For the past 50 years, psychotherapy has taken a back seat to biomedical psychiatry, largely due to reliance on medications for the treatment of mental disorders. Yet clinical evidence increasingly points to chronic, unresolved traumatic stress as the source of many — if not most — mental disorders. Furthermore, longitudinal analyses show continued use of psychotropic medications is bad for the body, even causing chronic diseases. Granted, medications can stabilize a body wracked by recurrent distress, but such an approach is hardly a long-term cure. According to psychiatrist and trauma specialist Bessel Van der Kolk, “dramatic advances in pharmacotherapy have helped enormously to control some of the neurochemical abnormalities caused by trauma, but they obviously are not capable of correcting the imbalance.” To correct the “imbalance” often requires learning to inhabit one’s body and relationships in new ways.
Fortunately, the psychotherapeutic treatment of psychological trauma has advanced significantly the past several decades. In part, this is due to scientific discoveries of how the body and relationships naturally defend against traumatic stress. In particular, trauma-informed psychotherapies that draw from neuroscience and attachment studies are more holistic and scientifically based than ever before, although they often support the intuitions held by originators of psychotherapy such as Pierre Janet, Sigmund Freud, and C. G. Jung.
The Neurobiology of Trauma
Pierre Janet was the first to recognize how the body responds to present events as if past traumas were recurring — what today we call flashbacks. He observed patients
“continuing the action, or rather the attempt at action, which began when the [traumatic event] happened, and they exhaust themselves in these everlasting recommencements.”
Today we know the neurobiological reasons for flashbacks. Unlike narrative memories that seamlessly integrate remembrances of the past — e.g., feelings, perceptions, thoughts, body sensations, beliefs — the memories associated with traumatic events largely remain unintegrated. This has to do with how the body has evolved to deal with threat. Thinking about a threat would slow down reaction time. Thus the frontal lobe — the so-called “thinking part” of the brain — effectively shuts down during perceived threats as energy and attention are directed towards survival responses. Consequently, a coherent narrative of the traumatic event is not created, inhibiting the past from becoming, well, the past.
These fragmented, often unconscious memories can be stimulated by even the subtlest reminders of past traumas. When this happens, the amygdala is also stimulated. The amygdala functions like the body’s alarm for the presence of danger, setting off survival responses even if no danger is present. The stock example of this process is the war veteran who hears a car backfire and automatically drops to the ground because his body “thinks” it hears gunfire. Today, sensorimotor psychotherapy, EMDR, and somatic experiencing are a few of the psychotherapeutic approaches that help release what Bessel van der Kolk described as “fixed action patterns” of the body that the trauma survivor would otherwise continually replay.
The Significance of Early Life Relationships
Sigmund Freud described psychoanalysis as “a cure through love.” Learning to trust love — and seeing oneself as lovable — remains one of the best possible outcomes of psychotherapy. Perhaps this is because even more debilitating than enduring something traumatizing is the pain of facing trauma and its aftereffects alone. Traumatic stress incubates in isolation and feeds on shame. Over time, survivors can lose trust not only in others, but also in their own minds as they defend against intrusive reminders of past traumatic events.
Common goals for starting therapy include gaining control over distressing emotions such as fear and anger, ending depression, creating better relationships, and functioning well at work. Traumatic stress and fragmentation are rarely seen as the root causes of suffering even though these experiences are often the neurobiological underpinnings of feelings of despair, distress, or impaired functioning. Furthermore, present difficulties are often the long-term outcome of adapting to maladaptive or traumatizing caregiving early in life.
Trauma-informed psychotherapies distinguish between two types of trauma:
- Big “T” trauma associated with fear-based events (i.e., overwhelming experiences that cannot be integrated)
- Little “t” trauma that results from maladaptive caregiving (i.e., cause emotional distress, but do not overwhelm)
Both can lead to mental disorders in later life as well as problems with intimacy. Connecting current problems to early relationships is difficult. It can be distressing to describe them as traumatic, or even maladaptive, when there are continued feelings of emotionally dependency on parents or caregivers. Even so, research and clinical evidence reliably show the extent to which we have evolved for specific emotional experiences with caregivers. When these experiences are lacking, or if there was abuse, developing intimate relationships later in life can be particularly challenging. There can also be difficulties with consistently feeling confident, calm, and hopeful about one’s abilities.
Clinical psychologist Richard Karen described attachment theory as a “theory of love and its central place in human life.” According to attachment theory, one of the primary roles of the caregiver is to teach the child how to bond with others and regulate emotions. Emotions are the basis for intimacy and are also fundamental for understanding one’s own needs and desires. Furthermore, having the capacity to regulate emotions is vital for forming relationships and knowing one’s own needs and desires.
Studies conducted by Mary Ainsworth revealed mothers who provided secure attachments do the following:
- reflect sensitivity rather than misattune to emotional needs
- accept rather than reject the infant’s emotional needs
- cooperate with the infant rather than attempt to control and dominate
- appear emotionally available to the infant rather than remote
- adapt to the infant’s natural rhythms and emotional needs.
Challenges to developing secure attachment include:
- the caregiver frequently appears frightened, such as when intimate partner violence is occurring
- the caregiver is emotionally unavailable, such as when the caregiver is depressed
- the caregiver is frightening, which is how a caregiver is perceived when abusive
- the household is chaotic, keeping the caregiver from emotionally attending to the infant.
According to the Adverse Childhood Experiences study, two-thirds of US households have conditions that can damage the caregiver-infant bond. Adverse childhood experiences also increase the likelihood of later developing mental disorders. Of note, most people receive or seek mental health services after a period of isolation, which suggests difficulties trusting others or having safe people in their lives who could offer support.
The Healing Impact of Relationships
Just as treatments for the body’s response to trauma have improved other the years, so has the “love cure” originating with Freud and others. Relationships involving the safe exchange of emotions may be the single most healing experience a person with a history of trauma can have. Yet such intimacy is a two-directional process, which challenges the idea that an effective therapist is a distant one. Early in psychotherapy’s history, C. G. Jung realized that psychotherapy heals when both therapist and client are equally invested in the relationship. He went so far as to claim, “unless both doctor and patient become a problem to each other, no solution is found.”
The idea of the therapist as “blank screen,” which Freud advocated, fails to fit the present-day understanding of the neurobiological effects of trauma or the nature of attachment. Instead, attachment theorists see healing occurring through the repeated experience of finding oneself in the mind of the therapist — and altering that image by genuinely impacting the therapist. Yet to have such an impact on another person means having a real relationship, albeit one in which the focus in psychotherapy is on the client. Clinical psychologist David Wallin wrote,
“psychotherapy ‘works’ by generating a relationship of secure attachment within which the patient’s mentalizing and affect regulating capacities can develop. … such a relationship must be an intersubjective one in which the patient comes to know him- or herself in the process of being known by another.”
I would venture to add the client comes to trust love through being loved.
Of course, therapy isn’t the only way to learn to trust love and trust loving oneself. We can begin to do this for ourselves and each other by prioritizing emotional safety and love in all our interactions. Sometimes this is as simple as asking ourselves, Is this emotionally safe for me/him/her/them? Is this loving?
This post was revised and adapted from an early version.
Written By Laura K. Kerr, Ph.D
The post Trauma-Informed Psychotherapy Puts The Body – and Love – Back In Mental Healthcare was written by Laura K Kerr, PhD. Visit her website at Laura K Kerr, PhD.
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As a psychotherapist with a body-centred focus, your description of the role and place of the body in the therapeutic relational process is spot on. One of the difficulties in body psychotherapy in the past has been to find a language which adequately describes how the change process occurs. These recent insights into the neurobiology of trauma validates and ratifies many body-centred practices and this development should be seen as an opportunity to upgrade the value of a body-focussed approach in helping people lead the lives they prefer to be living.
Thanks so much for your reflections. I practice sensorimotor psychotherapy, and like you, see the rewards of a body-centered approach to therapy.
How does body-centered or sensorimotor therapy differ from Bioenergetic Analysis/Therapy?
I read this article, because my girlfriend is a socialworker, and posted a link to this via Facebook. I myself know next to nothing about mental health topics or therapy in general. Please excuse my ignorance, but:
Why is there a picture of a train trying to outrun a tsunami?
Response to Victoria Brewster MSW:
Unfortunately, I am not familiar with Bioenergetic Analysis/Therapy, so I can’t make an educated comparison. But I can tell you a little bit about Sensorimotor!
Sensorimotor Psychotherapy was developed by Pat Ogden. It is derived from Ron Kurtz’s Hakomi Method, and thus is based in mindfulness practices and awareness of the body. It combines Hakomi with what is known about the neurobiological effects of trauma, research in attachment, as well as adapts Kurtz’s “character strategies” to understand how people adapt to adversity. The end result is a very sensitive and holistic approach to the treatment of trauma that is at its core collaborative and client-centered.
You can find out more about Sensorimotor Psychotherapy at their website:
http://www.sensorimotorpsychotherapy.org/home/index.html
Why do some traumatic events get integrated into our brains and others do not? Basically why do some of us get PTSD and others who live through similar events do not?
Amber, this is such a great question, and there are lots of partial explanations that can be given, depending on your frame of reference. And the question is not fully answered and still the focus of much research.
One explanation comes from looking at PTSD from a genetic perspective. For example, there has been some evidence that the length a particular allele can predispose a person to depression following early life adverse experiences. Thus some people may be more vulnerable to experience posttraumatic stress due to their genetic makeup.
There has also been quite a bit of evidence pointing to the impact of adverse childhood experiences, such as physical or sexual abuse, on the likelihood of later developing PTSD. This has been seen in a significant number of veterans who develop PTSD in response to combat. Thus, having a stressful or traumatizing childhood increases the likelihood of developing PTSD in response to a traumatic event that occurs in adulthood.
These are just two scenarios, and there are quite a few other explanations as well, including having a parent or caregiver who had PTSD, which can predispose a person to greater susceptibility to having posttraumatic stress responses to overwhelming events or situations.
Thanks for the great question.
Laura,
This is a great summary of what’s missing within most clinical settings today, especially within mental health shops not integrated with primary care. I have been exploring why suicide is so prevalent in our society, and our therapies so ineffective, since my 20 year old son succumbed to suicide in 2009. As a primary care giver (Pediatrician) I realized I had ‘anosognosia’ (blindness to the disorder) myself over the past 25 years. You are spot on – “psychotherapy has taken a back seat to biomedical psychiatry,… Clinical evidence increasingly points to chronic, unresolved traumatic stress as the source of many — if not most — mental disorders.” It seems persistence of suicidal ideation and unresolved PTSD both result from variations on unresolved “narrative memories?” “Fixed action patterns” prevent the depressed individual from seeking out and/or benefiting from help available if it does not address the ACE or establish a new relationship of love and trust, not only for others but especially with oneself. We consistently hear about a lack of “gaining control over distressing emotions such as fear and anger, ending depression, creating better relationships, and functioning well at work” with suicide attempt survivors. Traumatic stress and fragmentation ARE …the root causes of suffering, the neurobiological underpinnings of feelings of despair, distress, or impaired functioning! Failing to understand and deal with this explains onset of mental disorders in later life leading to suicidal ideation and frequent attempts when ‘the usual’ psychotherapy (and medication) don’t relieve the underlying emotional pain. Helping a loved one or client feel confident, calm, and hopeful about one’s abilities is certainly at the core of preventing suicide. Bottom line: ending suicide requires ending “isolation” by renewing trust in others. This is done in successful programs by “having safe people (brought back into our client’s) lives who offer support” – a safety net. You have nicely outlined how the “love cure” involving the safe exchange of emotions, a intersubjective two-directional process, may be the single most healing experience a person with a history of trauma can have, one in which the patient comes to know him – or her – self in the process of being known by another.” Would that we could find therapists for our citizens with severe mental illness before the next suicide occurs. “Trust love through being loved.” Those most in need (I.e. my son) can’t do this for themselves if we don’t first identify and treat the underlying mental illness often triggered by childhood trauma. Thank you.
George,
Thank you for taking the time to point to so many of the important aspects of mental illness and mental healthcare — that is, both the phenomenological experience of the person seeking help and the conditions that need to be in place if genuine holding of another’s suffering is going to occur. And I am so sorry for your loss, and that you had to come to this wisdom in such a profoundly painful way. We have the word “orphan” for a person who loses a parent, and “widow” for a person who loses a spouse, and yet no word for a parent who loses a child — the omission itself a tacit recognition that no word could sufficiently describe what it is to experience such a loss.
I have developmental trauma “since the sperm hit the egg” [see http://attachmentdisorderhealing.com/developmental-trauma/ ] and was frustrated with “talk therapy” — even after I found a wonderful attachment therapist.
Then I heard about Pat Ogden and Peter A. Levine’s body work — after hearing Dr. Dan Siegel (and others) say that our thinking brain doesn’t come on line until we’re 2 or 3. “If I had major trauma in utero and infant incubation, what’s the point of talking to my thinking brain about it?,” I told my therapist one day. “I need body work!”
He was interested but never heard of it. I happened to get hold of Levine’s older book “Healing Trauma” because it has a CD with voice exercises, brought the CD to my therapist and said: “This is what we’re going to do.” We did it together; “Don’t Try This at Home…”
As Dr. Kerr knows, but readers may not, Levine discovered 30+ years ago that mammals in the wild don’t suffer trauma because, when they survive life threats, their bodies instinctively reset via shaking and trembling motions. These simulate the running or other fight-flight action they were doing when, say, a predator caught them. This discharges volumes of stress chemicals which otherwise get frozen in the body.
The human thinking brain, however, suppresses this discharge. My therapist and I got quite a shock when I managed to access the discharge; the healing was enormous. And my beloved therapist got a whole new college education on body work; for a few months I wasn’t sure who should be paying whom….More here: http://attachmentdisorderhealing.com/featured-topics/healing-body-work/
Kathy,
I so enjoy reading your writing! I feel like I am on the healing journey with you.
I really appreciate your reference to Pat Ogden’s work. I’m trained in sensorimotor psychotherapy, as well as have assisted trainings. In the trainings, we practice the skills we learn on each other, which turned out to be some of the best (and free!) therapy I ever received. And I’ve seen clients benefit enormously from the modality as well.
Similarly, I know people trained in Peter Levine’s SE who report clients having experiences similar to yours. Although the discharge often must be preceded by creating safety and stabilization in one’s life (and often through therapy), when it does occur, there can be a very profound shift.
Thanks so much for sharing.
Dear Laura,
Your comment is very moving. It would help my other readers so much to see it. Would you mind if I also post it in the comments of my Healing: Body Work page at http://attachmentdisorderhealing.com/featured-topics/healing-body-work/ ?
That way, your brilliant blog here would also be indexed on my website for everyone to see and explore all your wonderful links.
Warmly,
Kathy
Yes, please do share! Thank you.
Dear Dr. Kerr:
I love how in-depth this blog post is and the spirit care and respect you have for the therapy process. I agree that the focus from medication and to secure attachment and newer styles of therapy is positive. However, I’m constantly wondering if any therapy relationship can be a “real” one when there isn’t an exchange, a give and take. I don’t mean therapy isn’t a service, a product that can be purchased or education that can be acquired or that it doesn’t have value. It does and certain kinds especially so.
But is it a real relationship when money changes hands, when it’s not a fair and even exchange and when the people in the relationship are not both “holding space” for one another.
I’ve always considered therapy as paid-for parenting and the one-sided relationship others may get from a parent but that isn’t available to me. For me, therapy has helped me from burdening my “real” relationships and for that it’s helped my life. But I don’t think of it as love but as support I contract for when I need more than feels fair or right from my voluntary tribe.
It’s not that therapy and therapists aren’t caring or warm or kind or good hearted. But is love something that can be contracted purchased or insured and scheduled by appointment? Is it something that isn’t voluntary and back and forth? I’m not sure that it is or can or should be.
It can be safe, predictable and educational. It can be warm, supportive and affirming. But it’s a product paid for and I don’t know how it could be seen as a real choice relationship with the money changing hands.
For me, friendships with older women who have adult children or long marriages or who live some of the things I didn’t see or know has helped me the most.
I listen to these women, watch how they manage their loves and have been able to see how they relate to their grown children. I can’t change what happened in my past but I can certainly watch, learn and hope to repeat some of what they do as I parent my child. I look for their example.
Once we reach adulthood, with high ACE scorers or not, we are most of the time dealing with other adults and needing to learn to manage as adults with other adults. The reality is that the most we can hope for is healthy interdependence with other human beings. I guess an exchange of services and cash could be a type of interdependence? I’m not sure….
I’m fine with paying to get skills I don’t have (whether it’s yoga or to color my hair or learn about attachment theory). But for me, I see it as parenting and supporting myself by buying these things – but not as love between me and the person I’m paying. I have never viewed it as a “real” relationship because it is completely appt. based and dependent on my ability to pay.
That’s just how it works and I get that those are the “rules” for engagement.
For me, I sometimes feel patronized when therapists speak of therapy as a form of re-parenting and even a little uncomfortable to think a therapist might consider the way they “love” me a part of my healing.
I’m curious if people who provide therapy consider it an emotional giving and voluntary or a professional and career kind of giving and if that distinction even matters or feels any different?
I am not bashing therapy (though talk therapy is not great for trauma) but I am questioning if secure attachment can be formed in a relationship that at the core involves money being exchanged. I would say that though it can be beneficial and healing it’s not a secure attached relationship.
I’m not trying to argue just genuinely sharing my own personal views as someone curious about yours and reacting to what you’ve written. Thank you for reading and sharing your impressions. I do admire the regard you clearly have for all sides and parties in the therapy process.
Warmly,
Cissy
Hi Cissy,
Thank you for your very thoughtful comment.
I think this issue of therapy as a relationship that involves the exchange of money effects both clients and therapists. Just this past week I was talking with a therapist about this issue, and she told me that in her entire career (over 20 years), she continually felt uncomfortable with the exchange of money. This was because she genuinely cared for her clients, and yes loved them, and the money complicated her feelings in ways she never anticipated. I have also heard a similar attitude expressed by physicians.
There is something very natural about supporting another in healing, and it is a great honor. And yet we live in a society that expects high levels of specialization, especially of healthcare workers. ‘Healing’ thus becomes a job, with all that entails in a capitalist society, including the exchange of money. Perhaps this is why so many seek out pro bono work — they hope in part to relieve the burden of having to be paid for what instinctively feels should be given freely.
I’ve heard more than one therapist speak of seeing themselves as paid for their education, their continual training, providing an office, the inherent risk of being a health professional (including legal as well as emotional risks, such as burnout), and so on, but that they are not paid for their genuine feelings for their clients. Because good therapists genuinely do care, and deeply.
I think friendships are a natural way to gain support as well as modeling for healthy relationships. In a perfect world, we would all have access to the kinds of relationships that either become secure attachments or can model the secure attachments needed when young. And yet, could there be a more imperfect world than one in which at least two-thirds have histories of adverse childhood experiences? And that the United States is a highly alienating and stigmatizing society, it becomes quickly apparent, at least to me, why there is a demand for psychotherapy as a method for healing past wounds as well as learning to feel safe in relationships.
Is there genuine love in therapeutic relationships? In good ones, I think so, but it is definitely different than a mutual relationship, as it should be, and this has its burdens for both the client and the therapist. Just as it may not feel natural for a client to pay for a supportive relationship, it isn’t natural for most therapists, as human beings, to day after day attend to others without any expectation of getting their needs met, and often supporting people with their most painful experiences. I think this issue is true of all healthcare providers, and the reason burnout is so prevalent. Yet people often don’t meet as frequently with their doctors or other carers as they do with their therapists, which may be why the issue of money and caring seems more relevant to psychotherapy. Psychotherapy is also the one field that openly claims the relationship as contributing to healing. However, the placebo effect has been increasingly shown as a central element of healing via physicians, suggesting that here too the relationship may be central to healing.
I also understand your issue with the idea of therapy as re-parenting, which frankly doesn’t appeal to me either. I think that approach pushes too much for regression and is at risk of creating a dangerous power differential between the therapist and client. Trainings such as sensorimotor psychotherapy explicitly show therapists how to work with attachment issues while supporting the client in maintaining dual awareness of both early childhood beliefs and present moment experience. Thus, the issue of attachment is addressed as part of the therapeutic process more than as part of the therapeutic relationship. And yet, I couldn’t imagine such deep work occurring without a genuinely caring therapist, who by authentically caring make possible the safe sharing of emotions.
Dear Laura and Cissy,
Looking for a photo, I stumbled on your exchange. Both your comments were so moving that I hope you’ll forgive my blurt here. I went through 3 harmful therapists before I found my current one, and for the first two years, I kept asking him the excellent, identical questions Cissy asks.
Then one day I was reading Thich Nhat Hahn’s “The Heart of the Buddha’s Teaching.” On page 5, Nhat Hahn writes of his youth in Vietnam, “I grew up in a time of war. There was destruction all around – children, adults, values, a whole country. As a young person, I suffered a lot. Once the door of awareness has been opened, you cannot close it. The wounds of war in me are still not healed. There are nights I lie awake and embrace my people, my country, and the whole planet with mindful breathing…”
Suddenly I dissolved in tears that such a leader of men could live with this terrible pain.
Then he says: “Please don’t run away from your suffering. Embrace it, and cherish it. Go to the Buddha, sit with him, and show him your pain. He will look at you with eyes of loving kindness, compassion, and mindfulness, and show you ways to embrace your suffering and look deeply into it. With this understanding and compassion, you will be able to heal the wounds in your heart…
Just as suddenly I flashed on a picture of my old therapist. Whoa, he’s a “Christian therapist,” and I’m a nice Jewish girl from Long Island — so “trust me,” as we say in New York, Dr. R. was THE furthest thing from my mind when I picked up Nhat Hahn’s book.
But now it hit me like a ton of bricks:
“Oh: Buddha!,” I said, speaking mentally to Dr. R., “This is how you look at me, this is how you create deep changes in my soul…” And then I was really bawling and calling Dr. Rs’s tape to leave a message reading him Nhat Hahn’s passage and saying, more or less, “Eureka, OK, now I get it! This is real attachment, it’s the real deal! Hey, Buddha…”
In the years since we’ve discussed it and lived it and he says it — but now I knew: Dr. R. is 100% invested in me. Not the way he’s invested in 40lks or in paying his mortgage; he could make a living an easier way. Instead, he chooses to invest his emotion s and attachment into his clients just as a dear friend would. He chooses to lay his soul out under me like a warm limbic carpet of deep emotional support, as Sir Walter Ragleigh did his cloak for Queen Elizabeth.
That takes courage and ginormous simply plain human compassion and sheer humanity.
Recently I read these words by Sir Richard Bowlby, son of the founder of attachment theory, addressing therapy for adopted children — but it goes for anyone who needs deep therapy, and it made my whole body sob:
“The …intervention …involves clinicians taping into their own empathic capacities to help children feel supported to such a degree that direct connections can be forged between the reality of children’s traumatic experiences and the parents and/or clinicians being able to tolerate their pain and so regulate the child’s distress down to a manageable level. The recognition that another person can truly understand and tolerate their pain can be a major contribution to the client’s therapeutic outcome. ” http://www.beyondconsequences.com/bowlby.html
If you consider the level of pain that I get into with developmental trauma since the sperm hit the egg, Dr. R. is tolerating hell on wheels – and that is because he did not shrink (ooooops, bad pun) from the only way to gain that skill: he has looked deeply within himself in years past, and he has done his own trauma healing as deeply as he’s asking me to do.
“General Theory of Love:” Therapy is Love
The psychiatric text “General Theory of Love,” in fact, documents that good therapy is nothing but love. The problem, they point out, is that too many therapists can’t manage it.
Human beings depends for survival on our mammalian “limbic brain,” they report. Our caregivers create our infant brain via “limbic resonance,” the resonating of an adult’s limbic brain with an infant’s limbic brain — via attuned deep eye contact. “By looking into his eyes and becoming attuned to his inner state, a mother can intuit her baby’s feelings and needs,” they write. “The regular application of that knowledge changes a child’s emotional makeup.” [FN1] More: http://attachmentdisorderhealing.com/love-theory-2/
The book’s second half demonstrates that psychotherapy works when it does, only due to love — love precisely of the above deep nature. Therapy doesn’t work when limbic resonance and love don’t flower. It’s got nothing to do with a charity date or even such foolishness as “re-parenting.”
It’s just plain and simple deep human compassion, eye to eye.
Just simple Humanity.
“When a person starts therapy… he is stepping into a somatic state of relatedness, ” they report. “Evolution has sculpted mammals… (to) become attuned to on another’s evocative signals and alter the structure of one another’s nervous systems. Psychotherapy’s transformative power comes from engaging and directing these ancient mechanisms.
“Speech is a fancy neocortical skill, but therapy belongs to the older realm of the emotional mind, the limbic brain.
“Love is not only an end for therapy; it is also the means whereby every end is reached. (p.168-9) The first part of emotional healing is being limbically known – having someone with a keen earcatch your melodic essence.” (p.170)
More quotes from “General Theory” on Therapy and Love: http://attachmentdisorderhealing.com/resources/z-under-construction/
———
FN1 Lewis, Thomas, MD; Amini, Fari, MD; Lannon, Richard, MD; “A General Theory of Love”, Random House, New York, 2000. See Dr. Lannon interviews at: http://www.paulagordon.com/shows/lannon/
Thank you for YOUR super thoughtful response.
I appreciate your perspective. I can’t imagine the burn-out in having a one-sided relationship constantly and even just to be in the constant role of relating that way must be fairly challenging given the number of hours a week a therapist must do that. Yikes.
I’d thought of the role of each but not the fact that a customer/client gets therapy for an hour or so a week but the provider/therapist is giving therapy for hours and hours and hours for many people. That’s got to be challenging.
I do hear and appreciate what you are saying. Thank you for enhancing my perspective. I like the idea of the dual awareness when it comes to the attachment work. I’ve not heard it said so well or so clearly. I’ve heard lots of people talk about the therapy itself as the healing safe space which models how relationships could or ought or might be. The people I’ve heard say it most are therapists. And it always makes me cringe a little.
It reminds me of when I worked at a shelter for homeless families as a college student and was asked to “model” parent-child interactions for the mothers.
I said to my boss social worker, “But I”m not a mother.”
She assumed, because I was in college and presumably middle class that I had more social skills, attachment, responsiveness to children or something. I said I could not imagine a parent watching me with their kid thinking, “I’m going to be more like that now that I’ve seen that way” but I could imagine a mom thinking, “She doesn’t even have a kid. What is she supposed to be showing me?”
I thought at the time, “Maybe if this mother wasn’t homeless she wouldn’t be as short with her kid so let’s speed up that house hunting process rather than probe and put her parenting under a microscope..’ I couldn’t imagine anyone living with three kids in one room who and dozens of strangers in the hall wanting her parenting assessed, judged and improved by a child-free college student assigned by a staff social worker.
I’m not saying the parents didn’t need support in their parenting but so much emphasis was put on their personal skills as opposed to realizing the stress they were under that would impede anyone’s ability to be more present, attuned and responsive.
I also wanted to add that while I feel therapy is a service and not a “real” relationship since it disappears when funds do. That does not mean I don’t think it’s provided by a “real” person with real, positive and genuine feelings about his/her work and clients. And I know some therapists have sliding scales or work out payments or in otherwise give of themselves to limit or minimize financial strain.
Thanks again for the respectful back and forth and for changing my thinking some.
As an adoptive mother who has been asked, “How much did your daughter cost?” I understand that it’s touchy when we talk about money at all in relationship to human being and human relationships. It’s not easy stuff. Money does change hands and it does make things murky. There are many ways to look at that money exchanges and some of them are always very, somewhat or maybe a little complicated.
The world is imperfect as you said.
Thanks again for your response! Cissy