As an inveterate bookworm and student, I am reading all the time, and there is never enough of it—Oy vey. But what a wonderful problem to have when compared with the years of slogging to get through the day. However, with all that I read, it is not that often that I learn something that really changes my way of thinking. Not only new information, that is easy, but actually making use of it differently or relinquishing old, often long-held views. Over now close to forty years of sobriety from alcoholism, I have been entrenched in an admittedly “orthodox” 12-step rigidity. Not the “God” part, which trips up many people. I resolved that right at the start. But rather a hardcore abstinence-only program.
Of course, a severe black and white perspective readily suited me. I was always an “all or nothing” kind of girl and defaulted to a hungry “more is better.” I remember from an early age my mother trying to teach me the word “moderation.”
That’s a pretty big word for a little girl. I never quite got it and probably still don’t, or not enough. However, now I understand it more in terms of regulation versus voracious greed or wild overzealousness. Total abstinence from alcohol was infinitely easier than trying to figure out how much was enough or too much, i.e., to self-regulate, so I grabbed on to that one for dear life.
I was always an “all or nothing” kind of girl and defaulted to a hungry “more is better.” I remember from an early age my mother trying to teach me the word “moderation.”
Some people resort to entering a convent, the military, a cult or an authoritarian party or regime because all the decisions are made for them. There, they don’t have to assess or conclude what’s “just right,” like Goldilocks. I admit that some of that was in play during my political activist days when ideology was strictly prescribed, and political correctness was fundamental to having any sort of value at all. To this day, I am most comfortable in tight-fitting clothes: they seem to contain me and keep me from blowing apart from the inside. Similarly, I recently discovered that a weighted blanket has a similar “holding” effect. I continue to have a tendency to “color outside the lines.”
From the beginning, we all need a mom, not least because a good mom is regulating and teaches regulation. Comfortable in one’s own skin, one can live, love, “pursue happiness” with all that means, create, learn and take pleasure in life. A history of childhood trauma and/or neglect puts one on a relentless quest to find it. I think of the 23-year-old that I was, 98 pounds, on the couch with my cat Marti, drinking a quart of Old Crow bourbon straight each night single-handedly; it was $6.95 a quart then. Marti, named for the Cuban National Poet, Jose Marti, lived to 22. I always said she was like a mother to me. Really it was all an endless quest to find that elusive calm in the war-torn world of my body. Marti certainly helped, and so much of addiction boils down to that.
The dictum to “just” stop, or “just say no!” (a day at a time of course) was not easy but simple, and much easier than finding my way with food, which could never be relinquished entirely, or not safely.
From the beginning, we all need a mom, not least because a good mom is regulating and teaches regulation. Comfortable in one’s own skin, one can live, love, “pursue happiness” with all that means, create, learn and take pleasure in life.
I have since learned several sobering “new” to me facts about alcohol. According to World Health Organization data, alcohol is one of the world’s leading causes of death, behind tobacco which amazingly is still a great killer. Alcohol kills not only in its insidious damage to the body and brain, but DUI car accidents, behavior and crimes committed under the influence, not to mention the suicides of not only the drinker, but collateral loved ones whose lives with that person have become unmanageable.
Alcohol also causes more brain damage than any other drug, and neuroimaging shows the blackened tissue, which is the poisoning and deterioration caused by inflammation and dying cells. No other drug, neither medical nor recreational, shows that kind of wreckage.
And finally, a measure I had not actually pondered before: damage is measured not only by a substances’ impact on the individual user but on others and the world. How many children and spouses are neglected and abandoned every day due to addicted or substance-abusing parents? How many were molested, raped, beaten or in some other way violated by someone who might have much better judgment or control if not intoxicated? It goes on and on. And in this tally, alcohol wins by a landslide in terms of how widely one person’s substance use reaches. More reasons to be grateful, I was able to stop at 28 before doing more damage! Unfortunately, a hugely profitable industry holds it in place. Prohibition failed. Culture, tradition and culinary aesthetic make it essential to find a way at mass level, to regulate and self-regulate. Of course, this would have to include, at least where possible, addressing the myriad realities that would inspire an individual to “escape,” even if momentarily.
Michael Pollan’s latest book, This Is Your Mind on Plants, has a long section on caffeine. What I found most interesting was the history of how coffee affected industry, the industrial revolution, and the world political economy. Well worth reading! And we, or at least I, had not thought so much about caffeine as a “drug.” But meanwhile, in the private laboratory of my own brain, I have had to look at it as such.
One of the ways I have grappled with my complicated sleep issue (and the “challenges” of sleep will be a topic of its own blog on another day!) is with my afternoon coffee. I also began to notice that if I woke up and had my morning cup too early, by early afternoon, I would have one of those scull-cracking headaches right in the middle of my forehead, the undeniable battle cry of caffeine withdrawal. So the afternoon cup became medicinal in more ways than one—Oy vey. I am back to being that rat on the wheel, trying to stay ahead of the breathless chase. And although I don’t believe in the rhetoric of the “addictive personality”, I know all too well about the deep-seated dysregulation of early attachment trauma.
I knew that to begin to ratchet down the caffeine headache loop and ultimately eliminate it, I would have to find a much better way to manage the sleep issue (which I am constantly working on anyway) and also endure the discomfort (agony?) of weaning myself off. That is no fun at all. Although my own alcohol withdrawal is a blurry memory, not only because it was so long ago, but due to the addled brain I would remember it with, I do remember one of my very first mental health jobs in a methadone clinic. It was there, with a clearer head of my own, that I was to learn most vividly about “dope-sickness.” So, facing the prospect of enduring headaches without relief, or perhaps relieved in some other undiscovered way, was daunting. That is precisely what keeps all addicts on the wheel. And it is reminiscent of the age-old attachment theory dilemma without solution when the source of comfort/relief and the source of devastation and/or terror reside in the same package, human or otherwise. All the more reason why we need a more regulated world, in all the ways, regulated relationships, self-regulating individuals.
Here is where I began a subtle process of “changing my mind.” I heard expert drug researcher David Nutt (what a great name for a psychiatrist!) talking about “Harm Reduction”. When I first started hearing people talk about this “new” approach alternative to total abstinence, I balked, trying to conceal my skeptical contempt. My “todo o nada” all or nothing sensibility was roused. However, Nutt is not only extremely knowledgeable but personable and experienced at talking to people about delicate, often highly personal and controversial topics.
According to Nutt’s data (culled from his talk at the recent Addiction and Imagination Conference):
“…reductions in consumption gain much greater value in terms of health than you might imagine if the curves were linear. If you go from someone drinking 100 grams of alcohol a day, say a bottle of wine, to just 50 grams a day, you would lower their consumption by 50%, but you reduce their risk of death by eight times. And even if you reduce consumption at the top end by 10%, you actually reduce the risk of death almost by twice. So this is why any reduction in drug consumption is hugely important and that’s why harm reduction approaches are likely to be the most powerful ones in terms of mitigating the harms of drugs.”
As many of us know when learning regulation, harm reduction paradigms are not “pie in the sky.” But perhaps, I must also consider they are also not another money-making gimmick like the latest in an endless stream of commercial diet schemes, but rather a viable interim option. I have actually “updated my files” to incorporate them. Even this old dog can learn a new trick now and then!
In an Imago Therapy conference, I attended probably thirty years ago, I learned a quote that I have never forgotten, although I can’t for the life of me remember the name of the speaker or of the First Nation tribe that originated it. However, the words have stayed with me, and I even made a colorful wall hanging with them, which is hanging in my office: If you think you know me, you have stopped my growth in your presence. My interpretation: If you hold me to what I said or believed thirty years ago, or last week, or even yesterday, you are closing off the possibility that I may be growing all the time in our relationship. So, harm reduction is an important consideration. So there you have it: Addiction 101!
But as for me, well, I will stick with total abstinence and neurofeedback!
Each time I write a blog, I always try to think of a song that I love that goes with what I’ve written. Today’s is I’m So Glad by Fresh Cream. I love this song, although sadly Eric Clapton has his own story about addiction.
My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.
As a very young child, as far back as I can remember, I felt, and I believed, that somehow I had no right to exist. I don’t know if it was because six million had perished in gas chambers or children were starving in Europe, but I was convinced that I must earn the piece of ground my feet occupied on the planet and ceaselessly justify and compensate for my probably mistaken existence.
Quite early on, I had my own particular calculus of worthy utilization of time: service to others like housework and cooking to relieve my mother’s burden, or being “good”, service to the world like collecting record-breaking amounts of money for UNICEF instead of collecting candy on Halloween, study, and later earning money for college, and exercising more and more and more as my eating disorder evolved its own unique ledger. It was as if I entered the world in debt, and life was a ceaseless attempt to pay it off.
How does a child come to have a sense of self-worth or self-esteem? As a stalwart student of Attachment Theory, I believe it is by (as an infant) looking up into my mother’s or primary caregiver’s face and seeing a loving reflection of me! It is through the early resonance, largely through the gaze, where my right hemisphere and theirs lock into a rhythmic dance, which registers deep in my primitive brain, and my default mode network, which will grow to house my sense of Self is stimulated to develop, grow and ultimately thrive – or so we hope.
How does a child come to have a sense of self-worth or self-esteem? As a stalwart student of Attachment Theory, I believe it is by (as an infant) looking up into my mother’s or primary caregiver’s face and seeing a loving reflection of me!
And what happens when I look up into a face that is terrified, or angry, or grief-stricken, or ravaged by depression, hunger, violence or just plain fatigue? What if there is a blank face? Or no face is there at all? The image I am left to have of myself will be some sort of reflection or self-reflection of that. I can only imagine what I looked up and saw as a tiny being. I knew that my mother was too young. She had a lively two-year-old already, a hard-working, largely absent and traumatized husband, and a terrible story of her own. I must have known early on that she really needed a mom. Of course, I don’t remember. But I do clearly remember the relentless drive to justify my existence. And sometimes, when I am in the presence of a client who talks from a familiar sounding place, I am visited by such an image and have to wonder what they looked up and saw.
Today I saw a man wearing a t-shirt that said, “Children Are to be Seen and Heard!” I thought, “Wow!” As I watched him pass hand in hand with his lively young son in tow.
Money was another mystery. There was never much, and it was a taboo subject. One never asks how much things cost or how much someone makes. I have never to this day had any idea of what either of my parents earned at any time. We were never to touch our mother’s purse. Our dad always had multiple jobs, and work of all kinds was highly regarded. Our dad was a chef, a waiter, sang in cocktail lounges and later taught and became a cantor. There was no shame in manual or service work, and my parents were always very respectful of working folk. Our mom’s family was well to do and intellectual before losing everything to the Nazis, but they, and certainly my grandmother, who was one of the first women ever to graduate from Oxford, never lost the sense of superiority that came from their class. I think they quietly or not so quietly believed that the US culture was superficial, materialistic and petty. Emotionally they all were quite impoverished, and life, certainly in our family, seemed like zero-sum.
One never asks how much things cost or how much someone makes. I have never to this day had any idea of what either of my parents earned at any time.
Our mom was a practical and careful shopper. She clipped coupons, journeyed across town to get a bargain, and scrupulously collected Blue Chip and S&H Green stamps which I ceremoniously helped her paste in the little books. I don’t remember what we would redeem them for, but I know it was a serious and committed endeavor. I remember when she shopped, she would matter of factly ask the checker, “So what do I owe you?” Thinking on it now, the expression sounds odd to me; it connotes a power differential? An imbalance to be corrected rather than a reciprocal exchange, or give and take, a debt. As I got older, I felt shame and contempt for this low price proclivity and took a wicked pleasure in paying “retail” even though it might mean playing roulette with the bank to stay ahead of often (temporarily) rubber checks. In those days, checks might take one or two unpredictable weeks to clear, so I often won.
Feeling worthless is readily a conscious or unconscious bi-product and even marker of neglect. Feeling invisible, unheard and categorically not understood is a short hop from the sorry conclusion that “it is something intrinsic about me.”
In the vacuous world of neglect, where there is no one to ask how the world works, the child must figure it out. I started earning money young because having my own money felt empowering. Babysitting brought fifty cents an hour in those days, a far cry from what I hear young parents groaning under now! I washed cars and mowed lawns in the neighborhood once we had moved to the suburbs, and in my early teen years, I had my own little housecleaning business. Earning money made me feel like I was worth something. To this day, I am jarred by the language used to describe wealthy individuals as being what they are worth.
I liked being able to buy things, and even more, I liked being able to give things. Perhaps I might have something to offer. I took great pleasure in giving, especially things that I had made. I still do, but then it was different. It was once again the quest to compensate, to purchase, to somehow equilibrate, merit or even the score.
Certainly to be loved. And like a rat on a wheel, I could never give enough to secure my position for long and relax. Of course, that kind of giving is a trap. Invariably I would overextend myself, feel depleted, pathetic and resentful. I believed that anger is the luxury and the privilege of popular girls. In my case, it would make me even less likable. It was hard to learn to regulate the giving because for so long, I believed if I were not always giving and gratifying, I would vanish.
Many are the children of neglect who are hard-pressed to receive. Interpersonal need is so dangerous that the ferocity of complete self-reliance is the safest if unconscious way to go. There may not only be a sense of superiority but safety in always being the one who dives for the restaurant check.
Giving and receiving is another of the delicate rhythmic dances of regulation. For many of us, it takes years to learn it. And as I attempt to teach others every day, including myself, both require great humility. Ultimately the balance can elicit equality, safety, connection and pleasure. As an old married lady facing into the unknowns of aging, I am grateful that our couple has worked hard to grow reciprocity and know what we can count on in one another.
My husband, a quintessential child of neglect, used to say to me when I had no idea what he was talking (or not talking) about, “you mean you are not in my head?” The child’s world of neglect is so solitary that much of it is never seen or known by another human. As adults or their partners, it may be jarring or, at best surprising to learn how oblivious they might be. I’ve heard many a partner lament, …”when I try and walk with you, you are always a good six steps ahead without even noticing that I am not with you!”
The insidious calculous of giving and receiving can also drop into this black hole of oblivion and slide into a transactional world missing consent. More than a few times, I have seen in couples, where one partner provides everything in one medium, which then, according to their own private calculator, entitles them to some sort of remuneration in their own preferred medium. But there is no handshake, no agreement, no awareness. We have a deal, but you don’t even know you are in it. In my mind it is “fair”, so I proceed as if we had an agreement and then get mad if you don’t deliver. Oy vey! This sounds much more intentional and duplicitous than I mean it to. It is a function of being too much alone, of a story of a child who grew up a stranger to the relationship world and has to learn about a world that is populated with real others. For a partner, it can feel frustrating at best and more often enraging.
All too often, the currency is sex, and because sex has so many meanings and so many individuals have charged histories around it, it can come to take on a life of its own or become a focus that may then eclipse these often deeper layers. Sex is a very big topic that we shall have to return to another day, especially because in its countess iterations, it shows up so often as the presented problem in my office.
Returning to where we began, the under-stimulated infant brain fails to develop certain connections that may result in some kinds of deficits around awareness and emotion. It is never too late to cultivate and grow these connections and regulations, so we can cultivate and grow relationships where we make our deals out loud!
Each time I write a blog, I always try to think of a song that I love that goes with what I’ve written. Today’s is Let It Bleed by The Rolling Stones.
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.
Many children of neglect, in their dark, lonely, scared hyperarousal, discover masturbation as a source of comfort, regulation or simply a way to get to sleep. Many are quite young and make the discovery well before they have any idea what they are doing.
They might before very long, get “caught” and reprimanded; or learn in some sort of religious or moral education that it is wrong or bad, or even in some way damaging. Orgasm itself may never be spoken about. Until they are older and learn of it as a mythical power that we should all be able to manufacture, and that makes us “hot”, powerful and sexy.
Originally a source of comfort, it might become a source of shame, pressure and power struggle between couples and a great mystery. And it is another of those taboo topics that no one really wants to be candid around or ask questions about.
Many people outside of the sex therapy field have never heard of woman pioneer Betty Dodson, a heroine worth honoring. In the Bay Area, March has been dedicated to women’s history, and I thought of Betty Dodson and her seminal work, an essential gift to women, and everyone really. She died in 2020 at age 91, healthy and vital until the end.
Many people outside of the sex therapy field have never heard of woman pioneer Betty Dodson, a heroine worth honoring.
Betty Dodson viewed part of her rich longevity to be a result of her viewing regular orgasms, along with sleep, good food and other exercise, as fundamental self-care practice right up until the end of her life.
I “discovered” Betty Dodson at my first sex therapy training in 2000. I was attending my first “SAR” or Sexual Attitude Reassessment. The SAR is something of an initiation, where the clinician is exposed to every imaginable and unimaginable variation of sex and sexuality and challenged to both examine and discuss what they/we think and feel. It is an effort to de-sensitize us so that we will not be shocked or scared by anything that might walk into our offices and also, to unearth what unconscious biases or attitudes we might have.
My first SAR was seven days long, in the Finger Lakes Region of Upstate New York, a spectacular setting for our long days that stretched from about 8:00am to 11:00pm of watching explicit movies, listening to speakers of every sexual ilk, and participating in small group processing after each presentation. We affectionately referred to this intense total immersion experience as “Sex Camp”.
Late one night, I was wandering around after hours, way too wound up to sleep, and I stumbled on one of our instructors watching a video in a classroom. On the screen I saw a circle of women covering a wide range of ages, shapes and sizes, all completely naked, and a leader who was teaching them how to have orgasms. That was Betty Dodson; at the time, she was “only” about 70. She also was wearing nothing but a beautiful pendant. That night, it became a bucket list item for me to attend one of Betty Dodson’s groups. I wanted to learn how to teach women to discover their orgasms.
Betty Dodson became a champion of women’s orgasms in the time period of the burgeoning Women’s Movement of the 1970s. Growing up in the rural American south, she was a gifted artist. Her art is truly spectacular, showcasing bodies in the classical style of Da Vinci or Michelangelo, only later to become exquisitely and (usually) tastefully erotic.
Marrying young, she came to find her marriage unbearably boring and lifeless. Her nice enough young husband was truly uninterested in sex and even less in her sexual pleasure. She came to find respite in long days in her art studio, where she settled into a brilliant and highly productive feedback loop: she masturbated often and found artistic inspiration in her orgasm, and the creation of art turned her on to masturbate, so her solitary days filled in with this colorful, energetic cycle.
She would come home at night energized and exhausted and pretty estranged from her already distant spouse. She was understandably secretly relieved and essentially freed when her deeply remorseful husband revealed that he had fallen in love with his secretary and wanted a divorce. Besieged with guilt, he left her their beautiful apartment in downtown New York, where she stayed until the end of her life.
Meanwhile, the Women’s Movement was gathering steam. Betty Dodson grew increasingly distressed about how overlooked and sidelined women’s sexuality was, and that became a centerpiece of women’s liberation for her. Women were indeed sex objects, expected to be available for men’s sexual pleasure without any value being placed on their own. In the women’s consciousness-raising groups she was involved in, she became loudly vocal about this, subsequently offering groups specifically on the topic.
Betty Dodson grew increasingly distressed about how overlooked and sidelined women’s sexuality was, and that became a centerpiece of women’s liberation for her.
My favorite story is when she wrote an article about women’s orgasm and submitted it to the newly established Ms Magazine, the first real mouthpiece of women’s lib. Up until then, women either read fashion magazines or House and Garden type periodicals filled with recipes and housekeeping tips. Ms being new on the scene, skittishly whittled Betty Dodson’s 18-page essay down to three, which had her understandably perturbed. She convinced the editors to agree to her placing a little note at the end of the published piece that interested readers could send one dollar and receive the uncut version. In the next several weeks, Betty Dodson’s mailbox swelled. with about $30,000 in one-dollar payments. Not bad for a starving artist. Clearly, she had hit a nerve – or a hunger – in many women’s worlds. Thus began her almost 50 years of groups.
In 2018, when Betty Dodson was close to turning 89, I saw an announcement of an upcoming workshop. I knew if I was serious about my bucket list, I better jump on it before it was too late. I made a pilgrimage to New York to attend what was a truly awesome experience. Betty Dodson was a brilliant teacher, even at 89. By now she had a delightful young assistant, Carlin Ross, who stood in for Betty Dodson’s ears and memory when they failed. (For the interested reader, I wrote a lengthy article about the workshop, Coming of Age which is available on my website here).
For now, I will say that I believe Betty Dodson gave countless women the joy and living pleasure of reclaiming their birthright and learning to value and create space for orgasm, both inside and apart from relationship.
Although I never went on to teach the art, not quite knowing how to incorporate that into a rather traditional psychotherapy practice, I found it invaluable to learn how it was done. And certainly, as you can see, how to talk openly about it.
For those dysregulated by trauma and neglect, sexuality is often hard hit. It requires an unusual combination of sympathetic and parasympathetic arousal; both ease, safety and relaxation are required, as well as excitement. Many brain areas are involved, besides the obvious body areas. Shame and anxiety are vasoconstricting, which means veins constrict and blood flow is inhibited. And of course, engorgement and erection are all about blood flow. It is important to me to convey that it is not only sexual trauma that engenders sexual inhibitions, impasses, and dysregulations of all sexual sorts. Neglect and many other traumatic and dysregulating experiences can do so too.
Many couples blame and fight about this misunderstanding. Betty Dodson had the courage to speak loudly on behalf of women’s orgasms and scream louder with pleasure. Let’s honor her by carrying on her legacy with pride and joy!
In the 1990s “Decade of the Brain”, we learned about neurogenesis: that we can produce new neurons. Prior to that, scientists believed that neurons were like ova – you are born with your life’s quota and that’s it. That would have meant that the thousands I killed during my drinking years were gone forever—Oy vey. We also learned that the three best ways to encourage neurogenesis are novelty, enriched environments and physical exercise. I have always been fond of saying that with good sex, we get all three!
One of the heroes of modern neuroscience was a poor soul named Phineas Gage, an affable, well-liked, intelligent and successful young man of 25. While working as a railroad foreman, he was tragically struck by an iron rod that went completely through his head. Miraculously he survived, although he emerged from his ordeal a very different man. He was angry, moody, and extremely hard to get along with. From studying his brain damage, scientists began to learn previously unknowable information about emotion regulation and which brain regions correlate to behavior and personality.
Phineas Gage’s recovery, however, was extremely trying for him. People found it very difficult to like the volatile new version of him. He was lonely, not to mention being faced with the challenge of securing employment. Somehow, he ended up driving a commuter train between Valparaiso and Santiago, Chile. Between the novelty of varying routes and the many languages and ethnicities of the people he encountered, Phineas Gage’s brain healed significantly, and he lived a strong 12 years post-accident. He died of a seizure disorder at the age of 37 (sadly missing out on the possible benefit of neurofeedback). Nonetheless, he was a testament to persistence and post-traumatic resilience.
So what does Phineas Gage have to do with orgasmic health and Betty Dodson? I guess it is all a pitch for persistence and a reminder of the resilient brain. And hope for those in search of an elusive orgasm.
Thanks Betty Dodson! Thanks Phineas Gage!
Each time I write a blog, I always try to think of a song that I love that goes with what I’ve written. Today’s is High Hopes by Bruce Springsteen.
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 recently heard a story where a self-identified Aboriginal woman in Australia learned that she was adopted when she was a teenager. “I always wondered why my mom was so mean to me, treated me differently from the other kids. I did look different from the rest of the family but discovered it was because I wasn’t really ‘hers’.”
A client of mine had the experience of being completely and utterly rejected by her father, who insisted she was not “his.” He brutalized her and her mother too about her being another man’s child. Seeing pictures of them together, she was the spitting image of him, and indeed she felt similarly “spat upon.” Although he eventually appeared to relent in his bitter hostility toward her, it was far too late, and she was profoundly traumatized by the rejection and the abuse.
I have worked with couples who struggled to conceive, and one partner was categorically opposed to adoption while the other was desperate to have a family. What does it mean to raise a family where maybe the genetic material is not (or not all) shared? All this got me thinking further about adoption.
Loss and rejection are threats to survival for species that rely on the pack for not only nourishment but also protection. What is the impact of having those essential needs fulfilled by a “substitute?” And in turn, what is the impact of this loss to the recently pregnant mother?
I remember from second grade Sunday School the picturesque story about Moses, who led the Jews to the Promised Land after their 40 years of wandering in the desert. As the story goes, the Egyptian Pharaoh ordered that all male Hebrew babies be drowned at birth in an effort to keep Jews from becoming too powerful. Jochebed, having recently given birth to Baby Moses, was grief-stricken and kept her baby hidden as long as she could. When she could no longer ensure his safety and her own, she tucked him into a basket and placed it in the reeds on the edge of the Nile. As it happened, Pharaoh’s daughter found the basket while bathing in the river. She took the baby home and raised him: an idyllic adoption story.
What, in fact, is the impact of adoption? Is it an attachment trauma? What if the baby is adopted at birth? What is the impact on the birth mother? All of these and many more questions began to swirl around my mind. Loss and rejection are threats to survival for species that rely on the pack for not only nourishment but also protection. What is the impact of having those essential needs fulfilled by a “substitute?” And in turn, what is the impact of this loss to the recently pregnant mother?
I had a client once who grew up in a fiercely religious community in the American deep south. She partnered with an African American man before intermarriage became legal in 1967, but even before that, she got pregnant as a teenager and was secretly whisked away to an “unwed mother’s home.” Nobody knew where she had gone. Her baby was as quickly and silently whisked away virtually at birth. To my client, it felt like having part of herself ripped away as if her body was ravaged by amputation. I saw her at least 30 years after the fact. She was still torn apart by grief, guilt and shame, both desperate and terrified to find and meet the child that, interestingly, she had named Faith. Every kind of regret was unbearable. She had much other trauma, which we worked with for some years.
Long after she left therapy with me, she finally met Faith. Although they did not appear to establish an ongoing relationship, she was comforted and achieved some sort of closure, if nothing else, than to make the story real for herself and also express her deep remorse and love to her daughter.
I read all the hefty biographies of Steve Jobs, another adoptee. I am a great admirer of his extraordinary genius (admittedly, I have a fascination with very smart, narcissistic and sometimes mean men, probably in the image of my father). Jobs fit that description. His unmarried teen parents gave him up for adoption at birth. A loving couple adopted him, and he described himself as quite harmonious and close with them. Some years later, Jobs’ birth parents had married each other and had a daughter, Jobs’ sister, Mona Simpson, whom he met some years later.
When Jobs was roughly his parents’ age when they gave birth to him, and similarly unmarried, he also fathered a child. Initially, Jobs vehemently denied paternity, even after formal paternity testing confirmed that he was indeed the father. He balked and paid the absolute minimum of child support required by law, even after his early company had begun earning well. Only after many years did he develop a relationship with this daughter (of course, I read her memoir as well.) To me, it seemed like some sort of trauma re-enactment, which would suggest that, at least in his case, being given up for adoption was traumatic.
I have had some adopted clients who seemed terribly dysregulated from being raised by the “wrong” mother. I have seen other veritable “love stories” of adoption. There is research that says indeed it is an attachment trauma. In the words of one researcher:
When working with adoptees, we must consider the possibility that this disrupted attachment may be a cause of at least some of their difficulties.
Belonging and being part of a group are sources of not only identity but safety and equilibrium. Knowing where I am from and where I belong creates a kind of orientation and balance in the world, as well as a place to retreat to under threat or in trying times. Although I am not a practicing or religious Jew, I am very much identified with the “tribe”. I love baking challah and bagels and always insist that my homemade bagels and homemade cream cheese are the “real Jewish Penicillin.” I consider the Holocaust and my parents’ Holocaust trauma very much a part of my identity and have a profound reaction to genocide, racism and segregation which are undeniably wound in with my own ancestral story.
I tend to unwittingly notice Jewish sounding names or other characteristics and feel, even unconsciously, rather kindred. I hope I do not suffer from some sort of racism in that regard. I feel strongly that when a child or adult is removed from their clan, group and often country of origin, the loss is visceral. The world of diaspora that we now live in is rife with such homelessness, which is growing alarmingly worse given the most recent world events. It frightens me, even when countries of refuge are relatively welcoming. It is no wonder that ethnic and country of origin food pop-ups are such a popular source of solace to many immigrants and refugees, at least in the food worshipping Bay Area.
While briefly dipping into the wide subject of adoption, I am reminded of another issue I feel strongly about; reproductive justice.
For same-sex couples, adoption is one of a number of options for having a family, perhaps the least expensive, although adoption also may run into significant outlays. The other avenues to pregnancy can run into many thousands and even tens of thousands, which amounts to discrimination of sorts. Who gets to procreate, and with what support? It would seem to me that the next step after legalizing same-sex marriage would be making same-sex family planning affordable, safe, and accessible.
To close on a happy note, I heard a heart-warming story the other night on one of my favorite wee-hours BBC programs. A young man, adopted at birth, who had a seemingly smooth childhood and upbringing, searched out and met his birth parents in his early thirties. He learned that, like Steve Jobs, his two biological parents had married each other and had several more children who were his full siblings.
He met his younger sister, who was herself several times a mother, and when our young man and his wife were unable to get pregnant, this sister proposed that she might serve as a surrogate and carry their child. They gratefully accepted, and their fertilized egg and sperm were placed inside her. As it turned out, they expected twin girls.
The crowded delivery room included three sets of grandparents: the young mother’s two parents, the young father’s adoptive parents, and his birth parents. It was a wild, unconventional and joyous welcome and family for those two little girls!
Each time I write a blog, I always try to think of a song that I love that goes with what I’ve written. Today’s is It Ain’t Me Babe by Bob Dylan.
My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.
As we mark the second anniversary of the seemingly endless global pandemic, let’s not allow it to eclipse International Women’s Day on March 8th, which doggedly rolls around year after year in the similarly seemingly endless march towards equality, justice and simple dignity.
Some decades ago, when cigarette advertising was still legal in the US, the specially designed “women’s” smokes had the catchy ad slogan ”You’ve come a long way, Baby…” Well, maybe some, in the First World anyway, but we still have a long way to go. As ever, I wrestle with my skepticism that “Me Too” and other momentarily epoch-making advances will disappear in the quicksand of traumatic memory, as other interests compel the public mind or sell news.
In 1970 pro tennis when male players were paid seven times (!) more prize money than their female counterparts (if women were admitted to compete at all!) and Billie Jean King fought for parity, it appeared as if female athletes were winning ground. Recent events like Chinese tennis player Peng Shuai’s “disappearance” and “silence” after speaking out about sexual abuse; or mysterious events surrounding teen Russian figure skater Kamila Valieva make me wonder.
As ever, I wrestle with my skepticism that “Me Too” and other momentarily epoch-making advances will disappear in the quicksand of traumatic memory, as other interests compel the public mind or sell news.
Perhaps Valieva’s tumble is a fitting metaphor. Yes, we have a woman vice president and women are even driving now in Saudi Arabia, but as contemporary Peruvian author Sylvia Vasquez-Lavado recounts in her recent memoir, even in her short lifetime she learned early that making herself ugly was the only defense against the relentless sexual intrusions and obnoxious attention of any random man.
Because of my own interest in “mother-lessness” and motherhood, I chose to focus on that female issue because it can have such profound meaning and impact on development, trauma and neglect. I remember when I first started therapy in my 20’s, my mother railed “It is the blame your mother generation!” That is certainly not my intent. However, Vasquez-Lavado’s mother is a vivid illustration.
In effect, “sold” into an arranged marriage at the age of 14; she had born three children while still a teen, until overwhelmed and overcome with tremendous shame and terror (and most likely dissociation), she fled. Vasquez-Lavado herself only learned her mother’s story years later, having always believed that the older relatives she thought were aunts and uncles, were her siblings. Of course, this all had a tremendous impact on her.
Deception, a mother’s disrupted development: generations of mother-lessness begetting generations of mother-lessness.
I have to wonder, with utmost compassion, what it was like for my mother growing up with my cold, upper-class intellectual grandmother. I believe there were a lot of nannies involved. And this, even before the explosion of the Nazi Holocaust.
I was stunned and horrified when I heard the story on February 5th that a Salvadoran woman identified only as “Etsy” was released after completing ten years of a 30-year prison sentence. The crime: abortion.
Well, they called it “aggravated homicide.” In El Salvador, abortion for any reason, including rape, incest, or danger to the mother’s health is strictly illegal. Still, in Etsy’s case it was an obstetric emergency that prompted her high stakes decision. Her release after ten years was a triumph of the international reproductive rights movement.
I don’t know if Etsy already had children before going to prison. If she did, they were motherless for ten years, and Etsy, besides being robbed of a decade of her life in conditions that I hate to envision, would have been torn away from them, Not to mention the grief of losing a wanted pregnancy.
This is all present tense. And as we all know, Roe v. Wade, the famous case that made abortion legal in the US in 1973, teeters on the precarious brink of survival.
Etsy’s trauma hovered right at the interface between abortion and miscarriage. In El Salvador, the line is blurry between the two, and even women who suffer miscarriages and stillbirths can be prosecuted for murder. I could not find any other countries that criminalize miscarriage, but I did learn that in some other cultures, women who miscarry are viewed as “dangerous” or possessed of some sort of spell that would make them, at the very least a threat and thereby unwelcome at baby showers and the like.
How very sad! Their likely grief and loss is then compounded by social isolation and ostracization – rejection. All too often, women are blamed or stigmatized for miscarrying, and certainly, this trauma is poorly understood by most who have not experienced it.
I have seen numerous examples in my practice of women who lost wanted pregnancies grieving with profound and vacuous loneliness upon these traumatic losses, especially when their reproductive window may appear to be soon to close. Somehow our culture is clueless about miscarriage, not understanding it as the death of a beloved other. I guess perhaps we don’t know what to say.
All too often, the grieving mother will hear something overly cheery like “you can try again…” or a quick jump to the joys of adoption, which may sound to the grieving “not-to-be-mother” like “this is no big deal,” or “there is nothing here to talk about,” or simply ”I don’t want to hear it.” The grieving one may then wonder if she is pathological or if her depression is exaggerated or self-indulgent.
There may also be medical complications or hormonal shifts that make healing slow, difficult and again lonely. There are no sympathy cards. There is no funeral, in most cases no spiritual or religious marker, public or private—a lonely and poorly understood road. And when grief is complicated and traumatic, and there is a subsequent pregnancy, that child spends its early months of development in a womb still lost in grief, stress hormones and fears that it might happen again. We could certainly help those children and later, adults, by developing an understanding of how to support miscarrying mothers-to-be and also make it a safer and kinder world in which to talk about miscarriage openly.
I was troubled to learn that in Spanish, or certainly in El Salvador, there is no word for miscarriage. The same word is used to refer to miscarriage as to abortion: aborto. So the mother of miscarriage is categorically likely to feel like a “sinner.” My recommendation to those who learn that a loved one or friend has lost a pregnancy and who don’t know what to say, is to just say that! Just say, “I don’t know what to say, but my heart goes out to you.” That is what I always recommend when we don’t know what to say, as it is a way to communicate that my silence is not because I don’t want to talk about this. I simply don’t want to make it worse. And it may serve as an invitation to let you know what would perhaps help.
I knew when I was five that motherhood was not for me. I was such a profoundly sad and lonely child, I knew I did not want anyone to ever come into the world and feel like that, and I feared I could not do better. I did not speak of it, but I always knew. As I got older, and my mother would refer to couples we knew who chose not to have children as “too selfish.” So, I concluded that my undisclosed plan for myself was another indication of my badness or defectiveness, it was probably true about me too. I was all the more compelled to be “unselfish.”
As I got older and saw how excited others and later my friends were about having families, I grew to believe that there was perhaps something monstrous about me and unnatural in my preference. In my thirties, as my window of possibility was narrowing, I had the good fortune to have a consultant, Mardy Ireland, who had recently written a book on the subject. All these years later, I still highly recommend that book: Reconceiving Women: Separating Motherhood from Female Identity.
Both Mardy and her book helped me tremendously to make my peace with my decision, which I have never regretted. I was also fortunate to partner with a man who was on the fence about children and therefore left it up to me. I am blessed with a wealth of nieces and nephews whom I adore, and the one thing that really endeared me to Tim Cook, the CEO of Apple, is when I read an essay he wrote on the joys of being an uncle. Being an aunt is one of the great pleasures of my life. I am good with that.
Admittedly I can slip into feeling that motherhood is an act of heroism and courage that I lacked. I must be mindful that when a client is grieving what she has not “accomplished” in other areas, that I do not miss the mark or intrude with my own formulation. And we all live or wrestle, like George Floyd in his final breaths, with a deep memory of the at least then, most important person in the world. In that spirit, I do say, thanks mom.
In the 1970’s Women’s Movement, we used to say Women Hold Up Half the Sky.
Happy Women’s Day to all.
Each time I write a blog, I always try to think of a song that I love that goes with what I’ve written. Today’s is Madre by Silvio Rodriguez.
My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.
When the pandemic began, there was a crazy run on toilet paper. Oy vey! An African client told me about exclaiming to his mother, “I don’t get it about this toilet paper thing. Americans don’t know how to clean their butts!” He explained to me that in his country their custom is to wash themselves with special cloths. For him, the TP “shortage” was kind of a joke.
In a fancy hotel in Cuba, I was fascinated by the bidet. I had never seen one of those before. When I texted the picture to my dear friend who is well-traveled all over Europe, she was intimately acquainted with them. I had a Greek boyfriend who squatted on the toilet seat—a balancing act I had never seen anyone do before. Admittedly I tried and never pulled it off too successfully. How often do we see what anyone does in the bathroom?
When we were kids, our dad used to go to the bathroom to hide or read. He might be in there for an hour. There was only one bathroom in our little apartment, but we knew not to knock or disturb. And admittedly, sometimes the man-sized odors made us want to run for it…
How we move our bowels is another of those unspeakable body functions, and like sex, no one really knows what anyone else does. We all think we are supposed to know and that whatever might seem different from the imagined “normal” is a point of shame. With neglect, where the experience is “no one gives a s—”, there is even less information shared, and sometimes even potty training or something as fundamental as having one’s diapers changed is missing.
I recently learned that one’s bathroom routine or ritual is as personal and unique as one’s walk or signature. Not only culture and experience but individual style shapes it. The same is true for how one thinks about it.
How we move our bowels is another of those unspeakable body functions, and like sex, no one really knows what anyone else does. We all think we are supposed to know and that whatever might seem different from the imagined “normal” is a point of shame.
Historically, humans have not been so squeamish about bowel function. In fact, before the heart was thought of as the “seat” of emotion, it was the bowels. In the Song of Solomon, one of the great love missives of all time, Solomon wrote:
“My beloved put in his hand by the hole of the door, and my bowels were moved for him.”
Voltaire was credited with saying:
“Persons who have an easy movement in the morning are the favorites of nature. They are sweet, affable, thoughtful, gracious and efficient. No words have more grace than a yes in the mouth of the constipated.” (Wow!)
Oscar Wilde’s Lady Chatterley “moved her bowels for the gatekeeper.” It would seem that Des Cartes’ mind-body split might have been a factor.
On the flip side, I remember one of the most rejecting insults a kid could make was, “I hate your guts!” That would imply something pretty essential.
Not long ago, I had a client extremely hesitantly recount not one but two recent episodes of leaking stool. (This same client had suffered an agonizing months-long bout of treatment-resistant constipation: a hideous parade of miserable visits to a spectrum of practitioners. I can’t remember how it finally remitted. It seems so long ago now.)
The recent “leak” was just “a little bit,” but she was horrified. Post-menopausal, it had happened twice over a period of several years. It was a push to reveal it, or expose herself that way, even to me. She was surprised to learn that it is a not uncommon fact of aging.
I was similarly blindsided by the advent of urinary incontinence when I got into my 60’s. No one had warned me that is a not uncommon side-effect of menopause. I learned the hard way after being surprised by a flood, thankfully in the privacy of a gym locker room. It was a blessing that men may readily experience the same thing, and my husband knew every bathroom in the Bay Area for our longer bike rides.
I had another client once, an attractive sixty-something woman, impeccably dressed in Chanel suits, perfectly accessorized with Louis Vuitton bags, who matter-of-factly reported “fecal incontinence.” She was not alarmed about it, and she was not a child of neglect. It was a simple element of aging that one had to take precautions to manage—no big deal.
I learned long ago that constipation is generally a communication of fear and terror. We have all heard the term “scared s—less.” In fact, when a mammal is under threat, and of course this includes us, priority goes to the survival functions of fight and/or flight. We don’t have the luxury of being able to commit energy to a “non-essential” body function like digestion. So that may stop for a while until the danger passes and the body returns to whatever homeostasis or regulation is possible for that organism or person.
Interestingly for humans, 30-40% of our energy is consumed by digestion. The Latin cultures have the right idea by observing siestas after their main meal, although I don’t know if they do that anymore.
Clearly, constipation can be a clear communication from the body of fear and terror or the body “speaking” to us about what is not consciously known or felt. A challenge of healing is learning to listen to these nonverbal utterances, and as parents, teachers, therapists and citizens of the world, making it safe and acceptable to speak out loud about body functions: dispelling the shame.
I remember “constipated” as being an insulting euphemism for “uptight” or not forthcoming. (“Anal” was used the same way.) It can, however, be essential information that informs treatment planning. It is certainly a point of inquiry or a marker of hyperarousal when doing neurofeedback assessment.
Laxative abuse, or manipulating the digestive function, can be a symptom of or an eating disorder in its own right. As with sex, we must learn to listen and learn to speak with respect and curiosity, without taboo, shame or jest, about functions and dysfunctions that we all share.
It appears that Japan is ahead of us in this way. I discovered a “poop’ or “unko” museum.
Unfortunately, I cannot read Japanese, so I am not sure how to visit the virtual venue. But it is cheerful and natural and worth having a look at, at least to me. Like Voltaire, it portrays an “easy movement” as cause for celebration. Why not? Cheap thrills for the regulated? Another incentive for regulation? At the very least, an indicator of regulation and progress in recovery from trauma and neglect.
My husband’s grandfather was known for saying, “Never pass up a chance to fill your stomach or empty your bladder.” We might make an addendum to those words to live by!
The recent ‘poop’ blog brought such a response that due to popular demand, I wanted to add one more little piece. Many with trauma and/or sexual trauma receive their doctor’s prescription for colonoscopy with dread and paralysis. In the US, it is recommended to get one regularly after age 50 for early detection of colon cancer, but many simply do not do it.
After I was 60, I finally took the hint. With a history of cancer in my family, this was not smart! I learned to my relief that I could fill the prescription with a ‘poop in a box’ system prescribed by my doctor. The specially designed box was delivered by FedEx and came with all the necessary instructions and accouterments. FedEx also picked it up, and it was done and gone. Poof, wiped away! I imagine for some medical conditions, and also in some geographic areas, it might not be available. However, maintaining health and safety while navigating trauma healing is a balancing act already. It may be worth looking into.
And because I can’t help myself, I will add that a ‘high point’ in Everest climber Silvia Vasquez-Lavado’s recent book In the Shadow of the Mountain, to be reviewed in a future blog, is when she not so happily poops at the cruising altitude of 30,000 feet! You can look forward to that!
As we used to say in junior high, “hope everything comes out alright!”
Each time I write a blog, I always try to think of a song that I love that goes with what I’ve written. Today’s is People Like Us by Talking Heads.
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 me historically, holidays, anniversaries, birthdays and other marked dates that cycled around every year laden with hopes and expectations, fantasies and even magical prayers were always a terrible trap. Particularly those that were supposed to be occasion for lavish and abundant presents. In our family they of course usually were not. I certainly longed for that special gift on that one special day that would symbolize and communicate that I matter, that I was indeed seen, heard, and even cared for, at least for a minute. The non-Jewish kids thought that because Hanukkah has 8 days, we got 8 presents, one each night. Not so in our family, where it was more or less one. Invariably at least one of us wound up in the bathroom crying every year.
As I got older, my refuge came in being an impassioned creator of gifts. My little world became a lively whirlwind of craft, the sewing machine buzzing, the floor littered with colorful threads, scraps and wisps of the flighty tissue paper of Simplicity sewing patterns. It was happy little workshop, although it also failed in the quest to feel special, loved, seen, and valued. Nonetheless parts of that set of rituals persist to this day, although the media have rolled over many times. And a variety of craft has become an activity of absolute and unadulterated joy or I won’t do it. In our little cosmos of childhood neglect and trauma, however, the holidays approached with a family tradition of hope and dread. Norman Rockwell was most definitely MIA.
Although she never spoke of it, our mom must have had some sort of strong feeling about the holidays too, or at least some of them. She always told the story that she and Dad got married on Christmas Day in 1949, so they would “always have something to celebrate that day too.” And I am sure it is from her that I inherited my hopeless case of Christmas tree envy, as she also loved the glittering trees, and of course we could never have one. In my twenties when I lived with my “gentile” partner, every year we got our Christmas tree the day after Thanksgiving. I loved watching the lights twinkle each night. Fire hazard or not, reluctantly we took the tree down on Valentines Day, swept up the little carpet of dry pine needles, and said good bye to the sweet smell for another by now only nine and a half months.
My husband and I emulated my parents just a bit, getting married the day after Thanksgiving, 1991. This year marks our 30th year of marriage, which is for so many reasons unimaginable. Between the trauma-neglect brain’s confusion surrounding time; the surreal blur of the Pandemic years, and the incredulity of not only living this long, but achieving and sustaining a joyful and lasting partnership… Well I never thought it would happen to me.
The nature of trauma and neglect is a surreality of time. The dorsolateral right prefrontal cortex which understands and regulates a sense of time, is one of the areas highjacked or knocked out by trauma of many kinds. It leaves a person feeling that this will never end. In a trauma ridden family home that is often true until the child gets old enough to get away. If you find it challenging or even impossible to practice affirmations and tell yourself something positive about tomorrow being another day, don’t compound it with self blame and censure. Just know that your poor old bushwhacked brain needs a hand and can get there. The cycling of the seasons, the inevitable approach of the seasonal markers of time getting away can be painful. It may seem to signify more loss: “life is passing me by…” Then the holidays threaten an even greater burden of weight.
And there can be the additional blight of anniversary reactions, another mysterious bearer of the trauma story. The body, emotional and sensory apparatuses log events in a wordless, impressionistic way such that even just the arrival of a season or time of year can bring a wash of felt experience or mood that may appear to “come from nowhere.” Perhaps the brain is summoning an emissary, like a “Ghost of Christmas Past” to deliver another chapter of the trauma story unknown to ordinary autobiographical memory. “Why do I feel so bad?” That may be why. It is easy to feel guilty or ashamed about not being cheerful and happy around these annual events. It is a ready reflex to sink into self-recrimination and compound the lousy mood with self-blame and self-hatred. That is one reason why I like physiology so much. I never imagined that science would be such a source of comfort! Repeat, “It is not your fault!”
It seems that every culture in the world, throughout time, has created its own repeating ritual traditions. They contribute to identity formation and a sense of continuity and even faith. It is often said that the definition of insanity is to keep doing the same thing and expecting a different result. However to keep doing the same thing and expecting the same result might be very sane indeed, and an adaptive practice. That has certainly been true of my little craft workshop.
When I got old enough, and blessedly have the resources and the privilege, my husband and I make a ritual of escape from the winter holidays. I despise what I call the “Three C’s” of these holidays: Commercialization, Consumerism and Commotion – at least in the US. The ever-present reminder to buy; what is certainly in the Bay Area off-the-charts traffic, not to mention the pressure to have families and loved ones to celebrate with… I find it all unbearable. We leave town and head for somewhere quiet, out of the way, and warm. One of the ironic perks of the COVID Pandemic, for those of us lucky enough to be healthy, was that all of that holiday uproar was perhaps tempered a bit. We just couldn’t mob the stores. Perhaps people did something parallel in the privacy of their own cyber worlds, but it was not as much “in my face” so to speak. I don’t mean to heartlessly and Scrooge-like disparage the ritual of gifts. I do also love them, when they have heart; are not obligatory or “transactional;” or part of some insidious unspoken “deal.”
I also like the annual reminder of charitable organizations, who toil tirelessly throughout the year, often doing the most difficult of work, and often on an underfunded shoestring budget, needing and requesting support. I feel better about their doing what I either can’t or won’t do myself, by helping as much as I can. I remember how some years ago now, San Francisco Mayor London Breed first got my “vote,” (not the most astute way of making political choices I’ll admit!) She wasn’t even running for anything yet at the time. I heard an interview where she told the story of growing up poor in San Francisco, raised by her grandmother. Without running water in their apartment, of course there was no money for Christmas presents. And then came Toys for Tots. “I got a present! I became that happy little girl who got a Christmas present!” Breed has loved Toys for Tots ever since, and certainly put it on the radar for me.
Although I am not religious, I do like the Jewish New Year tradition of self reflection. The Jewish New Year comes in the fall, usually in September so it coincided with what for me was the start of the school year. Nowadays I believe school starts in August which I view as a “crime against nature” as August to me represents high summer and is no time to start school! Anyway, the start of the school year was a laden annual marker in itself, and the injunction to review the past year and think ahead to the next one was a worthy and even somewhat natural practice. Cycles of the year, and known dates and events seemed to provide a welcome jog to my often-addled memory. Where was I last year on this date? And because it is a recognized date it may stand out in some way. Perhaps I can picture how I observed it then, which might open the flow to what my priority was then, what happened then? Where do I want to go in this next orbit around the sun? I used to journal. For some reason I don’t do that anymore although it can be a very useful practice.
IF we can do it without a whip I find self-reflection to be my go-to holiday observance. By whip, however, I mean self-reflection that is tinged with criticism, harsh regret and aspiration; or that smacks of judgment, even punishment. These are no way to celebrate a holiday! Hopefully I would never treat anyone else with tidings of judgment, blame and pressure to shape up! Why would I treat myself that way? There is even a contorted grandiosity in the expectation of exaggerated achievement or perfection; and there is a blessed humility in the act of heartfelt, realistic self-reflection, and flexible, fluid goal setting that allows for the unanticipated, which is often even better than what we planned.
Many do not know that the Hanukkah story is the story of a miracle. The “eternal light” is the ceremonial lamp that burns continuously in every Jewish sanctuary, symbolizing the eternal, unfailing presence of God. As the story goes, the Jews were embroiled in war with their then oppressors, and the eternal light in their Temple ran dangerously low on oil. At the key moment, there was only enough oil in the lamp to last one day, with the danger that the light would be extinguished. Miraculously the oil for one day lasted for eight, so the light burned on until the Jews were victorious, and able to replenish it. So besides being another celebration of victory over oppression, this miracle represents unending, uncompromising protection and comforting presence, maybe even hope? Not a bad symbol for our purposes I figure.
Milestones may also be a chronic rhythmic reminder of how painfully long recovery takes. One reason why I have been on an insatiable quest all these years, to learn all the newest and best evidence based treatment approaches for trauma, is that. It incenses me that after a childhood ravaged by overwhelming experiences not of one’s own making, survivors then have to spend years and seemingly endless amounts of money and time, to in effect, climb out of a hole and arrive in life. That is a tragic injustice as far as I am concerned, that I have dedicated my life to at least attempt to rectify. It is also important to know, that the devastating and seemingly endless duration is not your fault! Not your sloth or ineptitude.
Much of the deepest of injury is in the attachment systems of the brain and date back to developmental stages in infancy. This is not to make the duration appear worse or hopeless, but rather to “normalize” it. And I can honestly say, and this is one of those annoying things that therapists might say, every bit of my own journey which often felt (and even occasionally still does!) feel endless, serves me. As Bruce Hornsby says in his wonderful and timeless song Swan Song “To be sure I don’t regret much, not much at all.”
I believe recovery is a kind of miracle in itself. I do think of mine that way, replete with the many angels who entered my life as healers, teachers and helpers of all sorts. It is a good time to remember that, at least for me. So my wishes for all are Peace, Health, Love, and with luck, even some Joy. And because I can’t help myself, I must add:
Cheese on Earth!
Best wishes of the season!
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.
In our apartment building in New York, everyone seemed to have numbers on their arms, sad eyes and thick German accents. My great Aunt Gertrud would take me to the park in my stroller. She called me a “dickopf “ (fathead) because I was such a “terrible eater” right from the start. On Saturdays I often went with my dad on the subway to the orthodox “schul,” our special time together. I would sit next to him in the men’s section, my little legs dangling from the hard wooden bench, and braid the fringes on his “talis.” Other than that I did not get out that much. Mr. Shall the nice old man who painted portraits of each of us (see the portrait of myself age four); and Mrs. Bodine my piano teacher, were all in the building. So it was easy for me to believe, the whole world was like us.
It was only when I went to public school kindergarten that I began to get the confusing messages about identity that got more and more confusing as I got older. Fit in, but not too much. I learned the complicated word “assimilate,” which accompanied the complicated messages. My mother’s family, even though they had nothing, still identified with an intellectual elite, my grandmother proudly being one of the first women to graduate from Oxford. She tried desperately to talk my mother out of marrying my father, who never went to high school, (although he “showed” her years later by getting his MA from Stanford.) My dad was simply ferocious about our marrying Jews. So we were in some ways “superior?” certainly and thankfully not like them. And yet fleeing hideous rejection and persecution, many here were ignorant or prejudiced, so we might have to hide or prove ourselves as worthy or equal, or “pass.” Oy vey. And that was even before all the identity challenges of adolescence and then of moving to Indiana!
In the Colin Kaepernick movie “Colin in Black and White,” is one poignant scene, where the teenaged Colin has reached the long awaited milestone of getting his drivers’ permit and is out practicing with both of his white parents in the car. He is doing nicely, when he is randomly pulled over by a cop, apparently for “driving while black.” His father pipes up quickly saying, “What did he do, Officer?” The cop looks over at Colin’s dad, sitting in the passenger seat, and sternly asks, “Who are you?” His mother jumps in from the back seat, “We’re his parents.” And quickly adds, “he’s adopted.” It sounds almost apologetic. Variations on that scene repeat in the course of the movie, and one can only imagine how many times it recycled in his life. It reminded me of a time when I had a small crash on a bike trip in Oregon that left me with a whopping shiner. Walking down the small town street with a black eye, I could see people looking at me, looking at my husband, and glancing back and forth between us, trying not to be too obvious. I remember how ashamed I felt. Somehow it matters who others, even strangers think I am.
Colin’s life and identity formation as a person of color in a white world, was far more complicated than I knew as I saw him heroically taking a knee. Obama unfortunately does not address this experience in his recent memoir, which I doggedly trudged all the way through to its final 700th page.
This morning in the wee hours I heard another compelling interview, this time a young Pakistani man whose family were immigrants in Northern Ireland. I knew a tiny smattering about the fractured identity of Ireland. I remember when I was traveling in Latin America in 1981, following the news in the Spanish language newspapers of the Irish freedom fighter Bobby Sands as he struggled through an ultimately fatal hunger strike. The young interviewee, arriving in Ireland anxiously discovered that there was nary a brown face anywhere to be seen. Making it even more complicated was that his father was a devout, strict and authoritarian Muslim; and his mother had joyfully discovered and embraced Catholicism. Some of his childhood memories involved his mother secretly sneaking him out to go to be baptized, later to confession and ultimately Confirmation. These little clandestine escapades were exciting and special times with Mom. His father on the other hand, was fierce, harsh and demanding of both his mother and himself. Yet much like myself, his brutal father was also his greatest role model in some ways. I have always said that all of my best qualities are from my father, and he is the one whom you will most often hear me quoting and rhapsodizing. It has taken me years and decades to integrate these seemingly opposing pieces, and I suppose I am still not finished. This man felt quite similarly.
Caught in a clash of multiple identities, Irish, Pakistani, Muslim, Catholic, father, mother, he was plagued by the question, “who am I?” It was unanswerable. And he had a brewing rage toward his father that was only building, when in his teens, his father was mysteriously and violently murdered. The circumstances and facts of his father’s murder were never resolved, and his massive swirl of emotions and identity questions became a lifetime agony. I thought of my own little conflict, and how it has challenged me, and in comparison with that? Wow! And now I am doing what I always tell everyone not to do! It is pointless to compare or minimize one trauma against another! Don’t do it!
The developmental neuroscience researchers teach us that the sense of Self develops in the Default Mode Network (DMN) of the brain, deep in the brain’s most primitive region. This is like the idle mode of a car, where the car settles when it is not “under task” meaning in drive or park. It is where we drop for self-reflection or relaxation, if we are lucky. The infant brain develops in resonance with the brain of the caregiver, right hemisphere to right hemisphere. We begin to grow a Self through the consistent presence of a caring other: the gaze, the touch, the song, the loving emotional tone. That is how the little circuits begin to form and fire and wire, long before any of the complexities of life events intervene, distort, and compel.
So you may ask, why do I feel so bad? Why do I have so much confusion about who I am or what to do, or what is “right” or “good enough” or “real?” The answers may lie deep in the brainstem, long before we had the equipment for autobiographical memory, let alone the words. We needed that consistent other, and when that failed or was insufficient or absent, we lack for the essential tool to make sense out of all the many complications that might come later. For healing we need the consistent others, the touch, the song and the positive emotion.
As the Dalai Lama is known for saying “Be kind whenever possible. It is always possible!” I would emphasize, be kind to yourself!
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.
In the attachment literature Berkeley luminary Mary Main eloquently describes the “dilemma without solution.” For this bereft infant the source of safety and the source of terror, reside in the same person, who happens to be the most important person in the world: the primary parent. As every human baby is born into the world in effect a bundle of needs, these infants are born into an impossible bind, a perennial struggle with reaching toward and backing away all at once, in a painful and clumsy vacillation, that culminates ultimately in devastating freeze or collapse; and despair, ultimately devolving into numbing or dissociation. They are met with this destiny at their very arrival.
Dissociation is a confusing term in our vocabulary, because it corresponds to two related but distinct responses. It can mean both an emotionless, dull or numbing absence or failure of presence. And/or it can mean splitting off, i.e., separating or disconnecting into parts of the Self. Both can be the tragic outcome of this primordial neglect.
Admittedly I have two gnawing and often unpopular biases. One is what I call the “myth” of unconditional love. By nature, the human infant remains dependent longer than perhaps any other mammal. We would hope to be received and welcomed as a “bundle of joy,” a worthy hope that nature prepares us for. Nature’s design also is that the responsibility and the task of parents to attend to the unending needs of their infant child. That is why babies are so cute and irresistably charming, and why our systems are particularly laced with oxytocin, the love chemical, at this crucial time. Unconditionality is the birthright of that child, it is the parents’ unending “job” to provide and attend.
The child infant of course, has no words, only a cry. A “good enough,” present parent learns to differentiate which cry indicates which need: which indicates “I’m cold, I’m wet, I’m hungry, I’m lonely, I’m scared…” And again, according to the attachment researchers, the best of the “good enough” parents only get it “right” 30% of the time, the rest being a persistent dance of rupture and repair. In these happy cases, the child learns repair is possible. It is safe to receive or not, to need, to hope and to want, because one way or another, eventually we will return to homeostasis. Eventually Mama will pick me up and hold me, and all will be well. Gradually and with luck, we learn regulation. And this lucky child will also grow up with an ease about fundamental human need.
The child of neglect is not so lucky. Even hoping to receive becomes risky business. By any means possible, the child might try and fail to get attended to; get what they need for a while. They will experiment with various strategies: being cute, funny, inordinately smart, they might protest, attempt to be very good, even taking care of the parent. I am sure I tried all of them. In fact, my mother used to recall how at the age of three, little Ruthie was organizing the “little kids” in play, dancing around a tree. She would smile about it, I was desperately already then earning my keep.
When all else fails the child withdraws into the lonely devastation of numbing. And as placid as it may look from the outside, it is a state of high anxiety. From the inside it may come to feel like “nothing,” and there is no category for feeling. Self- reliance becomes something of an assumption or an identity. Need becomes a mortal enemy.
I have found that where many clients might reject the neglect designation, “self-reliance” seems to fit for them, and as it is highly regarded in the American culture of “rugged individualism” it may even seem like a compliment. However, the relationship to our fundamental species determined interpersonal need, our humanness, is distorted. Somewhere, deep inside, most likely far outside of awareness, the longing is logged: the missing experience of unconditionality, of being adored with nothing expected of us; of being understood without words, because the other makes it their task and their mandate to understand us; the expectation that our needs make sense to the other and will be gratified. And sadly our chance at interpersonal unconditionality, does not come again.
In adult life, however, the need might rear up, and center on an intimate partner. This is where my bias comes in: the myths that persist, in the fantasy of the child turned adult, is what I call the “myth” of unconditional love, of having a partner whose mandate it is or “should be,” to “meet my needs.” It is a trap, because (I believe) it will never again be someone else’s “job.” Sadly, by no ones’ “fault” that window has closed. There are schools of thought and even of relationship therapy that teach that these are reasonable hopes or even demands. I am afraid I am not of that school. Some couples argue about it. And it can be a very hard sell.
These last few historic years have faced the world with many unsavory truths. Two of them prominently featured human knees: George Floyd was brutally and heartlessly murdered with a heavy, unrelenting knee to his neck for over nine minutes, despite his cries and gasps for breath; and Colin Kaepernick’s heroic defiantly “taking a knee” in unrelenting protest against the unrelenting racism of this country. Both helped to fuel a growing Black Lives Matter movement, which I fervently hope will not get lost in the fickle march of history.
One thing I especially like about the language of Black Lives Matter, is that it forces the question of relevance and the hierarchy of our values. With or without our awareness, it addresses what we do or do not deem important. How much do we in fact care about the needs and dignity of others? There it is again, the often-inconvenient intrusion of human need, our own, the needs of others. How do we rank them? How do we respond to them? Both George Floyd and Colin Kaepernick have become kind of heroes to me, and firm gentle reminders, of what matters.
I have been doggedly watching for news of Colin over the now maybe five years that he has been black listed (no pun intended!) for his outspokenness about race and prejudice in the NFL and in this country, thus proving and consolidating his point. It has been a great sacrifice on his part. I eagerly looked forward to his recently released Netflix documentary Colin in Black and White. Last weekend I watched it.
Colin was adopted at birth by a kind hearted white couple, and grew up in a white world. The movie gives a closeup of his early years, and the many contradictions of life in a white and unintegrated world. It gives a whole new meaning to the word integration. And all the challenges of identity formation, the main requirement of our developing years, are heightened and further complicated by the unrelenting intrusion of race, and the additional complications of looking so “different” from his family.
Although the movie was perhaps disappointing to me in that it did not run very deep, there was one thing that struck me, and that harkens back to our theme. Colin was an all-around super star athlete. He excelled at football, baseball and basketball. When the time came, he was offered full ride baseball scholarships to virtually all of the most highly regarded universities in the US. But his dream was to be a quarterback. That was all he really wanted. Colin passed on all the baseball offers, holding out and tirelessly training for the elusive quarterback offer that almost never came. It was amazing to watch him painfully and steadfastly continue to work hard, endure and determinedly wait. When it finally does arrive, the viewer can see what a great sacrifice it has been for him to hold out for what was most wanted and cherished, and then to risk it and in effect lose it for his beliefs.
It is almost a mystery how dogged he is about his “first love,” being a football QB. Until we get to what for me, was the most poignant line in the whole movie. Describing his adoption story, he recounts, “my parents were all set up to adopt another baby.” He even knows her name, which I do not recall. At the very last moment, they learn that the baby they thought they were adopting, is “not available.” We are not told why, nor the race of the original baby. But they are offered Colin instead. His parents accept Colin, whom they love and thoughtfully care for and raise. But in the most profound and telling line in the film, Colin tells us, “But from the very beginning of life, I have never been anyone’s first choice.” He still languishes on the sidelines.
One of the perks of disordered sleep is that I catch some of the most quirky and extraordinary, imaginative programming on Public Radio. In this case, Public Radio Remix in the wee hours on Sunday mornings. The other day I heard a story about “the fadeout,” a particular style of ending songs that was popularized in the music of the 1970’s. I was fascinated, mostly because admittedly, I had never given a moment’s thought to how songs end. I never noticed how all AC/DC songs have the same ending, or the unusual, not always originally intentional endings of some of the most well known songs on the Beatles’ Sargent Pepper album, classic symphonic endings, even folkloric “shave and a haircut” type endings, or the “fadeout.” I simply never really asked the question: How do we end things? How do we determine what matters? Your “needs?” My needs? Football? Baseball? How do we harmonize them, integrate them, cooperate with nature? How do we order them with grace and dignity?
I woke up the other day with a crazy image. I saw two “bundles of needs,” old wrapped handkerchief-tied-on-a-stick type bundles, as from fairytale book illustrations. They have hands outstretched for a handshake. These two bundles of needs are greeting each other with “Pleasure to meet you!” What a great thought! With that, I fade out for today.
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.
My course with Quantum Way is now available for registration!