Chapter 51 Regu con’t

10-12-06

Regulation continued

[Siegel talks a lot in this part about disorganization]

“The capacity to regulate the appraisal and arousal processes of the mind is fundamental to self-organization; therefore, emotion regulation is at the core of the self.  The acquisition of self-regulation emerges from dyadic relationships early in life.  Attachment studies suggest that the type of interpersonal communication that facilitates autonomous self-regulation begins with healthy dependence.  Such relationships involve sensitivity to the child’s signals, contingent communication, and reflective dialogue that permits the child to develop coherence and mentalizing capacities.  Achieving self-organization occurs within emotionally attuned interpersonal experiences.  At the emotional core of attachment relationships are the amplification of shared positive states and the reduction of negative affective states.  As these dyadic states are experienced, the child comes to tolerate wider bands of emotional intensity and shared affective communication.  (siegel/tdm/274)”  copied also into end notes on emotion  7

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“…early attachment experiences and constitutional variables such as temperament help form these emotion regulation processes.  “Epigenetic” factors – especially the social experiences that shape genetic expression and the experience-dependent maturation of the brain – directly influence how neuronal connections are established.  In early childhood, such epigenetic attachment experiences create the neuronal pathways responsible for emotional modulation.  Continuing emotional development within adult relationships can utilize the same attachment elements in helping to develop new paths to self-organization.  (siegel/tdm/274)”  copied into chapter 51 regulation

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“Lack of mental well-being may often be a result of emotion dysregulation.  This may be experienced as abrupt ruptures of emotion through the window of tolerance, such as episodes of rage or sadness, from which it is difficult to recover.  In these ruptured states, the mind loses its capacity for rational thinking, response, flexibility, and self-reflection.  Waves of intense arousal and sensations of “out-of-control” emotion such as anger or terror may flood the mind.  In these states, the individual is both internally and interpersonally unable to function.  Helping such an individual requires the development of a more effective self-organizational process.  Metacognitive processes and mental- (siegelt/dm/274) izing reflective functions may be important in the development of an integrative mode of processing, which is essential to achieve a more flexible and coherent experience.  (siegel/tdm/275)”

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“If constitutional features, traumatic experiences, or severely suboptimal attachments have produced maladaptive emotion regulation, then individuals may be restricted in their ability to achieve emotional resilience and behavioral flexibility. (siegel/tdm/275)”

“In some situations, a form of “cortical override” mechanism may be useful.  If there has been excessive parcellation (pruning) of corticolimbic structures, then the brain’s ability to modulate states of arousal may be quite compromised.  Learning to use neocortical reasoning abilities to observe and then intervene in reflexive initial dysregulatory responses is often a helpful approach.  (siegel/tdm/275)”

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HOPE FOR RECOVERY

“When people move beyond their windows of tolerance, they lose the capacity to think rationally.  This initial response may be difficult to alter if it is engrained within deep circuits, such as those encoded early in life in the amygdala.  However, the neocortex can override these responses and bring the deeper structures into a more tolerable level of arousal. This can be accomplished by any number of “self-talk” strategies in which imagery, internal dialogue and evocative memory (for example, evoking the soothing image of an attachment figure) can be activated.  Over time and with continued practice, the frequency and intensity of breakthroughs into the “lower mode” of reflexive states beyond the window of tolerance can be significantly decreased, and the speed of recovery can be greatly enhanced.  (siegel/tdm/275)”

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Self-regulation is emotion regulation

Emotion links all layers of functioning

Emotion is the essence of mind

“Why is self-regulation seen as fundamentally emotion regulation?  Emotion, as a series of integrating processes in the mind, links all layers of functioning.  In fact, the study of emotion itself is essentially the study of emotion regulation.  Though emotion can be defined as a subjective experience involving neurobiological, experiential, and behavioral components, it is “in fact” the essence of mind.  “Emotional communication” is also the fundamental manner in which one mind connects with another.  Early in life, the patterns of interpersonal communication we have with attachment figures directly influence the growth of the brain structures that mediate self-regulation.  (siegel/tdm/275)”

RECOVERY PROCESSES

“When the intensity of an aroused state moves beyond the window of tolerance, a flood of emotion may bombard the mind and take over a number of processes, ranging from rational thinking to social behavior.  At this point, emotions may flood conscious awareness.  Some have called this an emotional “hijacking,” “breakdown,” or “flooding.”  In such a situation, one’s behavior may no longer feel volitional, and thoughts may feel out of control.  Images may fill the mind’s eye with visual representations symbolic of the emotional sensation.  For example, when angry, some people may “see red” [depressed may feel blue] or visualize doing harm to the target of their rage.  They may lose control of their behavior, performing destructive acts that would not be a part of their behavioral repertoire under “normal” conditions.  In this “lower mode” of processing, the state of mind has pushed beyond the window of tolerance.  (siegel/tdm/258)”

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My mother did not have a “normal” condition.   Nothing she did regarding me was truly volitional, nor rational, nor controllable.  She was hijacked all of the time, and she lost control of her behavior “performing destructive acts” nearly all the time toward me – even when I was an infant.  She was in “lower mode” processing” – yet what pushed her into a state of mind “over the edge” is what I am exploring as I explore my own states of mind.

I now feel most of the time that the intensity of my own emotions are nearly “beyond the window of tolerance.”  I almost feel like I would like to not feel much of anything at all.  I suppose I don’t really feel more than most people, but I seem to be very conscious of what I feel, am very sensitive, and the intensity of my feelings is intense!

I also lack the feeling of “feeling felt” and cannot offer anyone else that feeling, either.  I don’t know yet how this is connected, unless it has to do with the fundamental dissociation I experienced since birth and still have.  This failure to attach, this inability to attach.

I was thinking, if I dropped something round, say a marble, onto a smooth floor and it began to roll, I would not necessarily have any control over its direction or where it ended up.  Or, say, a coin fell on the floor on its edge so that it could roll – again, I would have no control.  Is this sense of “no control” part of the fundamental conditions of this condition?  This disorganized attachment?

We cannot “read” another person’s mind if our own is in disconnected, dissociated fragments.  Therefore (evidently) we have no hope of “feeling felt” or giving it in return.

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“…emotion, meaning, and social interactions are mediated via the same circuitry in the brain.  Information in the brain is not handled independently of the biological reality of how the brain is in fact structured.  For example, within the convergence of zones of one of the central regions of emotional processing, the orbitofrontal cortex, we can see the way in which brain structure shapes mind function.  In this neural region, inputs from anatomically distinct areas converge:  Neural firing patterns transmitting the “information” from these regions are directly sent to the orbitofrontal cortex.  This information includes social cognition, autonoetic consciousness, sensation, perception, various representations such as words and ideas, somatic markers representing the physiological state of the body, and the output of the autonomic nervous system (which allows for “affect regulation” via the balancing of sympa- (siegel.tdm.258) thetic and parasympathetic branch activity).  As we’ve discussed earlier, the capacity to respond adaptively to the personal significance of an event, not merely with an automatic reflexive reaction, may require both the capacity for response flexibility as well as its integration with these other prefrontally mediated processes.  (siegel/tdm/259)”

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I would think that this ability “to respond adaptively to the personal significance of an event” would have something to do with the goal directed states of mind – not that even the goal directed states themselves are necessarily “healthy” – but nonetheless, are probably present somewhere – even if they are disconnected dissociated states of mind.  At the very least, and at the very “bottom” reactions would be about survival – even if the value systems themselves are skewed by previous attempts to adapt to the impossible situations of infant peritrauma from chronic abuse.  They would be about competition for resources needed (or perceived to be needed) for survival.  Basic approach-avoid.

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“In states of excessive arousal, it has been suggested that the “higher” processing of the neocortical circuits is shut down, and that the direction of the energy flow within the brain and especially within the orbitofrontal regions is determined more by input from the “lower” processing centers of the brainstem, sensory circuits, and limbic structures than by input from the cortex.  In this way, the beyond-the-window-of-tolerance state of hyperarousal leads, neurologically, to the inhibition of higher perceptions and thoughts in favor of the dominance of more basic somatic and sensory input.  In this situation, we don’t think; we feel something intensely and act impulsively.  [right brain dominance/imbalance?]  What this means is that an individual who enters a state outside the window of tolerance is potentially in a “lower mode” of processing, in which reflexive responses to bodily states and primitive sensory input are more likely to dominate processing.  (siegel/tdm/259)”  [What does he mean by “primitive sensory input?”]

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I remember seeing my mother’s face change, her eyes change, her voice change, as if she became transformed into a monster – or a demon – or an animal.  And yet, this must be what Siegel is describing, the “lower mode” or primitive reflexive response that really does come from our “older” brain.

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++ When a person goes beyond the boundaries of their window of tolerance, and enters a state in which self-reflection, thinking about their emotions, achieving some distance from reflexive reactions, and considering other options for behavior beyond immediate impulses are not possible.

“All of these are thought to be cortical processes that are likely to shut down when a person is emotionally flooded in the state beyond the window.  (siegel/tdm/259)”

GETTING SOME TOOLS

++  important to learn the boundaries of their window of tolerance — is a first step in trying to avoid “out-of-control” states

++  learning and identifying “the points at which interactions with others” begins to “generate intense responses” in their mind that move them “to the edge of control”  [before they go past it – for me, just being in situations with people is a trigger!]

++  become aware of the state of one’s body (tension in muscles, tightness in stomach and throat) and the sensing of images of anger [or other emotions such as fear] in one’s mind are the first stages in gaining some sense of control over emotional outbursts.  [How is having a “sense of control” related from the beginning to “belonging” through attachment?  We lack a “sense of control” if our own selves and states of mind are disconnected and dis-associated from one another!]

++  Prevention of the ruptures through the window of tolerance can be most helpful

++  So is learning techniques for increasing the speed at which one can recover, once they are outside of the window – repair

++  when able to work with a therapist one can be in the state of hyperarousal

++  can then pay attention to internal state and external dialogue [external constraint]

++  can learn to reflect on nature of own mental processes

++  can picture one’s circuits with “an excessive flooding of activity” (siegel/tdm/262)

++  can notice tense muscles contributing to feedback of mind on presenting emotions

++  can begin to explore how present state connects to memories of past [often many implicit – in fact, much of what siegel seems to be describing here does sound like flooding of implicit memory]

++  when able to explore past connections to the aroused state and its emotions can focus experience in a different way

++  can learn to enhance recovery process by learning to use the energy flow and information processing of one’s mind

++  can use relaxation and imagery to “lower the energy of her circuits & tension in body

++  can strengthen metacognitive cortical capacities and make them more accessible during the hyperarousal in ways not possible before by reflecting in present on own internal processes

++  if the ability of metacognition is lacking one must make it a conscious part of processing of intense emotions – after a time of using these new capacities, which need to be first initiated intentionally and with mental effort, might become more automatic and “not require as much exertion of conscious effort.”  (siegel/tdm/267)

++  pay attention to what the focus of attention is BEFORE emotion bursts through the window of tolerance

++  become “sensitive to the subtle sensations of primary emotions long before they [are] elaborated into categorical states that so often burst through” the window of tolerance  (siegel/tdm/268)

++  these primary sensations allow one to become aware of what is arousing [in the present and from the past] to them

++  they also permit a reflection on how specific meaning of an interaction and the dual layers of appraisal of its significance in the moment and its parallel to historical meanings

++  important step is to associate primary emotions with consciousness

++  “Conscious awareness of emotional processes is always a beginning.”  (Siegel/tdm/268)

++ “ metacognitive analysis of the meaning of these interactions and emotional experiences” (siegel/tdm/269)

++  recognize that something “significant” is occurring

++  “connect (that is, to note similarities and to work with generalizations within working memory) the recurring themes” (siegel/tdm/269) of present with those from the past

++  examine meaning of these representations and compare to those of past to find the “nonconscious linkage in the past [that] had created an explosion.”  (siegel/tdm/269)

++  conscious reflection can see same comparison, but permits different outcome

++  identify what retrieval cues are reactivating past states  (synaptic memory process)

++  consciously add the dimension of metacognition  (“I am not a slave to the past – I recognize what is happening here and I can react in a different way.”)

++  “In both the individual and social feedback processes, regulating external expression of an internal state can help to keep the state of arousal from breaking through the window of tolerance.  (siegel/tdm/271)”  masking internal state

“Instead of nonconscious, reflexive response, consciousness permitted response flexibility and a more adaptive reaction.  By acquiring the ability to reflection the relationships among past, present, and future, this patient was developing her capacity for autonoetic consciousness.  She could choose not to become explosive.  She could decide that what was best for her was to alter her initial impulses and try to achieve her professionals goals in a more productive manner.  (siegel/tdm/269)”

++  the feeling of stopping an outburst is exhilarating

“This allowed her to consciously alter her bodily response by reducing the somatic marker feedback that was automatically reinforcing the cascading cycle of appraisal and arousal.  This clearly allowed her to alter the flow of activation (energy) through her mind.  (siegel/tdm/269)”

“Metacognition gives the developing minds of children (and adults) the ability to perform a number of unique processes:  thinking about thinking itself; forming a representation of one’s own mind; becoming aware of sensations, images, and beliefs about the self; and reflecting on the nature of emotion and perception.  (siegel/tdm/267)”

++  encourage self-reflection

++  blockage in information processing and inhibition in flow of energy can become more adaptive states of mind

++  capacity for emotion regulation and thus for self-regulation can become more flexible and more effective

++  will then enter these hyperaroused states less often and recover from them much more quickly

++  “…consciousness can permit two fundamental elements of emotion regulation:  the modulation of the flow of activation or energy through the brain, and the adaptive modification of information processing.  (siegel/tdm/266)”  copied from chapter 52 reg con’t

“The band of tolerable levels of activation of the autonomic (siegel/tdm/281) nervous system – of either the sympathetic or parasympathetic branches – may vary widely among individuals.  Movements beyond this window of tolerance, in either the sympathetic or parasympathetic branch direction, may be accompanied by diminished ability to function in an adaptive and flexible manner.  Neither excessive, nonregulated arousal (sympathetic activity) nor excessive inhibition (parasympathetic activation) is healthy for the development or the ongoing function of the brain. (siegel/tdm/282)”  copied from prenotes ch 44 child’s brain

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“When a patient has a history of disorganized attachment, the therapist is faced with the especially crucial challenge of providing the essence of a secure attachment:  a predictable emotional environment in which the patient can learn to depend upon the therapist for regulating state shifts.  [external constraint]  The therapeutic relationship and the dyadic self-regulation subsequently become “internalized” through the development of a mental model of the self with the therapist and through the acquisition of new capacities for autonomous emotion regulation….achieving this new level of self-organization is often facilitated by an integrating narrative process which facilitates a deep sense of internal coherence.  (siegel/tdm/294)”

REPAIRING THE RUPTURES

“Micromoments of misattunement”  (siegel/tdm/292)

“Recovery means decreasing the disorganizing effects of a particular episode of emotional [over] arousal.  (siegel/tdm/260)”

“How does the mind ever recover from this state of suspended cortical processing and thinking about thinking (metacognition)? The recovery process may vary from person to person, again depending on present context, constitution, and personal history.  Certain states (siegel/tdm/259) may be easier to recover from than others; specific contexts may activate a particular cluster of neural net profiles [states of mind] from which it is especially difficult to recover, whereas others may be more readily repaired.  For example, if a person feels betrayed by a close friend who has never been suspected of being disloyal, then recovering from a flood of anger and sadness may be particularly difficult.  On the other hand, being let down by an acquaintance of dubious reliability may create anger that is relatively easy to bring back into the window of tolerance.  (siegel/tdm/260)”

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(all one paragraph)

“Recovery means decreasing the disorganizing effects of a particular episode of emotional arousal.  Recovery may be a primary physiological process in which appraisal mechanisms bring the degree of activation to tolerable levels.  This modulation may involve a dampening in the intensity of arousal, as well as a restriction in the distribution of neuronal groups activated within the state of mind at that time.  [Sounds like a “limitation” process.]  Recovery may also involve the reactivation of the more complex and abstract reasoning that the cortex mediates.  This will then allow for the metacognitive processes of self-reflection and impulse control.

“The capacity to reflect on mental states and to integrate this knowledge about the mind of others and of the self may be important in enabling this aspect of emotion regulation.  These reinstated cortical processes in part may help by altering the characteristics of the elaborated emotion and permitting an individual to begin to tolerate levels of arousal that previously would have been flooding.  For example, the person engulfed in rage at a close friend may find that activating old memories of the friend and engendering a feeling of loss and sadness may allow the characteristics and intensity of this emotional experience to be transformed. For some, sadness is more easily tolerated than rage [and probably a great deal less dangerous!].  (siegel/tdm/260)”

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This is asking a lot of those of us who are disassociated.  We are lacking the “capacity to reflect on mental states” including our own from the beginning.  And if we can’t do this, how can we “integrate this knowledge about the mind of others and of the self,” especially if we don’t really even have a self?  How do we get “enabled” to be able to do these “tasks” in the first place when we missed those developmental brain-mind-self stages through disorganized attachments?

Again, like the “restoring me to sanity” thing when one has never been sane in the first place, how do we reinstate cortical processes that we have never adequately had in the first place, so can’t reinstate them?  This is NOT just semantics!!

But if this is the goal — altering the characteristics of the elaborated emotion and permitting an individual to begin to tolerate levels of arousal that previously would have been flooding – to allow the characteristics and intensity of this emotional experience to be transformed – maybe there is a way we can work around our dis-abilities to get to this same end point:  TRANSFORMATION of an emotion and the state of arousal created by it and in relationship to it.

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“Some individuals have extreme difficulty recovering from emotional flooding of any sort.  For these people, life may become a series of efforts to avoid situations that evoke strong emotional reactions.  These avoidance maneuvers are defensive, in that they are attempts to keep the individuals’ systems in balance.  For those whose windows are quite narrow for certain emotions, such avoidance behaviors can shape the structure of their personalities and their ways of dealing with others and the world.  If recovery processes are unavailable, then such individuals become prisoners of their own emotional instability.  (siegel/tdm/260)” copied to study this 7

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It is natural to “avoid pain,” and so this reaction would also be a natural one for those with very real limitations.  It would possibly be true that those with avoidant attachment histories would be really good at avoiding.  [What happens to those who, along with the disorganized babies, also exhibited more dissociative behaviors than normal pre adolescence?  Where did those behaviors go when they got older?  Siegel does not say.]

Is this a judgment on Siegel’s part?  It feels like it to me.  Like we are supposed to feel humiliation and shame at our inadequacies that were GIVEN to us and CREATED within us?  Fine for him to say – infant abuse didn’t happen to him!

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“Therapy includes various aspects of an attachment relationship, as well as the co-construction of stories, bearing witness, teaching, and role modeling for patients….Giving her a conceptual framework for how her emotions worked and influenced her experience of herself and interactions with others was vital in allowing her not to feel “accused” of being defective.  The shame sate involves a sense that something is wrong with the individual, and this emotion is often at the root of why patients have not developed the ability to relect on their own contribution to their troubles.  They may have an inner belief that they are defective, and they seek to hide from revealing this “truth” to others.  (siegel/tdm/268)”

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I still don’t feel convinced that Siegel isn’t “shaming” those of us who “don’t know better” or “can’t do it better or right.”  It is like the split archetype in “Power in the Helping Professions.”  As long as the therapist is seen to be the expert, power is out of balance – and things are out of balance enough to start with!  Or is it humiliation?

But how is this not the wisest course in many situations?  It is not only — prisoners of their own emotional instability – it is our disabilities and our inabilities.  And very real ones they are!  Again, what do they think happens to us who were so terribly abused as infants?  NOTHING?  There ARE consequences, and this is part of it.  Also, not avoiding the “triggers” can also create our criminals, who act out from outside their windows.  How much better that one at least be aware of the limitations and take protective cautions?

I am not talking about “any of us.”  I am talking about the most abused and hence damaged – I suppose, about the “other” “us.”

Above he says “Recovery means decreasing the disorganizing effects of a particular episode of emotional arousal” – note the disorganizing effects part – it fits in and is important as we are talking about disorganized attachments.  We were forced into “prolonged states of disorganization.”  Siegel’s insistence that they are “ineffective” really does puzzle me.  Weren’t they the only means of adaptation that we had at our disposal?  And didn’t they form our brain’s structure and circuitry?

It sounds as though he is critical, and CRITICIZING these “adaptations” to our “impossible situation” as we tried to solve the “unsolvable problem” of our infant abuse.  Those of us who were faced with the “paradoxical injunction” from the time of our birth were put into the position of not having any way to adapt in an “organized” way to our peritrauma.  We must ALL realize this fact, fundamentally!  We were pushed “beyond the boundaries of our windows of tolerance” from the time of our birth.

We had no possibility of RECOVERY then.  Recovery was not one of the options we were given.  That is what made us disorganized in the first place!  We did the best we could do, and we still are!  So don’t demean us, or diminish us by placing us in the category of “any of us.”  We are not the same as you!

I feel like I am facing the monster eye to eye, nose to nose, and its breath stinks!  Yes, our original condition was HARMFUL to us.  Fundamentally harmful.  And yes, that does put us in the position of conflict, trying to live any life at all, let alone one that is not “potentially harmful to ourselves and others.”

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“Emotions are central in the self-regulation of the mind.  It is inevitable that at times emotional arousal will be too much for any of us to (siegel/tdm/260) tolerate.  At these moments, the flood of emotions without an effective recovery process will result in prolonged states of disorganization that are ineffective and potentially harmful to ourselves and others.  (siegel/tdm/261)”

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IMPORTANT

This would be healing —

“Recovery allows us to move back within the boundaries of our windows of tolerance and to “push the envelope” but not to break it.  In essence, recovery allows the self-organization processes of the mind to return [here is “return” again – when we never had it in the first place] the flow of states toward a balance that maximizes complexity, moving the system between the extremes of rigidity on the one side and excessive randomness on the other.  The system becomes more adaptive by tuning itself to both internal and external variables in a more flexible manner, thus enhancing complexity, which allows the mind to achieve stability.  (siegel/tdm/261)”

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“How can recovery occur?  Looking toward the two fundamental elements of the mind – energy and information – can help us to answer this question.  (siegel/tdm/262)”

“ideas about windows of tolerance, emotions, memory, and states of mind….how [our] own mind [betrays us]

hyperaroused, beyond-the-window states.

“Now entered the crucial elements of change.  Within these states in the therapeutic session, her experience (siegel/tdm/261) of being “out-of-control” was joined by the reflective and supportive dialogue with her therapist.  She was able to listen in her agitation, but remained hyperaroused.  However, she now had two objects for her attention – her internal state and the external dialogue.  As time went on, she was able to begin to reflect on the nature of her own mental processes.  She could picture her circuits with an excessive flooding of activity; she could notice her tense muscles contributing to the feedback to her mind that she was furious; and she could begin to see how the deadline error meant something to her and her past, beyond what the colleague and the mistake in reality were about.  (siegel/tdm/262)”

“This woman learned to enhance her recovery processes by learning to use the energy flow and information processing of her mind.  Therapy allowed her to experience emotionally flooded states, and within that state of mind, she was then able to apply her newly acquired abilities.  She could use relaxation and imagery to “lower the energy of her circuits” and the tension in her body.  Her metacognitive cortical capacities were strengthened and made more accessible during her rages in ways that were not possible before.  Such capacities allowed her to use previously inhibited pathways during this state of mind to alter the way she processed information.  What had been a blockage in information processing and an inhibition in the flow of energy now became more adaptive states of mind.  Her capacity for emotion regulation, and thus for self-regulation, became more flexible and more effective.  She could say to herself, “This interaction is more about my feelings of shame than about my colleague,” and focus her experience in a different way.  The overall result, fortunately, was that in addition to entering these states less often, she learned that she was able to recover from them much more rapidly.  The effect was to give her a deeper sense of stability and clarity than she had ever had before.  This was just the beginning for this woman.  Her next step, of course, was to work on getting new clients and establishing meaningful relationships with others in her life.  (siegel/tdm/262)”

REPAIR

“Missed opportunities for attunement and misattunements, whether these occur in psychotherapy, parenting, or other emotional relationships, are unavoidable.  Unless repair of these disruptions in attunement is undertaken, toxic senses of shame and humiliation can become serious blocks to interpersonal communication.  [remember this from prenotes chp 44 child brain: “Shame is different from humiliation.  Shame-inducing interactions coupled with sustained parental anger and/or lack of repair of the disconnection lead to humiliation, which Schore has proposed to be toxic to the developing child’s brain. (siegel/tdm/280)”]  These dreaded states are not merely uncomfortable and disliked; they can feel like a black hole, a bottomless pit of despair, in which the self is lost for what seems to be forever.  Repair requires the recognition that a rupture has occurred in the attunement process, and then the realignment of states between the two individuals involved.  The repair process is an interactive one, requiring the openness of both people in attempts to reconnect after a rupture.  (siegel/tdm/291)”  [For those of us with disorganized or other insecure attachments, I would think this would be especially threatening because we have a history of a whole lot of ruptures and no repair!  How would we even believe repair was possible?]

“The public self strives to avoid the dreaded states of shame and humiliation; it scans the social environment for clues of connection, but is often unable to prevent the activation of these states.  The anxiety accompanying the emergence of these dreaded states into one’s consciousness can induce defensive adaptations.  (siegel/tdm/291)”

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Micromoments of misattunement

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ACCESS TO CONSCIOUSNESS

“As our appraisal mechanisms operate and as our primary emotions are differentiated into categorical ones, our minds are influenced by our value systems in every aspect of their functioning. These influences occur without the necessity of conscious awareness.  The idea (siegel/tdm/262) presented in this book is that emotion is a central set of processes directly related to meaning, social communication, attentional focus and perceptual processing.  Emotion is not just some “primitive” remnant of an earlier reptilian evolutionary past.  Emotion directs the flow of activation (energy) and establishes the meaning of representations (information processing) for the individual.  It is not a single, isolated group of processes; it has a direct impact on the entire mind.  (siegel/tdm/263)”  copied to study this 7

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++  “conscious self” is small part of mind’s activity

“Perception, abstract cognition, emotional processes, memory, and social interaction all appear to proceed to a great extent without the involvement of consciousness….  These “out-of-awareness” processes do not appear to be in opposition to consciousness or to anything else; they create the foundation for the mind in social interactions, internal processing, and even conscious awareness itself.  (siegel.tdm/263)”

++  most of mind is nonconscious – nonconscious processing influences behaviors, feelings, thoughts & “impinge on our conscious minds:  we experience sudden intrusions of elaborated thought processes (as in “Aha!” experiences) or emotional reactions (as in crying before we are aware that we are experiencing a sense of sadness).  (siegel/tdm/263)”

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“So we can say that for the most part, the self is not divided by some line between a conscious and a nonconscious self.  Rather, the self is created by nonconscious processes, as well as by the selective associations of these processes into something we call “consciousness.”  To put it another way, we are much, much more than our conscious processes.  (siegel/tdm/263)”

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“…when processes become linked within consciousness, they can be more strategically and intentionally manipulated, and the outcome of their processing can be adaptively altered.  Consciousness may allow us to become free from reflexive processing and introduce some aspect of “choice” into our behavior.  (siegel/tdm/263)”

[Allows, then, for problem solving – looking for alternatives – considering alternatives – making decisions]

“…a process made conscious can be directly shared across individuals, and the outcome can be strategically altered.  The strategic manipulation, the introduction of choice, and the sharing of information are made possible by consciousness.  (siegel/tdm/264)”

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WORKING MEMORY AND SELF-REFLECTION

“Consciousness is important for focal attention and working memory, which allow information to be processed into long-term explicit memory storage…working memory is considered the “chalkboard of the mind”; it allows us the ability to reflect on several (seven, plus or minus two) items simultaneously.  Such reflection allows us to manipulate these representations, to process them (for example, to note similarities and differences, create generalizations, and recognize patterns), and to create new associations among them. Working memory allows self-reflection and creates cognitive “choice.” In other words, it introduces the possibility of personal intention and strategic, deliberate behaviors that are independent of automatic reflexes.  (siegel/tdm/264)”

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“Appraisal processes, operating even without consciousness, recruit new neuronal groups into their active state of mind.  The addition of consciousness to such a recruitment effort permits further mobilization of a new set of processes:  Consciousness allows for the manipulation of representations in new combinations within working memory….Consciousness involving (siegel/tdm/269) the linguistic system and autonoesis allows for reflections on the past and future moving us beyond the lived moment.  We are also able to be motivated by our awareness of emotions, which then facilitates more strategically focused achievements that are not likely without the involvement of consciousness.  (siegel/tdm/270)”

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What, exactly, did I focus my attention on when I was a child experiencing abuse?  What was in my “working memory?”  Not self-reflection.  I had no self-reflection and I had no awareness of CHOICE.  I did not have PERSONAL INTENTION and only very minimally did I have strategic, deliberate behaviors that are independent of automatic reflexes.

This is an important mystery & puzzle to be solved as I write this book!

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“At the most fundamental level…consciousness involves the selective linkage or binding of representations, which then can be intentionally manipulated within working memory.  The idea of intention is itself a philosophical puzzle.  What we can say is that with consciousness, new information can be introduced or new manipulations can be attempted within the mind for a strategic purpose that is determined by the individual.  Consciousness itself is not necessary for information processing, but it is necessary at times to achieve new outcomes in such processing.  (siegel/tdm/264)”

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My mother made sure from my infancy that I did not retain any semblance of a “mind of my own.”  She was the great “deliberator” of my existence.  Her assessments of me and of everything about me [as noted before] permeated my entire being and existence.

It seems that perhaps she even controlled my “working memory.”  I was not allowed to be “intentional” or to manipulate anything.  I became some sort of passive ameba that was completely dependent upon her in a hideously ugly destructive way.

“with consciousness, new information can be introduced or new manipulations can be attempted within the mind for a strategic purpose that is determined by the individual” (siegel/tdm/264) —  I was not a self-determined or self-determining individual!  It is very hard to track this mercurial formation of my self that was not a self.  I was a vaporous self, an amorphous self, and invisible and intangible self.  I had no consciousness, and there was neither new information available to me, nor any hope of achieving “new outcomes” through any kind of self-processing.

So was I unconscious, or was I dissociated or was I dis-associated from my own working memory – from the my own experience of my own experience of my own life as a child (until I left home at 18)?

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“… emotional processing – the initial orientation, appraisal, arousal, and differentiation mechanisms [of emotion] usually occurs without consciousness.  An individual’s consciousness of these processes allows for the qualitative sensation of emotion  (siegel/tdm/264) ….”Feelings” can therefore involve energy, meaning, behavioral impulses, or the discrete categories of emotion.  (siegel/tdm/265)” copied to emotion notes 7

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“The ability to involve conscious processing with something as fundamental as the creation of meaning, social relatedness and perceptual processing certainly does give the individual an increase in the flexibility of response to the environment.  Having a consciousness of emotions is especially important in the social environment.  Without it, we are likely not to be aware of our own or other’s intentions and motives.  Awareness of emotional processes has a value for our survival as a social species:  We can know our own minds as well as those of others, and can negotiate the complex interpersonal world with increased skill and effectiveness at meeting our needs.  (siegel/tdm/265)”  copied to study this 7

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I did not have this, either: “Having a consciousness of emotions is especially important in the social environment.  Without it, we are likely not to be aware of our own or other’s intentions and motives.” (siegel/tdm/265)  It was like being in a forbidden zone – forbidden to read the horrible and horrifying mind of my mother, to read my own mind, to read anybody else’s mind.

I don’t think my own emotions developed correctly, either.  I don’t think that I was able to achieve proper, organized differentiation of my own emotions, and probably not consciousness of them, either.

And as per below, without consciousness – or without an adequate access to it, effective processing within consciousness would not be possible – as with dissociation, as with disorganization of the mind, the integrative process would be impaired.

Dissociation:  impairment due to blockage of flow of energy and information within the mind and between states of mind [my thoughts]—no “coordination of mental processes and response (see below) – no executive function to “direct the integrated flow of energy and information”

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RESPONSE FLEXIBILITY AND ATTENTION

“Recall that consciousness may involve an integration of distributed neuronal activities that achieves a certain degree of complexity.  Effective processing within consciousness can thus be seen as the furthering of such an integrative process.  Consciousness is more than the mere activation of representations in working memory that have become linked via the thalamocortical system and the lateral prefrontal cortex.  Active, executive functions that direct the integrated flow of energy and information – possibly mediated also by nearby regions such as the orbitofrontal cortex and anterior cingulated – play an important role in the coordination of mental processes and response.  (siegel/tdm/265)”

(same paragraph con’t)

“For example, Nobre and colleagues suggest that recent findings regarding the orbitofrontal cortex indicate that its activity may be important in “inhibiting prepared motor programs” and in “the tasks of motor selection and preparation requiring withholding of responses.  The orbitofrontal cortex participates both in the redirection of the response based upon a violation in stimulus contingencies and in possible changes of emotional state….Activity in the orbitofrontal region is recruited as stimulus contingencies change, interacting dynamically with the basic neural-cognitive system that directs attention.  The anatomical connections of the lateral orbitofrontal cortex support this ability.”  [this is the contained quote he has here from Nobre]  Earlier we have called such a capacity “response flexibility” and have suggested that such a process may be an important element in self-regulation (siegel/tdm/265) and in the behavioral and attentional flexibility seen in the contingent, collaborative communication and coherent adult narratives revealed in secure attachments. (siegel/tdm/266)”

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Where was my ATTENTION?  Doesn’t our ATTENTION grow and develop from infancy – and in normal circumstances, continue growing as in a FLOW – like of states?  With dissociation, where is ATTENTION?

Attentional flexibility – this would be disturbed in disorganized attachment, and would contribute then [my thoughts] to dissociation and to an incoherency in adulthood

Deprived even of access to my own working memory, so that my own attentional focus was disturbed from infancy, how could my life be coherent?  It wasn’t, it was (and is) fragmented.

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“What role does consciousness itself play in the regulation of emotion?  Consciousness can influence the outcome of emotional processing. Conscious awareness allows for self-reflection, which can enable the mobilization of strategic thoughts and behaviors and can therefore enhance the flexible achievement of goals.  This can be seen as the achievement of new levels of integration. … Given the fundamental role of the appraisal system in distinguishing what is good and should be approached from what is bad and should be avoided, emotions being accessible to parts of cognition that can consciously mobilize behavior can be crucial in having emotion be effective in certain adaptive ways as a value system. Consciousness allows emotion to play a more adaptive role in the individual’s behavior.   (siegel/tdm/266)”  copied from chapter 52 regulation con’t to study this 7 and emotion notes 7

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I had no goals growing up – no sense of time, consciousness or self-reflection, either.  All I could do as I got older was to cooperate with the beatings in such a way that I could evade life threatening blows or directional falls to avoid being killed.  NOW THAT is some “flexible achievement of goals!”  That was about it for my “mobilization of strategic thoughts and behaviors.”

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“…consciousness can permit two fundamental elements of emotion regulation:  the modulation of the flow of activation or energy through the brain, and the adaptive modification of information processing.  (siegel/tdm/266)”  copied to chapter 51 regu con’t in the “how to” part

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THERAPEUTIC RELATIONSHIPS AND HEALING

“Studies suggest that the orbitofrontal cortex remains plastic throughout life; that is, it is able to develop beyond childhood.  The orbitofrontal cortex mediates neurophysiological mechanisms integrating several domains of human experience:  social relationships, the evaluation of meaning, autonoetic consciousness, response flexibility, and emotion regulation.  (siegel/tdm/285)”

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All one paragraph

“…interpersonal relationships can provide attachment experiences that can allow similar neurophysiological changes to occur throughout life.  In extreme cases of trauma, such as neglect or abuse, the deeper structures of the brain may be impaired to such a degree that improvement may be difficult to achieve.  Even in these situations, however, the principles learned from attachment research may perhaps still prove useful in organizing an approach to help people adapt to life’s stresses.  [Organize an approach to help the disorganized organize themselves – or reorganize themselves.}  “Studies suggest that the orbitofrontal cortex remains plastic throughout life; that is, it is able to develop beyond childhood.  The orbitofrontal cortex mediates neurophysiological mechanisms integrating several domains of human experience:  social relationships, the evaluation of meaning, autonoetic consciousness, response flexibility, and emotion regulation.  (siegel/tdm/285)”

“In many cases of disorganized attachment and clinical dissociation, for example, therapeutic relationships can facilitate effective movement toward well-being and adaptive self-regulation.  “Studies suggest that the orbitofrontal cortex remains plastic throughout life; that is, it is able to develop beyond childhood.  The orbitofrontal cortex mediates neurophysiological mechanisms integrating several domains of human experience:  social relationships, the evaluation of meaning, autonoetic consciousness, response flexibility, and emotion regulation.  (siegel/tdm/285)” [deeper structures of the brain did not develop well]  copied also to dissociation notes 6

“In less extreme cases, the deeper structures of the brain may have developed well, but the states of mind that have been engrained may be maladaptive.  For these people, therapy may help to move the systems of their minds toward more adaptive modes of processing information and regulating the flow of information.  (siegel/tdm/285)”  above 3 copied also to dissociation notes 6

“Sometimes specific techniques within a psychotherapy relationship are needed to alter engrained patterns of emotion dysregulation.  The patient-psychotherapist relationship may provide a sense of proximity, a safe haven, and an internal model of security.  These elements of an attachment relationship, within therapy or other emotionally engaging relationships such as romance and friendship, may possibly facilitate new orbitofrontal development and enhance the regulation of emotion throughout the lifespan.  (siegel/tdm/285)”  above 4 copied also to dissociation notes 6

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“In therapy, the child was encouraged to look at the therapist’s face.  Her parents and teachers were counseled about the nature of attachment social referencing, and the use of face-to-face communication in the development of emotion regulation.  The impairment in her vision, now corrected, was offered as a working hypothesis for why this girl exhibited such social difficulties.  Over a period of several months of intervention, she began to look more frequently at others when she spoke.  In play, she engaged more in identifying dolls’ internal states, and their emotions become a more active part of the stories that unfolded in therapy.  With the development of these capacities for facial perception, “theory of mind,” and social referencing, she began to engage more appropriately in social interactions.  The use of reflective dialogue – talking about feelings, thoughts, memories, beliefs, and perceptions – in conjunction with the nonverbal face-to-face communication enabled her to develop previously unstimulated abilities in her mind.  Her ability to regulate her emotions seemed to improve:  Her explosions became less frequent and less intense, and her impulsive behavior diminished significantly.  One could hypothesize that each of these developmental accomplishments was mediated by the interactive maturation of her orbitofrontal cortex.  (siegel/tdm/286)”

“The use of this approach allowed this child to take in the vital information of other people’s minds instead of living in isolation, where her frustration level was high and her behaviors appeared “impulsive” because they were so independent of the signals and needs of others.  (siegel/tdm/287)”

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“In some cases of engrained patterns of dysregulation – due to a number of combinations of constitutional and experiential factors – psychiatric medications may be needed to help the brain achieve the capacity to regulate the flow of states of mind, through direct biochemical effects that alter the synaptic strengths determining the internal constraints of the system….It may be the case that certain individuals – whether because of genetic factors, early traumatic experiences, or some combination of inherited vulnerability and stressful environmental conditions – have developed such maladaptive brain structures and self-organizational capacities that intensive psychotherapy and/or medications are essential.  It is important to keep in mind, however, that the limbic regions of the brain (especially the orbitofrontal cortex) may continue to be open to further development throughout the lifespan, and thus remain open to experience-dependent maturational processes.  Psychotherapy can utilize this potential in helping facilitate the further development of the mind. (siegel.tdm.295)”

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BRAIN PLASTICITY

“Central to this integration is emotion…. (siegel/tdm/306) emotion is inherently an integrative function that links internal processes and individuals together.  This view reinforces the central role of emotion in self-regulation and in communication within interpersonal relationships….  (siegel/tdm/307)”
”Emotionally meaningful events can enable continued learning from experience throughout the lifespan.  Such learning may be seen as, in effect, the ongoing development of the brain.  Experience plays a primary role in stimulating new neuronal connections in both memory and developmental processes.  Findings from neurobiology suggest that such development may continue to some degree throughout the lifespan.  (siegel/tdm/307)”

same para con’t

“In particular, the neural circuitry facilitating integration may also continue to develop throughout life.  Those neurons that serve to coordinate information from distributed regions may continue to develop perhaps with genetic programming, with the inherent mechanisms of aging, and with specific forms of experience.  [gaining wisdom – an evolutionary programmed process that leads from embryo to old age.}  (siegel/tdm/307)”

“For example, in studying the progressively increasing myelination across the lifespan in the hippocampal pathways that interconnect widely distributed regions….[quote he puts here from Francine Benes) (siegel/tdm/307)  …In this manner, experiences and innate developmental processes may allow our neural capacity to integrate an array of processes to continue to develop throughout our lives. The mechanism of this differentiation of circuits…may involve a range of processes from the growth of axons into widely distributed regions of the brain, the establishment of new synaptic connections, and the increased conductance of nerve fibers via their increased myelination.  These mechanisms may be at work in the dramatic maturation of the corpus callosum during the first decade of life, and perhaps, we can propose, in its possible ongoing development throughout life.  (siegel/tdm/308)”  copied into brain notes 8

“The movement toward such integrating neural connections is consistent with complexity theory:  highly differentiated and functionally linked subsystems maximize the complexity achievable by the system.  In this manner, it may be a natural developmental outcome for increasing levels of differentiation and integration to occur across the lifespan.  One outcome of such a process for some individuals, we can imagine, might be the development of wisdom with age.  The capacity to “see the forest for the trees” may emerge from an integrative capacity to focus on patterns over time and across situations rather than on the details of particular events.  (siegel/tdm/308)”

same para

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EXTERNAL EXPRESSION

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MASKING THE INTERNAL STATE

“The self is capable of at least two contextual states:  a private, inner, core self and a public, external, adaptive self.  Some authors have used the parallel notions of a “true” and a “false” self.  [This is like the conversation I had with Cindy H where she said the public self she has is not false, just adaptive…]  This terminology, however, suggests that it is somehow false to adapt to social requirements; instead, it may be more useful to accept that different contexts evoke different states in each of us.  [Or should evoke them – for me it is very hard to be public and what feels to me, false]  Repeated patterns of social interactions can make a specific state, such as the masking of internal emotions from the outer world, an important adaptation. There is nothing “false” about a mechanism of survival.  However, if the brain often relies on the expression of emotion as a signpost of what the individual truly feels, then this masking process certainly can create a challenge to knowing one’s “true” response.  (siegel/tdm/271)”

“The regulation of emotional expression may assist the mind in modulating its states of arousal by social and intrapsychic mechanisms.  [1] Socially, masking internal states can permit the individual to avoid an experience of interpersonal resonance, in which the contingent response of the receiver can alter the initial state of the sender.  [2] Masking inner states can also enable an individual to avoid being misunderstood, in which case the painful state of shame would be induced.  [3] Within the individual, regulating affect can dampen the positive feedback loop in which an internal state is expressed externally as facial expressions and bodily response, which then are perceived by the mind and heighten the initial emotional state.  [4] In both the individual and social feedback processes, regulating external expression of an internal state can help to keep the state of arousal from breaking through the window of tolerance. (siegel/tdm/271)”

[My mother was very good at having a public self – so that nobody guessed what was really going on behind the scenes!  This can be so dangerous!]

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“We all need contingent communication.  Our history of being close with others [or not], having affective attunements [or not] and resonating states of mind [or not], allows us to connect with others [or not] and to have a sense of coherence within our own internal processes [or not].  Adaptations to patterns of misattunements without repair, and to the subsequent dreaded states of shame and humiliation, shape our subjective experience of self, others, and the world.  These patterns of relationships can lead to a large disparity between our adaptive, public selves and our inner, private selves.  [Here he is again with this idea – and me without a public self!]  The attachment models that reflect these early, pre-explicit-memory experiences influence our emotions and their regulation [and hence the organization of self and mind], response flexibility, consciousness, self-knowledge, narrative, and openness to and drive toward interpersonal intimacy [and increasing complexity].  (siegel/tdm/298)”

“At times, engrained dysfunctional patterns of self-organization may require the specialized interpersonal relationship of psychotherapy to alter the emotion dysregulation that has come to be the source of pain in some individuals’ lives.  Psychotherapy establishes a safe environment in which present and past experiences can be explored.  A therapist and a patient enter into a resonance of states of mind, which allows for the creation of a co-regulating dyadic system.  This system is able to emerge in increasingly complex dyadic states by means of attunement between the two individuals.  The patient’s subtle nonverbal expressions of her state of mind are perceived by the therapist and responded to with a shift in the therapist’s own state, not just with words.  In this way, there is a direct resonance between the primary emotional, psychobiological state of the patient and that of the therapist.  These nonverbal expressions are mediated by the right hemisphere of one person and then perceived by the right hemisphere of the other.  In this way, the essential nonverbal aspect of psychotherapy, and perhaps all emotional relationships, can be conceived as a right-hemisphere-to-right-hemisphere resonance between two individuals.  (siegel/tdm/298)”  copied to prenotes brain lateralization 7, next paragraphs on rt lft copied over there

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“Psychotherapy is a complex process.  The brain can be ravaged by interactions between genetically influenced mental storms and experiential histories of family strife.  Both inherited disturbances and adaptations to traumatic experiences can have complex effects on the neurophysiologically constructed reality of our subjective lives.  Our minds are complex systems constrained in their activity by neuronal connections, which are determined by both constitution and experi- (siegel.tdm.299) ence….Whatever tools or techniques are used, the relationship between patient and therapist requires a deep commitment on the therapist’s part to understanding and resonating with the patient’s experience.  The therapist must always keep in mind that interpersonal experience [including the one with the therapist] shapes brain structure and function, from which the mind emerges.  (siegel/tdm/300)”

“It is a challenge, and a profound privilege, to keep an objective focus on a patient’s emotional needs while at the same time allowing oneself as the therapist to join with the patient’s evolving states of mind.  This resonance of states bonds patient and therapist.  By joining, they become part of a larger system that develops its own self-organizational processes and coherent life history.  In many ways, therapy reflects the challenge of all human relationships:  understanding and accepting people as they are, and yet nurturing further integration and growth.  These connections within ourselves and with others are the essence of living vital lives and remaining open to all layers of our own emerging experiences.  (siegle/tdm/300)”

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“Our dreams and stories may contain implicit aspects of our lives even without our awareness.  In fact, storytelling may be a primary way in which we can linguistically communicate to others – as well as to ourselves – the sometimes hidden contents of our implicitly remembering minds.  Stories make available perspectives on the emotional themes of our implicit memory that may otherwise be consciously unavailable to us.  This may be one reason why journal writing and intimate communication with others, which are so often narrative processes, have such powerful organizing effects on the mind:  They allow us to modulate our emotions and make sense of the world.  Integration, as observed in coherent narratives, directly shapes self-regulation. (siegel/tdm/333)”

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