On Connection (Part 4/6)

In neurosis there is a loss of integration among brain sites so that memory cannot be conflated with inner sensations and external reality. We lose our wholeness so that past and present cannot be differentiated. Remember again that when animals are traumatized and then put again in a similar situation without the trauma, the brainwaves are practically identical. The brain cannot tell the difference between past and present, and forces us to react as we did in the past even when that reaction is not called for. In neurosis we live in the past without being aware of it. We are shy with others because an angry father forced us to give in and submit unquestioningly. This kind of father takes the child’s “no” away so that later on she cedes to other’s wishes all of the time. Thus, she reacts in the present as if it were the past.

Without lower level connection to higher levels, we are only considering the late developing cortical brain and not the brain as a whole. Sadly and happily, no one can make a connection (insight) for us; it must come out of a feeling, and it must do so in slow orderly fashion. When the patient has the connection, we know it is time. When the insight is forced by a therapist, it usually is not the time—organically; it defies evolution—ideas after feelings, not before. Neurosis manages to fragment that reality (disconnection). Feeling therapy reestablishes that total reality. There is a unity of nature that happens only with connection. Connection, therefore, is the merging together of related neural networks on all levels of consciousness.

It should be clear that dissociation restricts consciousness, not awareness, and we need consciousness, not awareness, for control. I can make this same impatient individual aware (left frontal area) in therapy that he is terribly impulsive and cannot stand waiting, but that does not produce the bottom to top connection that allows for control—the connection between deep right brain and left pre-frontal brain. Even with full awareness, the right lower brain sends impulses throughout the body that gnaws away at various organs. The result may be colitis (often first line originated) or bleeding ulcers, which cannot be stopped without first-line access. The aware person can be totally unconscious of all of this. The unconscious has no way to become conscious in the neurotic. Neurosis means an altered state of consciousness. That includes defective or impaired bottom-to-top brain circuitry. In brief, the brain is rewired. In the adult, instead of feeling the need for love and caress, one may feel immediate sexual impulses or the drive to eat. The more that those circuits are deviated and continue to fire in a specific way, the more the rewiring becomes reinforced.
We need to go back and relive the times of first deviation if we are to make headway to resolving it. We go back to reset the set-points toward normal. That is why in our therapy, the naturally produced inhibitor or repressor—serotonin—is enhanced after one year of sessions. Its set-points have been reestablished. It is sometimes possible to get relief by delving only into later childhood traumas, leaving the prototype in place. If the threshold for symptoms is raised by this approach, all the better. There will be no overt symptoms but the tendency is still there. Thus, an alcoholic may not be forced to drink when some of the pain is relived, but he will always be in danger thereafter. If we are looking for total personality change, it will not be possible without addressing the imprint. If one is happy with having no symptoms, then so be it. It is the patient’s life, not ours.

Early trauma, birth, and pre-birth, will generally interfere with the proper evolution of the right brain and its connections to the left. It remains so excited that even neutral events can set it off. Do we need a therapist to help us see outside reality? No. We need a therapist to help us find the internal one; the rest takes care of itself. To be specific: We need to access the right brain because that brain (specifically the orbito-frontal cortex. And the lower brain, as well) contains a map of our emotional history and our internal state. With access we don’t have to figure out what happened to us at age two, we can re-experience and know it. And we will immediately know how that experience drove us. That is why recall is so different from reliving.


(Let me hasten to add that there are any number of limbic structures and adjacent ones that are involved, including the ventral anterior cingulate which seems to “straighten out our perceptions”. It is beyond my competence and intent to discuss them).

On Connection (Part 3/6)

Connection cannot be achieved when the connecting cable (corpus callosum) has been impaired or thinned out due to early trauma. Once the event has been dissociated, the right lower brain areas have a “mind of their own.” That is, the energy of the pain innervates (lead to, connect to) the heart and key organs and begin their ever-so-subtle damage so that years later, there is a serious illness and no one seem to know where it comes from. Suddenly the person develops high blood pressure or heart palpitations, or worse, a stroke. Because the origin is so remote, one could never dream that it was due to a birth trauma. The treating doctor says, “Have you been under stress lately?” “Not that I know of.”

How can we speak to a brain that has as yet no words? And no comprehension. The suffering component of infancy has direct connections to key organs of the body governed by the right brain. The left brain insists that all is well while the right is sending messages to the lungs, immune system, circulatory system, and heart saying things are terrible. All done “sotto voce.” After all, it doesn’t want to be overheard by the left. Once the secret is out it has to be dealt with, and the left just cannot do it. The truth of the hurt is already out, only it is revealed indirectly through the organs. There is a pain in the gut or in the heart (ischemia, angina). These are the somatic aspects—fragments of the memory— of an overall pain imprint, which as yet is not conscious. And it is not conscious because it is overwhelming in its force. Remember that there are nerve fibers from lower down that impact the pre-frontal brain area that can and do change its structure and function, particularly the right frontal area. A Primal means putting it all together, connecting the various disparate symptoms into an overall whole.

In neurosis there is a different brain. UCLA neuro-psychologist Allan Schore believes that early trauma overrides genetics in our personal development, and I agree.

The reason for the descent down the chain of feeling to be orderly and methodical is that as we descend, the valence of the pain increases. Thus, in birth where death may have loomed, the pain is horrible. It should only be experienced after many lesser and later pains have been felt. If we try to get there with hallucinogens, for example, as some therapists have done, the result is often wild symbolism as the neocortex scrambles to circumscribe and contain it. If the therapist sees this as normal and even healthy, then all is lost because the patient is lost. He now lives in a labyrinth of convoluted ideas that have no relationship to internal reality. Instead of feeling that reality, he is encircled and dominated by it.
Early trauma impairs the proper evolution of the right brain so we later misperceive, cannot sense nuance, and over or under react. We cannot sense nuance because that is right brain, and we are disconnected from it. Thus there is a tendency to be literal and not see the implications in certain situations. Right brain impairment may also cause us to lose our ability to empathize because that too is right side. Anything that involves feeling, in short, is missing with disconnection. It is critical for a therapist to have right brain access, and even more importantly, to be right-left brain integrated. She must see beyond the words of the patient. Or more important, see beyond the words of a politician. The right brain senses insincerity.

In the example of the inability to wait, it is clear that unless we go all the way down the chain, we will not have complete resolution and change. If we relive the waiting in childhood (the need to go home after being in boarding school), we would resolve only a part of the trauma. There will still be an urgency about waiting but not so desperate as before. What gives waiting its life-and-death urgency is the birth trauma, which, indeed was a case of life and death. This is a general rule about any problem or act-out. The compulsive-obsessive aspect of it is largely driven by preverbal traumas, which are usually pure impulses. It is what makes sexual act-outs so difficult to treat. And unless a therapy arrives at the prototype, they will not be eradicated fully. The difficulty here is that first-line trauma underlying the act-out already has an urgency about it. The devilish aspect of this is that there is no way to go deep without first going shallow—no visiting the past without first dealing with the present. We must obey evolution, albeit evolution in reverse.