Recently I read a brief story about California Senator Dianne Feinstein, a recent target of loud complaints about “cognitive decline” due to her advanced age of 88. Feinstein equally loudly and vehemently disputes the claims, arguing that she is doing just fine. Alongside the article I pondered the decidedly unflattering photo, her incensed expression seemed to say “says who?!” Granted it is certainly hard to measure mental competence from the inside. (In AA they say “You can’t fix your broken tool with your broken tool,” and I suppose the same can be said, at least to some extent, of self-assessment.) 

Admittedly, I am not neutral about DiFi, as she is affectionately called by many. It was she in 1978 who, after blithely walking into his office, shockingly found the brutally murdered body of her friend and California’s first openly gay elected official, Harvey Milk. Her courage, grace and heart in handling that trauma earned her my eternal positive regard. I suppose I forgive her (and even her billionaire husband,) rather a lot. But the article reminded me of the ever-present reality of age.

I remember my grandmother lamenting for years that “the golden age is not so golden.” She was born in 1887 and I was born in 1955. So, when I was born, she was 68, barely a year older than I am now. My entire life, she had white hair, she always seemed ancient to me. Her husband, my grandfather, had died before I was born, meaning she lived alone as a partnerless widow for virtually all of her middle to later years. Also, for me unimaginable. But I never thought much about age. 

I remember my grandmother lamenting for years that “the golden age is not so golden.” She was born in 1887 and I was born in 1955. 

An endurance athlete, and known in high school as “the fastest girl uphill,” probably also pretty deficient in proprioception (body awareness), I had denial, even hubris, about the indomitability of the body. I could drink my quart of bourbon, get up in the morning and run 20 miles. I could ride the bike a hundred mountainous miles, only eating one banana all day. I never took care of my skin, preferring a “golden,” unprotected tan. My neglect was such that no one ever really knew where I was anyway, and it was only a matter of time before the feeling “I don’t matter” morphed into a rather wild freedom. My abandonment turned to abandon.

In UCSF geriatrician Louise Aronson’s 2019 book, Elderhood: Redefining Aging, Transforming Medicine, she makes the interesting point that we have traditionally made the distinction between two different life stages: childhood and adulthood. She proposes the additional stage of “Elderhood.” What is that? Well, let’s just say “I know it when I see it.” It is when the grandiosity of youth is challenged.   

Elderhood is when it is suddenly no longer true that I am “never tired;” I may find myself straining to hear, and irritating other’s by saying, “what? what’s that?” so often that I am driven to get the hearing test that informs me I have “severe hearing loss,” and must insult my vanity with hearing aids; when the glare as I drive home is blinding; when my former “steel trap” is embarrassed by memory blips; when I opt to miss the Bruce Hornsby concert that I have been waiting for, because “I just don’t feel like going out.”  Once impatient with others’ “organ recital,” I silently admit to my own aches and pains. 

On the first post-COVID plane trip we took, I was struck by how helpful people were. Were they offering to carry my bag, because they were kind, or because I looked so weak and infirm that I needed a hand?  Who is this person? No one warned me. My grandmother was “ancient” when she complained about the “golden age,”, and then, I was barely a kid. And tragically, many who spend years and decades working hard to emerge from a traumatic childhood, meet with grief when they find themselves already in elderhood, by the time they arrive in the present time. 

Another important point that Aronson makes, is about the prejudice, the dishonor, and ostracization – certainly in western cultures – directed at the aged. Another epoch of neglect; invisible, sidelined, forgotten. Seniority with its wisdom and experience is devalued at best, if not warehoused and trashed. How much money and time are spent each year in attempts to erase or hide it? Admittedly I too look in the mirror, gag and try to figure out how to make it go away. Hair, teeth, skin, muscle tone, I’m not 19 anymore. Although I do enjoy the freedom from unwanted sexual attention; and menopause is indeed a blessing, the advantages of age are rarely acknowledged.  I recall but one exception: a book I read many years ago: Elkhonon Goldberg’s The Wisdom Paradox: How Your Mind Can Grow Stronger As Your Brain Grows Older, published in 2005. In it, he describes that the aging brain acquires a “new” and heightened capacity for pattern recognition. It actually is quite noticeable to me in my work with couples, where recurring interactive cycles now more quickly come into focus.

Aronson describes her own experience as an accomplished M.D. in a relatively progressive medical setting, as one of discrimination, devaluation, and agism which appear to be ubiquitous in the professional medical world, and the tech world too. Part of her intent in proposing the new designation is to create not only a category but a valued and respected category for a growing minority that is rapidly approaching majority.  

My neglect was such that no one ever really knew where I was anyway, and it was only a matter of time before the feeling “I don’t matter” morphed into a rather wild freedom. My abandonment, turned to abandon.

Grey Hair

I remember a frequent commercial when I was a teenager, where the glamorous young model with gorgeous hair blowing on a  slow-motion gentle breeze, is saying “as long as there is Lady Clairol I will never be gray!” I was definitely down with that. The advertising slogan was “does she or doesn’t she? Only her hairdresser knows for sure.” Both of our parents were salt and peppery by their early 50’s, and Mom was anything but vain. Sure enough as I crossed into my 50th year I started to spot a sprinkle or two. Oy vey. I did not spring for the Lady Clairol right away, but I certainly thought about it.

Here is my mysterious “wow” story. I am not telling you this to drum up business, and before I am accused of false advertising, I will emphasize that I am not promising it will happen to you. In fact I really have not read or heard of anyone else having the experience I had/have, and I also know it is unquestionably true. As they say, “it’s my story and I’m sticking to it.”

In 2009 I was first introduced to Neurofeedback at a conference. I was immediately gripped by it, and I could not wait to get trained and become a practitioner. In those days, the training was much harder to come by. The soonest I could get the first level training was nearly six months away, and in Connecticut. I came home to the Bay Area, to find an incredible poverty of practitioners, even worse than now, and it is still pretty sparse around here for some reason that I don’t understand.  I found someone, an experienced if somewhat unconventional “older lady” an hour’s drive from me, in Palo Alto. I diligently attended sessions with her until my long-awaited trip to Hartford. My favorite protocol, which my therapist called “dessert” was the calming, eyes closed, alpha-theta protocol. She always saved it for the end of my session, and I begged for as much as I could get.

When I got trained and had my own equipment, I could practice on myself (as well as anyone else that would entrust me with their brain), and of course, I treated myself with ample helpings of dessert. By now, by the way, I was 55, and plucking gray hairs out of my head more regularly than I would care to admit, trying to tune out the siren call of Lady Clairol. 

Distracted by my new passion, it was a while before I noticed. Since I had begun neurofeedback training, my gray hair mysteriously vanished. No I wasn’t losing hair (or marbles?) rather the gray stopped appearing, stopped growing until by attrition, it was all gone, never to return. Now at almost 68, all traces of gray hair have long since vanished, and I forgot completely about Lady Clairol, even as friends and family around my age were evolving their own relationships to their respective hoary heads. Go figure. Yes, I love neurofeedback. And I swear it is true! (“Only her Neurofeedback practitioner knows for sure…”)

Cheese

Anyone who ever reads the acknowledgments of most any book, is familiar with the author’s often effusive gratitude to the various people who put up with their absence, preoccupation, cranky fatigue or moodiness, and often seeming  inability to show consideration. Although I am not a mother, in my mind, writing a book is akin to a protracted gestation and labor, in my case decidedly more than nine months. In spite of myself, my husband, with his own prior and severe neglect history, was victimized again. I promise to do better with this next book! 

The Pandemic hit when I had barely begun my most recent book, so I was pretty ungracefully adjusting/transitioning to working from home, and remotely: two things I never dreamed I would do, and had been outspokenly opposed to my whole career until then. An additional casualty of that time, admittedly was my progeny, the cheese. For about five years now, I have been a rather obsessive home cheesemaker, which can be a consuming “hobby.” In my case, it has been (usually) affectionately referred to as a diagnosis, although I insist it is also awesomely regulating and rewarding. So it is with horror and shame that I confess the degree of neglect that my little brood of cheeses suffered. Beside the initial making: mixing ingredients; allowing them to “ripen” and “set,” cooking and pressing, which take most of a day, there is perhaps the even more important process of affinage, meaning daily and weekly care: attending to the cleaning, washing with salt or other cultures, turning, and simple “checking in.” It is not enough to give birth, and turn a creature out into the world, as many the neglect survivor can attest, one has to care for and “raise” the child. Well, I perpetrated an extreme of neglect.

Please don’t misunderstand me! I do not, by any means intend to liken something as immeasurably valuable and vulnerable as a child, to a wheel of cheddar, but rather, the cheese was a teacher to me. When I had hit the send button on the manuscript and was truly able to survey the damage, the crumbliness, the proliferation and contagion of unwanted mold, some delicious, some pretty stinky, I was dismayed to see how my own self-concern and priority had left a little world of living growing beings to fend for themselves. And although age is desirable, for cheese, when not attended to, it might be unwieldy, fail to thrive and even die. I was overwhelmed by the wreckage. 

Only a day at a time, could I begin the massive cleanup effort. Each day, I spent 15 minutes on one small corner of the task essentially of healing and trying to make for as gentle an advanced age as possible. The same is true for my own tattered and neglected self. The ways that I failed at self-care along the way: sleep and rest, skincare, teeth, eyes, forgiveness, balance, it is not too late to salvage the remaining years. Perhaps I cannot completely make up for my failures, but I can learn, and hopefully teach, so as to minimize the intergenerational transmission.

By the way, did you know that for $20.00 US per couple, where at least one partner is over 60, the US National Park Service offers a senior pass? Free admission to all the National Parks’ in the country for one year, rather than $10 per person (even pedestrians) per single visit. That checks a few boxes, as far as I am concerned, honoring age, self-care and regulation, and loving the natural world.

Today’s song (I love the Old Lady at the beginning, and the Little Girl at the end!)

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

I remember once hearing someone say at a sex therapy conference, “Everyone, absolutely everyone you see walking down the street, has a sex life.” At first, a trite, mundane, rather obvious remark suddenly seemed profound. That submerged within everyone is a teeming subterranean universe that is mostly never shared. It may or may not include live human others, and what goes on there spans a range as wide as the world. 

Of course, plenty of violence and harm originates there, as well we know much of my career has and continues to be centered on that. Thinking, however, about this week’s blog, I thought, well, we have talked about poop and masturbation. What’s next? What other tabus can we bust? What else can we talk about that is not likely to be uttered aloud or explained in the vacuous neglect family, if anything is spoken about at all. 

It has been said, only somewhat tongue in cheek, that people become sex therapists because they think about sex twenty-four hours a day. I doubt it has been researched, so I can’t say if it is universally true, but I will leave that one to your capable imagination. In our conferences, we learn about all sorts of provocative themes, some of which I have and some admittedly I had never heard of or even imagined. Our presenters are physicians, serious researchers and academics, not only therapists like me. So although my tone may be light, I don’t by any means wish to make it sound like this is fluff or, even worse, titillation. I thought I would scratch the surface, if cursorily, of the broad topic of sexual fantasy.

 I remember once hearing someone say at a sex therapy conference, “Everyone, absolutely everyone you see walking down the street, has a sex life.

A number of brave clients have divulged to me, usually after knowing them for a fairly long time, their persistent, even distressing sexual fantasies. They may be alarmed, ashamed and mystified, even horrified by the content, but unable to uncouple it from their erotic arousal, leaving them feeling somewhat alienated from or mistrustful of their own bodies. It becomes even more complex when these fantasies are the most direct, even the only way to get to orgasm. “What does that mean about me?”

After several conference presentations, I read a whole book on sexual fantasy, (Who’s Been Sleeping in Your Head: The Secret World of Sexual Fantasies January 2009 by Brett Kahr) a hefty scholarly tome. Well researched, It recounts the sexual fantasies of his 23,000 subjects. By the end, I was more than satisfied, and the point was made: the sky is the limit. 

And like dreams and other sorts of fantasies, they surely relate to something. Sometimes if we dig deeply on our own, with or without the help of a good therapist, we discover something interesting. That has certainly been true for me.

Sometimes if we dig deeply on our own, with or without the help of a good therapist, we discover something interesting. That has certainly been true for me.

Am I a Pervert?

I do have some important take-away points about this. Especially because the child of neglect perennially has no one to ask and so is trained by a lifetime to not ask – not even need to ask. And these are topics tabu to ask about in most circles anyway. 

First of all, there is no shame in what appears unbidden in your head. Just as your hideous nightmares are not your “fault” or your monstrous alter-ego, neither are your sexual fantasies statements on your character, with the caveat, of course, that we know the difference between fantasy and reality

An unorthodox or worse fantasy may be a turn-on only insofar as it stays in one’s imagination. If it is enacted in real life, on another being, especially non-consensually, that, of course, is something else entirely. I hope that is unmistakably clear. This is not license to have a field day with one’s sexual fantasies!

Secondly, research to date has shown that sexual fantasies appear to be deeply wired and very difficult, if not impossible to change. I don’t know if this has been studied with neurofeedback or any other brain training modality. Who knows what might be possible if someone made a project of that? At one conference, I heard a heartbreaking case presentation about a woman Holocaust survivor, sexually brutalized at a young age while in Auschwitz. As a therapy client in her 50s, she, for the first time, disclosed to the presenter – who was her therapist – that her entire life, her orgasm had been inextricably wound in with her Nazi torture. She could not get off without the fantasy of her sexual torture, which caused her unending conflict and shame and a sense of betrayal by her own body. And which made her want to avoid sex which she otherwise quite enjoyed. The best the highly competent therapist could do for her was to help her ultimately make her peace with it. Perhaps we could do better now.

Danger, Fear and Risk

My long time friend and colleague, Pat Love (yes, her real name!), whom I still think of as the best couples therapist in the world, cited formal research showing that danger, fear and risk had proven aphrodisiac properties. Something about being under threat heightens erotic interest and sensation. Perhaps that is part of what makes illicit sexual liaisons all the more exciting. It may also shed light on some of the sexual practices that I have found harder to understand because they are not to my taste or even involve pain and fear.

More recently, I began to learn about some neuroscience research about the brain’s Default Mode Network (DMN). It is a primitive brain region, deep in the brain stem, where a sense of self emerges. It is where the brain “idles” or retreats when not “under task”, meaning not “doing” anything else. And it is a hotbed for self-reflection of whatever kind. We are all familiar with the tendency, when not busy with a task, to think about number one, that’s me

Neuroimaging research has shown that the brains of survivors of developmental trauma and/or neglect show negligible activity in the DMN. It is largely cavernously dark. Only under threat does the DMN start to fire in these brains, and then it lights up almost brightly. Whatever their trauma story, terrifying experience is what brought the subjects’ DMN to life. So the tendency persists, that terror and even pain makes them feel alive. I am curious about this as it relates to sexuality. At this point, it is merely speculative. My own mind wandering. Perhaps in time, we will know more. Meanwhile, in the words of Mary Oliver:

…Whoever you are, no matter how lonely,

the world offers itself to your imagination, 

calls to you like the wild geese, harsh and exciting,

over and over, announcing your place

In the family of things …

Wild Geese

Each time I write a blog, I always try to think of a song that I love that goes with what I’ve written. Uncharacteristically, today’s song is instrumental to allow more leeway to your imagination. It’s a fave of mine. 

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.