In my morning workout, I was swept out of my usual reverie by a vocal. Most of the time my Pandora musical feed keeps me happy and in rhythm with instrumental music. My station is a mix of contemporary/jazz/Spanish guitar which for me is just right. At first, I was annoyed, it was a slowish cut and Santana does not exactly belong on my Pandora station. When I began to tune in a bit, I realized it was Santana’s “I Ain’t Got Nobody, That I Can Depend On.” Then I realized that Pandora was suggesting that I write about the core dilemma of neglect, and the terrible dilemma that results from that early experience.

I always loved Santana. The band’s leader, Carlos Santana, was the first to effectively and successfully, broker the intermarriage between two of my favorite musical styles: rock and Latin. It was a pretty gutsy of him, and an innovative undertaking for a young kid from Jalisco, Mexico. But in San Francisco in the late 1960’s, much was possible. Certainly in the music world. In my typical way, I read a biography of Carlos almost a decade ago. I don’t remember much. He grew up in a musical family; he was sexually abused between the ages of 10 and 12, by an American man who brought him across the border. He subsequently lived and went to school in the San Francisco Mission District which was then a Spanish speaking ghetto, of immigrants from many Central and South American countries. (Now it is a wildly gentrified neighborhood and foodie hot spot, where finding a parking space is like winning a Las Vegas jackpot.) I remember walking through the streets of the Mission when I had my first alcohol treatment job, teaching drunk driving school in Spanish. I loved passing the many Latin music record stores, and often stopped on my way home to buy vinyl “discos.” 

I remember that many of Carlos’s relationships were stormy, with the band changing members and managers multiple times. But I suppose that is not so unusual in the complex and often drug laced musical world, certainly in those days. He divorced after more than three decades, in 2007 and not long thereafter married his drummer with whom he is still married. I do remember that I reflected when I read about him: his appeared to be a challenging, like many an immigrant, life of neglect. That song came from somewhere!

Way back in the middle 1970s, I cooked in a restaurant. I was a pretty good cook, having had the dubious distinction of being the only one who could be in the kitchen when  Dad was doing his cyclone-like chef act. Dad had learned to cook by “stealing with his eyes”, as he said, watching the experts and doing what they did, as he worked in restaurants around the world in his diasporic flight from Hitler. 

When I was born, he and Mom had a little restaurant in Carmel, and my sister and I spent our early years in the sink. This job, however, was a “movement job” at La Pena de Berkeley, a wonderful restaurant and community center supporting the Latin American solidarity movement. It is still there. It was there I really learned to cook. I was in my early 20’s and had a friend named Erica, who was tall and blond and looked like a model. I never imagined having a friend who looked like that. Erica was an amazing cook and taught me to make soup. Every day I made a 10-gallon pot of the soup du jour. I got pretty good at the soup thing, in fact, once one of my great idols at the time, Puerto Rican singer Roy Brown, praised our food from the stage.

My mom always loved my mushroom soup. Erica taught me how to make cream soups, and I loved the smell of the “roux,” the heady blend of butter and flour slowly roasting in the pot. Mom always started talking about Mother’s Day about three or four weeks ahead of time so we would not forget, so she could tell us what she wanted, and we had plenty of time to make or get whatever that was. She often asked for mushroom soup for her Mother’s Day dinner. It took about half the day to make, and I was so glad there was something worthwhile that I had to offer. 

I am not a mother, and my mother and grandmother are long gone. So Mother’s Day is a non-event for my husband and me. Except for the fact that roses are double in price for a week or two. So it is unfettered and free for reflection.

May is American Cheese Month. No, I don’t mean American Cheese (Kraft Singlets, that hideous impostor masquerading as or feigning to be cheese.) Granted, those singlets were the” perfect melt,” producing an immediate bright orange gooey ooze that dripped dramatically off the burger, providing a mouth-watering visual. It melted as quickly as its single-serving polyethylene wrapper probably would have and didn’t taste much better. The singlets additionally produced an ample supply of landfill, also sadly “American.” But we didn’t think much about those things then. No, this month honors American cheese, or to be precise, and certainly more politically correct, cheeses originating and produced in the US.

So why a month? Probably a commercial initiative to remind and encourage people that the step-child of domestic cheeses actually has an honorable and noteworthy tradition, history and even some products. The fans of a Wisconsin football team call themselves “cheeseheads,” as Wisconsin is one of the most venerated US origins of cheese. But I also remember from years ago, long before I cared much, billboards with beautiful scenes of California landscapes, touting “Come for the Views, Stay for the Cheese!” I often feel that way at our home.

Europe: France, Switzerland, Denmark, Italy, Greece are all the icons of great cheese. Like neglect, “American” cheeses dim and fade from view and allegedly at least can’t compete. I will differ with that (much as I do about neglect!) as some of the creations coming out of Marin, in the Bay Area, are pretty darn good, and even some of mine are getting there, although I would not dream of selling it. So, a month suggesting that we buy some, try it, well, how could that be bad? And for the home cheesemakers like me, a reminder to – as Gavin, my beloved Australian cheesemaking teacher, always counsels, “Keep calm and make cheese!” I hardly need reminding.

And cheese, besides being a passion of mine and an inspiration in countless ways, provides an infinite supply of ready and exquisite metaphors. Like peeling the plastic singlet wrap and setting the stuff to melt, I miraculously get a quick spill of words and ideas. The ups and downs of cheese making, replete with dramatic disasters of failure and the occasional wildly delicious success, replicate the non-linear trauma/neglect healing process. It also reminds us that some things are, in fact, intended to stink, and if we learn or develop the taste, we may even come to like that.

Many know that during my first year or so of cheesemaking, my failure rate was a dismal 60%. Many feel that way about their first year, or even maybe ten, of trauma therapy. What would make one hang in there? People ask the same question when I tell them that my husband and I fired five couple’s therapists back in the early days (blessedly three decades ago now!) before we found one who could help us. We thought we were the couple from hell and probably were. Ultimately after about two years and thousands of dollars wasted, we found someone who could, in fact, help us and who even inspired me to become a couple’s therapist. So, what would make one stay the course, or as Gavin would say, “soldier on?” After all, my husband is the one who, after 30 pages, if the story hasn’t “begun,” gives up on a book. I still can’t do that, always having to keep going and finish the thing, endlessly hoping that “it might get better…” (He did, ultimately, teach me that it is OK to walk out of a movie, although admittedly, it took a while.) Trauma/neglect therapy is not linear, and that is for sure. However, I do believe it will get better. For those who stay with it, in my experience, it invariably does.

The Vietnam War was the big bang that hurled us into awareness of trauma and sparked the birth of what was to become the field of traumatic stress studies. I say both “the” and “Vietnam”, somewhat embarrassed by a new awareness of another expression of cultural chauvinism. Centuries of war bloodied that small country, colonized and embattled with China, Japan, France, Britain, Cambodia… so “the” war with the US was one of many. Similarly, I am newly aware that spelling “Vietnam” as one word instead of two is somewhat of a corruption of the indigenous “Viet Nam”, which ironically means “unity.” 

American veterans returning from that war with glaring, seemingly intractable symptoms, commanded long-needed attention to what in 1980 became the diagnostic category of overwhelming experience: PTSD. Nightmares, flashbacks, irregularities of memory, exaggerated startle response, depression, and anxiety all became the growing and perhaps similarly overwhelming list of boxes to check. When I worked at the VA some 15 years after the real-time end of the war, I saw how many of the aging men, (and most of our patients were men,) were still living it. Florid drug addiction blanketed many of their unbearable symptoms. Sadly, living close to Haight Ashbury and Golden Gate Park, I believe some of our homeless are those same guys, now 48 years older.

I recently woke to another population that at least I had completely ignored. Once again, I was awakened by an interview in the wee hours on public radio with Viet Namese author Que Mai Phan Nguyen about her new novel Dust Child. Besides the population of US veterans I am familiar with, and (by now I have had more than a few clients who were their sons and daughters,) I became aware of vast groups, generations, of attachment-traumatized American veterans, Viet Namese women, and Amerasian or mixed-race offspring of the two. 

The novel artfully weaves together threads of three different stories representing a new view of the intergenerational transmission of attachment trauma and neglect. We meet a white male war veteran, like most GIs, barely more than a child when he finds himself embroiled in a bloody war far from home. Like most of his cohort, he does not choose to be there and does not really understand what it is all about. Like many of his buddies, lonely, bored, and desperately needing to block out painful reality, he whiles away his evenings in the seedy bars of Sai Gon (also two words in the native language,) drinking and being “entertained” by attractive young local women.

Secondly are the sad stories of painfully young Viet Namese women attempting to stave off starvation and save their families from homelessness by working in bars, serving drinks and providing company, and “more.” And finally, a generation of “Amerasians,” the often abandoned and orphaned offspring of desperate and lonely bar liaisons. These children are of any and all mixed-race colors, with apparently African American fathers (these being the most painfully outcast,) some mixed Asian and Latinx, and every imaginable variation. Our character in the story is dark-skinned, curly-haired, and unspeakably lonely, longing for family, hopelessly wishing his father would come looking for him and transport him to the dreamed-of better life in the US, and in search of a loving mother who would want him.

One protagonist is the now middle-aged white veteran, visiting Viet Nam and searching for the beautiful barmaid whom he had truly loved, now ashamed that he had both cheated on his faithful wife waiting at home and had left his young girlfriend pregnant. He did not know if the girlfriend or the child of unknown gender had survived the war.

We get the backstory of the then-young “girlfriend,” fleeing the extreme poverty of the countryside, seeking to earn enough to keep her family from losing the small plot of land that sustained and housed them, only to discover she had unwittingly signed on for sex work. I won’t spoil the rest of the story. Suffice it to say, the battlefields of Viet Nam are haunted by the gruesomely dead, the walking wounded, and the multitudes of ghost-like orphaned and abandoned whose invisible scars of attachment trauma, deprivation, and neglect leave many with huge questions about identity.

When I was young and deeply involved in Latin American anti-imperialist political work, the freedom fighters who organized and fought clandestinely against authoritarian dictatorships were called La Resistencia, the resistance. They boldly left their insignia, a capital R in a circle, as their quiet battle cry to show that they were not vanquished, ferociously not gone. I have always rather liked that it was also my initial, and I could sign off, if not in battle, certainly as a champion of the oppressed and unfree. However, the ways the word “resistance” has been used in the world of psychotherapy and, to some extent, in common parlance has irked me. I even occasionally hear disgruntled spouses hurl it crudely in an unruly couple’s session before I get a chance to nip it. It suggests intentionality, a willful thwarting of something. I rarely see psychological pushback that way. It invariably represents something else, certainly where trauma is concerned.

The core dilemma at the heart of neglect trauma is a profound internal conflict about attachment. Starting from the initial heartbreak, the child interprets the neglect scenario the only way they can, as rejection: “I am not good enough. I don’t matter. I am worthless. I am invisible. I don’t exist.” At first, if the neglect is early, which it often is, there are no words, only a quaking emptiness, hunger, agitation, a shapeless, rudderless flailing disorientation and confusion. After a while, there is collapse into the futility of waiting, and perhaps a freeze. Later, what most often emerges is a default to rock-solid self-reliance. What other choice do they have but to become strong, fierce, enduring, and to do it all themselves? It is the signature of the child of neglect, perhaps their/our version of the defiant “R.” But it is far more than a statement; it is survival, a way of life.

I began to learn about the ferocity of self-reliance in my work as a therapist. Often the child of neglect is reluctant to seek psychotherapy in the first place because they are not used to thinking of another person as a resource, or as being of any use. Often, these children of neglect are some of the most competent, accomplished, and outwardly successful people one might ever hope to find. The fact that there is a gaping interpersonal vacuum or “disability” might slip by unnoticed, even by themselves. They might know that they feel bad, or maybe they don’t even “have time” to notice that because they are too “busy” or too practiced at whatever their chosen medium of numbing out.

Re-enactment

One of many reasons I have found couples’ therapy with survivors of trauma and neglect so compelling is because of how dramatically and even explicitly the trauma stories make themselves known. I always say to my clients (and sometimes my husband!), “Nothing is activating like the intimate partnership!” Perhaps the couple is as “family-like” as any relationship, so we regroup the trauma family in this “new” configuration, and it becomes the stage for the story to unwittingly unfold. Oy vey! So, the couple’s therapist sees dynamics, and often well-hidden aspects of a person, that the individual therapist might never see or imagine. Clients do get angry or shut down with the individual therapist, and to greater or lesser extents, the transference projections appear. But however, regrettably, I do know that my husband has seen the worst of me like no one else has. And as a result, the fact that he is still there makes him a reassuring beacon of safety like I have never known. Those couples who stay the course get to enjoy that outcome too. This is not to say that I never lapse into, usually and hopefully, momentary states of unbidden memory. But I/we become much more able to find our way back to the prefrontal cortex fairly quickly. And yes, long and diligent work is required.

It continues to amaze me how diametrically, stunningly, my perceptions can become distorted, even now. If there is something I am particularly uncertain or insecure about, my lens perceiving judgment and rejection under every rock zooms into the forefront, like when I hit the “zoom in” option on my View menu and the whole screen leaps out at me. Suddenly I am that little godforsaken neglected girl again who can’t trust anyone, whom everyone is “out to get”, as our dad would say. And I am unshakably believing it. Reassuring words annoy me, rolling off like water off a duck’s back. Yeah, but… Perhaps after some gentle and nourishing sleep or a nice long stir of the cheese vat, the whole world looks different. I can see the exaggeration and distortion and find compassion for whomever I may have villainized or projected onto. Of course, usually, there is a kernel of something to pay attention to in real-time. But it is no longer catastrophic as it had seemed when I was activated. Often all that is required is settling the addled nervous system or simple rest. So simple, and yet how messed up the world becomes without… Oy vey!

Yes, even now, I am visited by episodes. But I can generally keep from embarrassing myself, recognize them reasonably quickly and locate the MIA prefrontal cortex, where my self-knowledge, good sense and generosity live. The more work we do, the quicker the turnaround, which is why I am such a stickler for doing the work, and staying the course, whatever that might mean in your lexicon.

Life is infinitely less “dangerous” now, at least in the interpersonal field, which was always the most volatile (and generally is for those with trauma and neglect – at least those of us privileged enough to live in the First World or where there is not a literal war going on…) And now I do, in fact, have the unthinkable: support, places to turn, and even internal resources.

Com Panis

When I was in the throes of my eating disorder, our dad would rail at me that the word “companion” emerged from the Latin com panis, sharing bread. Eating together was a natural and human way to connect. Ideally, that would be true. My not wanting to was somehow “inhuman.” For so many who grew up in a household of trauma and neglect, this was sadly far from true, and disordered eating is a not-so-uncommon expression of dysregulation.

I was interested to learn that, in a strange way, the whole category of “com panis” and food culture became a mechanism of social control and an attempt at cultural change in the Soviet Union. I heard an interesting story, “Dissident Kitchens”, on one of those wonderful late-night Public Radio programs. After the revolution in 1917, food was scarce. The new Stalinist government set about industrializing food, essentially dictating what was to be eaten by everyone. The new housing, small apartments where everyone lived, was built without kitchens. Rather, there were large communal kitchens, and people broke their bread in dining halls with 500 comrades. The Bolsheviks were not interested in the tradition or the aesthetic of food. First, food shortages devastated all that, but further, private kitchens were considered “bourgeois.” The foods to be eaten were determined by the government, and everyone ate the same. Apparently, and understandably, the people hated that and sorely missed cooking and the ritual of sharing intimate family mealtimes. 

When Kruschev replaced the Stalinist regime in 1953, in addressing the housing shortage he had apartments built once again with small kitchens, which became a place for families and friends to gather. Now, cookbooks and programs reflect the slow and steady revival and reclamation of traditional Russian foods. And although Russia is currently alienating many of us, its food story is informative, and reminds us how very elemental the family table is. Eating together in harmony is on the order of a birthright. And the way it is corrupted in micro and macro forms of trauma is a crime against nature as far as I am concerned!

Drudgery and Begrudgery?

“Sex-positive” has become something of a buzzy designation, kind of like “trauma-informed:” a sub-credential attempting to offer a space safe where people are free to speak or be open about sexual matters and be accepted and understood. When I first started training for sex therapy, I quickly discovered the work of Peggy Kleinplatz, whom I think of as the best sex therapist in the world. Additionally, Kleinplatz is a researcher and a professor – truly a pro. When I first saw her at a conference, I was amazed at how such a giant could be so diminutive, with beautiful hair almost as long as she is tall. I hope it is not sexist that I describe her appearance, as I certainly do not mean to diminish any of her other attributes! 

At one of those first conferences was an opportunity for “Breakfast with the Presenters.” I managed to be early enough to score a seat at the smallish round table with Peggy Kleinplatz! I was so starstruck I really could not speak or ask my questions, let alone eat! We have since become friends, and I have since been the presenter at one of those tables. It is a distant and sweet memory.

One of Peggy’s great achievements and contributions is that for several decades she has been seriously studying the positive: the elements of long-term, satisfying, monogamous sex. She has interviewed thousands of self-identified sexually happy long-term couples of every stripe to answer the question, how do they do it? How do they keep sex from devolving into “drudgery and begrudgery?” (Confession: I stole that catchy turn of phrase from Bono’s recent memoir. The book isn’t great, but that line is brilliant! I wish I could claim it!) Peggy came up with thousands of couples who could do it. (She studied non-monogamous couples as well, not to discriminate!) I was delighted when in 2020 she came out with a popular book, Magnificent Sex: Lessons from Extraordinary Lovers. Circumstances change, bodies change, and health intrudes, and yet these couples continue passionately going strong. How do they do it?

Attachment Trauma 

The first thing I successfully read, after a magical one session wonder with Peter Levine transformed my brain, was Allan Schore’s monumental Affect Regulation and the Origin of the Self. It is a dense read (and similar themes are somewhat more accessible in Daniel Siegel’s The Developing Mind, which appeared close to the same time.) Both transformed my thinking even further. 

The essence of both is that the infant’s brain develops in resonance with the mother’s brain. We might say primary caregiver, but given that the mother houses and often nourishes the infant with her own body, she is primary. The “resonance,” a fluid dance between them, is through the gaze, right hemisphere to right hemisphere. Ideally, the mother sees the child through that gaze and learns to discern the spectrum of signals, many of which are needs or distress, of course. She learns to recognize which is hunger, cold, thirst, fear, pain, need to be held, need to be left alone, joy, and pleasure. 

Through learning to differentiate the different cries, attending to them, and responding with the appropriate “supplies,” the infant is soothed, comforted, and regulated. The child will feel safe. Ultimately, through the mother’s “good enough” regulation, the child, in time, learns self-regulation and how to calm themselves down when distressed. This experience contributes to a baseline sense not only of safety, but of value. The child learns from experience, “my feelings matter.” This feeling matures to become the experience of “I matter.” And as we know, the most persistent and devastating refrain for the child of neglect is “I don’t matter! I am worthless.” So this is where that comes from…

Only in recent years, mostly from some of the luminaries in the Neurofeedback world, have I begun to learn about the Default Mode Network of the brain, residing deep in the brainstem, the most primitive part of our brains. That is where the sense of self primarily resides. That is where this early imprinting does and does not occur. We can affect it with Neurofeedback, and that is wonderful. I wish I had known neurofeedback sooner – it really might have sped things up.