III - THE POWER OF SITUATIONS
As a result of our evolution, human beings have the most “social” brain of any mammal. As Frans de Waal, one of the world’s leading researchers on primate behaviour, wrote:
There was never a point at which we became social: descended from highly social ancestors – a long line of monkeys and apes – we have been group-living forever… life in groups is not an option, but a survival strategy (de Waal, 4).
The evolutionary advantages of being able to practice complex forms of social cooperation are the primary reasons for the growth of the neo-cortex, which is central to our “higher” mental functions, and which is most developed in the human species.
One foundation of our social nature involves mirror neurons. This discovery illuminates the very profound way in which people are connected to each other and also provides a neurological foundation for empathy, which is so central to being human that whenever we even think about hurting someone else, our brain automatically generates a negative emotion. The mirror neural system also illuminates the profoundly social nature of our brains (Siegel, 2006A).
Another study demonstrated that empathy is a normal function of a healthy brain (de Waal believes that it developed out of maternal-infant bonding in mammals, op. cit). It found that a person who has suffered an injury to their ventromedial prefrontal cortex (VMPC), were more willing to harm others than those whose brains were functioning normally. As one researcher summed up: “Because of brain damage, they lack empathy and compassion” (ScienceDaily, 22 March 2007).
People are hard-wired for compassion and cooperation. Not only is it natural to care for others, but nurturing relationships with family and friends are vital to our emotional and physical health.
Eric Fromm argued that we must consider how, in addition to the individual unconscious, cultures develop their own particular “social unconscious” in which political, economic, and cultural forces actively suppress certain “unacceptable” ideas and emotions, while promoting others (Fromm 1955).
There is wide agreement that the corporate media are a major factor in the construction of ideologies. Kahneman notes that,
People tend to assess the relative importance of issues by the ease with which they are retrieved from memory – and this is largely determined by the extent of coverage in the media (op. cit. p. 8).
This view that one’s social unconscious plays a significant role in determining one’s political views has been receiving support lately, as new research sheds light on how these unconscious forms develop.
For instance, “there is evidence that life experience as intangible as culture can also reorganize our neural pathways”. Research shows that both younger Asians, and Westerners in general, view the world differently than older Asians, who grew up with less Western influence. Psychologists using fMRI scans showed people 200 complex scenes, such as an elephant in a jungle or an airplane flying over a city…” The lead researcher summarized the results: “An Asian would see a jungle that happened to have an elephant in it...Meanwhile a Westerner would see the elephant and might notice the jungle” (Binns, 2007). The differences between younger and older Asians support the view that these results stem from cultural rather than genetic causes.
The fact that most people usually hold the same religious and political views as their parents is a reminder of how profound such early influences are. Most children born to Muslims remained Muslim, and the same is true for Hindus, Christians, Jews, and so on. By the same token, most children of liberal parents are liberal, while conservative parents generally produce children who lean to the right.
The effects of one’s environment can interact in a number of ways with one’s “nature” to affect attitudes towards other people. For instance, a recent large-scale study (N = 15,874) in England,
found that lower general intelligence (g) in childhood predicts greater racism in adulthood, and this effect was largely mediated via conservative ideology. A secondary analysis of a U.S. data set confirmed a predictive effect of poor abstract-reasoning skills on antihomosexual prejudice, a relation partially mediated by both authoritarianism and low levels of intergroup contact. All analyses controlled for education and socioeconomic status. Our results suggest that cognitive abilities play a critical, albeit underappreciated, role in prejudice (Hodson, Busseri, 2012).
There are many ways, as noted above, in which natural empathy can be lost. After all, biology is not destiny, except in the sense that it underlies the wide repertoire of human behaviour, which is more varied than in any other species. Consider the immense variety of cultures that exist, and that have existed, and it is clear that our behavioural flexibility is vast. The question of which of our potentials and behaviours are actualized depends on our past experiences as well as our current environment. Phillip Zimbardo (who ran the [in]famous “Stanford Prison Experiment argues in The Lucifer Effect that:
we are born with a full range of capacities, each of which is activated and developed depending on the social and cultural circumstances that govern our lives…the potential for perversion is inherent in the very processes that make human beings do all the wonderful things that we do (Zimbardo, 2007).
Monday, June 4, 2012
Saturday, June 2, 2012
Treating the Patient With Respect
Why can’t any therapy help patients with their feelings? One good reason is that they are talking to the wrong brain—the brain that thinks rather than the one that feels. Unfortunately the correct brain, the right brain and lower brain, doesn’t talk much, doesn’t understand English and, as a matter of fact, doesn’t understand words. It doesn’t understand in the way we think of understanding. The correct brain is one that contains our history, our pain and our feelings; the brain that processes our deep feelings that can finally liberate us. It does understand feelings; we need to speak that language—one without words. We have to convince the brain that spouts words and ideas that it is necessary to go back to early life and a world devoid of intellectuality (kids are not intellectual as yet), and relive feelings—that lack of love—that were too much to feel at the time. We have to convince that thinking brain to let go, let the lower brain systems emerge and breathe the air of freedom. It can be done; cure can be accomplished. But only by stealth, not by deliberation. Feelings have to creep up on us, not be sought out. It has to be a therapy of nuance, of subtleties, of flexibilities and lack of domination; that is, it cannot be a therapy of experts because the only expert is the patient. The doctor has to let go of any notion of superiority. Even keeping the patient waiting for a session is a sign of superiority, which I do not tolerate in our therapy: it says “I am more important than you and my time is more valuable”. And while you are trying to get back some self-esteem, the doctor lowers it by keeping you waiting. It is subtle but there. And above all, we need to get rid of any time constraints that force a crying patient in the midst of her feelings to leave and wait until the next session.
We do not touch the patient when she needs to feel unloved; we touch her when the pain is so excruciating that we need to lower its force so it can be experienced and integrated. It is one means of keeping the patient in the primal/feeling zone. If the therapist cannot feel he cannot distinguish the difference and will touch at the wrong time or in the wrong way. Patients can sense when they are being touched out of the needs of the therapist and not their own needs.
When a therapist cannot tolerate the patient's suffering she may touch to ease the pain, and thereby ruin the session because it kept the patient from feeling all of his pain. The therapist may be acting out her own need for touch and caress in her own early life. Watching the patient writhing may bring up great pain in herself, setting off her own feelings, forcing her to stop the patient from feeling.
So the therapy can go wrong when the therapist has not resolved a good piece of her own pain. And none of that can be taught: when trainees take notes all of the time it usually means that they cannot feel what is right and need intellectual signs of what to do. This is a therapy that cannot be done by the numbers. It is a matter of sensing, intuition, and instinct…plus a soupcon of training…a lot of training.
ON PAINKILLERS AND PREGNANCY
The more painkillers a woman takes during labor the more likely her child will be to abuse drugs or alcohol later on. Karin Nyberg of the University of Gothenburg, Sweden, looked at medication given to the mothers of 69 adult drug users and 33 of their siblings who did not take drugs (Nyberg, et al., 2000). Twenty-three percent of the drug abusers were exposed to multiple doses of barbiturates or opiates in the hours just before birth. Only three percent of their siblings were exposed to the same levels of drugs in utero. If the mother received three or more doses of drugs, her child was five times more likely to abuse drugs later on in life. Enough animal studies have been done to confirm the finding—exposure to drugs in the womb changes the individual's propensity for drugs later on.
There is some evidence that a mother taking downers during pregnancy will have an offspring who later will be addicted to amphetamines, known as “uppers” (speed) (Jacobson, et al., 1988); while a mother taking uppers during pregnancy—coffee, cocaine, caffeinated colas, may produce an offspring later addicted to downers—Quaaludes, for example. And the reason that the person can take inordinate doses, such as drinking two cups of coffee before bedtime and still be able to sleep easily, is that there exists a major deficiency of stimulating hormones—the catecholamines. In short, the original set points for activation or repression have been altered during womb-life and persist for a lifetime.
I have treated patients who have taken enormous doses of speed and yet have shown very little mania as a result. While other patients of mine have taken lethal doses of painkillers in previous suicide attempts, enough to kill anyone else, and yet still lie awake hours later, only feeling slightly drugged. The severe brain activation by imprinted pain resists any attempts to quell the system.
Jacobson, B., Nyberg, K., Eklund, G., Bygdeman, M., Rydberg, U. (1988) Obstetric pain medication and eventual adult amphetamine addiction in offspring. Acta Obstet Gynecol Scand 67:677-682.
Nyberg, K., Buka, S.L., and Lipsitt, L. (2000). Perinatal Medication as a Potential Risk Factor for Adult Drug Abuse in a North American Cohort. Epidemiology 11(6):715-716.
We do not touch the patient when she needs to feel unloved; we touch her when the pain is so excruciating that we need to lower its force so it can be experienced and integrated. It is one means of keeping the patient in the primal/feeling zone. If the therapist cannot feel he cannot distinguish the difference and will touch at the wrong time or in the wrong way. Patients can sense when they are being touched out of the needs of the therapist and not their own needs.
When a therapist cannot tolerate the patient's suffering she may touch to ease the pain, and thereby ruin the session because it kept the patient from feeling all of his pain. The therapist may be acting out her own need for touch and caress in her own early life. Watching the patient writhing may bring up great pain in herself, setting off her own feelings, forcing her to stop the patient from feeling.
So the therapy can go wrong when the therapist has not resolved a good piece of her own pain. And none of that can be taught: when trainees take notes all of the time it usually means that they cannot feel what is right and need intellectual signs of what to do. This is a therapy that cannot be done by the numbers. It is a matter of sensing, intuition, and instinct…plus a soupcon of training…a lot of training.
ON PAINKILLERS AND PREGNANCY
The more painkillers a woman takes during labor the more likely her child will be to abuse drugs or alcohol later on. Karin Nyberg of the University of Gothenburg, Sweden, looked at medication given to the mothers of 69 adult drug users and 33 of their siblings who did not take drugs (Nyberg, et al., 2000). Twenty-three percent of the drug abusers were exposed to multiple doses of barbiturates or opiates in the hours just before birth. Only three percent of their siblings were exposed to the same levels of drugs in utero. If the mother received three or more doses of drugs, her child was five times more likely to abuse drugs later on in life. Enough animal studies have been done to confirm the finding—exposure to drugs in the womb changes the individual's propensity for drugs later on.
There is some evidence that a mother taking downers during pregnancy will have an offspring who later will be addicted to amphetamines, known as “uppers” (speed) (Jacobson, et al., 1988); while a mother taking uppers during pregnancy—coffee, cocaine, caffeinated colas, may produce an offspring later addicted to downers—Quaaludes, for example. And the reason that the person can take inordinate doses, such as drinking two cups of coffee before bedtime and still be able to sleep easily, is that there exists a major deficiency of stimulating hormones—the catecholamines. In short, the original set points for activation or repression have been altered during womb-life and persist for a lifetime.
I have treated patients who have taken enormous doses of speed and yet have shown very little mania as a result. While other patients of mine have taken lethal doses of painkillers in previous suicide attempts, enough to kill anyone else, and yet still lie awake hours later, only feeling slightly drugged. The severe brain activation by imprinted pain resists any attempts to quell the system.
Jacobson, B., Nyberg, K., Eklund, G., Bygdeman, M., Rydberg, U. (1988) Obstetric pain medication and eventual adult amphetamine addiction in offspring. Acta Obstet Gynecol Scand 67:677-682.
Nyberg, K., Buka, S.L., and Lipsitt, L. (2000). Perinatal Medication as a Potential Risk Factor for Adult Drug Abuse in a North American Cohort. Epidemiology 11(6):715-716.
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