing or attractive about US Supreme Court Justice Clarence Thomas. Sexual harassment, greed and opportunism were what I knew of him until this morning when I heard an interview with documentary filmmaker Michael Kirk who has recently unveiled a movie about him the man. Hearing his story broke my heart. Born in a small rural town, so poor that there was not only a lack of food but no running water -even toilets. He was fatherless, unwanted by his mother and then grandparents, his cohorts in his attempt at the seminary, and his high-powered colleagues at Yale Law. Even ostracized by his black peers for being “too” dark-skinned, he was rejected everywhere. Thomas never was enough, never achieved enough, and never got nearly enough. The culmination of the haunting unending deprivation, the continued gnawing of ravenous hunger of every iteration must be what spawned the impulse to stockpile and squirrel away to somehow ensure safety and survival. Hardening against heartbreak or need, the attempt to somehow feel a modicum of power, all added up to what is almost a caricature of the neglect adaptation, the despicable character I have read and heard about in the news for years.
The word “regulation” has become very “buzzy” in the last couple of years. I am almost hesitant to use it as it has become almost as hackneyed and tired as “pivot,” “double down” and “deep dive.” Oy vey! How do these expressions become so viral? And I fear regulation could lose its crucial meaning if it has not already.
By regulation, we mean the ability to return to a calm equilibrium after having become activated in one direction or the other. It is the capacity or fluency for calming down after becoming agitated, anxious, aroused, or thawing and returning to presence after a freeze.
Regulation, or “self-regulation”, is the ability to fluidly and naturally move between states. An infant learns to return to a baseline calm, initially by being calmed by a regulating other. That is how we develop the circuitry, how the brain and body learn the pathways, which we ultimately become able to replicate it on our own, -eventually. Certainly not overnight! And as parents of adolescents know, it is phased work and goes on for years to greater and lesser degrees.
The failure of regulation by a present, attentive, and hopefully caring and consistent other sets the stage for all sorts of aberrations that may show themselves and persist in the body, emotion and behavior. And may indeed add up to being one way or another out of control. Thomas shows every indication of that. Which certainly does not excuse his terrible behavior, (even only what we know about.) And clearly, this contradiction between outrage and sympathy again is among the many complications and tangles of healing at both the micro and macro level. Long story short, regulation is the answer.
For those interested, the Clarence Thomas documentary is free and available for streaming on Youtube. I have not watched it yet, but I plan to.
That is enough for today. I wonder what “Da Mayor,” Willie Brown is up to!
Today’s song:
When I was growing up, there was no internet, no Google. There were encyclopedias. I remember a three-tier caste system of them: the most expensive and most sophisticated was the Britannica. The “middle class” was the World Book and the “lowbrow” I think, was called Colliers. I don’t remember. We had the World Book. I think we got it from a door-to-door salesman. There were door-to-door salesmen in those days, invariably men, in cheap suits and ties like the fuller Brush Man, peddling various products. Our World Book was bound in white, not quite 26 alphabetical volumes. I think X-Y-Z were all in one.
The set sat on the lowest shelf of the living room bookshelves. I could curl up quietly on the rug for hours, looking all kinds of things up. No one really knew where I was. And that was one of the few places I could surreptitiously learn about bodies, except for the occasional National Geographic photo of naked indigenous people somewhere. Admittedly I pored over those too. Thank goodness for the World Book! How else was a solitary little child of neglect to learn how the world works?
One of the missing experiences with neglect is having someone to talk to about random, thoughts and questions or teach them about things they might never have thought of or heard of. Children are by nature curious beings, the world, at least at first, is one grand oyster, or ideally so. I am so delighted to see my sister with her little grandson, nourishing his love of octopi by learning all about them with him. And exposing him to many other weird and interesting curiosities of nature. She is a wonderful teacher, and I am infinitely grateful to her as she was the very one who taught me to read when I was probably the age he is now, three-ish? That was a godsend, a lifeline, and books became a lifelong source of comfort, company and information. I have never stopped reading since.
Children lacking an attentive parent or caregiver, who takes time and even takes pleasure in their learning and navigating the big world are once again thrown on their own developing resources to “figure it out.” It involves flailing, looking for models on TV or on the playground to imitate, or as a final resort, making things up. Besides the World Book and what I could get my hands on at the library once I was big enough to go there, all of those were my “answers.” But to be honest, I was, for the most part, pretty clueless. In fact, I remember in my early 20s when I finally started therapy, shyly asking my therapist, “What do people do when…” I still had no idea, and I have always said I only started learning to be a “regular person” when I worked in restaurants, also in my early twenties. The other waiters talked about music and movies and sports, and I learned to imitate them and get over as somewhat “normal.” But I never really knew. And if or when I finally knew anything, I hung onto it for dear life, It seemed tied to existence somehow.
Years later, when I began to formulate what I came to call the “neglect profile,” my anecdotal catalog of consistently observed traits in survivors of childhood neglect, I began to notice or perceive a “charge” at the very least, surrounding the whole notion of “knowing.” Admittedly, earlier on in my work as a therapist, before I put the pieces together, I might become exasperated and more than once lost my cool and exclaiming with frayed or absent patience (and certainly too loudly,!) “If you know everything already, why the heck am I sitting here?” Oy vey! Makes me blush to think about it now. It took a while for me to get it.
Knowing what we know, or what we believe we know, anyway, is a survival strategy. Never having anyone to turn to for answers, the child of neglect resorts to their usual and only default: they pull in on themselves and solve the problem on their own, often with some pride or even self-righteousness. And often become quite defensive or “touchy” about what they know. If I were to mess with that, it might be on the order of taking away a life raft, they might feel rudderless, defenseless. I learned pretty quickly not to argue about these things when possible.
Now on the internet, one can find answers about pretty much anything. There is no shortage of junk science, pop psychology, and “diagnoses du jour.” Admittedly, and it is probably obvious, it can irk me when precisely what I have been doggedly studying, consulting the best research from the top experts in the world for four decades, and a “lay-person:” friend, family member, client or random person, spouts expertise on something that is “my area.” We used to joke, “I heard it on TV, so it must be true.” Now it is the internet. Suddenly surfing the net becomes “research.”
My husband is a devoted supporter of my work, a survivor of hideous neglect himself. Recently reviewing something I had written about my longstanding “three P’s of neglect”, he innocently suggested an idea he had of a 4th P. I was momentarily incensed. My model, my turf, I was once again that reactive, touchy neglect survivor, as if I was in danger of disappearing or dissolving into worthlessness again. Thankfully these things don’t last too long anymore! But a well-worn circuit is persistent, and being a lifesaver, defaults to sticking around without a lot of self-awareness and ongoing mindful work!
It can often happen in couple’s therapy, where one partner will repeatedly say, “We talked about that!” Yes, and of course, they may have talked about it even and often ad nauseum. If it keeps looping back around, something has not been empathically or sufficiently understood and processed. If it had been, it would be laid to rest and stop rearing up. Updating the files can be a tall order! It means relinquishing something one might have been convinced of, which has felt quite essential.
A “know it all” quality is not attractive. Many survivors of neglect, at least before working on it, may come across that way. Sometimes I am able to gently remind myself, “Yes, that is how she makes people not like her,” or he, as it were. Then I am sheepishly reminded of making people not like me that way. Occasionally I can still lapse; briefly, I would hope. Suffice it to say that knowing, and being fierce about what one knows, is another expression of the lifesaving armor of self-reliance. Becoming safe enough to acknowledge interpersonal need and to receive is a goal of our work. It also requires courage and humility, and, unfortunately, time.
The child of neglect craves to be seen, heard and understood. I have learned from my mistakes never to offer unsolicited information if I can help it. I am still accused of “mansplaining” once in a while. I am trying to learn. Learning to learn from others is a rocky road of processing fear and discovering that it can be OK to not know, that someone else knowing or teaching me would not rob, endanger or annihilate me. And is often quite fascinating. What do you know?!
Today’s song:
Pondering how I first happened on the translucent, barely visible child of neglect, the oddest image appeared in my mind. I imagined myself, middle thirties strolling placidly along a quiet beach. In one non-remarkable step, walking through the innocuous and pleasantly warm sand, I am suddenly nudged into alertness to discover that one little mound, apparently indistinguishable from all the others, had a little hole in it. Just as suddenly, it explodes into a geyser-like cascade of tiny ants. They are everywhere, teeming and flowing in every direction. They are immediately all over my feet and ankles. Wow! Where did that come from?
Encountering the unexpected world of neglect was like walking into an industrious, quietly busy camouflaged ant hill, which turned out to be a mountain. My mom used to say, “Don’t make mountains out of molehills!” And she generally did the opposite, at least where I was concerned. But in this case, no exaggeration. I hope likening the hapless child of neglect to an ant does not seem insulting! It is not intended that way, and who knows where these seemingly random flashes come from? Besides, ants are really quite amazing. I have seen teams of the little critters working together to heave and lug a leaf infinitely larger than the whole pack combined across a human-sized dirt hiking path. A remarkable mission of strength and courage, too, as the trail is regularly trudged over by hikers and passersby, most likely not looking down. An amazing feat, no pun intended.
I will dispense with the story of how it all began, in real life, I have told it so many times. I am told I am quite the storyteller. I never realized that I am until only much later when there was actually someone to tell stories to. Rather, I would like to paint a picture of the emerging character that began to take shape in my observation and in my thinking as I watched and studied this to me newly identified population.
In cheese making, a rather astonishing process occurs, which still continues to amaze and delight me. A minuscule amount of rennet, the “coagulant,” maybe one and a half teaspoons in an 8-gallon pot of milk, after adding that and an hour or so of peaceful rest, miraculously, a pot of liquid congeals into a large pot of what becomes increasingly a solid pot of curd. That is how I remember the gradual coagulation of what I came to call the “neglect profile.” I will only begin to sketch it here. Like a good cheese, it has aged and continues to age over months and years.
Pecorino, Parmesano, Provolone? Well, those are all good, but not what I had in mind. The first recurring character pattern that began to jell in my observation was what I came to call the triumvirate of Passivity, Procrastination and Paralysis, or the “Three P’s.” The P’s came to be a signature that I spotted early on that pointed to neglect. They seemed to resonate with people. Why would this be?
Three major tent poles of my thinking, the rennet perhaps, were neuroscience, attachment theory and Neurofeedback. From neuroscience, Allan Schore, one of my earliest and most profound influences, we learned that the infant brain develops in resonance with the brain of the primary caregiver, right hemisphere to right hemisphere, primarily through the gaze. If that infant gazes into a face that is angry, fearful, expressionless or unpredictable, the earliest experience of that developing brain will be fear, uncertainty, confusion: dysregulation. And if there is no one there, the gaze is into a vapid emptiness. Left alone too much, that little brain will be under-stimulated, not to mention scared and sad. But of course, emotion will only register in a sensory or bodily way at that stage. This is the unremembered, at least not in narrative form, beginning of the neglect experience. The under-stimulated brain will lack the encouragement and the incentive; thus, the initiative to reach, to begin, to try. Why bother?
From an attachment standpoint, the child who experiences the presence of a loving, supportive other is safe enough to go forth, to explore. We have probably all seen the videos of infants and toddlers crawling and walking further when they look back to see the encouraging, even applauding loved one attentively watching. Presence, having their back, makes for safe exploration.
Similarly, the essential “dilemma without solution,” which will be addressed in great detail in future writings, where the source of comfort and the source of terror or distress are the same people, and the child is in an irreconcilable quandary: reach toward or withdraw? The ambivalence makes for a toggling to and fro; fogginess at the very least, if not a full-on freeze response. Not conducive to purposeful action.
And a child left alone with minimal response to their cries will soon conclude it is pointless to cry, pointless to reach, pointless to act. Passivity would be a realistic default.
And from a neurofeedback standpoint, the under-stimulated infant brain will fire at slower frequencies, making for perhaps a slowing or clouding of attention. This, in turn, makes for what I have perceived to be a high co-incidence of attention deficit complaints from (or about) children of neglect. And although I have not seen data yet on the correlation between attention deficits and neglect, neuroscience of trauma expert extraordinaire, Ruth Lanius, has informally agreed with the hypothesis in a couple of personal communications. So there you have it: three P’s, and not as yummy as cheese, to say the least!
I might add that a frequent accompaniment to the P’s, or a ready refrain, punctuated with a deep shrug, was “I don’t know what to do!” Or, “there’s nothing I can do!” Of course! There wasn’t! The child had no impact. And there was no one to safely ask.
The hallmark of neglect, however, the signature or flagship, curiously became clear only secondly, after the unmistakably consistent P’s: A ferocious self-reliance. In the US, with a cultural history and iconizing of “rugged individualism,” self-reliance is admired, That is probably why I, for one, did not recognize it sooner, being a beacon of at least nominal or illusory self-sufficiency most of my life. Being pack animals, humans are by nature dependent and interdependent. Attachment is a survival need, and interpersonal need is nature’s design. Neglect is the failure or absence of reliable care. A child left alone too much has nowhere to turn but inward.
Self-reliance is a defense mechanism and a survival strategy originating with pain. It may evolve to become a haven of safety and the only comfortable way to be in the world. It may also be a point of pride. Before I was 15, I had my own little housecleaning business. I rode my bike to those big houses where rich people lived and started saving up my money for college. I could not compete with the Holocaust, but I did quite well at making my own way, and I thought it was pretty great.
Self-reliance, although exquisitely adaptive, also makes havoc in the world of relationship. Satisfying relationship involves reciprocity, and if we don’t let the other give also, they may feel unequal, rejected or unsafe. Or they might also appear to take advantage, which ultimately results in messy and often terminal ruptures. It took me decades before I could keep anyone in my life for long, before I learned how unsatisfying and controlling my over-giving might feel to the other, and how disempowering of them my inability to receive could feel.
Therapy is also a challenge for both neglect survivor client and therapist. To let the therapy “work” punctures the self-reliant armor. It is no longer “doing it all myself.” Being desperate for therapy to help and change something collides with the self-reliant armor, replicating a version of the original dilemma. Oy vey.
Finally, admittedly self-reliance can inadvertently blur into a kind of self-centeredness that I call the “one-person psychology.” The survivor is so busy taking care of everything for themselves that they can appear to forget about the other. Many a partner of a child of neglect complains about feeling similarly forgotten and neglected.
These were the beginnings or the foundational elements of what I have come to call the neglect profile. There was so much more to learn. And there still is. This is a start for now, as I begin to unwind and present the inner and outer, the experienced and the observable markers. I want everyone to learn to see what is not there and recognize neglect in others and themselves. Let’s make this world “neglect informed!”
Today’s song:
On the 24th of April, we lost another queen. Admittedly where I was amazed and perhaps baffled by the dramatic display of emotion and attention following the death of the British monarch last September, when Tina Turner, also known as the “Queen of Rock’n Roll” died last week, the outpouring of grief around the world, made perfect sense to me. The old rolling Stones’ song, “I Know It’s Only Rock’n Roll But I Like It…” well I guess that is me in a nutshell. Turner was an icon in so many ways. She was, among her many “firsts,” perhaps the first public figure to speak openly about domestic violence, which of course had a tremendous impact on women everywhere. She was the first African American to break into the white world of rock, without following a rhythm and blues, jazz or MoTown route, and like a phoenix, she rose out of destructive flames repeatedly in her life. She was a powerhouse and an inspiration.
Tina’s trauma began long before her well known battering by first husband and musical partner, Ike Turner. She knew from the start that she was not wanted and never felt loved by her parents. They already had two children and had no intention of having another when her mother was unexpectedly pregnant again.
Born Anna Mae Bullock in a small Tennessee town where her father was a sharecropper, she picked cotton as a small child, before her parents left to relocate to another town. She and her two sisters were separated, and all sent to live with different relatives, Anna Mae staying with her cold, strictly religious paternal grandparents. When the family reunited two years later, Anna Mae witnessed her father, now clearly alcoholic, violently abusing her mother, until her mother ultimately left, abandoning the three girls. Two years later, her father remarried, and Anna Mae and her sisters were sent to live with their other, the maternal grandmother.
When she was a young teenager, one of Anna Mae’s sisters died suddenly in a car crash. Attachment shock, as psychiatrist and trauma expert Frank Corrigan so elegantly renamed the developmental trauma of attachment and loss, like hers, were her earliest experience, and the “hits” just kept on coming.
Anna Mae sang in the church choir, and from early life loved music and dance. Later as a teen she frequented music clubs, which is where she first saw and heard the musical performance of Ike Turner. She was mesmerized and immediately wanted to sing with him. Ike however, had no interest, at least at first. Somehow when Turner’s drummer’s back was turned and he had stepped away from his mic, Anna Mae grabbed it and belted along. The listening crowd was transfixed by her voice and energy. So originally unwanted by Ike, she suddenly appeared to offer some kind of “ticket” or entrée for his aspirations. Although highly talented as a musician, he lacked the magnetism and verve that this young woman displayed. So Ike took her on.
Ike right away changed Anna Mae’s first name to Tina, and her last name to Turner after marrying her. He patented the new name so she could not leave him, or if she did, she would not be able to take it. Thus, Tina Turner was “born.”
Unwanted from the start, then unwanted again, nameless and used even before being beaten, the young woman, now Tina, never intended to become intimately involved with Ike. Their first intimacy was non-consensual, but she went along. They became the Ike and Tina Turner Revue, and in spite of his ongoing infidelities and violence, she lived and worked with him for 16 years. This is perhaps where the emblematic ferocious self-reliance and survivorship that accompany early neglect, can be a mixed blessing.
It took two years more (after their initial 14 years) of Ike’s drug use and violence, and her one thankfully failed suicide attempt for Tina to finally leave Ike. She even lost a son to suicide along the way. But like the “Grey Goose” of the old spiritual, who simply would not die, in spite of unending parade of assaults, somehow, Tina’s volcanic energy and undying persistence prevailed. After some years of recovering herself which included becoming a Buddhist, with a sustaining (and I would guess regulating,) serious practice of chanting, she did the unthinkable. She made her spectacular re-entry to the music scene, becoming a solo rockstar in her 40’s. Tina performed with the likes of the Rolling Stones, Bruce Springsteen, Rod Stuart, Bryan Adams and more, which, if you are anywhere near my age, you would recognize as the top of the top. And she was a fireball in her own right, loved all over the globe. She said, although she was not a “superstar” like Madonna in the US, in Europe she actually was, and she later made her home there.
Tina met and married her husband Erwin Bach when she was 47. He was 30 at the time. They were close and intimate for 26 years before they finally married. She continued her progression of “firsts” becoming the first woman and the first person of color featured on the cover of Rolling Stone magazine. Mick Jagger credits her with teaching him some of his most cherished dance steps. She scored 10 Grammy Awards; and was twice, (the first time being with Ike,) inducted into the Rock and Roll Hall of Fame.
Tina’s final decade, however, was a tragic series of serious illnesses. A massive stroke made it impossible for her to speak or walk for a time, all of which through dogged determination and hard work, she regained, although singing by then became a challenge. Thankfully she could still chant.
Next came a serious run of colon cancer, which resulted in a surgery that cost her much of her large intestine. And finally, a bout of kidney failure that nearly took her down. Although she was unafraid of death, and was prepared to go whenever her time might come, she graciously assented when her husband underwent surgery to give her one of his kidneys, which kept her going for her final years. She died at 83.
Turner was proud and grateful for her life and her accomplishments. She continued to feel a debt of gratitude toward Ike, in spite of everything. I can understand that feeling as I like her feel profound and immense admiration and gratitude for the man who most hurt me in my life. Tina similarly experienced great joy and fulfillment in her also pain racked life. Like many of us who have histories of trauma and neglect, she felt that all that adversity gave her the depth and intensity, the energy and indomitable drive, the creativity and understanding, that marked her life and her work, and contributed perhaps more than anything to her gifts to the world. I can relate to that too, if on my much smaller scale.
Tina also garnered a prestigious star in the Hollywood Walk of Fame, which this past week has been blanketed with a deep drift of flowers, gifts and missives of appreciation, love and grief. Tina was, as a part of her great legacy, a tribute and a testament to the indomitable power, strength and healing possible, even for the most traumatized. She was indeed “Simply the Best.”
I am sure Tina would have wished to be remembered having this much fun! And like me, she always had a crush on Mick.
Rest well Tina, you so earned it, and you will be deeply missed!
Today’s Song:
When I was young and deeply involved in Latin American anti-imperialist political work, the freedom fighters who organized and fought clandestinely against authoritarian dictatorships were called La Resistencia, the resistance. They boldly left their insignia, a capital R in a circle, as their quiet battle cry to show that they were not vanquished, ferociously not gone. I have always rather liked that it was also my initial, and I could sign off, if not in battle, certainly as a champion of the oppressed and unfree. However, the ways the word “resistance” has been used in the world of psychotherapy and, to some extent, in common parlance has irked me. I even occasionally hear disgruntled spouses hurl it crudely in an unruly couple’s session before I get a chance to nip it. It suggests intentionality, a willful thwarting of something. I rarely see psychological pushback that way. It invariably represents something else, certainly where trauma is concerned.
The core dilemma at the heart of neglect trauma is a profound internal conflict about attachment. Starting from the initial heartbreak, the child interprets the neglect scenario the only way they can, as rejection: “I am not good enough. I don’t matter. I am worthless. I am invisible. I don’t exist.” At first, if the neglect is early, which it often is, there are no words, only a quaking emptiness, hunger, agitation, a shapeless, rudderless flailing disorientation and confusion. After a while, there is collapse into the futility of waiting, and perhaps a freeze. Later, what most often emerges is a default to rock-solid self-reliance. What other choice do they have but to become strong, fierce, enduring, and to do it all themselves? It is the signature of the child of neglect, perhaps their/our version of the defiant “R.” But it is far more than a statement; it is survival, a way of life.
I began to learn about the ferocity of self-reliance in my work as a therapist. Often the child of neglect is reluctant to seek psychotherapy in the first place because they are not used to thinking of another person as a resource, or as being of any use. Often, these children of neglect are some of the most competent, accomplished, and outwardly successful people one might ever hope to find. The fact that there is a gaping interpersonal vacuum or “disability” might slip by unnoticed, even by themselves. They might know that they feel bad, or maybe they don’t even “have time” to notice that because they are too “busy” or too practiced at whatever their chosen medium of numbing out.
The core dilemma at the heart of neglect trauma is a profound internal conflict about attachment. Starting from the initial heartbreak, the child interprets the neglect scenario the only way they can, as rejection.
I had a humbling lesson about my own, perhaps avoidant, self-reliance only a few short years ago. My beloved therapist was undeniably getting old. I had been with her forever and had come a long way in letting myself know how important she was to me. I had always said to her, “I am going to keep coming here until you shut the door!” I was committed to that. By now, she was 89. In all our years together, she had never forgotten things. That stunned me when I first met her. She actually listened to me and tracked what I said! My parents had never even known my friends’ names, if I ever had any. Here was someone who was holding my whole life. Unbelievable. Now at 89, she was occasionally slipping, understandably, of course. I could not deny it.
I am a rather compulsively punctual person. All my years of therapy, I paid riveted attention to the clock, always cautious not to “overstay my welcome.” I liked to pay first, so I had “earned my keep.” I never wanted to impose in any way. And I scrupulously arrived on time. Until now. “Suddenly,” I began arriving at my sessions late. I would walk the mile or so from my office to hers. I had always enjoyed the walk, and window shopping on College Ave. It was a lively, colorful street, and now post-pandemic, it is coming back. I enjoyed being out in the world. And I made a point of managing my work days so there would be time to walk – until this point in time, when things started “running late.” I was unwilling to give up the walk and drive to be on time for my sessions. I stubbornly insisted on walking. We observed me arriving later and later to therapy. My therapist, always attentive to everything, especially where our relationship was concerned, would ask me, “What is up with this lateness?” I shrugged it off. My work… but it seemed I was starting to be sometimes almost 20 minutes late for a 50-minute session.
It took a long time to recognize that I was starting to fear not only her retirement but her death. Anything remotely related to losing her completely unnerved me. Except I did not even let myself know that. She worked to nudge and delicately steer me into that material for a long time before I “got it.” If she or anyone had dared to call it “resistance,” I am sure I would have had a righteous hissy fit.
The fear of loss is so profound it evokes the first “loss,” which was not really having anything in the first place, so far beyond conscious awareness. It took many months of wasted, lost time I could have had with her. She did retire before she turned 90. Now she is 93? I’m not sure. We are still in touch, and I still struggle sometimes to let myself call and see how she is doing. I know she will not live forever, and somehow that is unbearable. Need and loss are two sides of the same lousy coin. Neglect makes one desperately vulnerable to both, so we toggle back and forth, keeping them, as much as possible, outside of awareness. We deny, disavow, OK, resist. It can be a tragic waste.
Yes, our core dilemma is that the source of longed-for comfort and the source of perceived terror, loss, and/or rejection are the same person. What is a child to do?
Yes, our core dilemma is that the source of longed-for comfort and the source of perceived terror, loss, and/or rejection are the same person. What is a child to do? They push and pull, reach toward, recoil from, rock and roll, and ultimately culminate in collapse, freeze, or both. The same conflict can unfold in psychotherapy. On the one hand is a desperate longing, not only to connect, but to have the therapy “work” and actually be helped. On the other hand, is the seemingly lethal danger of interpersonal need, of letting the lifeline of self-reliance be punctured, and the puffed up, imagined, even experienced safety of isolation, whistling airily away. It is perhaps like a balloon with a hole, hissing and shrinking, spinning away from the risk of being abandoned, rejected forgotten again.
Some clients “resolve” or avoid it by having something like “serial monogamy” with therapists: going from one to the next as if they are interchangeable parts, not relationships, as if we therapists have a “shelf life.” It makes logical sense, but it is not what the heart craves. It is not “really” safe. It can most definitely be a challenge for therapist and client. Some view the method as the vehicle of change: the neurofeedback, EMDR, IFS, SE DBT, whichever of the alphabet soup, rather than a person. Those are all essential, don’t get me wrong. But the deepest healing comes in the relatedness.
It is a long-term challenge that I have been at for many years. I try not to think of it as “resistance,” even my own stubborn lateness, my preference to look at all the beautiful clothes in the shop windows. That makes it sound purposeful. Rather it was an urgent gasp to maintain autonomy, to save my life, and to protect my long-ago broken heart. I have come to think of the vacillation, the reciprocal reaching for, pulling back, perhaps as a kind of rocking? Perhaps it is a simulation of the loving somatic experience of being cradled, having a large and containing other’s body gently embrace, enfold us in gentle, rhythmic movement. It is often a grievously missing, even dreamlike experience, and people can try in vain to give it to themselves. What a terribly lonely, if logical, formulation.
We must go kindly with this. It takes its time to heal. Many of my comrades, the Resistance fighters I knew and did not know, I fear have died. Some I know about, some I never heard about again. They quietly slipped undercover, and who knows what happened? A different kind of cover than the craved cradle blanket. I still cherish the mighty R and the songs that honor them. And it is essential not to confuse different avenues of survival: both are heroic, each in their way in the service of freedom and life.
It is turning to spring in my hemisphere. Best wishes for whichever of the season’s holidays you observe.
R
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.
Anyone who has known me more than a minute has heard me, probably ad nauseum, reference the renowned relationship researcher John Gottman. Gottman, originally an MIT-trained mathematician, changed direction to a study of psychology, mostly to try and figure out why he couldn’t get a date. The result – 40 years of longitudinal data about what makes relationships work and the predictive factors of separation and divorce. He also wound up with his long-term partner and collaborator, Julie Gottman, although I don’t know the story there.
I have great respect, admiration, and gratitude for good researchers. I certainly would not be able to do it, and probably wouldn’t care to, but research changes history, makes our work credible on a larger scale, and also can serve as an often much-needed guide, especially in something like psychotherapy which hovers somewhere between science, art, and some think alchemy.
One of my favorite tenets of Gottman’s research, which is central to my work, is the simple and undeniably well-proven principle, that in a relationship, to break even – not make progress and not backslide, but simply maintain equilibrium – the ratio of positive to negative is (drum roll) 5:1. Just to break even. That means appreciation, compliments, smiles, and gestures of affection. It can be most anything positive to the other, measured against complaints, criticism, grumbles, etc.
Certainly, in the neglect experience, these random shots of positivity are glaringly absent. Our best hope may be to exist, which may not be such a positive thing… So I am always looking to inject positivity whenever I can, which is not always easy in the bleak landscape of trauma and neglect. As we know from operant conditioning, the principle on which neurofeedback is based, the brain responds most favorably and learns from “reward,” so positive feedback is, by nature, re-enforcing. An additional win! 5:1 or better is a quick and sure way to change the “weather” in a relationship. A positive spin on “climate change!”
Gottman also reminds us, perhaps reassuringly, that evolutionarily speaking, relationships are significantly different now. It was not much more than a hundred years ago that our species did not live long past our reproductive years. Once the mandate to preserve the species was accomplished, monogamous partnership was not, at least biologically, essential anymore. Now we live decades beyond child-bearing and are challenged to maintain harmony, let alone eroticism, until death do us part. We are in a slow and trying process of changing nature’s design.
In the neglect household, as in much of the world, really, sex is not talked about. Certainly not in any kind of constructive or instructive way. In the world of trauma, and in general, we mostly hear or speak about sex in its worst light: abuse, exploitation, trafficking, harassment, commodification, and aggression, both micro and macro.
I thought, how about ringing in this new year with something positive about sex? Next week is Chinese New Year, the Year of the Rabbit. A lover of animals, I appreciate the tradition of each year correlating to one or another species. Besides their reputation for liberally proliferating, I also like the idea of jumping, rabbit-like, into this year.
“Sex-positive” has become something of a buzzy designation, kind of like “trauma-informed:” a sub-credential attempting to offer a space safe where people are free to speak or be open about sexual matters and be accepted and understood.
“Sex-positive” has become something of a buzzy designation, kind of like “trauma-informed:” a sub-credential attempting to offer a space safe where people are free to speak or be open about sexual matters and be accepted and understood. When I first started training for sex therapy, I quickly discovered the work of Peggy Kleinplatz, whom I think of as the best sex therapist in the world. Additionally, Kleinplatz is a researcher and a professor – truly a pro. When I first saw her at a conference, I was amazed at how such a giant could be so diminutive, with beautiful hair almost as long as she is tall. I hope it is not sexist that I describe her appearance, as I certainly do not mean to diminish any of her other attributes!
At one of those first conferences was an opportunity for “Breakfast with the Presenters.” I managed to be early enough to score a seat at the smallish round table with Peggy Kleinplatz! I was so starstruck I really could not speak or ask my questions, let alone eat! We have since become friends, and I have since been the presenter at one of those tables. It is a distant and sweet memory.
One of Peggy’s great achievements and contributions is that for several decades she has been seriously studying the positive: the elements of long-term, satisfying, monogamous sex. She has interviewed thousands of self-identified sexually happy long-term couples of every stripe to answer the question, how do they do it? How do they keep sex from devolving into “drudgery and begrudgery?” (Confession: I stole that catchy turn of phrase from Bono’s recent memoir. The book isn’t great, but that line is brilliant! I wish I could claim it!) Peggy came up with thousands of couples who could do it. (She studied non-monogamous couples as well, not to discriminate!) I was delighted when in 2020 she came out with a popular book, Magnificent Sex: Lessons from Extraordinary Lovers. Circumstances change, bodies change, and health intrudes, and yet these couples continue passionately going strong. How do they do it?
Not only sexual trauma but trauma in general, including neglect, can wreak all sorts of havoc in the sexual body of an individual.
I won’t spoil it. Everyone should read this book. I will simply recount a few highlights. Peggy describes her incipient interest in the project, which proceeded to span decades. As I have said before, therapists, or people in general really, enter the sex therapy field out of some particular fascination (preoccupation?) with sex. Admittedly true for me. However, I was also faced with couples with one or another iteration of a sexual impasse daily. Not only sexual trauma but trauma in general, including neglect, can wreak all sorts of havoc in the sexual body of an individual. Requiring a delicate balance between sympathetic (excitement) and parasympathetic (calm), the dysregulated traumatized organism is challenged. (Much more to be said about this expansive subject in future writings!) In the case of neglect trauma, abundant anecdotal observation has revealed complex sexual difficulties based on the profound ambivalence, if not crisis, about interpersonal need. The child of neglect is compelled by both interpersonal longings and terror, which creates an additional dilemma around sex. Again, much more to be said about this, but I promised to keep it positive today!
Peggy began her exploration by asking new sex therapy clients who came in complaining of (or being complained about!) “diminished sexual desire” to describe their time of greatest sexual longing, realized or not. Remarkably, they all had some. Says Peggy, if we want to inspire sexual desire, we must have a vision or experience of “sex worth wanting!” Seems so obvious, no?
I will jump ahead to the “lessons,” partly because I encourage you to get it straight from Peggy (and her co-author, whom I do not know, but do not wish to neglect, A. Dana Menard,) and because I want to leave you with something positive. And admittedly because I risk going on all day about this!
The top three ingredients of magnificent sex, according to Kleinplatz and Menard’s research, are (drum roll): presence, superb communication, and exquisite empathy. So it is not about novelty or rose petals, fancy positions or role plays, but the most longed-for and most tragically missing ingredients in the neglect experience, and in the world, really. What a magnificent world it would be if we all cultivated and practiced those three! So, there you have it. As Rabbi Hillel would say, “Now go and study!”
The welcome earworm in my head jumping into 2023 and the Year of the Rabbit is John and Yoko’s timeless 1969 classic Give Peace a Chance. “All we are saying is give peace a chance…” I would take it even further and add “Give Magnificence a Chance” (And my own additional verse, “Give Sleep a Chance!”)
Kung Hei Fat Choi!
Today’s song:
My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.
For better or worse, we are all too aware that nature’s design is to exist, survive and persist into the future by proliferating one’s likeness and perhaps broadcasting that. It is as if the world were a giant Petri dish of infinite rabid species in a wild race to replicate their own. Some organisms cross ethnic lines and collaborate to help one another in the endeavor of spreading: mushrooms helping trees, bees helping plants, many plants helping each other, and some of the heroic people who work to rescue the endangered from extinction. In Michael Pollan’s lovely book, The Botany of Desire, he poetically describes this.
Left to ourselves, however, across nature, we would all be blindly cloning ourselves into perpetuity. With great frustration, I saw this during months when I was too busy to keep up with regular daily cheesemaker “hygiene,” and the roqueforti, like greedy imperialist pirates, ferociously took over the world in my “caves.” It was everywhere. Blue cheese is delicious and all, but when you are trying to make Gouda or Gruyere, it should not voluntarily turn blue. Oy vey. After my book was written, like rebuilding after a war or flood, recovery took many months. Lesson learned.
Many parents indeed strive, perhaps unwittingly, to sculpt little echoing 2.0 iterations of themselves, maybe attempting to get a few bugs out, maybe actually failing to see those and passing them on. There is, of course, great pride in tradition, bloodlines, and culture, and there is something comforting and safe about more and more of the same. I remember, as kids, singing “rounds:” Row, Row, Row Your Boat, Frere Jacque, Hinay Ma Tov U Manayim, repeating the same little song over and over with a different little voice jumping in at intervals, continuing to make a lovely harmony. We could go on like that for ages – it was so simple and sweet. As one with some undeniably OCD-like tendencies (unlike my variety-loving husband,) I find repetition and routine to be regulating and reassuring as well as efficient – call me boring. (I do get a lot done!)
Often, we work to “manipulate” or control proliferation or the direction of transmission and development.
And of course, we find the inevitable mutations, some devastating like cancer, some less so. Some are for the better, which is how we get evolution. Before Roger Bannister broke the four-minute mile in 1954, such speeds were deemed humanly impossible. Since then, the record has been broken many times over, and by 1999, a mere 45 years later, another 20 seconds had been shaved off by subsequent generations.
Often, we work to “manipulate” or control proliferation or the direction of transmission and development. This can be dicey and controversial: pesticides, genetically engineered food, test tube babies, some producing the stuff of horror movies. Some results are miraculous, like vaccines and disinfectants, or processes like pasteurization or retrofitting. So, it is complicated. I find it amazing that the addition of minuscule quantities of starter “cultures” (and I love the irony of that multi-definitional word) changes the nature of milk, making it receptive to transformation not only from liquid to solid, but changes in its sensory character, giving us literally thousands of delicious flavor varieties. Yes, interrupting nature is indeed a mixed bag.
By now, we are all painfully aware of the intergenerational transmission of trauma and neglect, the complex chain of repetitions that continue to enslave, infect, and blind ad infinitum. I am like a broken record on the gnawing subject. And yet it persists seamlessly in both the macro and micro. The nature of untreated trauma is to re-enact it, attempting to recount in behavior, a story too deeply hidden or too despicable for ordinary language. The language of re-enactment is insidious, and the ramifications can be like a tumor where the aberrant cells are so entangled with nerves and healthy tissue as to make extrication a deadly operation. Where to begin? Or where to continue, as we are certainly not the first to wonder.
In 1865 slavery was officially abolished in the U.S. That was President Lincoln’s most admirable intent. But the change only went so far – we did not get to the root level. We got “Jim Crow,” a way of formalizing and canonizing segregation and inequality, becoming a vigilante free-for-all. With “redlining” or refusing loans and insurance to targeted groups, the freedom-endowed blessings of home/land ownership, to hold and bequeath for generations, and suffrage were legally and culturally unobtainable to huge groups of the nominally “free” citizens. The wealth and intergenerational progress that might have been accessible in a truly just and equal nation were barricaded and jealously kept for the white and male. Obviously, we are still saddled with the self-perpetuating impact. Anger, poverty, disenfranchisement, alienation, and unaddressed trauma, large and small, is being visited on subsequent generations, who, if not helped, are doomed to repeat and pass it on. So, how do we break these intergenerational chains? A resounding question.
Acknowledgment is precisely naming and owning the wrongdoing, fully and to the satisfaction of the injured party, without minimizing, qualifying, or “explaining,” and verifying if the acknowledgment encompasses the extent of the hurt.
Admittedly my own checkered past catapulted me from trying to work on a grand macro level to finding my place of work in the micro. It is only new for me to begin to work and speak more widely about trauma and neglect. I suppose it took me a while to get a voice, but there is no one right way to engage. We must simply do something, and if we do heal and transform ourselves, even unwittingly, like the roaming roqueforti (or Covid-19!), there is an undeniable contagion or call and response of some kind.
On the macro level, again, it is “complicated.” In San Francisco, there is a loud debate about a local public high school long known to have super-achieving graduates with the highest test scores in the country. It has historically been predominantly, if not exclusively, white. There is vociferous disagreement about desegregating it and making it more inclusive versus maintaining the strict “merit” system of admission. “Merit” versus some iteration of affirmative action. What is “just?” How do we break the chains of repetition that cement the growing divide between rich and poor, which certainly in San Francisco is becoming cavernous, with legions of individual trauma and neglect survivors or victims exploding within it. Where do we locate the ”affordable” housing, if it is to be built at all? In “my backyard?” Hot discussions here.
I spoke with my longtime colleague and friend Dr. Forrest Hamer, an African American Jungian analyst who thinks deeply and teaches about reparation, asking him his thoughts about confronting this gnarly and enduring hydra. He described a three-step model of reparation, primarily based on the famed Truth and Reconciliation Process undertaken in South Africa in 1995. His model is undeniably and, of necessity, quite fluid, owing to the different needs and injuries of different victims or afflicted populations. It is not terribly different from the model of apology I teach couples, but it inspired me to rethink my own protocol, because this one sounds even better. It consists of three steps: acknowledgment, redress, and closure. I can hardly hope to do justice to it here, but I will lay out the broad strokes, and think on it much more for future writings.
Acknowledgment is precisely naming and owning the wrongdoing, fully and to the satisfaction of the injured party, without minimizing, qualifying, or “explaining,” and verifying if the acknowledgment encompasses the extent of the hurt. Just yesterday, perchance, I had a flashbulb memory of a client I had some 25 years ago, a man with a deep childhood neglect injury who, in adulthood, lost his life savings in the now mythical Madoff Ponzi debacle that spanned 17 years in the 1980s and 90’s. My client was wiped out, losing all that he and his little family counted on to supplement his meager earnings. He was never made whole and died way too young. What sort of acknowledgment is in order there, let alone remuneration? How much is enough?
The second step is “redress.” What sort of action would be a salve and a meaningful recompense or gesture of rectification in each case? Would it be restitution in the form of financial compensation? How do you put a price tag on George Floyd? The legions of “disappeared” in Latin America? The robbed and ravaged First Nations of the many colonized lands? I heard from a gentle Hawaiian man the story of how his ancestral land on the Big Island was slowly devoured by mainland real estate moguls as it became increasingly impossible for Natives to pay quadrupling taxes on their long-held family properties. He himself, as a construction worker, was forced to build the very homes and resorts that displaced him, torn apart by internal conflict about participating in his own devastation, because he needed the work to feed his kids. It reminded me of concentration camp victims forced to dig their own graves. What would repair the loss of his grandmother’s sacred property, now dotted with multimillion-dollar homes? It is a very personal, painstaking process. For some, the cash is the redress. But not all.
The final step is closure, where both parties in dialog agree that some measure of justice is, at the very least, in progress. For many, this would include symbolic, ideological, and policy changes that would allow healing to endure and the wrongs not to be forgotten. Policy change alone, without community dialog and ideological discussion, can make for a whole new set of problems. I had one profoundly neglected African client, who, when he survived a round of layoffs in his tech workplace, was certain that he was retained simply for the purpose of diversity “quotas.” It made him not only less certain of his performance but the target of bitterness from apprehensive or displaced colleagues. I have heard other stories about workplace dissonance between “diversity hires” and “merit hires,” creating a 3.0 of racism. True closure, says Forrest, involves some kind of commitment to change that will stick and have meaning, that it is more than simply changing the street or sports team’s name.
Today I have more questions than answers, food for thought. For trauma and neglect survivors, what sort of response from perpetrators, if any, might heal? Or is complete detachment the more self-affirming path? And on the macro level, examining one’s own attitudes deeply and searching for a way to engage. When I embarked on the overwhelming process of cleaning up the roqueforti rein of terror, I committed to disinfecting the cave walls and checking each aging wheel every single day. Now perhaps eight months later, it is pristine in there and free of the blue scourge. Ah, were it all so simple…
Today’s song (our dad used to sing this):
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 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.
When I started therapy in 1978, long before many of my readers were born, our mom muttered bitterly, not quite under her breath, “…the ‘blame your mother’ generation!” I have no idea why I even told her. From then forward, my therapist ever retained her reign as “public enemy number one.” Blame is not my paradigm – that I want to underline – and my purpose is anything but that! Rather connecting perhaps counterintuitive dots, that might lead to better self-understanding is my wish. And admittedly, sharing insights that might be interesting to me.
Similarly, “Refrigerators, Helicopters and Tigers” (oh my!) may seem to evoke Dorothy exclaiming the perils of a terrifying world or a bad joke (what do the three have in common…) So, bear with me please as I seek to elucidate more less than obvious expressions of neglect.
Again, the deepest and most injurious sequela of neglect is the rupture or failure of the primary, most important attachment(s,) most notably with the mother whose body houses the child at first, and ideally would continue as a home and source of comfort, regulation, and protection from the perils of that dangerous world.
Perhaps the most integral and the first vehicle of comfort and regulation is the “simple” experience of being seen. Gazing into the face of a present and loving (ideally calm and regulated) other is foundational. Brain development begins with the resonant dance of the gaze and evolves into being accurately heard and responded to. Not perfectly of course. It seems so simple, no? A no brainer in more ways than one. Sadly, it is so very often lacking. Missteps and mistakes, of course, are part of the deal, but with repair, we are actually better for them. Confidence or knowledge that repair is possible makes the inevitability of imperfection bearable and survivable.
The most devastating impact of neglect is the deathlike loneliness of not feeling seen, but even worse, not being or feeling known. When I am known as me, as distinctly, uniquely ME, this means I exist. This feeling or sense that I exist may, with luck, evolve to a sense of self, and with even more luck, a sense of self-worth: I exist, and I matter. Without it, we may drift unmoored in a foreign world, wondering what is wrong.
Gazing into the face of a present and loving (ideally calm and regulated) other is foundational.
I recently encountered the term, previously unknown to me, “Refrigerator Mom.” (If not for the chill factor, I would associate such a label with an abundance of food!) I came to find out that, in 1943, Austrian psychiatrist Leo Kanner theorized that cold, unresponsive, and emotionally inattentive parenting resulted in children who failed to develop and retreated from social contact. Kanner identified the child’s aloneness from early in life as the explanation for autism. In the later 1940s through the 1960s, Bruno Bettelheim, renowned psychologist, researcher, and educator at the University of Chicago, advanced further acceptance of the theory with the medical establishment and with the wider public.
Although understanding of autism has evolved since then, I find it interesting that some time ago, the connections were already being drawn between maternal emotional distance/absence, the young, developing brain, and subsequent social withdrawal. I also think that my serious, intellectual, decidedly cool-tempered, proudly Oxford-educated grandmother might have qualified as a refrigerator mother to our mom. She was stiff and unaffectionate, undemonstrative and matter of fact. She certainly was not a fairytale baking and gift-bestowing type of grandmother, either, and when our mother was a child, pre-Holocaust, being of substantial means, I am sure nannies contributed to the distance. No wonder our mom, from my point of view, was disconnected and lacking in emotion, presence, and warmth.
Confidence or knowledge that repair is possible makes the inevitability of imperfection bearable and survivable.
In our part of the world, hovering in the shadow of Silicon Valley, where many over-achievers are made, horizons are crowded with the so-called Helicopter Moms. These are the micro-managing moms that are on top of the child’s every move, pushing and pulling, prescribing and buzzing, or roaring as it were around the suffocated and overstimulated child. The hovercraft is everywhere, researching and making decisions for the breathless little one, who has no opportunity to even see what the choices might be. Play dates, after-school activities, sports teams… These are the parents overzealous in the stands, cheering the child on as if their lives depended on winning the championships.
In his 2017 book, The Matheny Manifesto: A Young Manager’s Old-School Views on Success in Sports and Life, professional baseball manager Mike Matheny describes in detail the behavior of these roaring sports “chopper” parents, many of them trying to compensate for their own mediocrity, or failure, living vicariously through their young jock child. Mothers are far from immune. The incidence of Tommy John shoulder surgery, once unique to elite professional pitchers, has proliferated among younger and younger kids, being allowed and perhaps overly encouraged to practice and play too much.
Helicopter mothers are of course not limited to athletics, but it is a good example of the child being micromanaged, controlled, pressured to perform in some way that does not originate with their own will and preference, and too much. The same can be true for playing a musical instrument, some other form of art, academics… anything really. In effect, the child is a foil or surrogate, an alter-ego, and not a unique and treasured individual. Treasured most specifically for their exquisite uniqueness.
The term Tiger Mothers was originally associated with Chinese mothers who mercilessly pushed their children academically to the point of illness and injury. In effect, it is a variety of abuse. Although that is where we got the term, I am more inclusive in how I would use it, having seen examples of these poor, exhausted kids across national and ethnic borders. I have been amazed hearing what kids had to do to be accepted to a local high school, in the way of not only academics and sports, but additional extracurricular activities (not to mention the application process itself and the tuition costs of such schools!) I would be breathless and wiped out from merely hearing about it! Perhaps the mothers did not roar or bite, but ferocity of the wild feline often sadly did seem to fit. I would find myself uncertain as to whether it was good news or not when the final acceptance or rejection from the school arrived.
It may seem counterintuitive to recognize profound neglect in such seemingly attentive, “involved,” seemingly child-centered parents. It is similarly painstakingly challenging to help such a child of any age recognize their experience as neglect. Some may be blindly “successful” in their honed abilities and live dissociated and detached socially and/or emotionally: Kanner’s autism. Some may crash in their struggle around partnering, finding the fulfillment of the marriage and family part of the script beyond their super capabilities. Some may be like the superstar Miss USA, Cheslie Kryst, who seemed to have it all, and shocked the world when she committed suicide by jumping from a high building. As Amy Tan powerfully stated, “loneliness is not about being alone, it is about not feeling understood.”
In spite of being seemingly swaddled with devoted attention, when what is being seen is not really me, it can be some of the most devastating, life-destroying iterations of neglect. Especially as the child, whatever their age, feels so guilty and unentitled to feel bad.
I recently heard an interview with Michelle Obama, talking about her new book, The Light We Carry: Overcoming in Uncertain Times. She said that we can create authentically independent, strong, and self-actualized kids by being present as long as they need it, then showing them that we trust them enough to let them do it their own way. Parents evolve, she said, from “managers to advisors,” thus enabling kids to grow into, and feel free/able to manifest, their own unique authenticity; kids that have the delicious opportunity to say with pleasure and pride, “That’s 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.