Bowlby's Attachment theory, trauma and scientific dogma

Was very honoured to attend a lecture yesterday organised by the Hampshire Association of Counselling and Psychotherapists (HACP) featuring Sir Richard Bowlby the son of the eminent psychiatrist and researcher who, together with Mary Ainsworth, developed attachment theory of human development. I cover the significance of this theory in my new book but it was great to hear it 'from the horses mouth' so to speak via his son. It's interesting that his theory was so radical at the time (and very contrary to the current understandings of human mind of his supervisor and senior colleagues) that he almost failed to pass his psychiatry exams! Until then it was though that any behavioural problems with children were due entirely to failings in the brain of that child rather than as a direct response to their environment (and specifically their bond with mother). It was a radical departure to suggest that the infant brain was affected in its development by the degree of attachment to the mother (and later the father).

Mary Ainsworth, (who, typically, is often missed out in the official record), developed a practical test called the 'Strange Situation' to monitor the behaviour of very young children (typically less than a year old) when a stranger enters the room, and later the mother leaves. They identified 2 distinct patterns (later expanded) - securely and insecurely attached. We watched videos of these experiments and close-ups of the children's faces which would search their mothers eyes for clues to whether this was safe or unsafe. Children who are securely attached (i.e. have bonded with their mother who is attuned to their needs) will seek close proximity and refuse to be comforted by a stranger. Those insecurely attached will dissociate (show by a wide eyed look of pain but numbing) and play disconsolately with their toys instead and show no relief when mother comes back. It is a telling moment because these bonds and their behavioural adaptations remain with us for life.

We can become avoidant of close relationships because we are not sure we will be rewarded/comforted or clingy where we feel imminent abandonment so ask for constant reassurance.
I was so interested to see the neurological consequences are being considered finally.

In the afternoon Richard presented the results of a pilot study conducted by another researcher Jane Sherwood who has proposed that early trauma across the generations of the maternal line may predispose to Alzheimer's Disease (AD) and dementia generally. It was fascinating stuff. She's written a book called  'In the shadow of Loss'. Richard was careful to say there were flaws in the study as it was small and privately funded but nevertheless with 120 participants and a clear pattern of association, not to be dismissed. Indeed I think we may be able to point to a  method of transmission. Mitochondrial DNA is passed from the maternal line and is intimately linked with the cell danger response when stress (environmental including attachment trauma) is present. This switches off the efficient energy production cycle of the mito's into a low energy pathway. We know that AD results in protein tangle accumulation in the brain but not everyone who has these gets the disease. Could it be that trauma is at the heart of this disease too.?

Richard was clearly in the shadow of his father but sensibly has decided to dedicate his life to further promulgating his ideas while not taking any money for doing so (remarkably his career has been designing racing cars!). So we were privileged to hear the latest research and without having a/ travel to London or b/ pay a fortune. Thank you Sir Richard and the HACP.

Human Givens

Read an article written by the Human Givens originators Ivan Tyrell and Joe Griffin on depression - was really interesting - I realised 3 of my human needs are not being met right now with the problems I've been having with my clinic not being watertight (= secure) despite being busy:

• Security - safe territory in the home (read home AND work here)
• Volition - a sense of autonomy and control over what is happening (I have no control whatsoever - unless it's over my response)
• Competence - a sense of achievement (although met in other ways i.e. professionally I feel really incompetent when it comes to looking after the building. I can't solve it and I spend all day and night worrying about it.

So, my sleep is permeated by awful dreams which leave me exhausted. Human Givens have a theory for this too which is that dreaming is a necessary discharge of the Autonomic Nervous System (ANS) in order to balance what has been denied during the day. Too much REM sleep and not enough slow wave which is responsible to restoring the immune system and cellular health. How interesting.. That explains why I wake exhausted and still 'wired' despite loads of dream sleep.

They have developed an 'expectation theory of dreaming; "dreams, as we shall see, is nature’s way of metaphorically discharging the autonomic nervous system (ANS)  of accumulated expectations we got worked up about during the day and did not deactivate by taking action in the real world. Emotions, we know are both motivators to DO something (from the verb emovare 'to move') and our greatest intuitive connection to our own truth. The problem is when they get stuck, as in depression, and we feel powerless to change them, our innate needs are not being met and the ANS gets set into fight, flight or freeze which sends us into a downward spiral of rumination and fear. This is the essence of depression and anxiety and it explains why it feels so physical; there are very few physiological processes that aren't affected by the ANS: immunity, metabolism and digestion being just some.

In some ways the Human Givens ideas are very much in parallel with my own that I detail in my book: Stress, Trauma and unresolved emotion in Chronic Disease. But my approach is probably more geared towards the body than this purely psychological framework would have it.

Great British Bake off - a multicultural phenomenon

Well we're nearing the final of this incredibly popular TV show.. how to explain it's popularity? Sure, it's a competition and the nerves are jangling as you watch the highs and lows of the various challenges. But, I think, more appealing, is the ability of 'ordinary' people (albeit superb bakers) to raise themselves and their art week after week with humour and emotional honesty. Of course, it's great TV, and edited no doubt to keep us hooked, but I for one think it's done more for tolerance and understanding of what it means to be an immigrant to this country (2 of the 3 remaining have families from other countries) including a British born Muslim woman who wears a headscarf and a 'hearthrob' man of Indian extraction.

Here's the phenomenon - we can identify with people as people regardless of race and see their common humanity - through the medium of cakes! Riveting stuff.

http://www.bbc.co.uk/news/entertainment-arts-34423035..

The scar that won't heal

Today is a very important day. It's the day after I uploaded my book to Kindle - a year's work and a very intense year it's been. Not only did it take a year's writing to get the 85K words, but then there's the proofing (thanks to the stalwart efforts of a friend), references and booklists to compile, getting someone to write the forward and so on. The book was actually written about 2 months ago but all the rest took a long time to complete.

During this time of writing and fretting, I've also been struggling with some personal issues which has entailed me getting quite anxious in a way that hasn't occurred since my last bout of depression 15 years ago. Initially all was going well but sometime around August my clinic (which is a conservatory at the back of my house) developed a leak. After heavy rain a stain would slowly make its way from the corner of the room and fill the air with the smell of damp plaster until it dried out again with the sun. Now, under normal conditions I would just call in the builder who erected it and demand reparations. But he is not to be found.. And I have no written guarantee despite months of requesting it. Beware a builder who can't/won't respond to your requests for things in writing!

So I called in another builder who has painstakingly worked backwards from the most likely cause to the least, repairing and making 'good' various badly done bits from flashing to the roof. After each repair comes the hope, then dashed after the next rainstorm. Finally this last weekend I admitted to myself my reaction has been so extreme, that I need therapy. I can't sleep when rain is due, my guts churn, my chest feels tight. I can't sit still, or eat for worry - and it feels like a personal attack when that stain comes back time after time..

So, of course it's no co-incidence then that my book is called The Scar the won't Heal; Stress Trauma and Unresolved Emotion in Chronic Disease'. Perhaps in the writing of it, I have touched upon some of my most painful memories, including the death of my father at 19. In EMDR (Eye movement desensitisation and reprocessing) therapy this week, it was this that came up. My feelings of abandonment when he died, and that I was somehow responsible. How strange! I know logically this isn't true but my emotional brain believes it, and the issue of fixing the leak has become a cipher for what I couldn't achieve 30 years ago. I had no control then and I have none now.  And both things seem to threaten my sense of self in a way that sounds ridiculous but nevertheless that's how my body is reading it.

So, it's really been a case of 'healer heal thyself' and I have tried to see this time as an important reminder of how illogical emotional memory formation is and how it affects us in later life if triggered. Which is exactly what my book is about - and how this can translate into anxiety, depression and chronic pain, IBS, TMJ, etc. So the universe has given me another swift kick up the backside to look at myself and deal with my stuff so I am in a better position to help others deal with theirs. Onwards people. Oh and please god I get the leak mended soon. Driving me crazy. Literally.

Highly Sensitive People and Business

As I've nearly finished reading the Highly Sensitive Person by Elaine Aron (and what  a great book it is!) I thought I'd put my thoughts down about how this relates to me (definitely an HSP) and those of us who are working as therapists, counsellors, health workers, etc. It seems to me that most of us are that category of easily over-aroused people who therefore prefer to be our own boss, having quiet time away from the hubbub, and avoiding the strident dominant types who tend to run corporations and, increasingly these days, public life (including service sector and local government, education, etc), According to Elaine, about 20% of people are born this way, and the only way they can survive and thrive is to create an environment that fits this personality style. Well, I seem to have done that.
Working with clients is a very introspective process, but as we need people it is also a chance to contribute and make a difference in life without the over-stimulation that high pressure sales, or self-promotion that entails.

However the downside to this I've found is  though we're very good at the therapy bit, we're less confident around marketing and promotion which we largely leave to others or completely. Hence there are a lot of us out there seeing maybe 3-10 clients a week, making do. If, like me you're also running a small therapy business then maybe you'll recognise the following scenario:
You know you're rubbish at the marketing. you want more clients but you hope they'll just come to you. You see an ad for 'how to market your therapy business/ conquer social media/ find your inner salesperson and you sign up. you do the study for a while, you apply a few of the ideas (which are usually sound) but, because they put you in the uncomfortable position of being 'out there' selling yourself, you soon lapse and fall back into your own routine. Another course wasted. And of course there is no shortage of courses...

It seems to me that there are lots of 'A-type' driven people out there selling courses for how to be more like them to those of us sensitives who know we can't do it. After my last course (about the 8th!) I vowed to do no more. It's not that I don't think it's a good idea to focus more on marketing myself. I just struggle because it's not 'me'. It feels all wrong. I try but it  comes over as inauthentic and that's how I am perceived. So, I've decided I'm not going to do it their way. I'm going to write a book, do my PhD and develop myself steadily, with focus but no rush. It saddens me to think there's so many of us therapists out there doing good work but most of us feel inadequate in some way cos were not out there selling our latest juicing package or social media marketing techniques. And yet, we do ok. Truth to tell, we don't want to be seeing 40 clients a week like the courses tell us we should be. We want to do what we do but not to overstimulate ourselves with sales targets and radio interviews and accolades. I say that knowing that there are some therapists out there who do and good luck to them. I see them making great headway, helping more people, that's great. But I have to accept who I am, not because I don't want to get better or improve my lot, but I don't want to do it their way. I want to do it mine. Slow but steady.

My Book nearly completed and musings on Virgina Woolf, Amy Winehouse and the nature of trauma.

As I near the completion of my soon-to-be-published book 'The scar that won't heal'; healing everyday trauma and unresolved emotion', I realise I have learnt to  notice the effects of trauma so well that I can spot it in the stories or lives of others. Yesterday watching the new BBC series 'Life in Squares' about the Bloomsbury Group, it suddenly occurred to me that the reason that the writer Virginia Woolf suffered from such debilitating depression was maybe due to a traumatic incident in childhood. Nothing in the series indicated that fact. It was purely from the evidence of her early struggles with mental illness, the triggering of severe relapses by the death of her parents (which I read about subsequently) and something about the strict Victorian upbringing which the series so clearly shows, which stultified the two women.

The Victorians were notorious for their sexually strict morals (outwardly) and the therefore unfortunate fact that many children were sexually abused in secret. What differs then of course was that no-one dare talk about it - Freud when he first declared that much of the neurosis he saw was due to sexual abuse of his clients as children scandalised Viennese society and he was forced to retract the idea and declare instead that these were children's fantasies (after all doesn't every child want to have sex with their parents??). Sadly these ideas were universally accepted as he was so influential no-one dared to disagree for many years. Even in the 1970's a standard psychiatric textbook declared incest to be so rare as to be unimportant and in any case had no significant effect on the child!* Today after the Jimmy Saville enquiry and the grooming of children in major UK cities we know differently..

Children are profoundly affected by such experiences, as well as lesser traumas such as being unloved or betrayed and the result, when their brains are still forming, is permanent dysfunction from subconsciously triggered traumatic memory. And, as my book makes clear this has very real physical results; dizziness (fainting), tinnitus, depression, migraines, panic attacks, irritable bowel syndrome and so on. These effects are real and they could be the basis of much mental and physical suffering including bipolar disorder which Virginia is believed to have suffered from.

I was incredibly saddened but also vindicated to read that she and her sister Vanessa, had indeed been abused by their half brothers, George and Gerald Duckworth, as she recalled in an essay ' A sketch of the Past' written in 1939. Could our current understanding of traumatic memory have saved her if she lived today?

Would Amy Winehouse be dead if she'd had trauma treatment rather than standard addiction detox therapy (the eponymous 'rehab' of her famous song). This relies on abstinence which deals with the effects of addiction but not the cause. As soon as the stress builds up again, the cravings return. Although she did not have abuse in her past, she most definitely had trauma - the divorce of her parents when she was 9, was, to a highly sensitive child, hugely significant. And then, in later life,  her father wasn't able to provide the boundaries she so needed. Add to that meeting a similar addictive, traumatised partner, and her death was assured. Trauma is no respecter of talent.

But would she and all the other people who have these hidden scars be healed now?  To be honest it's unclear whether this information has filtered down to mental health professionals, or certainly primary care where most people first report mental health issues. There is still much work to be done. I hope in writing my book, which details much of the science behind the stress response and how it relates to traumatic memory, will help elucidate this information to a sceptical public and other professionals. The science is there. It just hasn't been joined up sufficiently yet to be understandable within a specialised, fragmented medical model. I hope to redress that balance.

* Bessel van der Kolk, one of the worlds' leading figures in the study of trauma, read us an extract from the manual as part of my trauma training. It was mind-blowing.

Why whole grains may not be good for you after all

The problem with Grains

For many years I have believed that whole grains were part of a healthy diet and have swapped my processed cereal breakfast for an oat-based one I made myself with nuts and seeds that I added.. however I note my teeth are not in great health (and where the teeth are going the bones soon follow). I have had to have a root canal filling and the enamel is chipping. Recently I read an article that explained the problem.
Certain whole grains (especially oatmeal) contain a molecule called phytate that inhibits mineral uptake - it binds Phosphorous in a form that we then cannot use, Calcium which we need for healthy bones is then leached from the body and we get bone loss - unless we have enough Vitamin D and other fat -soluble vitamins.
High-phytate diets result in other mineral deficiencies too; Zinc, Magnesium and Iron are all inhibited. This would explain why my iron levels are low even though I eat a wholefoods diet.

Solutions

So what can we do? Well firstly we need to soak or sprout the grains first and if you are not prepared to do this then you need to swap a grain-based breakfast to one based on animal fats like egg and butter - it is interesting that absorbable calcium from bone broths and raw dairy products, and vitamin D from certain animal fats, can reduce the adverse effects of phytic acid. Get yourself a slow cooker to make your meals with meat on the bone..
Add Vitamin C to your diet to help iron absorption. Research shows that adding ascorbic acid significantly counteracted the effect s of phytic acid in wheat. Green leafy vegetable are best but of course if your gut is compromised you may have difficulty absorbing them. Once cooked they tend to lose most of their vitamin and mineral content so the best thing to do is to juice raw greens.. Adding Vitamin A and beta -carotene from coloured veg is also good - so add beets and/or carrots to your juice/blend..

Why now?

Why are we only now having this problem? Well it seems that humans do not produce enough phytase to safely consume large quantities of high-phytate foods on a regular basis because our gut flora are compromised (due to toxicity, spraying of foods, poor diets etc). We need them to produce the enzyme that digests phytates; phytase which makes the phosphorus available and reduces the mineral depleting qualities of the molecule.. One species of good bacteria in particular seems to help more than others; probiotic lactobacilli and other species of the endogenous digestive microflora can produce phytase. Thus, humans who have good intestinal flora will have an easier time with foods containing phytic acid. Increased production of phytase by the gut microflora explains why some volunteers can adjust to a high-phytate diet. Sprouting activates phytase, thus reducing phytic acid.
 
We need to sprout and soak our grains and eat more animal fats! Almost opposite to the advice we have been given for years. So eat your butter and yoghurt (which is semi-fermented making the milk less allergy inducing). If you eat meat, cook it slowly it on the bone and not frying in polyunsaturated oils - (vegetable oils). Use coconut oil, or olive oil. And, juice all you can.

For more information see http://www.westonaprice.org/health-topics/living-with-phytic-acid/