I worked at the San Francisco VA for one year to the day. It was March, 1989-1990. I remember it well because it was the year of the historic San Francisco earthquake. I was definitely not cut out for that work, but I definitely recommend that any trauma therapist do a stint at a VA as there is so much to be learned there. In 1989 there were still plenty of Vietnam vets cycling in and out. And yes I do mean cycling. It was a wacky system, I don’t know if this has changed since then, but at that time, if a veteran recovered, or if PTSD symptoms even partially abated or remitted, their benefits were systematically cut. “service-related disability” was measured in percentages, and dollar amounts were proportionally calculated. So there was built in incentive to not get better. Of course we really did not have good treatments back then either.
One of the great lessons I in my time at the VA was about “triggering.” Admittedly I try to avoid that term, preferring to use activating or stimulating old trauma. By definition, trauma re-sets the brain to ferociously defend the organism against letting the trauma happen again. So any stimulus even vaguely reminiscent of the trauma, can activate a cascade of sensory, emotional, body sensation or whatever that individual retained of the original experience. I don’t like the word “triggering,” because in my mind it conjures gun violence, which in many cases is accurate, but also in many cases not. In my work with traumatized couples, who activate one another quite readily, unfortunately, such language can sound accusatory in suggestive ways that can exacerbate conflict. However, it is hugely important to learn about this, and the veterans taught me well.
My most potent teacher was a man whose entire platoon was wiped out before his eyes by a helicopter bombing in Vietnam. All of his buddies were dead, and he was the sole survivor. The SF VA is in a beautiful location perched on the ocean. The view is serene. I remember one scenic afternoon a helicopter passing overhead in the blue cloudless sky. This man was instantly sent into a tailspin of abject terror. He was screaming as he rolled under the nearest bench shaking. It was as if it were happening right now. That particular helicopter chopping innocently by was benign, like an unthinking partner often can be. It was a dramatic depiction I will never forget.
The word “triggering” has also found its way into common parlance, where it is used to mean all kinds of things, even just generic unsavory emotion. I am very picky in its use as it has an important and precise meaning, whether or not we choose to use that term. I insist on precision as it is vitally important for healing, to learn when we are activated, or activating the other.
In couple’s therapy, when one partner is activated and truly believing it was the other partner that upset them this much, I will routinely say something like, “…this feeling you are having right now, what does it take you back to from your childhood? Tell your partner a story about a little girl/boy who felt just like this.” The point is to get to the original trauma material, that the partner is simply stimulating. The stimulus is not without merit, but it is a small proportion most of the time. This is an important lesson in both psychotherapy and couple’s work.
In a session the other day, I was sitting with a lesbian couple. It was a calm moment, and one of the partners, a child of tragic neglect, bravely said to me “…There is something I need to say to you.” I prepared myself. She said, “You know how you say, ‘tell MaryAnn (not her real name of course,) a story of a little girl who felt just like this…’ that really upsets me…”
I expected I knew why. Children of neglect are often frustrated by a gaping poverty of interpersonal memory. That is often the diagnostic marker that tips me off when I first meet a new person. They also generally have a hard time knowing what they feel. I expected this client’s frustration with me, to be one of those, or both. I was humbled and surprised by what I heard instead. She said, “My mother always treated me like a little girl, dressed me up in girly clothes, made me get the girls’ sneakers that wear out in three days, instead of the boys’ Keds with the rubber caps. But I never felt like a girl. I did not exactly feel like a boy, but I definitely did not feel like a girl! I tried and tried to tell my mother this. She just ignored me, as she did about most things. I felt unheard and unseen, completely not known.” (All classic traumatic markers of neglect.) And most decidedly “I felt like I did not exist!” And “when you say that to me, I feel again, like I do not exist!”
Needless to say, I was horrified! I could not believe I had made that terrible, ignorant mistake! Here I am supposed to be so knowledgeable about neglect, and more, I am a sex therapist! I had thought of myself as scrupulously mindful about sexist language, and issues of sexual orientation; I had thought I was sensitive and self aware about all things sexual. I felt terrible about my unthinking binary assumption. Much more than a “micro-aggression,” it seemed like a “macro-aggression” if there is such a word. I fell all over myself apologizing. And I thanked her for educating me.
Although I am well familiar with the current discussion about pronouns, apparently not so much as I thought. I can see I really did not get it! Until now. I am immeasurably grateful! I am grateful that my client had the “spine” and the “voice” to tell me. By spine, I mean agency, or the ability to operationalize purposeful action on their own behalf. Voice, being the ability to express out loud and in relationship, what is genuine and authentic. These are the greatest tasks of healing from neglect.
I recently heard an interview with rock musician, Tory Amos. Certainly not any kind of fan of hers, I was driving and almost always tune in to Public Radio in the car. She apparently had just written a book, so that was nominally the focus of the interview. The interviewer asked her, “So how was it for you writing a book?”
Amos answered, “it was hard!”
The interviewer queried,
“—so, what was hard about it?”
Amos replied:
“My first language is music. Spoken word is my second language. It was like writing a book in my second language.”
I thought, “how profound!” Something as seemingly elemental as language, is so easy to not think about. Easy because of cultural, ethnic, cisgender, able-bodied chauvinism, narcissism or sheer blindness. It is so easy to take for granted that the language in my head or tongue is the predominant or majority language. Particularly in a world of neglect, that is so solitary, it is so effortless, and actually one’s default mode, to create one’s own whole world, without even realizing it. My husband used to say with a laugh, “You mean you are not in my head?” He really was only half joking. It is so easy to just assume.
With gender as with race, culture, gender and sexuality, bodiedness, age, so many categories, it is so important to watch our language. Oy vey! So many languages to learn. Alas it leads us back to the foundational missing experience, taking the time, having the care and the bandwidth to actually learn who a person is. With mindful attention, thoughtful presence… it seems so simple. And simple it is, but not easy. If only that simple ingredient were part of everyone’s daily lexicon, and everyone’s early experience, how much trauma and early life trauma would be eliminated? And without trauma, as Bessel van der Kolk so sagely proclaims, “The DSM would be a pamphlet!” Not to mention much of the menu of physical illnesses, whatever that manual is called. I was immensely grateful to this client for having the guts and the gumption as well as the articulateness to correct my sloppy delivery, and to teach me. I think it was a healing moment for us both.
One of the great gifts of the 1990’s the “Decade of the Brain,” was to learn that the brain is plastic. Ironically, that fateful year at the VA, rattled by the earthquake, also engendered that! We had previously thought we were born with a lifetime set of neurons, rather like our life’s quota of ova should we happen to have female anatomy. That is what you get, we thought. We now know we can regenerate, and birth new neurons, and we can learn. Our dogs and other mammals can too, if we have the patience and generosity of spirit to teach them. What a blessing! We have more than one chance!
The brain can change, and even the mind! Neurofeedback is based on this principle in its very obvious beeping way: “operant conditioning.” Psychotherapy as well, and none of us would engage in it unless we had some remote belief, at least some of the time, that change is possible. Of course in many cases we must do our part to make it happen. And in many cases we can. As the saying goes “Pray to God (if that is one’s paradigm of course!) and keep rowing to shore.”
Now it is my task to integrate what I have learned, to remember and make use of it, with this client, and in the world. My world is enlarged when I do, and how healing to others to be accurately seen and heard, not to mention my own pleasure in seeing the appreciation in the eyes and body of the other. Because we are designed for interdependence, the brain also kicks in a bonus reward of its own with a dopamine surge, for re-enforcement! More joy and love are in circulation. In this COVID-weighted world, so sorely needed. Can you beat that?
Some years ago, I was asked to be a main presenter at a weekend Institute of the American Association of Sex Educators, Counselors and Therapists (AASECT) to teach about trauma and sexuality. I was thrilled. It was my first time ever being invited in that public of a way. I was the main attraction and I could hardly believe it. The director of the program was a lovely woman named Susan whom I had never met before.
I was self-conscious about everything. I never missed a conference, but I had never attended one of the weekend “institutes” I did not really know my way around PowerPoint then, and I had endless nervous questions, while also being embarrassed about having so many questions. Oy vey! What I was soon glad to learn, was that Susan always answered my emails immediately, with patience, care, warmth, and never implying any kind of judgment or sense that my questions were excessive or reflected ignorance (-or idiocy which is how I felt.) I discovered that Susan was much like me: thorough, somewhat perfectionistic and painstaking to do her best. As ever, there is always a song in my head. I asked her “Susan, do you know the old song by Santana, “You Are My Kind?” I love that song, and I felt that very kindred, connected feeling with her. She said she did not know the song, so I sent her a youtube link so she could hear it.
Susan gently guided me through the preparation process for the Institute, and through the Institute itself. All went quite well. As the weekend drew to a close, I was more than a little relieved. Susan did one last amazing thing, that cemented the feeling that she is my kind, (and also brought me to tears.) As the weekend drew to a close and people filed out, she piped our song through the large conference room loudspeaker.
One of the tragic sequelae of trauma and neglect is the shame and grief ridden feeling of not belonging anywhere. The child roams the world orphan-like, like the mythical little bird in the famous children’s book Are You My Mother? In that story, the poor little thing approaches every creature (and even some machines) in its path, asking the same urgent question: “Are you my mother?” It is a profound and primitive primal need to be attached to a caregiver and a pack, certainly when we are young and not nearly able to care for ourselves, but not only then. It is wired in to the limbic brain, that the first line of defense when a child or young mammal is scared or distressed is the “attachment cry.” We reach for connection. Only after that fails, do we then resort to the fight/flight or freeze defense. The need for affiliation, to be connected and secure by being part of a larger group, persists through the lifespan. When that connection is deficient or missing in early life, it can become, as for the little bird, a relentless and gnawing quest. For the child of trauma and/or neglect, the search for a group or family can go all sorts of ways.
I got very confusing messages growing up. My parents both being survivors of the Nazi Holocaust and refugees in the United States, felt on one hand, like strangers in a country that was not ours, while also being immensely relieved and grateful to be there. They felt both welcomed, and a profound fear and mistrust. We were supposed to fit in but not “assimilate” too much and lose our identity. And never quite let our guard down, because you never know when people will turn on you. It was a confusing message for a child. I surely did not know what that identity was. My father often told us “You just don’t know what it is like to go to bed hungry, or live on bread and worms!” So, I knew I was not really like him, and did not know how to be enough like him to please him. My mother’s first major heartbreak was when as a little girl, her best friend turned on her from one day to the next, to join the Hitler Youth, I longed, like all little girls, for a best friend. But not like that!
When I was in college, I became an impassioned political activist. Latin America was exploding with military coups and fascist dictatorships that were enough like my parents’ experience as to make me feel perhaps kindred, but different enough, that I could rebel against my parents. I remember a book I read during that time, the story of a Chilean diplomat, Orlando Letelier, exiled by the dictatorship and living in Washington DC. He was murdered by a car bomb on Embassy Row in broad daylight. It was a chilling account.
Letelier’s killer was identified, as Michael Townley, an American employed by the secret police of the Chilean Dictatorship. The book was largely a character study of Townley, or that is what I remember about it these 40 years later. Townley was a lost soul. He lacked a sense of direction, a sense of home and identity, roots or purpose. Somehow, he wound up in Chile. I don’t believe the book told much of his background. But my experience has been, that whenever a young person travels thousands of miles from family and home, there is always a story. In Chile, he was prime bait for the Chilean DINA, the notoriously vicious and cruel secret police, best known for the torture of thousands after the 1973 coup. Being disenfranchised and searching, Townley was a ready and receptive candidate and rapidly excelled at the job. He was technically skilled, and efficiently orchestrated and executed the bold murder or Letelier and his young assistant Ronni Moffitt. Townley was a vivid example of the disconnected, rootless, most likely child of neglect, being easily seduced and transformed into a tool for some other and that other’s personal agenda. So, in need of someone to please, and a grouping to be a part of, they can seamlessly become even a proficient professional killer.
Around that same time period in my life, one night my apartment mate in Berkeley, brought home a young woman she had encountered on the street. The child-like woman was sobbing uncontrollably, and blubbering unintelligibly, clearly under the influence of some unidentified drug. She was terrified and grief stricken, and probably no more than 18 at the most. My friend found her curled up and shaking on the sidewalk, in the vicinity of a “spiritual” cult there dancing and chanting on Telegraph Ave. All we could discern was that she had been lured her to join them, and drugged into this barely conscious state. We kept her safe overnight, and in the morning when the drug had worn off and she could talk, we learned that she also, was a disenfranchised, survivor of some sort of trauma, again, a ready target for a “group” or a place to belong. I don’t remember the rest, but just remember making the connection with Michael Townley. How deep and sometimes blinding the loneliness, longing, the driving attachment need can be! It can over-ride coherent judgement and land the child of trauma and neglect (at any age) in some community or role, they might never have chosen.
Although I always understood climate change as a concern, it was never at the top of my hierarchy of concerns. I was always most compeled by causes with a more directly human cost and exhibiting palpable human suffering- until I read Thomas Friedman’s book, Thank you for Being Late. The book is one of those good books that are about 200 pages longer than necessary, but I did soldier all the way through it. In the chapter about climate change, it described how in countries of East Africa and the Middle East, climate change resulted in such drought and water shortage as to kill whole crops. Farmers were desperate both to make a living and to feed their families; and food was in short supply. Due to climate change, people were starving. And hungry people did not feel taken care of by their governments, like neglected children, they were left to fend for themselves. Many men began to migrate to other places where they might at least earn enough to feed their families. Many of course died. And many enraged by the neglect and by hunger, were readily receptive to terrorist ideologies and larger group identifications, spawned at that time. I can only imagine and guess, that those receptive to become terrorist killers and members of cultlike organizations, had an antecedent of neglect, an old rage ready to be ignited and erupt, and an urgent need for affiliation, activated by hideously neglectful governments. Again, what role might neglect play in dangerous or deadly dynamics we see in the world? These are questions that roll around in my mind.
The need to attach and belong is ubiquitous and primal. We share it with all mammals and some birds and invertebrates too. It is not to be underestimated in ourselves. Susan made me feel connected, cared for and like I mattered. That profoundly affected what I felt able to do, as well as my mood of joy and love through the process of preparing and delivering my presentation. All the more reasons why we must heal neglect, both positive and negative. Humans function better and feel better when they/we are part of something. And when we are not, our desperation can make us even perilously vulnerable. We can easily find ourselves in the “wrong” relationships, one way or another. We must be passionately present for our own children, and we must learn how to facilitate healing in the adult survivors of neglect and interrupt both the suffering and any intergenerational transmission.
To end on a positive note, have a listen!
I have a special affection for leopards. As I love to say, “you know the old adage ‘A leopard can’t change its spots?’ Well, I can. And I change my spots every chance I get.” Healing is all about that. The “Decade of the Brain” and neuroimaging technology taught us that “Neurogenesis” is possible, that we can grow new neurons. Before that we believed we were born with our life’s quota of neurons, and that was that. We now know that with neurofeedback, psychedelic assisted psychotherapy, somatic therapies, mindfulness practice, and yes even the old fashioned “talking cure,” we can generate not only connections, ie networks, but molecules. This is wonderful news for all of us, both with respect to our own brains and our clients’ brains if we are practitioners of some kind. So why do spots have such a bad rap?
I remember when I used to drink alcohol, I had to either stop wearing white, or switch from red to white wine. All my pretty white blouses were speckled with unsightly red spots. Oy vey, I always was a sloppy drinker. As an adolescent, ugly facial spots, we called them “zits,” were referred to in commercials for acne products as “blemishes.” Spots were blights on the skin, and on faces that in so many cases already housed shame and self-doubt, or self hatred. Spots were like nature’s “mistakes.” But nature, for the most part, does not make mistakes. If left to itself, it has a brilliant unshakeable plan. Occasionally there is an aberration or mutation, as with the Corona Virus for example, but perhaps we will ultimately come to discover what the ecological (or existencial) intention of that was to be. Most likely it is human intervention that produces disasters of nature, or so is my jaundiced and not-research-based speculation.
Once I had the privilege to visit Milan, Italy. I admit, in my love for pretty things of many kinds, I love clothes. Milan is a wonderland as the fashion hub of the world. Of course, we had to visit the Armani showrooms, a veritable museum of haute couture, clothes I could and really never would buy, but love to look at like I love looking at art. I was struck by a theme, that in every window in a long seeming small city of windows, each of the numerous masterpiece garments, whether on a mannequin or a hanger, had a conspicuos wrinkle in the way it was hung or draped. It was striking. I wondered, “what is he trying to say?” My husband did not notice until I pointed it out. Was he trying to teach us something about “mistakes?”
Once in a training with the somatic therapy genius Peter Levine, we were instructed to make four “mistakes” in every practice session. It was an intentional part of the assignment. The idea was to integrate the idea that mistakes are inevitable in this work. And to develop the humility to tolerate and learn from them. And then to learn to repair them. So many of us who grow up with trauma and neglect, come to learn that mistakes can be life threatening, or have the “hubris” to strive to be “perfect,” blameless or safe from retribution; or worthy of love. A futile aspiration.
In relationship, “mistakes” are an inevitable ingredient in development. The attachment researchers teach us, that even in the ideal secure attachment, where the attunement of primary caregiver and infant is “good enough,” the optimal percentage of accurate attunement, the best we could hope for is 30%. 30%!! That means that the other 70 percent of the time is the delicate dance of rupture and repair, rupture and repair. That is how we learn about relationship, and really about being. How sad that in the world of trauma and neglect, these skills are rarely learned, so the inevitable ruptures are terrifying, even life threatening. And relationship comes to in effect be an icon for suffering, however much it is longed for.
Much like Peter, the attachment research people teach us that the “mistakes” of rupture are invaluable, and much better training than smooth sailing without rupture. As my husband exclaimed many years ago when we emerged from the nightmare of chronic cycles of triggering and reactivity, “Wow, knowing how to recover when we disconnect is such a relief! I don’t have to worry so much about screwing up, because I know we can get back together if I do. I don’t feel so chronically unsafe and fearful around you anymore!” What a blessing!
As long-time serious bicyclist, my nemesis became potholes. I have only had two serious crashes in my in my 50 plus year cycling life, and in both cases I lost consciousness, so I don’t really know all of what happened. I admit, that I am grateful to have had those two traumatic events so I could experience different trauma modalities on those sorts of “one-time” incident traumas. What I did know was that I came out of the accidents with anxiety about bad road surface, and a veritable phobia of potholes.
Riding in Cuba, was like a dream come true. Just going there was a bucket list item of many years. I could not believe it when we were riding through the beautiful scenic countryside, carefully dodging chickens and navigating around horse drawn buggies carrying crates of fresh eggs. Coming around a bend to the base of a hill on our first long riding day, I happened upon the most colossal potholes in the known world. Of course, after six decades of being suffocated and strangled by the world political economy, the Cubans certainly had not had resources for infrastructure, especially as they used the meager resources they had, to first take care of people. The roads were tragically un-maintained. I gasped. It was only our first day of riding!
Embarking on that pothole scarred road, out of nowhere I was visited by a flashbulb image. Back before the pandemic when I drove to the office every day, I was routinely stopped by a traffic light, just as I was getting off the freeway. At that street corner was a little skateboarding venue, a little “park” of concrete, fitted out with sharp hills and walls, obstacles and vaults to jump, slalom type circles. Groups of adolescent boys (I never once saw a girl!) in baggy hoodies wildly flying round and round, jumping, crashing, rolling up the steep sidewalls, clearly having a blast. From the large graffiti on the walls, it appeared they referred to themselves as “punks.” As I waited for the long red light to change, I loved to watch them, always thinking “You wouldn’t catch me doing that!” Never!
Well suddenly that day in Cuba, the “light changed.” Was it a neurofeedback “moment?” I don’t know…Suddenly the Cuban potholes reminded me of those kids, who intentionally sought out the bumpiness, the vertical crashing and landing on their wheels upright, the slalom curving and dodging and missing each other, they do this for fun! Suddenly I imagined myself one of the ”punks,” having fun with the Cuban potholes. For the rest of that trip, I made a game of pothole dodging and jumping. Missing infrastructure, and prior trauma became my game: joy, fun and triumph!
Another symbol of transformation that I love, are butterflies. However, I‘ve never been fond of caterpillars. I even have a terrifying childhood memory from when I was three or four, of a park in New York where there were so many squiggling caterpillars that I literally could not put my little feet anywhere without stepping on them. All I remember is just wailing “Daddy, Daddy carry me!” I don’t remember if he did, just the terror. Anyway, those unsavory little creatures somehow become butterflies. Which are beautiful and I love them!
Interestingly, we call nervous excitement “butterflies” in our stomachs. I remember Peter Levine’s reminder that in the body, excitement and fear feel very similar. The Cuban word for potholes is “paches.” Que Vivan los Paches!
My first book, published in 2010, was a sorry child of neglect. At that time, I lacked the knowledge, the wisdom, and most of all the confidence to do any promotion at all. Ironically, there is also a measure of humility required, it would be a magical belief to assume that “my child, however exceptional, will raise itself!” Oy vey! A recipe for tragic neglect, which is what I did. The book languished in semi-obscurity, although those who read it seemed to like it. It stayed in print and I continue to get an annual accounting from the publisher of some meager number of copies that went out each year. That is not bad, for an eleven year old book, but nothing like it would have been, if I had given it a good start in life. It is an apt metaphor for the shame, grief, loss and anger that so many adult children of childhood trauma and neglect are often bathed in. “What would my life have been like?…”
The two key tasks of recovery from neglect, are “getting a spine and getting a voice.” I learned this from Stephen Johnson, a brilliant pioneer in somatic therapy who wrote a series of wonderful books on character theory. Getting a spine means emerging from shame and hiding, and standing tall and visible. Neglect, with its primordial solitude and the accompanying assumptions about “why” one is “unwanted;” worthless;” “untouchable;” “hopelessly different and alien;” etc, etc, etc, makes for a perennial withdrawal into crouched shadow, and the well recognized stooped posture of shame. It is no way to begin the life of a book, or any life of course, and most especially a book that touts hope.
Voice means having the willingness, again the confidence and the humility to speak up. The child of neglect imagines, if I am not the natural recipient of attention, there is nothing to be done about it. (For an infant that may indeed be a tragic fact of life.) In fact, when I fist began collecting my anecdotal data about neglect, way back at the turn of the century/millennium, a signature or marker that alerted me to a client being a neglect survivor, was the shrugging, default refrain, “I don’t know what to do!” Or “there is nothing I can do!” I had no science back then, but it was a dead give-away. And I also did not realize then, that I too had that gene.
Voice, is besides standing up, using not only spoken language, but certainly using spoken language, to call attention to oneself. In the case of an infant, it is often about essential need. For an adult, it could be anything, even “hey, have a look at my new book!” even if I have not “earned” the attention.
With my new book, that came out on August 31st, I resolved to do it differently. I found myself a rock star marketing person, who has begun to inundate your in-box with unsolicited mail. I hope it does not drive you crazy, but I am also well acquainted with the invaluable “unsubscribe” button that I am not ashamed to liberally use when I receive unwanted mail. Of course I invite you to do the same, should you see fit.
Not one for advice giving, there is one piece I will readily dispense. Any measure of success I have ever achieved, was facilitated by this: find the best consultation money can buy, tell them everything, and do what I am told! So that is what I have done. She said, “write blogs!” Initially I always believed, “who the hell wants to hear it, my random mind wanderings?” But here we are, and I even discovered that I love it!
Some of my close people have long said, “resuscitate the first book!” As you can most likely see, this is what she has done. It is never too late to heal from neglect! She has culled chapters from it that may seem of interest, packaged them anew and sent them out into the world. Again, the child of neglect later in life, comes to experience the world, perhaps later then one would have hoped, but yes, at last.
So here I am practicing what I preach, and modeling what I am trying to inseminate: I am very pleased to announce my new book will appear on August 31st. Although it is first and foremost a clinical book, devoted as I am to teaching therapists to recognize and help the long neglected population of neglect survivors, all my reviewers, have offered the unsolicited feedback, that it can certainly be of interest and utility, and is accessible to the sophisticated psychotherapy client. Meanwhile I am preliminarily hatching the blueprint of the lay-person’s version, which will follow before long.
Should you buy the book on Amazon, please do take a moment to post a review. It is helpful to me to know what does and does not “work” for people. And my friend and colleague, Deirdre Fay, whose excellent new book Becoming Safely Embodied, sprinted to best-seller status in seeming no time, advised me, the reviews that post in the first few days after publication show the most powerful and speedy results. You don’t have to read the whole thing before you say something.
And finally, those with visual impairment, or who simply like to “read” while walking the dogs, or stirring the cheese vat, have requested an Audible version. If you are one of those please do say so in your review, or let me know. My publisher has said if there is sufficient demand they will consider adding that to the roster of offerings. So there, I did it! If you are a child of neglect, you might try this. It didn’t hurt at all!
Although I am not a mom, I somehow have an image of a small overnight bag, standing by the door. I don’t know if it is an actual memory of when my mother was getting ready to have my beloved little sister. I was only two and a half. Back then, women stayed in the hospital for a week when giving birth, so my mother was getting ready to be gone for a while. Mrs. Sheba would be staying with my older sister and me. She was an old German lady, who smelled much like our great Aunt Lottie and Great Aunt Gertrud, also old German ladies. Mrs. Sheba used to say “You vant to go to bett?” which of course we never did, what a silly question. We had no choice. I don’t know why she asked.
I remember the stories of how the nurses all buzzed around my dad, who felt queasy and sick in the delivery room, while my mother was as ever, quietly neglected. I can’t imagine her crying out or even complaining. I remember when the beautiful little baby, as yet un-named, came home. When they opened, she would become known for her big eyes. She looked like our dad, and I was in love, and so jealous. Anyway, as we approach my pub date, I feel rather like the expectant mom, waiting for the water. I guess this blog is my little bag.
I remember from a Bruce Springsteen concert download, a lively call and response between Bruce and the audience. Bruce in his inimitable way, bellows “Is there anybody alive out there?!” The crowd roars. And the exchange is repeated enough times with building fervor, for the show to start with a loud twang, the starting shot for Born to Run. I guess I feel that kind of excitement. So here’s my call and refrain. I would be delighted to hear from you!
Being a writer is strange. I spend months holed up in my little home office, all the more blurred by the unreality of Pandemic year, banging on the computer. I churn out my ideas, shared only perhaps with a handful of editors or consultants, stumble through editors’ comments and somehow a finished book reaches the world, or does it? Perhaps it flies out into a mysterious and empty black hole of oblivion, much like the vast empty landscape of the neglect survivor’s world. It is truly unclear if there is anybody alive out there, or if all of this just a backdrop for my own solitary movie, and none of the rest is real. I used to wonder about that when I was young and so alone.
A writer’s world can replicate that, if we don’t proactively make it different. So, in my overnight bag, is an invitation: Let me hear from you! I’d love to know your thoughts. What is interesting and helpful? What is drivel or psychobabble? Is it enough about me already?! Is it too much or not enough science? One reader of my first book told me my citation of the Talmud was erroneous! Oy vey! I so rarely invoke the Talmud or anything like it. Of course, it was too late to change it. But I was humbled and gratified to learn. My dad would have noticed. Fortunately, although that book was showcased on his coffee table from 2010 when it appeared, until he died in 2020, I am sure he never cracked it open, except maybe to read the inscription.
I recently got an email from a blog reader named Julie. She said she enjoyed reading my weekly blogs, and wanted to keep reading them, but now the pandemic was permitting her to go back to work. She wondered if we could offer an audio version so she could listen to the blogs on her way to work. She said a friend of hers had a feature on her podcast site where you push a button and get an audio version. I thought, what a spectacular idea. We are looking into that. What was most striking to me, was “wow, a live one!” All this to say, talk to me! I may not always be able to respond, but I will certainly try! Thanks Julie!
Continuing with the theme of audio, my sister who is a devoted mom to her dogs, loves to listen to books out on the trail. She said, “what about an Audible version of the book?” I love audio books too, especially during those long stirs of the cheese vat. I have also heard this from people whose vision makes it hard for them to read print as much as they would like. I asked my publisher, and she said if there is sufficient demand, they will consider that. I don’t know what sort of numbers constitute sufficient demand, but I would ask, if an audible version would be of interest, include that in your Amazon review, or let us know by email. My friend and colleague Deirdre Fay, along with her husband read her new and bestselling Becoming Embodied themselves. Apparently, my publisher still owns the rights, so at this stage, I am just asking you to let us know you might want that.
Of course, not much need be said about reviews. Especially Amazon reviews, and especially on or around the pub date, are a great help to getting the word out. Taking that moment to review for Amazon, even if you have not finished the book yet, is a great help. If you have access to some sort of publication which reviews books, even better. Thanks!
It is interesting to me, that once I bumped over the hill of Sixty, I became much more aware of age. Oy vey! I never had really thought much about that. I would look at other people and look at myself, and wonder how old I look or how young in relation to them, much as I used to do about weight, where I would look around a room and think about who was thinner and who was fatter than me.
As an aside, I must add this little anecdote about neurofeedback. When I was in my fifties, my hair started to have salt and pepper sprinkles of gray. Most of my family were already graying by those ages, and I was beginning to follow the family path. In 2009 when I started practicing neurofeedback, I was that graying 54, and mysteriously through avid neurofeedback training, all the gray disappeared! I never targeted that, but it was an unexpected surprise of neurofeedback. It has never returned. At 66 I have never colored my hair and all the gray is gone! Go figure!
That was a digression however. Now when I go to conferences, or when I used to go in person and now virtually, I would feel powerfully moved to see the new generation of young therapists coming up, studying and training to help this complicated and troubled world they are inheriting. I remember 25 years ago when Ruth Lanius was a young medical student I first saw and heard at a conference of a trauma organization, that may not even exist anymore. I remember how the crowd gasped when we saw the early brain scans of this new-on-the-scene young person. Now she is the best in the world. I am getting ready to step aside while new young people pick up the reins. It is my greatest hope to help the invisible population of neglect to be seen and heard, to finally get recognition and help, and to have a chance, to matter as they never have. I used to care about things like selling books, making a name for myself, getting my dad to notice me. Now I just want therapists to learn this work, so the child of neglect can be known, helped, and part of the world.
Finally, I plan to write a lay people’s book about neglect, once I recover from finishing this one. My early readers have commented that this clinical book is somewhat accessible to “lay” audiences, which I have always thought of as kind of a mixed blessing. Perhaps it dilutes my impact in either direction. I am not so sure. I hope this book will be of use to as wide a readership as possible. And of course, as I embark on the next project, I’d like to know what is helpful, unhelpful or lacking, to make sure to include it in the next tome. So input is invited and welcome. Thanks!
Well, I did not expect to pack this much into my little overnight bag. I guess I am ready to deliver. Hope I won’t shriek. But I don’t know!
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 2006 I made my personal discovery of local treasure Michael Pollan, courtesy of Terry Gross, the voice and brains behind National Public Radio’s iconic program “Fresh Air.” The dean of UC Berkeley’s School of Journalism, Pollan was already a prolific writer, but my first encounter with him was through his then new Omnivore’s Dilemma which has since become perhaps my favorite book of all time. It is a book about food (admittedly one of my favorite subjects!) but presented comprehensively including anthropology, history, culture and ethnicity, religion, nutrition, agriculture, ethics, psychology, art and science, wow! and even written skillfully with a poetic hand. I was stunned. And also amazed that for a bookworm like me, I had a rare if not first experience, of having one book actually significantly alter my view of more than one thing. I remember when I joined the throng of attendees at a (then free of charge!) public reading in the basement of Grace Cathedral early on a Sunday morning. I lined up with everyone else to have (an additional copy of) my book signed, I told Pollan, as I shook his hand, “You are perhaps the first author I have ever encountered in all of my bookworm years, who can actually change my mind!” Those words “Changing Our Minds,” later became part of my professional logo. Of course I loved it when his 2018 blockbuster came out, and with the title How to Change Your Mind. He of all people would know.
In 2018, my husband and I drove 50 miles each way and paid $20.00 a ticket for the reading. Still we were lucky to get a parking space and two seats together. The crowd was mostly boomers, veterans of the Timothy Leary and Alan Watts generation, some accompanied by a subsequent generation or two. The topic of the book was evolving and expanding field of hallucinogenic substances. As ever, Pollan’s writing is exquisitely personal, a style I find compelling, believable and inspiring. As with sourdough baking, home brewing, and even hunting, Pollan’s first research subject was himself. He had the guts not only to experiment at the edges of the laws surrounding controlled and illegal substances, but to write about them.
Later that same year, I read somewhere that Daniel Siegel, the renowned attachment neuroscience researcher, infant psychiatrist cum Buddhist practitioner and teacher of mindfulness meditation, was studying the use of hallucinogens to address end of life issues. Perhaps most importantly, however, I found that Bessel van der Kolk, the North Star of my professional career was featuring at his annual Trauma Conference, my decades long go-to for cutting edge next steps in professional practice, full day workshops about the latest research in the use of psychedelics in the treatment of PTSD.
Although I was no stranger to altering my own state, as many of us struggling to tame wildly dis-regulated nervous systems, I quit everything in 1983 and became a grateful, sober endurance athlete. Considering these substances as a possible accelerated vehicle for healing, was mind expanding in itself. Attending that first workshop, although I had already read Pollan’s book, was inspiring to say the least. Most significantly because seeing the video presentations of Iraq war veterans before and after a series of guided sessions using MDMA, and observing the transformation, was like watching the old time-lapse photography films where a caterpillar morphs into a butterfly in a period of moments before my very eyes. Sadly I recalled the one year, fresh out of graduate school, that I worked at the San Francisco VA. Back in the early 80’s when we barely had a name for PTSD, let alone effective treatments, veterans of the Vietnam war suffered in their own personal never-ending war. Many of them looped in a revolving door-like cycle, in and out of the hospital, carefully not improving too much and having their benefit payments cut. The young men and women in the MDMA trials, in the mind-blowing videos, would most certainly go on to have lives and families, purposeful work and joy.
Since that first workshop I have attended the subsequent three including the virtual one during the Pandemic year. The progress in research and also FDA approval trials, is exciting. Psilocybin (magic mushrooms) LSD and Ketamine, are all also being carefully researched, including a to me local study, led by UCSF Nurse Practitioner Andrew Penn, on the use of Psilocybin for treatment- resistant depression. Ketamine is now fully legal for use as a prescription medicine. And MDMA is edging up on approval for prescribed use for PTSD, with luck in the next year or so.
None of these medicines are or will be “stand-alone” treatments. All are to be administered by a trained, skilled and licensed health or mental health care provider. The treatment is defined and described as, for example, “MDMA Assisted Psychotherapy.” Psychotherapy is the treatment, the medicines are components of said treatment, or “assistants” to the clinician. Similarly the clinician “assists” the journeying client. Training programs for how to assist are popping up like mushrooms in graduate programs around the country. I know in my area, they are exclusive and in high demand. Scoring a spot to even learn to be a guide, is growing to be increasingly competitive. I am cautiously optimistic and enthused by that, because it may mean the seriousness of the students, and thus growing public acceptance of the modality.
I do not see myself becoming a guide, much as I would love being able to add this remarkable treatment option to my armamentarium. The great task of the guide, apart from carefully crafted and executed pre and post psychotherapy sessions, is to be impeccably present. The guide might sit quietly for much of the six-hour journey, gently tracking, making observational notes and writing down whatever few words the client might say. In all candor I would have to say, I am not so good at the sitting quietly part, being much more inclined to interaction and reciprocity in my work. Thankfully there are already a number that are, some of whom have studied and trained with the true experts, indigenous people of both the US, and countries south of our borders. I am finding them and connecting with them so I will be well prepared with information and referrals.
I remember when I first heard about the Concorde jet, which could fly from New York City to London in 2 hours, 52 minutes and 59 seconds. For one who is not so good at sitting quietly for any length of time, that sounded beyond imagination. The work with hallucinogens may be the next “Concorde jet for PTSD, Developmental Trauma and Neglect!” I am hopeful! Meanwhile, Pollan has another brand new book: This Is Your Mind on Plants. In his inimitable style he expounds on his personal and then scientific explorations of Opium, Caffeine and Mescalin. Another highly recommended read. Happy Trails!
My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” is out now. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.
On June 15, 2021 I marked my 38th year of recovery from alcoholism. As is often the case I am stunned by the passing of the years, and also shocked to be reminded that I am that old! Oy vey! In this case I am profoundly grateful for the years, and the many hard lessons, and amazing blessings they contain.
In 1983 I was a profoundly depressed 28 year old, lost soul. Like most all survivors of trauma and neglect I was on an endless quest to find a safe place in the world; and beyond finding a purpose, justify my sorry existence. Like all other survivors my addled nervous system ricocheted ceaselessly between high anxiety and numbness; “hyper-arousal” and hypo-arousal” searching for the elusive moment of calm and ease, or at least relief. I was a distance runner, covering between 6 and 20 miles per day; I weighed 100 pounds (about 45kg). And each night, alone in my apartment in Berkeley, I drank a quart (roughly a liter) of straight Bourbon, Old Crow $6.95 a quart. I don’t know if they still make Old Crow. That was my “go-to.” It was what they called “rot gut” and I am sure it was! Then I would quietly pass out on the living room couch, with my journal or the latest book I was attempting to read, and my cat arrayed around me. A graduate of the University of California, and this was the best I could do? or so began the morning diatribe.
In the mornings, the face in the mirror horrified me. “What am I doing to myself?” I’d put on my sweats and go out to run. Those long stretches on the road, one would imagine I was thinking? I thought of nothing at all, it was raw flight. But I could not get away from myself. I would come home, somewhat sobered by sweat and the cool air of the wee hours, and make proclamations about quitting that day. Sometimes I would go to the length of writing a detailed plan of how I would do it, and then by evening, it would all begin again. I was like a rat on a wheel. We have all heard plenty of these boring “drunk-a-logs” as they are called in AA, and mine is not even colorful, racy, or funny. It was “pathetic” as I angrily told myself, and enduring.
Now looking back through a far different lens, it is a different story I see: it is the endless cycle of a traumatized brain and body desperately seeking “regulation” and calm, or at least relief, from the agony of unending flight. The alcohol was a momentary escape from that agony, moments at a time… until as they say, it wasn’t.
The most salient lessons of these 38 blurring years, is that the drinking, the running, or it could be eating, love, shopping, whatever the obsession du jour, is yet another desperate attempt at momentary regulation, the ability to calm oneself down.
I learned just recently of old research using neurofeedback to treat addiction, that alcoholics literally use the alcohol simply to feel “normal.” The measured “alpha” level, or the baseline nervous system calm equilibrium in the non-alcoholic control group was matched only by approximately 6 shots of hard alcohol in the alcoholic group. In effect, it took them 6 shots on average to get to “normal…” and that only briefly. As Sebern Fisher has so eloquently proclaimed, we are not really endlessly seeking a mother, but rather we are endlessly seeking regulation, and ultimately most of all, self regulation.
This is no “pink cloud” story. It did not get better overnight, by any means. I am eternally grateful and will always love AA, Alcoholics Anonymous, and no, one does not have to believe in God to benefit or to “fit in,” in most fellowships. I went twice a day for the first two years of recovery: 6:00AM and 7:00PM and for those two years, those quiet hours in smoky church basements (and yes, in those days everyone smoked cigarettes!) were the only little islands of peace that I knew. I owe my life to that motley old organization. And my therapist Joan, yes the very one who inspired me to become a therapist after I saw that she really saved my life, recognized that it was the alcohol that kept me alive for those worst years of my 20’s, until it started to and would have succeeded at killing me. Blessedly she had the wisdom to know the difference.
My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” is out now. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.
For some reason I have long had a fascination with athlete biographies, autobiographies and memoirs. Willie Mays, Arthur Ashe, Andre Agasse, even tennis star Alice Marble, of whom I had never heard; and Steve Young whom I decidedly did not like. I especially like the athletes who have taken a political stand like Jackie Robinson, Billie Jean King and James Blake. I have already pre-ordered Colin Kaepernick’s book, even though it is not yet written. Odd, as I am not a fan of spectator sports at all. I have never watched a football game in my life. The closest I have come is watching the halftime show at a Super Bowl where the Rolling Stones performed. I have attended a couple of baseball games when my beloved nephew was playing, and I have humored my husband by joining him at the screen for a moment or two when he is enthusiastically watching the Tour De France. That is about it for me.
I was the girl last chosen for the sports team, as I was uncoordinated and had poor hand eye coordination and poor perception of where my body was or a ball was in space. I have since learned that the vestibular system or the balance system of the brain, is compromised by trauma and neglect. That network includes the senses of interoception and exteroception. Interoception is the perception of what we are feeling or what is happening inside the body; exteroception is the perception of where we are in space. Both are essential for catching a ball or landing it inside a basketball hoop; or over a volleyball net.
When I discovered running and bicycling, it was a wonderful thing. I found that not much talent was required, only strength, and perhaps willingness to hurt. Endurance of course was my expertise, and I found both that I could out-endure pretty much anyone. I also discovered that running and riding enabled me to put distance between myself and my family home, which was both empowering and made me feel free. I did not know the word regulation when I was a young adolescent running 20 plus miles a day. I just knew it made me feel better. And I was pretty good at it. In my middle forties I was working out with a personal trainer, and he called me an “athlete.” I was amazed, I had always thought of myself as a misfit trying to calm down.
The truth is that exercise and sport is a highly effective method of self-regulation, or calming down, that many survivors of trauma and neglect discover and come to rely on. And reading the many memoirs and biographies of athletes reveals similar beginnings. I found it interesting that certain sports attracted survivors of certain kinds of childhood experiences. Many of the ‘individual” sports like running cycling or even tennis, attracted survivors of neglect, as did endurance and most especially ultra events. These people are accustomed to solitude, loneliness, being in a quiet one-person world, or residing in the “default mode network,” the quiet, self- reflective region of the brain. And endurance. Baseball, which although it is a team sport, seemed to be a magnet for neglect. It is a team sport, where each team member acts much as an individual with not that much interaction, except perhaps between pitcher and catcher. And there is a lot of standing around and waiting. These were interesting things to think about for someone like me.
I once had a client; a man with a heart breaking neglect history. With a confusion of fathers, he was literally like the old Talking Heads song that says “I don’t even know my real name…” He was 23, movie star handsome, very bright, and a phenomenal athlete. From the outside he seemed “perfect.” His chosen sport was crew, and by the time I met him he had been doggedly training for the 1992 Olympics for quite a few of his young years. He trained with a team, and put in the hours of a fulltime job. Barcelona, where the Games were to take place, was the True North of his life. His little team of four rowers, was like the family he never had. When he did not qualify for the team, it was as if the bottom had fallen out of his life. He seemed to “lose” rowing as a way to make himself feel good, he lost his little “family” and he lost his focus. Not oriented to psychotherapy before, suddenly he found himself so bereft as to search out someone like me.
As a non-spectator, I have not been a watcher of the Olympic Games either. The last time I remember watching them was in 1972 when I had my wisdom teeth out. I remember because it was when “Little Olga Korbut” the tiny Soviet gymnast burst on the world scene and blew everyone’s minds by seemingly taking gymnastics to a whole new level. If not for being otherwise incapacitated, I probably would have missed that too.
In more recently times, the 2021 Summer Games garnered a fair amount of news coverage for a number of reasons. Some was to do with the contagion of the Corona virus which made for a fair amount of news about athletes getting sick or competing without an audience. There was also news around a variety of political stances, governments and athletes which I vaguely followed some of. What I found most interesting was that there is now a new awareness of athletes’ mental health: the incredible pressure and stress upon these young people, on top of the major blow of the 2020 Olympics having been cancelled, which must have been massively disappointing and disorienting for them, having been organizing their lives around them for years, like my former client. And of course, the dramatic case of gymnast sexual abuse.
What really got my attention at that time, however, was a story I heard on NPR that both surprised and moved me. In 2015, ten athletes after their lifetimes of training, were displaced from their home countries due to either natural disaster or political terror. As a result, they had no country to represent in the 2016 Rio de Janeiro games, and therefore no team. The International Olympic Committee hatched the idea and raised the funds to create an International Refugee Olympic Team. This group afforded them affiliation, and the possibility to proceed with their life plans. Hearing interviews with a few of them, it made a world of difference in their lives.
In 2016 the Olympic Refugee Team had 10 members. In 2021 there were 29 members, competing in 12 different sports. They hailed (originally) from Syria, the Democratic Republic of Congo, South Sudan, Eritrea, Venezuela, Iran, Afghanistan, and Cameroon. So, 29 traumatized young people, who probably needed the regulation and familiarity of their sport, and the affiliation of a team more than ever, did not have to give up the dream and the hard earned opportunity to compete in the Olympics. What a brilliant idea, certainly the best thing I have ever heard about the IOC! Bravo!
“The Refugee Olympic Team sends a great signal about what enrichment refugees are for our Olympic community and for Society at large. Watching them compete is a great moment for all of us, and we hope everyone will join. The athletes are welcome in our Olympic community, among their fellow athletes – competing with them but also living with them under one roof.” – Thomas Bach, IOC President, 2021
With a surge in the numbers of people being displaced from their countries of birth, I hope this will continue to become part of the fabric of the Olympics, reflecting our increased understanding of what it means to belong.
Today’s song:
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