1 chapter 1

Remembering the self

Includes mirror neurons

Dissociation

Empathy

Theory of Mind

Rules

Self

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Northoff 2007

Abstract – Laboratory of Neuroimaging and Neurophilosophy, Department of Psychiatry, Otto-von-Guericke University of Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany. georg.northoff@medizin.uni-magdeburg.de

The question of the self has intrigued philosophers and psychologists for a long time. More recently distinct concepts of self have also been suggested in neuroscience more specifically in neuroimaging. AIMS: The aim here is to apply these findings to abnormalities of the self in depression and to develop neuropsychiatric hypothesis. METHODS AND RESULTS:

Patients with depression suffer from an increased self-focus, attribution of negative emotions to the self,

and increased cognitive processing of the own self.

We assume that in major depressive disorder (MDD),

the abnormal self-focus may be related to altered neural activity in the ventral cortical midline structures (CMS),

the one-sided attribution of negative emotions to the self with neural activity in the amygdala and the ventral striatum/N. accumbens,

and the abnormal cognitive processing of one’s self with reciprocal modulation between ventral CMS and lateral prefrontal cortical regions.

CONCLUSIONS: It is concluded that the transdisciplinary investigation of the self between neuroscience, psychiatry and philosophy yields novel insights into the psychopathology and pathophysiology of the self in depression as well as into the neurophilosophical concept of the self in general.

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Gracey et al 2008

Abstract – Oliver Zangwill Centre for Neuropsychological Rehabilitation, Princess of Wales Hospital, Ely, UK.

There is a growing body of literature on the nature of subjective changes experienced following brain injury. This study employs personal construct and qualitative research methods to address the question of how people make sense of, or construe, themselves after brain injury. Thirty-two individuals who had experienced acquired brain injury engaged in small group exercises based on a personal construct approach. Bipolar constructs were elicited through systematic comparison of pre-injury, current and ideal selves. The constructs elicited in this way were subjected to a thematic analysis. Nine themes were derived and an acceptable level of reliability of the definitions of these themes achieved. The highest proportion of constructs fell into the theme “experience of self in the world”, followed by “basic skills” (cognitive, sensory, physical, social) and “experience of self in relation to self”. It is concluded that following brain injury, people make sense of themselves in terms of the meanings and felt experiences of social and practical activity.

This is consistent with social identity theory and stands in contrast to traditional neuropsychological sense making in terms of impairments and abilities alone, or activity or social participation alone. The implications of these findings for future research and rehabilitation are briefly considered.

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I suspect that our mirror neuron system is triggered into overwhelming states when we watch harm being done to another – as if that harm is being done to us ourselves.  The precuneus, the brain region most concerned with representing out self in interaction with the world, is full of mirror neurons.

This contributes to the social unwillingness to consider the full impact of traumas.  There has to be a “social containment system” in order to process trauma.  Individuals who are fortunate enough to have people in their lives who are expanded containment systems within themselves can offer support to someone who has experienced trauma, and through interaction with them a trauma survivor can release the toughest impact of their traumas by sharing them with these expanded individuals.

That is the essence of secure attachment.  If people had secure attachments as infants they internalize those attachment patterns so that they carry their secure base within them, which is the best insurance against the overwhelming mental threat of trauma exposure.  These people also know they have other secure-base people in their lives they can count on to be there for them should they ever need them to process trauma survival themselves.

The self that sits in the top of the head in the region full of mirror neurons watches the world in those mirrors and applies the information to the self-in-interaction-with-the-world.  Watching harm come to another person activates those mirror neurons.  Hearing about it does the same thing, as can reading about it.  I believe the social taboo about talking about severe harm done to infants and small children relates to this self-mirror neuron system, and we have to be careful and aware about what we expose our mirror neurons to.

Imagination is a gift of the human brain that has served our survival well.  We must not underestimate its power or its warnings.  It carries the power to resonate and expand reality – both positively and negatively.

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There is a connection between what experts call “fantasy proneness” and dissociation.  Dissociation is not compatible with consciousness or with the development or preservation of a coherent sense of self.  Dissociation and disorganization are related.  Consciousness is bout regulation, modulation and organization of self in the world that enables us to be aware.  Consciousness is about efficient, cooperative communications.  When we withhold information from ourselves, it is in an effort to preserve our own sense of order in the world.  The experience of peritrauma during acute trauma experiences leaves us with too much information.  And we have social taboos that enable us to identify and to walk around mental land mines without being disintegrated.

Our imagination allows us to empathize with others.  This is an entirely different process in the brain than is mirroring.  There are no mirror neurons in the empathy section.  Empathy is a conscious, cognitive process.  If we have the ability at all, and some do not, then we have the ability to control it.  I say this because readers need to beware-be aware of the difference and to protect themselves according to their need to limit or expand their awareness regarding traumas – both of their own and of others.  If the mirror neurons are activated during consideration of trauma, this means that the self is involved in a formative fashion.  If empathy is involved, you can control it.  Taboos exist, I believe, to protect the self.  If we make the choice to allow new information to enter us, we are making a choice to invoke our empathy abilities.  Allowing the information to impact the mirror definition system of the self should be undertaken with caution.

Allowing unfamiliar information about trauma to enter our mind through our self mirror system means that something will change.  Some transformation of the recognition and formation of the self will ensue.  Allowing the information to come in through the empathy system contains less of a risk.  It simply means that the self you already have formed can recognize the pain of another.  The empathy system is like an extension of the pain matrix, a cognitive add-on that allows us to interact with one another from a position of self-wholeness that happens because we have protective and regulatory boundaries in place that allow us to know absolutely that we are separate entities from the person we are empathizing with.

The mirror neuron system of the self does not make these distinctions.

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Cavanna & Trimble, 2006

Precuneus and episodic memory retrieval

Implicit – non-declarative memory allows for some types of skill learning and conditioned response

Explicit – declarative memory enables remembering of past events

Subdivided into (according to Tulving (1972)

…..episodic memory, employed for storage and recall of previously experienced                                              ……………………..events which are sequentially ordered in time

………..   has autobiographical reference

…………………….entails recollection of information that is linked to an individual’s ………………………..experience

…………………… capacity to place events in time and to reference them to oneself may form the basis for a special awareness for subjective time called “autonoetic consciousness”

…..semantic memory, corresponds roughly with general knowledge about the world, without any autobiographical context

….sometimes identified with “noetic awareness”

………is measured by “know” rather than “remember”

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I am searching for what I know inside of me to be mirrored back to me in the professional articles.  I need the real words to talk about my experiences.  Their memories are within me and I will resonate with the truth when I find it.

We cannot talk about our memories if we have no vocabulary for them.  Those of us with altered brains and those of us on the brink of getting them, need to be told the truth about what happened to us, why, and what that has in essence done to us.

What happens to us when our reality is in conflict with our reality?  I carry my memories with me from hostile to safe world, yet those hostile world memories, did those things really happen to me?  Were they real?  Was it all a dream?

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Lou et al 2004

Parietal cortex and representation of mental self

“For coherent and meaningful life, conscious self-representation is mandatory.  Such explicit “autonoetic consciousness” is thought to emerge by retrieval of memory of personally experienced events (“episodic memory”).” 6827

fMRI – differential activity in

medial prefrontal and

medial parietal cortices

“…these medial regions …are activated according to the degree of self-reference

activation increases in

left lateral temporal cortex and decreases in the

right inferior parietal region with decreasing self-reference

functionally the

left lateral temporal cortex was preferentially connected to medial prefrontal cortex

the right inferior parietal region preferentially connected to medial parietal

medial parietal region is a nodal structure in self-representation,

………functionally connected to both the right parietal and the medial prefrontal cortices

medial parietal cortex in this network is essential for episodic memory retrieval with self-representation

this network is strikingly similar to the network of the resting conscious state, suggesting that self-monitoring is a core function in resting consciousness

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In the absence of self-consciousness “…our representation of ourselves and our world becomes kaleidoscopic and our life chaotic…(ref Flanagan o, 1995).”  6827

I usually think of my own experience as feeling like a broken kaleidoscope.  But in 8^th grade the absence of self-consciousness sure allowed me to be able to play basketball!  I think with a distorted connection to self and self-consciousness, there remains perhaps more of a sense of mystery about life because so much is unknown that I think others just take fore granted because it has all been wired into their brains from birth and then built upon – maybe like setting up well-placed dominoes in a line.

In attachment terms, they are describing a disoriented/disorganized attachment system.

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explicit autonoetic consciousness — “thought to emerge by retrieval of memory of personally experienced events” – episodic memory –

I never looked backwards in memory as a child, and did not look forward – there was no me

Cerebral activation pattern of episodic memory

……….involves medial parietal cortex

activation of  semantic common knowledge we are familiar with

…..involves left lateral temporal lobe

looking for the network – “distinct neural correlate to the emergence of explicit representation of the mental Self in the mind”

emergence of self-representation:

differential activity in medial prefrontal and parietal/posterior cingulate regions, together with bilateral occipital and parietal regions, and confluent left inferior prefrontal and temporal region

emergence of representation of other (Queen)

activation of nearly similar regions

relative contributions of two of the above regions are, however different…for self, activity is comparatively high in right parietal region and low in left lateral temporal region

during retrieval of judgment revealed differential activation predominantly in medial parietal/posterior cingulate and medial prefrontal regions, regardless of self or other (queen)

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Trying to locate life in the center of the galaxy of the mind-brain.  Trying to understand the mapping of regions and functions in the brain is probably more complicated than a search of the galaxies for life would be.

Because of the uniqueness of my childhood experiences, nobody can really tell me not so much what is WRONG with me, but what is DIFFERENT about me and my brain and the way it operates and how that affects me in my life – differently from “normals.”

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Don’t throw a fish in the water and expect it to swim if nobody ever gave it any gills.

A brain does not develop according to any supposed optimal end if the blueprint in the beginning was completely altered from the expected norm.

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Malouin et al, 2003

Does an infant learn to walk by imagining the activity required first?  Before they ever take their first step?

These authors investigated the supraspinal structures involved in human locomotion

They wanted to know which brain structures were neurally involved in the imagination of locomotor tasks.  They found that as the tasks become increasingly difficult and demanding, higher brain centers became correspondingly increasingly involved.

Mental simulation of the most complicated and difficult task, walking with obstacles, involved activation on both sides of the brain (bilaterally) of the precuneus.

The less demanding task of walking activated the left cuneus and left caudate, “suggesting that the basal ganglia plays a role in locomotor movements that are automatic in nature.”

Is it therefore only analogy, or is it based in brain fact that once an action becomes familiar and automatic the precuneus can stay out of the arena?  When we are very small these actions are far from automatic.  What is the interaction between our growing sense of self and the precuneus in the beginning?

What about from birth, is the precuneus involved in our learning to identify our self with our body with the first wave of our hand in front of our face that we can identify as us doing this with us?

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How do I understand the neuroscience information that is presented from studies with normal people into an understanding of what happens to those of us whose early brain developmental environments factually altered the trajectory of our brain’s development?

My suspicion is that when someone cannot complete their trauma cycle at older ages, even if their brain was developed properly in the first place, their brain will adapt to become more similar to ours than is normal if the trauma cannot be healed in time to prevent this from happening.

If my suspicions are also correct, and if trauma does not let go of us because it connects on a body level with memory that is needed by our species to deal with worst case scenarios, wouldn’t we find corresponding alterations in the parts of the brain that process self in relation to others?  If we are required by biological evolutionary circumstance to retain these memories and their corresponding important-for-survival-of-the-species information, then we become ultimately altruistic by being required to sacrifice our personal and individual awarenesses and realities, which have become subservient to the needs of the bigger, higher good of our species.

Hostile realities are only mirrored in dangerous, malevolent realities.  Benevolent realities are mirrored in a safe world.  What happens if we have unresolved trauma memories, which cannot be included or absorbed into a self-definition format?  What are the corresponding brain operational changes that we might see, anticipate and expect?

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DOLAN & Fullam, 2006

article

EMPATHY, psychopathy

Psychopathy is a “higher-order construct” under the personality disorder diagnostic category of the antisocial personality disorders

………….psychopathy, occurs in about 20% of prisoners with antisocial PD diagnosis

………disorder is significantly higher percentage than in the population as a whole — Dolan & Fullam, 2006, 1563

antisocial personality disorder “…are a group of overlapping disorders of personality that are associated with significant intra- and interpersonal dysfunction.”  Dolan & Fullam, 2006, 1563

Blair (2005) Integrated Emotions Systems (IES) “…suggests that the amygdala is the primary locus of dysfunction in psychopathic individuals, while dysfunction in the orbito-frontal cortex is implicated in impulsive aggressive behaviour.”  Dolan & Fullam, 2006, 1564

Amygdala damage is known in humans to reduce “the ability to acquire conditioned autonomic responses (Bechara et al. 1995) and impair the capacity to recall emotional material (Cahill et al. 1995)… Dolan & Fullam, 2006, 1564

“…amygdala is activated by affectively loaded visual stimuli….”  Dolan & Fullam, 2006, 1564

psychopaths show reduced amygdala activation in

………”impaired capacity to recall emotional material”

How is this connected to the avoidant/dissociated article by Wessel et al 2001?

………fear-conditioning tasks

………face affect recognition

……….lack of normal response in anticipation of aversive stimuli

……….abnormally low startle response

……….weakened “normal memory bias for affectively laden material” Dolan & Fullam, 2006, 1564

“…recently, it has been suggested (Hare & Neurmann, 2005; Vitacco et al. 2005) that a four-factor model comprising, [interpersonal] arrogant and deceitful, [affective] deficient affective experience, [impulsive] impulsive and irresponsible lifestyle, and [antisocial] antisocial behaviour, may refine the construct of psychopathy.”  Dolan & Fullam, 2006, 1565

EMOTION RECOGNITION DEFICITS

“children and adults with psychopathic traits

…………………show an impaired ability to recognize sad and fearful vocal intonations (Stevens et al. 2001; Blair et al, 2002).”

………………….reduced reaction to sad but not angry expressions

………………show selective difficulties with recognizing sad & fearful expressions

Dolan & Fullam, 2006, 1564

“We examined the specificity of the deficit in sad/fear recognition in a sample of [compared to match healthy controls]  and [49] male [incarcerated] criminals meeting the criteria for dissocial (antisocial) personality disorder….we tested the hypothesis that psychopathy is associated with a reduced ability to recognize sad/fearful faces….”  [compared to match healthy controls.”  Dolan & Fullam, 2006, 1564

“Face affect recognition was examined using…standardized…photographs contain[ing] poses of the six basic emotions, anger, disgust, fear, happy, sad and surprise, which are morphed to create sequences of variable expression intensity (25%, 50%, 75% and 100%) [to minimize and to exaggerate a normal emotional expression].”  Dolan & Fullam, 2006, 1565

“…the PD group had significantly worse recognition accuracy for sad, happy and surprised face affect [compared to controls].”  Dolan & Fullam, 2006, 1565

the PD group had an average group lower accuracy score at the 100% intensity level of face expression for sad and happy affect but at 100% level there were  no group differences for the intensity level of surprise  Dolan & Fullam, 2006, 1565

it took the PD group nearly twice as long as normals to identify the emotions – true for all six

this is interesting

“There were no significant group differences in recognition accuracy for anger, disgust, fear, happiness or surprise…”  Dolan & Fullam, 2006, 1566

“In the PD sample there was a significant negative correlation between psychopathy total score and recognition accuracy for sad face affect.”   Dolan & Fullam, 2006, 1566

sad affect recognition did not appear to have a specific relation with any of the four-facet model factors  Dolan & Fullam, 2006, 1566

the higher the PD’s score was for anti-social behavior, the less accurate was their recognition for happy face affect  Dolan & Fullam, 2006, 1566

“We found that the PD group compared with controls had a deficit in sad and happy affect recognition even at 100% intensity.  Our finding suggests that having an antisocial personality and/or being criminal may be associated with a specific difficulty in recognizing these emotions.”  Dolan & Fullam, 2006, 1566

those with higher PD [symptom] scores on the psychopathy spectrum  “…had significantly lower recognition accuracy for sadness than those with low psychopathy scores.”  Dolan & Fullam, 2006, 1567

mentions other studies that showed lower PD recognition in adults and children for fearful and sad, but does not address their lack of findings regarding fearful.  That seems odd to me that they wouldn’t at least mention it!

“The present findings add some weight to the IES model proposed by Blair (2005).  According to the IES, an amygdala-based impairment in the formation of conditioned responses through aversive and instrumental learning [try altered brain development, folks] leads to poor socialization in antisocial and particularly psychopathic individuals.  Within this model, face expressions of sadness and fear are unconditioned human submission responses that in psychopathic individuals fail to become associated with their actions (e.g. violence).”  Dolan & Fullam, 2006, 1566

so does that mean that there are ongoing complications from them always being in a challenging and competitive mode – that they don’t recognize the “giving up and giving in” responses?

“It is possible that a deficit in the recognition of happiness may be a non-specific correlate of antisocial/criminal behaviour.  It could be postulated that this association may be mediated through the dimension of hostility, which tends to be high in violent offenders, and that a hostile attribution bias impairs the ability to recognize positive emotions such as happiness.”  Dolan & Fullam, 2006, 1568

“…Larkin et al. (2002)…fund an association between high hostility scores and poor happy face affect recognition accuracy in a community sample.”  Dolan & Fullam, 2006, 1568

“Overall, our findings tentatively suggest that antisocial personality/criminality in general is associated with a deficit in the recognition of sad facial affect and that this impairment is particularly notable in criminals with marked psychopathic traits.” Dolan & Fullam, 2006, 1568

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Notes on a not having a social brain:

A goose in a V is not rescued if it falls.  “Going on being” from birth prepares our brain to go on being – alone.

What if the survival of the species depended on only a “chosen-cursed” few?  In what we call psychopathy – without a startle response, no fear – cannot see sadness or another’s pain – they have been created in the worst by the worst for the worst.  That is a human phenotype.  “Tough job but someone’s got to do it.”  We do not get the luxury of a social brain.  That would slow us down.  We are way over on the other end of the spectrum of our species as if we were born over 200,000 years ago, before language.  We have pre-language brains.  Pre cooperative brains.  We are like specially-bred survival machines.  We have been created and transformed by trauma.  No “grooming behavior” chit chat for us.  No distractions.

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Zhou et al. 2007

Abstract

Hippocampus implicated as part of the physiological base of schizophrenia

Anterior hippocampus as region of interest in resting-state functional connectivities of the bilateral hippocampi

“In patients with schizophrenia, the bilateral hippocampi showed reduced functional connectivities to some regions which have been reported to be involved in episodic memory, such as ….”

posterior cingulate cortex (PCC)

extrastriate cortex

medial prefrontal cortex (MPC)

parahippocampus gyrus

“We speculated that these reduced connectivity [sic] may reflect the disconnectivity [in schizophrenia] within a neural network related to the….”

anterior hippocampus

damage in hippocampal connectivity

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Wang et al 2006

Alzheimer’s

Found that functional connectivity between the right hippocampus and set of regions was disrupted in AD:

Medial prefrontal cortex (MPFC)

Ventral anterior cingulate cortex (vACC)

right inferotemporal cortex

right cuneus extending into precuneus

left cuneus

right superior and middle temporal gyrus

posterior cingulate cortex (PCC)

found increased connectivity between the left hippocampus and the right lateral prefrontal cortex in AD

rightward asymmetry of hippocampal connectivity found in controls was diminished in AD

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Baliki et al 2008

Diminished quality of life

Recent studies demonstrate chronic pain harms cortical areas unrelated to pain – structural impairments

Behavioral deficits

“…Long-term pain alters the functional connectivity of cortical regions known to be active at rest, the components of the “default mode network” (DMN).”

“This DMN…is marked by balanced positive and negative correlations between activity in component brain regions.  In several disorders, however this balance is disrupted….”

(Raichle et al, 2001; Greicius et al, 2003; Vincent et al, 2007)

investigated whether the impairments of chronic pain patients could be rooted in disturbed DMN dynamics

display reduced deactivation in several key DMN regions

“chronic pain has a widespread impact on overall brain function…disruptions of DMN may underlie the cognitive and behavioral impairments accompanying chronic pain.”

(I am calling in this article….hopefully!)

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I put PTSD and unresolved trauma with chronic pain

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Shulman et al 1999

Resting state defined “…is the rate of regional glucose metabolism without any peripheral stimulation.” P 3247

“…the regions involved in performing a sensory or cognitive function are located by an increase in their neuroenergetic requirements.” P 3248

“…the baseline awake value of this specific neuronal activity is quite substantial and in fact is larger than the incremental activity.” 3248

“The high level of neuronal activity in the absence of stimulation provides an explanation for recent reports of negative signals in functional imaging experiments….a reduction in baseline activity during stimulation is not expected.”  3248

“We suggest that the negative signals [in CMR glucose measurement of brain activity] may be explained by the present analysis,  If the entire magnitude of neuronal activity, not just the increment, is required to support a function, then the negative signal indicates that the functional processes occurring the baseline state required more activity than during the task.  How the total magnitude is composed of individual neuronal contributions remains to be understood.  However, the negative functional imaging signal does not require a novel explanation from this perspective.  Rather it supports the importance of total regional activity for brain function.”  3249

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Fransson & Marrelec 2008

In press

“…intrinsic brain activity as observed by functional magnetic resonance imaging (fMRI) manifest [sic] itself as coherent signal changes in networks encompassing brain regions that span long-range neuronal pathways.”

Default mode network (so-called) – is one of these networks – “…recent investigations to link intrinsic activity to cognition and how intrinsic signal changes may be altered in disease.”

“In this study we assessed functional connectivity within the default mode network….”

“Prominent features of functional connectivity within the default mode network included an overall strong level of interaction between

the precuneus/posterior cingulate region

and the rest of the default network, as well as a high degree of interaction between the

left and right medial temporal lobes combined with weak interactions between the

medial temporal lobes and the rest of the default mode network.”

“Additionally, we found support for strong interactions between the

precuneus/posterior cingulate cortex and the

left inferior parietal lobes as well as between the

dorsal and ventral sections of the medial prefrontal cortex.”

“This suggested pivotal role of the precuneus/posterior cingulate cortex in the default mode network is discussed.”

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Wessel et al, 2001

The Netherlands

Avoidant [as in avoidant attachment?]

“Overgeneral autobiographical memory refers to a relative inability to respond to cue-words with memories for specific events.”  Wessel et al, 2001, 411

they also say “to respond with specific (i.e. referring to one particular event) memories.”  Wessel et al, 2001, 411

my comment:  In life, people can even avoid the cues and control their responses —  their brain can do this so that they don’t even see the cues, or don’t have “normal” reactions to the cues – sort of a hyposensitive vs the hypersensitive of the anxiety disorders including PTSD – an understated state – conserves resources

study compared low with high dissociate scores from a measurement instrument

authors were assuming that high dissociation reflects “avoidant information processing style” so that high dissociation scores would display fewer specific memories than low dissociation scores

authors also looking at:  finding that dissociation overlaps with fantasy proneness – “To the extent that fantasy proneness implicates good story-telling abilities, one expects high dissociation individuals to display more rather than less specific memories.”  Wessel et al, 2001, 411

“The results show that autobiographical memory did not differ between high and low dissociation groups, although group differences were found with regard to fantasy proneness.”  Wessel et al, 2001, 411

they call this a “memory dysfunction” that “has been found in various clinical groups, including parasuicide patients…, clinically depressed individuals…, patients with Borderline Personality Disorder (BPD; Jones et al., 1999), and post-traumatic symptomatology (…McNally et al, 1995; Acute Stress Disorder, ASD; Harvey et al., 1998)…..it occurs in a broad variety of emotional disorders.”  Wessel et al, 2001, 411

“…what, if any, shared characteristics underly [sic[ the phenomenon.”  Wessel et al, 2001, 411

“Dissociation is usually defined as a lack of integration of mental processes such as thoughts and feelings in the stream of consciousness and memory (Bernstein and Putnam, 1986).  Memory problems are thought to represent an important aspect of dissociation (Gershuny and Thayer, 1999).”   Wessel et al, 2001, 412

“If an avoidant strategy of coping with autobiographical memories is, indeed, a hallmark feature of dissociation, one would expect dissociative individuals to display a poor (i.e. Overgeneral) autobiographical memory.”  Wessel et al, 2001, 412

Merckelbach and Muris, 2001 – review of fantasy proneness

“Fantasy proneness refers to a tendency to become deeply and profoundly involved in fantasy and imagination (Lynn and Rhue, 1988).One striking characteristic of individuals scoring high on fantasy proneness is their ability to develop unusually vivid memories for personal experiences.”  Wessel et al, 2001, 412

memory word cues used:  5 positive – happy, surprised, interested, successful, safe

5 negative – clumsy, angry, sorry, hurt, lonely

DES – Dissociative Experiences Scale (Bernstein & Putnam, 1986) – 28-item self-report measure – authors suggest some fluctuations did occur with the measurement tool and there is room for improvement

Subjects 48 psychology undergraduates age range 18-23

“…compared autobiographical memory performance….”  Wessel et al, 2001, 414

“First, no evidence was found to suggest that participants with high dissociation scores respond with more Overgeneral memories to cue-words than participants with low dissociation scores.”  Wessel et al, 2001, 414

“Second, the pattern of results obtained in the current study lends no support to the alternative hypothesis that due to their heightened fantasy proneness levels, high dissociators would display more specific autobiographical memories than low dissociators.  Wile it was the case that high dissociators had higher fantasy proneness scores than low dissociators, groups did not differ on any of the autobiographical memory parameters. This pattern is difficult to reconcile with the idea that dissociation fosters memory specificity through its overlap with fantasy proneness.”  Wessel et al, 2001, 414

“The hypothesis that dissociation is related to overgeneral memories rests on two assumptions.  The first is that dissociative symptoms reflect an avoidant information processing style (e.g. van Ijezendoom and Schuengel, 1996; Gershuny and Thayer, 1999; Jones et al., 1999).  The second assumption is that cognitive avoidance interferes with memory retrieval resulting in overgeneral autobiographical memory (Williams et al., 1999).  Both assumptions may be incorrect.”  Wessel et al, 2001, 414

“..doubts on the idea that a link between dissociation and overgeneral memory must be mediated by cognitive avoidance (Jones et al., 1999).”  Wessel et al, 2001, 414

“…the present study found no evidence for overgeneral autobiographical memory in highly dissociative individuals.  This casts doubts on the avoidant information processing account of dissociation.  Furthermore high dissociators did not display better memory performance, a finding to be expected if an important correlate of dissociation, fantasy proneness, was related to memory specificity.  It may still be possible that overgeneral memory results from the joint action of dissociation and other variables (e.g. frequent intrusive memories.).”  Wessel et al, 2001, 414

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O’Toole et al 1999

Abstract – Australia – I am getting this article called in

Various wartime stressors is related to different PTSD symptoms – inconsistently reported

641 male Australian Army Vietnam Veterans

.PTSD measures comprised symptom criteria for

reexperiencing

numbing and avoidance

hyperarousal

.PTSD for lifetime and current within past month

examined effects of combat, wounding, and peritraumatic dissociation together on PTSD

………combat experiences comprised 4 components:

direct combat exposure

exposure to death and injury

exposure to civilian death and injury

exposure to mutilation

each were differentially related to reexperiencing, avoidance, hyperarousal, and PTSD diagnosis

………..Being wounded was not related to lifetime or current PTSD

……peritraumatic dissociation was related to all diagnostic components of PTSD in presence of other variables

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berle & Starcevic, 2005

Australia

Thought-action fusion (TAF) – people have a tendency to assume certain thoughts either imply the immorality of their character or increase the likelihood of catastrophic events

“Inconsistent definitions of magical thinking have hindered better understanding of the relationship between TAF and magical thinking.”  Berle & Starcevic, 2005 abstract

not clear:  Does TAF refer to specific appraisal style, more enduring belief or both?

How is this implicated in theory of mind (ToM)?  How does this relate to “rule making” from childhood?  I still have to look at how early experience affects our perception of rule-making – I think the brain from birth is learning about the “rules” that govern reality, and particularly in the years around 4-5 these rules can become scrambled through particularly betrayal trauma – where nothing makes sense in relation to the child and the world, every thing is upset – turned upside down and inside up, and there’s nobody there to help the child sort it all out.  It is too much for a young child to do, they do not have the skills.  They become overwhelmed, their world is overwhelmed, and this is where the self is in great danger….

TAF – associated with tendencies to OCD but is implication is inconclusive –[remember in the evolution of mothering article where she says OCD is about the reward, not the motivation system] – TAF may not be specific to OCD but may be relevant in other disorders also like anxiety disorders, depressive symptoms and may contribute to preoccupation in eating disorders – “TAF is also associated with the presence of psychological disorders in children and adolescents.”

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Hazlett-Stevens et al, 2002

meta-cognitive beliefs

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precuneus

I need to copy all of this into my working section on the self and the precuneus

“Learning-related decreases in the precuneus have been described previously using working memory (modified Sternberg task; Koch et al., 2006) and decision-making tasks (Ernst et al, 2002).  Interestingly, precuneus activation was also what distinguished slow learners from model-conform learners both during the exploratory and the proficiency phase.  The precuneus is closely connected to the DLPFC and has – among others – been ascribed a role in shifting attention between different targets and object features (Cavanna and Trimble, 2006).  For example, in a set-shifting task that required to change the sorting criterion in response to incorrect feedback, a transient increase of activation occurred in the precuneus and the pre-SMA which was time locked with attention shifts (Nagahama et al., 1999). The precuneus is also activated during risky decision-making (Dickaut et al, 2003; Paulus et al., 2003; Krain et al., 2006; Ernst et al., 2004) which may also be explained by the attentional requirements involved in tracking contingencies and supplying alternative response strategies in the presence of uncertainty (Paulus et al., 2001).”  Sailer et al, 2007, 1483

“Similarly, differing set- and attention-shifting requirements can explain why precuneus activation was larger in the exploratory phase than in the proficiency phase, why it was noticeably larger following ambiguous than unambiguous feedback in the exploratory phase, and finally, why it was also larger in slow learners than in model-conform learners.

As slow learners fail to grasp and automatise the correct response strategy, they may feel a greater need to adjust their response strategy and to pay more attention to the task than model-conform learners from the beginning of the task up to its end.”  Sailer et al, 2007, 1483

I can see a “self” putting great effort into trying to get it right – applying oneself to the task – effortful control!!  Self as agent – paying attention – I think it is related to trying to learn the rules and apply them.  This describes a difficult life process!!

I see the description of the model-conform learners to be like those who learn about themselves and the world in a secure attachment, safe environment.  The slow learners have been, then, forced to continue to try to learn what was easy for the MC learners

They don’t talk about the precuneus being the seat of mental images – but I get the picture of Dorothy wanting to go back to Kansas, the center that was her home – the tornado of life transported her from one center to another – into the world of drama and adventure – home being an earlier place, though she had no family and was evidently an orphan…

I feel like an orphan.  Maybe the precuneus is the place we are at in the world, alone – born alone, die alone – meet the challenges alone, ultimately – maybe this is our orphan place, the center of our wheel of effort, of trying, from beginning to end.  Maybe we trauma survivors know this place better than others, having been overwhelmed, having been challenged past what was ours to give to the task – and still we survived, but it is like getting home early, too early – before the whole of our life was completed – dropped on the other side of the finish line before we got to run our race one foot in front of the other – trauma tripped us up.

It stole from us our “right” to run the race of our lives our way – we constantly have to try to assert ourselves over the survival will of our bodies so that we, as a self, can participate in our lives as more than some fractured illusion of a self.  When one rule does not grow in an orderly fashion from the preceding rule, attached to the next forthcoming rule, in an orderly and predictable fashion – what’s left?

Maybe when we dissociate the precuneus is the place we go to.

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Jones et al 1999

Overgeneral in their autobiographical recall – does this covary with their susceptibilities to dissociative experiences – 23 BPD and 23 controls –

Abstract

“Participants with BPD scored significantly higher than the control group on the measure of depression, anxiety, trait anger, and dissociative experiences and also retrieved significantly more general memories on the Autobiographical Memory Text (AMT).  The number of general memories retrieved by the BPD group correlated significantly with their dissociation scores but not with their scores on mood measures.  CONCLUSIONS:  Patients with BPD have difficulties in recalling specific autobiographical memories.  These difficulties are related to their tendency to dissociate and may help them to avoid episodic information that would evoke acutely negative affect.”

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the Netherlands

Kremers et al 2008

BPD comparison with controls on social problem solving capabilities and specificity of imagining future events.

Hypothesis that there would be a relation between problem solving and specificity of remembering past and imagining future events.

“Seventy-eight patients with BPD reported fewer active means to solve interpersonal problems and depressed patients with BPD tended to have more difficulties in imaging positive future events in a specific way compared to controls.  Specificity and problem solving were hardly related in patients with BPD.

“Social problem solving deficits in BPD may be a consequence of disturbed emotion regulation rather than a consequence of restricted memory accessibility.”

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I am required from within myself to investigate the condition of the Borderline Personality Disorder because I believe that is what so twisted my mother’s reality that she was able to nearly entirely destroy me – and my connection to and development of my self.  Even though I do not have “her” disorder but rather my own case of PTSD and dissociation as a result of having my brain formed by her, enough of her brain’s functioning was transmitted to me through the experience-dependent growth my brain was forced to take in accommodation to her distortions.

The common thread of the lack of having a coherent life story is what we inherit through insecure attachments from birth.  It is the legacy we receive from our disturbed early attachment interactions with disturbed caregivers – especially when there is no buffer agent to counteract the impact the disturbed caregiver has on the growing infant’s brain (let alone all the years of childhood experience that follow this distorted beginning).

Fuchs 2007

Abstract

“The concept of a narrative identity implies a continuity of the personal past, present and future.  This concept is essentially based on the capacity of persons to integrate contradictory aspects and tendencies into a coherent, overarching sense and view of themselves.”  Fuchs 2007, 379

I do not take this author’s perspective from a Freudian point of view, but I am willing to consider that there are some important implications in this article

“Patients with borderline personality disorder lack the capacity

[because it was robbed and stolen from them when their hearts were broken as they tried to figure out the rules to the adult world – most often through betrayal trauma at an extremely vulnerable developmental point of their mind’s growth – usually based on a very shaky early brain building background of insecure attachment from birth – creative and “dreamy” children being most vulnerable, I believe – during the theta brain wave period of brain functioning – where the boundary between reality and fantasy has not formed firmly – where what to us is a hypnotic and suggestible brain wave state is to a young child their normal state]

to establish a coherent self-concept.”  Fuchs 2007, 379

[They lacked it a very long time ago because nobody kept them safe enough for long enough for them to gain a “coherent self-concept” in the first place.  How do we expect young children to make coherency out of a “bad” world with “bad” people doing “bad” things to them that break the rules these same children are supposed to be learning so they can be “good” children?  Don’t give a child rotten eggs and expect them to bake you a wonderfully delicious cake!  The fault, I believe, is ours if we ever suggest that such a thing is possible for them to do.  Who is it that then suffers from delusional and wishful, childhood thinking?]

“Instead, they adopt what could be called a ‘post-modernist’ stance towards their life, switching from one present to the next and being totally identified with their present state of affect.  Instead of repression, their means of defence [sic] consists in a temporal splitting of the self that excludes past and future as dimensions of object constancy, bonding, commitment, responsibility and guilt.”  Fuchs 2007, 379

“The temporal fragmentation of the self avoids the necessity of tolerating the threatening ambiguity and uncertainty of interpersonal relationships.”  Fuchs 2007, 379

[I believe they lost the choice to live otherwise a long time ago.  That choice was robbed from them – back when they were broken]

“The price, however, consists in a chronic feeling of inner emptiness caused by the inability to integrate past and future into the present and thus to establish a coherent sense of identity.”  Fuchs 2007, 379

“…the increasing prevalence of these disorders is linked to the development of a mainly externally driven, fragmented character in post-modern society.”  Fuchs 2007, 379

[We don’t have to go to any philosophical level in regard to attachment disturbances that are caused mainly by inadequate normal and natural infant caregiving from birth.  We are creating instances of disconnection between our infants and their mothers – mostly – because we are not making wise choices that are allowed to us to make as we gained the brain capacity to go against the biology of birth and infant caregiving.  We are making mistakes.  Nature gave us the opportunity to choose how we are as a species going to behave toward our offspring – we did not achieve this degree of freedom by choosing stupidly or wrongly.    We were given the choice because we earned it.  We found, as a species, better ways of caring for our young than nature could provide without our mental interventions.  If we are choosing to treat our offspring wrongly, and are going against the wisdom nature has built into mammalian innate behavior, and we are throwing away all the wisdom we gained by doing an even more superb job with our offspring, we are going to pay a price.

Yes, the price is a chronic feeling of inner emptiness – but the groundwork made for this to become a lifetime chronic problem without recourse comes from bad caregiving of infants.  We can only go so far in breaking natural rules – and when we break these rules with our infants and children as their brains are forming these experiences into the neural circuitry, structure and operation of their brains, we will have hell to pay.]

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I also suspect that it is not the borderline’s present that is problematic as separated from a past and a future.  I am believing less and less that a present even exists.  Each “present” moment is the future as it continually unfolds with us in it – if we are among the living this is the way of life.  The past is meant to inform our future.  Our brains are forward reaching metabolizers, operating continually in an excitatory-inhibitory fashion.  Our brains are always reaching forward with the “hands” of the past.  Our “fingerprints” are continually leaving their mark in the future as it becomes our past – each mini-qubit of information at a time.

INTRODUCTION

“The beast, by living unhistorically, ‘closely tied to the peg of the moment’ and not knowing about past or future, lives in simple happiness.  For man, however, who is unable to forget, this kind of happiness remains for ever out of reach.”  Fuchs 2007, 379

Oh, how romantic!  Take that beast out of your stylized oil painting and drop it in its own habitat, and then judge how it lives its life – and not by some standards you have made up in YOUR mind, as some pastoral cow kept pristine and never old, dying or dead on your plate.  How can we say the beast is happy?  It may for an instance experience well-being, but it will be driven continually to fulfill its needs for survival, continually moving into its own future, compelled to make efforts on its own behalf and on behalf of its offspring.

Not even a fish is simple enough to eat food provided for it in a part of a tank that has meant receiving a shock in the past.  Not even a sheep will voluntarily enter a paddock that requires it to pass through a chute that has given it repeated shocks in the past.  Animals do remember.  Of course they remember.  But they are perhaps unlikely to cognate about their experiences – though they do solve problems creatively, they do make new provisions based on past experiences – within the limits of their species, of course, but we are not as alone in this world of the living as some evidently want us to believe.

“…someone who is ruled only by his momentary impulses, i.e. who is driven and impelled by his first-order desires – a drug addict or a borderline patient, for instance – lacks an essential feature of what we call a person, namely autonomy.  He is unable to control his impulses and may not be held responsible for his actions.” Fuchs 2007, 380

Well, how self righteous is this statement?  How ignorant and archaic?

“…the French philosopher Paul Ricoeur places the essence of the human person in the temporal relationship that we have toward ourselves.  According to Ricoeur [4] [Ricoeur P:  Oneself as Another (trans K Blamey) Chicago, University of Chicago Press, 1992], persons are not just things in the world that are characterized by remaining the same over time, by the mere constancy of their names, bodies or characters.”  Fuchs 2007, 380

That is exactly how I was raised, and exactly how I experienced my childhood – as some thing, a figment made incarnate of my mother’s externalized psyche.

How does this man think we become a self?  Through some hocus pocus magic spell cast upon these bodies we are tied to at some magical point in our development?  We are already our self (or not) by age 2.  Either a whole self, or an injured and wounded one.  I was deprived even of having a “character.”  These people come from a different world, are made by and for and in a different world – some benevolent world that those of us formed in and by such malevolent worlds as we have seen know very little or nothing of – we use our imaginations in an attempt to understand such people.  Do they use theirs to attempt to understand us?

“The person is rather someone who acts and speaks and, in doing so, proves to be a self-understanding being, a being that relates to itself.  Therefore we ask ourselves: ‘Who am I?’ and not ‘What am I?’.”  Fuchs 2007, 380

Believe me, acting and speaking is no guarantee that a person is a “self-understanding” being.  I was raised as a “what,” not as a “who.”  When a child is abused, neglected, hurt and violated during its brain formative years, the result is an inability to regulate even the most basic of responses to and in the environment.  If there are no caregivers to look in the eyes of that newborn and see the tiny burgeoning self-to-be, and if these caregivers are unable to respond in the correct biologically determined mirroring fashion to that infant, no “normal” self will be born.  There will be a body, and the body will take care of its own the best that it can – but being a “self” as we pompously like to define one, and having a “self” is a luxury that evolution gave to us because we as a species were able to earn it.  We worked for the ability to have self-reflection, awareness, consciousness, cognition, language and choice.  But we did not work for this as newborns or as very young children.  We were well  taken care of as infants because after the life of the adults, the children were most precious, valued, wanted and needed – for without them and their survival, there would have been no species.  We would not have made it as a species and we would not be here now.

“The answer to the question of who I am lends another quality to singularity and sameness:  it is only me that can be responsible for acts done by me in the past; and I remain myself by being faithful to my promises in the future..  Ricoeur calls this kind of temporal or historical identity, different from the mere constancy or sameness of things, ‘ipse identity’ or ‘ipseity’.”  Fuchs 2007, 380

In a malevolent world CONSTANCY is a very big deal.  It means we are here.  It means we have survived the unsurvivable.  We have defied the odds.  We live in spite of the world that made us.

IPSE

Function: noun

Etymology: Latin, he himself said it

Date:15th century

: an assertion made but not proved  : DICTUM

“The ipseity or selfhood of the person opens up the sphere of responsibility and faithfulness, of the values and norms we adhere to, and thus establishes the historical continuity that we regard as essential for personal identity.”   Fuchs 2007, 380

Yes, but…..  that is what I refer to as the rules:  values and norms we adhere to.  These are exactly what a child is trying to make sense of, along with the physical rules that govern the basics of movement and activity in the world.  Betrayal trauma breaks these rules – it is by now common knowledge that 80-95% of BPD were sexually abused as children, most by a person close to the child and one that the child is dependent upon for their existence.

When the rules are broken that harm an infant or a child, that breach creates a break in that child’s  historical continuity. Developmental experts refer to rupture and repair – a pattern that will be a part of our lives from our first to our last breath in this lifetime.  When a breach of epic proportions overwhelms a child, without any adult there to help the rupture heal into repair, something inside that child is likely to be broken for the remainder of their lives. And there are consequences….

How can a child make sense of a world that has allowed this fundamental violation of their BODY self to be violated even before their “ipseity” self is formed?  Ipseity THIS, my dear man!  There is a biological innate awareness, I believe, that resides in our DNA that lets us know that molesting children and beating up babies is wrong.  Who takes responsibility for that harm?  Who has broken the most basic, previous and sacred promise of our species – that we will take care of our little ones so that our species may endure?

This promise is both implicit and implied – implicit in our biological heritage on the species level, and implied in whatever family we are born into.  Or is SHOULD be implied.

The trouble with trauma all the way around is that it breaks the implicit rule we live by that the world is a safe place and we will be allowed to continue in it relatively unharmed.  When traumas come upon us even in adulthood it takes a securely attached person to make it through them – and not alone.  It is the promise of belonging to our species, and with our species, that is being broken with betrayal traumas.  It is really the illusion of safety that gets us as soon as we are old enough to appreciate that something terrible has happened to us as adults.  Children in between have to make sense of any trauma the best that they can – and children desperately need adults around them who care enough to lend a hand – not beat or rape the child with it.

“Both responsibility and promise make clear that these concepts of personal identity are essentially related to the other, that means the person we talk to and to whom we are responsible, be it a real or imaginary person.  There is an inner witness in most of our actions and intentions to whom we could give an account of what we did and justify what we are doing – an implicit other.”  Fuchs 2007, 380

When “the other” wounds a child, and there is no restitution and repair, the inner witness of the child is overwhelmed, without the resources to cope adequately with the trauma.  Overwhelming trauma damages biologically – and that includes damage to the brain.  When adults wound children, and there is no accounting of what the adult did, how is the child supposed to give an account of what they did?  Never is child wounding justified, and the implicit child knows this.  And the entire attachment system crashes, but more on this later….  Right now, I want to know, who is the witness to the harm done to these children?

I had no implicit other in my brain as a child.  She was completely explicit – no doubt about that.  The internal movement between inner reality and outer reality does not match in the malevolent psychological world of child abuse.  If a grown lion ate a child, that would be explicit and obvious.  But what about the sexual abuse done in “implicit” private?

Where is the governor then?  Who is governing what and whom?  Who is being governed?  A molested child cannot govern the perpetrator now can they?  And if the adults cannot govern themselves with the child’s well-being center stage, how in the universe, both known and otherwise, is a child supposed to make sense of the rules about this?

“This leads to the concept of narrative identity as put forward by authors such as MacIntrye [5], Carr [6] and Ricoeur himself.  Narrative identity implies a meaningful coherence of the personal past, present and future that is similar to the unity of a story that we are telling…..A narrative, however, only makes sense for a real or an implicit other.”  Fuchs 2007, 380

Inability to tell a coherent life story is the number one symptom, the hallmark of an insecure infant attachment history.

It is the very nature of trauma to rip through the veil of the unity of life – to shred it into nonexistence.  What was before a trauma happens will never be the same again.  It has been shown through brain scans that the language area of the brain, Brodmann’s, is closed off in silent darkness when a PTSD survivor is having a flashback memory.  The brain itself goes speechless.  How can there be a narrative when there are no words?

Trauma defies the “ordinary” unity of anyone’s life.  At the same time, trauma’s existence  defines what we consider ordinary and unified.  If trauma were the ordinary, we would be living in a different world than what most would desire.  And yet it is in these very malevolent worlds that we see the body and brain’s alternative paths of evolutionary adaptation appear.  And then we dare snub our nose at the miracle of human life that can survive what the mind cannot endure?

It is OK to talk about the norm as if it were so.  But trauma is trauma because it will not necessarily spare you.  But how you react to trauma depends to the largest extent upon the kinds of experiences you had that built your brain and nervous system before you experience a(nother) trauma.  Making trauma coherent is a big job, and children are not big enough to do it alone – nor, for that matter, are most grown ups! To include repeated, unending, overwhelming traumas into a coherent narrative of a life story?

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Nobody wants to hear the narrative stories of abuse, horror, violence, terror….not our own self within ourselves – not very many others.  I think we need to make ourselves more skilled and available to listen to one another’s stories – that the process of telling and listening is healing.  There is much debate about memory and its role in processing trauma.  As a member of my species, Homo sapien sapiens, the wise ones, I do not believe it is wise to silence our own or others’ stories.  I will talk about this more in the chapter on learning – how can we learn a cotton picking thing from something that we silence within us and among us?  We can express these stories any way we want, perhaps semantic words being the last of them – but tell them and communicate them we must.  Safely, wisely, carefully, of course.  This telling and this listening is worth more than anything extraneous we could conceive of buying with money – think about this.

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This self referent at the center of the circle of self is built into the center of the nervous system from birth (actually before)….later chapter on this…and is tied, or supposed to be tied, to a center point of calm.  In a malevolent world, this is not what happens…

“In all our actions and in the actions of others, we assume a basically intelligible, meaningful course of goals and means, of beginnings, middles and endings, and we assume the acting person to be the agent or author of this sequence, similar to an author of fiction.”  Fuchs 2007, 380

This is why I am so thrilled to have my mother’s childhood stories.  Knowing what came after they were written, it seems to me to be such a gift from her life, that these stories exist.  And I want to share them.  I want to understand them.

My mother was essentially a writer, though as I have spent some time working with her adult Alaskan journals, I can see that the force behind her words had vanished long before – and she did not know it.  That is the tragedy of the malaise that is borderline.  Part of me wants to perform a kind of artificial resuscitation to give my mother her life back – as if giving her life back, running the entire scenario backwards to her childhood beginnings, could somehow give me my life back – the life I was robbed of as she was robbed of hers.  And yet we breathed and lived and walked this earth, thus being the only life we did have, though not the live we could have had, or perhaps more crucially, the life we SHOULD have had.

No child can make intelligible the horrors of molestation, violence, torture, heart break and abuse.  No child can find the goals in that meanness.  Trauma is a shock to what self there is in this life, at whatever point it invades our existence and takes over the stage, takes over the story of our lives.  Trauma does not easily appear in the sequence of order, of unity, of the world of explanation.

“Thus, our everyday dealing with others already implies a narrative ‘pre-understanding’ which may, but does not necessarily have to be put into the words of an explicit story.”  Fuchs 2007, 380

We can talk about how the hippocampus is quite capable of frying its neurons through the heat of the stress hormones that wash over any purposeful effort the neurons might be making toward preparing a trauma memory for coding and future storage….but that is in the learning chapter.  Just know that the emotional memory and the physical memories are retained even if the actual facts of an experience are fried in the hippocampus – and they will haunt us, they will arise later, they will match the environment for cues of threat more than safety – the body remembers – implicit stories.

“Moreover, the concept of narrative identity does not imply that narratives are solitary works of isolated writers of their own life stories.  Personal identities are rather constituted by a complex interaction between first-, second- and third-person perspectives….The others are not only the implicit auditors and witnesses, but also the co-authors of our life stories.”  Fuchs 2007, 380

“…rather than maintaining a passive model of a person’s identity, recent hermeneutic theory emphasizes its active and creative construction by the person as the ‘author’ of the self-narrative.  In these concepts, temporality, narrativity and coherence of identity are closely intertwined.  What is the significance of these concepts for psychopathology?”  Fuchs 2007, 380

“Here we have to take into account that narrative identity is essentially based on the capacity of the individual to integrate contradictory aspects and tendencies into a coherent, overarching sense and view of his or her self.”  Fuchs 2007, 380

I cannot imagine how this would be for someone who has a secure attachment history and a benevolently-formed brain.  I just read the Swiss article on absence of PTSD in their study – I am tempted to put that with stress and distress rather than with symptoms – they did not find one person in their study with PTSD – no matter what the trauma was that a person reported.  That lets me know such a thing is possible – rather than ending up with an inability to integrate the severe contradictions that trauma can present a person with.  Do they not have people with troubled childhoods?

“Divergent tendencies and strivings have to be ruled out more or less permanently; otherwise the story would splinter into incoherent fragments.”  Fuchs 2007, 380

And this is exactly what happens!  Especially as a result of child abuse.

“…The power of second-order volitions, promise and conscience is often not sufficient to keep one’s life on track:  neurotic disorders are the manifestation of repressed wishes and unconscious memories that are permanently excluded from awareness in order to establish a coherent and predictable identity.  Repression and neurosis are the price that individuals of Western society pay for their identity, constancy and mutual reliability.” Fuchs 2007, 381

The author seems to be taking some giant leaps here, and with such pessimism is polluting his own waters.  All our early experiences are implicitly embedded in our bodies and in our brains, and depending on their nature will depend on how secure or insecure our internal world has been created.  In extreme cases, and certainly in cases of sexual molestation betrayal trauma for young children, of course there are wishes that will never be fulfilled.  Nothing can take the trauma away once it has occurred, even if there is healing on many levels. When innocence is trampled and done so prematurely, there will be consequences.  And couching those realities in some psychoanalytic jargon does nothing to enlighten any of us.  And once the water has been made murky by dropping each and every Westerner into it, it becomes impossible to distinguish who really has been traumatized from those that have not – a distinction that must be made in order to name the beasts among us.

The author states that since Freud’s time “…this picture seems to have changed dramatically….The formation as well as the concept of personal self-coherence has been questioned by three major developments:

+ 1  the rise of new kinds of early or ego-structural disorders with marked disturbances of identity , above all borderline personality disorder (BPD) – patients who are unable to develop classic neurosis;

+ 2  the rapid dissolution of traditional family structures and role patterns in post-industrial society, resulting in fragmented biographies;

+ 3  the post-modernist criticism of the traditional concept of the person as being only a historical and artificial self-construction….

Well, gee.  So if my mother had not been a borderline she would have graciously descended into a mere “neurosis” that someone, somehow, could have managed to deal with?

His point number 2 has to be taken into account along with the changing roles of women.  My grandmother was a piss poor mother, my bet.  She did not nurture my mother.  Neither did she protect her.  Perhaps such things have always gone on as far as sexual abuse of children – but something about the “morality” that my mother was exposed to, the bad-good dichotomy, I believe fed the split in her psyche.

And 3 – I have no idea where he is going with that one…

Fragmented Selves:  BPD

“Giving a general characterization, we may say that patients with BPD lack the strength to establish a coherent self-concept [then he repeats what is up earlier from the abstract].  Fuchs 2007, 381

I do not believe that this is the way it is.  Unless one is going to go further and admit that there are things in this life that are more than a person can bear.  And if their body does survive it, their mind – which requires a coherent self in order to run properly – will not make it across the chasm of trauma.  This is what we find with an insecure attachment history – lack of a coherent self.

Author believes that impulsivity is the core symptom of BPD.

Impulsivity is the symptom of a dysregulated brain, one that was formed incorrectly to live in a benevolent world.

“They undergo most intense and abrupt mood changes, including mainly anxiety, dysphoria, anger, shame and depression, but also short-lived enthusiasm or euphoria.  The more extreme the distortion in one direction, the easier it tips over to the opposite pole.  Each time, however, the patients are completely identified with their momentary state of mind, unable to gain a distance from the present situation.  As a result, they are torn by emerging impulses – bursts of anger and aggression, compulsive eating, addiction, self-mutilation, and so on.  They may also be curious, constantly seeking for novelties and events, but they do wo without patience, desperately searching for immediate satisfaction or reward.”  Fuchs 2007, 381

And the list goes on.  We know the disaster of these people’s lives – and the disaster they cause to those of us who have no choice but to have one in our lives.
“In other words:  borderline individuals lack the capacity to form enduring second-order volitions in the light of which present impulses could be evaluated and selected.” Fuchs 2007, 381

They don’t form second-order volitions because it is not in their brain mechanics to do so – that ability having been robbed from them permanently.  As long as we seem to lay the blame with them for being so flawed, we do not have to hold ourselves accountable in any way for a failure to provide a safe and secure environment for such children in the first place – a failure to provide for them what their brains needed to grow correctly in the first place.

Feedback, feedforward:

“…the patients are unable to draw on the experiences of the past in order to determine their own future by reflected decisions.”  Fuchs 2007, 381

We need to put our energies into understanding what has gone so wrong in their brains – memories – both forward memory of the future and backward memories of the past exist in the neurochemical environment of our physical brain.  If there’s something wrong there, then that’s the fact – and denying this reality gets us nowhere.

“They miss the experience of agency or authorship of their life.”  Fuchs 2007, 381

It was while they were children in the process of working all of this out, this self as agent in a world that makes sense – suddenly finding themselves in an overwhelming world where they could make no sense of it at all – like my mother’s last childhood story shows us – from inside the mind of one of these children.

“One could say that instead of projecting themselves into the future, they just stumble into it.  Thus borderline individuals exhibit a characteristic temporal structure:  they are only what they are experiencing at this moment, in an often intense and yet empty and flat present; for this present may only be experienced passively not as the result of one’s own planning and will.”  Fuchs 2007, 381

I think this is very accurate – but again, all these abilities we like to talk about, pride ourselves on if we have them and point the finger at and shame those that don’t have them – are functions of a healthily developed brain.  There’s no magic here, good or bad.  How a brain is built determines what it can and cannot do.

“…their transitory present has no depth.  It lacks the fulfillment which only originates from the integration of past experience and anticipated future.” Fuchs 2007, 381

Yes, I agree with this – but it a characteristic of unresolved trauma that it is past experience that is not integrated – in PTSD and in borderline – and again, why are the Swiss spared?  Do they have a borderline population?

“In order to fill the void, momentary pleasures, thrills and ecstasies are sought, turning life into an unconnected series of fleeting events instead of a continuous history….Others have defined borderline temporality as a cyclical structure without any historical progression [15].”  Fuchs 2007, 381

My mother took this to an Alaskan homesteading experience that was one continuous hell of drama and incompletion.  It was a continual running like hamsters on a wheel – up and down the mountain, from one crisis to another – all under the guise of a grand and worthy cause.

Splitting

This part certainly hits home – miserably so.  Her splitting was pathological and complete – and consumed 18 years of my life and formed my brain.  Scary stuff.

“The result is…a fragmentation of the narrative self:  a shifting view of oneself, with sharp discontinuities, rapidly changing roles and relationships and an underlying feeling of inner emptiness.”  Fuchs 2007, 382

I do not see how there can be this fragmentation of the narrative self without some element of dissociation “running in the background” like an invisible program running out of sight on a computer.  I suspect these dissociations can operate anywhere in the brain that a transition is required.  When he talks about “rapidly changing roles and relationships” I read into this “trauma drama,” which involves the switching between the dramatic roles of perpetrator, victim and rescuer.

In childhood the perpetrator and the rescuer are of necessity bound up in the body of the person or persons that the child is dependent upon for their survival.  Research identifies that with disorganized/disoriented insecure attachments, 80% of the children will adapt by fighting back in their behavior either between aggression or caretaking.  That leaves another 20% that I see nobody discussing – what happens to those children?

“There is no sense of continuity over time and across situations, no concept of self-development that could be projected into the future, but only an endless repetition of the same affective states, creating a peculiar atemporal mode of existing.”  Fuchs 2007, 382

This  implied separation between “concept of self-development” and the individual does not exist.  The entirety of an individual is carried within the brain of a person.  Thus this “concept” cannot possible be projected into the future – unless the author is suggesting that this concept is a part of future memory that exists as a function of the human ability to both remember the past and to remember the future.  It is the self that makes the connection between past and future, the self that moves along on this continuum of implied time.  If an individual does not possess a self in the first place, then obviously there can be no concept of self-development.

In addition, this described “peculiar atemporal mode of existing” is typical of the experiential state in the middle of peritrauma – of acute trauma experience as it is going on – or is ongoing.  In conditions of trauma the most common experience of “an altered sense of the passage of time” is retained.  There is no beginning or end to the peritraumatic experience, thus no shift to this experience of trauma-time.  This is what the brain has been forced to build into itself as a result of being influenced by the ongoing experience of trauma – peritrauma – as it grew.

Again, Teicher calls this brain an evolutionarily altered brain designed for and built in and by a malevolent environment.  There is no time in this kind of world other than the very instant of the present moment where threat-to-life requires a bodily response in order to best assure ongoing physical life.

“Patients describe a painful sense of incoherence and inauthenticity; they feel as if they were only pretending to be what they are, as if they cheated others into believing them.  In fact their personality often changes dramatically depending on who they are with.”  Fuchs 2007, 382

My mother had a “persecution complex” with the devil, through the instrument of me, being her persecutor.  She also “consumed” the identity of a homesteader, as if this focus allowed her a field of gravitation that kept the fragmentary pieces of herself pulled together around an external core.

In addition, the production of externalized components of her internal psychic world – the good daughter and the evil daughter – modulated or regulated the internal pressure she could not bear.  I suspect this resulted from the “too muchness” over overwhelming pressure and weight upon her child mind as it grew – what she could not endure even though her body kept on living.

“The fragmentation of identity is connected to an incoherence of autobiographical memory to be found in borderline individuals.”  Fuchs 2007, 382

This is not the only place it is found – PTSD also disallows integration of autobiographical experience –

“They have marked difficulties in recalling specific autobiographical experiences. And often their narrative accounts show large gaps or inconsistencies [19-21].  One subject who was unable to remember several years of her childhood and could not even recognize herself in photos from that period, described a sense of radical discontinuity of self over time:  “I feel like I am a completely different person that I used to be’ [18, p. 354].”  Fuchs 2007, 382

I have experienced this nearly every day of my adult life – now that I am “tuned in” to how I feel each morning when I wake up – it is only by being able to pick up a continuated thread from the day before, so that I can begin doing what I was doing the day before, that I can understand on a fundamental level that I am now the same person that I was yesterday – or at least I can “pretend” to be.

I laugh when I say that I have a dissociative identity disorder without the identities, but that is an accurate description of the experience.  I think in some way that is what the brain does with what it considers extraneous information that does not matter – does nothing to assure continued existence of the body, which is the natural imperative. Anything else we might like to consider “human,” is merely icing on the cake, gravy, frivolous extras, nonessential to the continuation of the body.

There is no reasonable way for me to assume that evolution instantaneously, at any point in human history, assigned us with the ability to extrapolate a separate individualized self from the billions of neural processes going on in our brain.  We evolved this ability to have or to conceptualize a conscious self through our continued advancement over time.  As ontogeny recapitulates phylogeny, this ability is not an instantaneously – or magically – endowed capacity for any single individual, either.

If things had not gone right back there in our history, we would not have evolved consciousness as individual  selves.  And if things do not go right for us in our individual development, we do not get an ideal self, either.  We can’t have nature any old way we want.  Nature follows rules in the development of any organism.  Exceptions to the rules only exist within an allowable range.  Those of us who have undergone traumatic formational stages of brain growth and development will show alterations from those whose brains developed, or evolved individually, in a benevolent, safe world.  We have different brains.

“These difficulties are mainly related to the patients’ tendency to dissociate [22].  Dissociation may be regarded as a failure to integrate perception, sensation, affect, memory and identity into a coherent and unified sense of consciousness and self.  There is much evidence that susceptibility to dissociation is, at least in part, the result of traumatic experiences and adverse early environments [23].  Dissociated states first manifest themselves when traumatic experiences are initially stored in memory as sensory fragments without a coherent narrative, and they recur when there is a subsequent failure to activate these memories.  Dissociation as well as overgeneral autobiographical recall may serve as a strategy to avert trauma-related distressing emotions.  On the other hand, they undermine the coherence of the life narrative.”  Fuchs 2007, 382

I do not believe that dissociation is what someone might refer to as a “second-order” defense designed to “avert trauma-related distressing emotions.”  Is the author describing one or two strategies – dissociation and overgeneral autobiographical recall?  Are they related, and how?  Yes, I agree that either or both undermine a coherent life narrative – but only the body needs to know survival information in worst case situations – not the mind.  Dissociation is a break in a flow of information.

The fragmentation of identity may further be explained by the context-dependence of memory as demonstrated by cognitive psychology.  Each context acts like a programme which activates images and memories related mainly to that one domain – e.g. we may remember what we wanted to do at home but forget about it once we are at work….The more intense a given state of mood or affect, the more it stimulates mood-specific autobiographical memories.  Rapidly changing affects and moods in (382)BPD therefore result in an incoherence of mood-related memories and self-concepts.  The tendency to experience extreme oscillations of mood makes the person almost feel like several different people, each defined by a particular mood state.”  Fuchs 2007, 383

I don’t think my mother ever had enough of a capacity to engage in self-reflection to notice if she felt like “different people” or not.  It didn’t matter to her.  She was continually going over Niagara Falls.  What use would the rudder of self-reflection be in such a desperate context?

“An additional reason for deficient identity may be seen in a lack of shared or intersubjective memories that help define the self over time.  For BPD patients, who cannot sustain many long-term relationships, life becomes a series of disconnected episodes with people who enter and leave their lives in a ceaseless succession.”  Fuchs 2007, 383

I know what this feels like – and I believe it is related to the inability to “feel felt” which I believe is the hallmark of a severe insecure  attachment disorder.  We lack the mental representations of people outside of their immediate physical presence – and even if they are physically present, we do not detect and emotional connection with them that is anything other than a projection of what we MIGHT suspect they are thinking or feeling.  I believe this is because the initial infant insecure attachment did not build the connection-with-other circuits in the beginning, so we have no access to this accurate information about others when we go through the stage of building a theory of mind.  It is all based on guesswork – which is really fundamentally true for everyone – but in normal, securely attached or even with the lesser of the organized insecure groups, the systems are operating at their higher evolutionary capacity levels.

Otherwise, we are closer to the “old ways.”  Closer to how the brain operated before there were more sophisticated brain mechanisms for clarifying others’ intentions and experiences.  We learn what the world is like for ourselves and for others through adequate infant caregiver interactions.  Without them, we do not have accurate information about either others or ourselves.

If animals are more alike than different, then it is our differentiation that is a result of evolutionary advances that is missing with those of us with the evolutionarily altered brains.  We are more alike one another than different.  We are tied to the capacities our bodies have to ensure our survival.  Perhaps this less-than-sophisticated threatens those who have been allowed to develop the more advanced capacities.  Maybe it’s like buying a new car without any extras.  We get just the basic model, they get the models with the extras.  Everybody would want the extras.  Nobody would want to imagine that theirs could be stripped from them.

“…the felt lack of inner identity leads to desperate fears of abandonment and even to suicide attempts in order to prevent it:  when the other is needed for establishing a fragile sense of continuity and coherence – even if only by serving as a carrier of intolerable negative affects projected onto him – then the threat of abandonment evokes a loss of one’s very self.”  Fuchs 2007, 383

I concur, as my father would say.  Except that the other arm of this is that those of us with this fragile self will also remain attached in relationships where we can accept someone else’s projections.  We have been trained to do this.  If we are used to having our shape defined – because we are invisible otherwise – then we are sitting ducks for someone to throw their projections over us to ex-form us, rather than we being in-formed for ourselves.  If we lose their projection onto us, we lose ourselves.  It works both ways.

Intersubjectivity

OK, here the author is getting to the meat of it:

“This leads us to finally conceive of the identity disturbance in BPD as a disorder of intersubjectivity.  I have pointed out in the introduction that the concept of narrative identity is essentially based on an implicit other who would understand our actions and projects, to whom we could tell our life story and to whom we would also feel responsible.  This implicit presence of the other, however, presupposes early experiences of object constancy and secure attachment to important others.  When the mother or other early caregivers provide adequate holding, soothing and mirroring for the child, they experience a mutual emotional attunement or what has been called ‘dyadically expanded states of consciousness’ [25].  Repeated experiences of this kind are internalized by the child as implicit [built into the brains circuitry and neurochemical operation] ‘schemes of being-with-others’ and as secure attachment patterns, from which a coherent sense of self and self-esteem can evolve [26,27].  The basic sense of continuity of our life depends on a history shared with others, on an intersubjective temporality [28].”  Fuchs 2007, 383

This would not be true if we were not a social species.  It would not be true if we just hatched from an egg and went instantly about our business of being alive instinctively, needing no extra additional learning time to get up on our feet and get on with this business.

Attachment builds patterns that are actually neurochemical patterns in the brain.  This is essential, not conceptual. It reflects what we fundamentally know, not what we know about, or think about something.  Without a secure attachment pattern built into the brain, I believe what results as a consequence is a corresponding degree of desperation. Anything less than a safe world is a desperate one, to one degree or another.  And for every degree of desperation built into our brain is a corresponding loss of a degree of freedom in our brain’s operational capacity – which then show in our lives.

“…several studies have examined attachment in borderline patients and found a majority (75-90%) to show disturbed (i.e. overinvolved-preoccupied or avoidant) attachment patterns [he is not even mentioning the insecure disorganized attachment pattern], mainly due to adverse or traumatic early environments, in particular to abusive caregivers [20,29].  Thus, the patients’ chronic feelings of emptiness, bursts of rage, fears of abandonment and lack of a stable sense of self may be derived from deficits in early social attunement and resulting attachment disorders.”  Fuchs 2007, 383

We need to take the additional step in our understanding and realize that without stabilizing attachment, the  emotional regulation areas of the brain are not formed correctly.  The set point for equilibrium in the entire nervous system including the brain, and the development and operation of the immune system are not set at calm, and the switch point for the entire system of the body is altered, as well.  Every brain system and process will be altered, from regulatory and attentional systems, associational systems, decision-making systems, memory systems, stimulus response systems, learning systems.  The manifestation of our genes are affected.  And we do not know if these alterations actually change our DNA that can be passed down to future generations.  These realities can be seen in rat studies, primate studies, as well as human studies when people are paying attention to what matters most.

I also need to make note of the importance of SHARED attention in self-development

“When experiences of trustful relationships are missing, the child will not establish the inner representations of others [which exist as neurochemical reactions in the brain] that are necessary to form coherent narratives of oneself.  Hence, BPD may also be regarded as a disorder of early social attunement and intersubjective temporality.”  Fuchs 2007, 383

“Though these disturbances date back to preverbal and prereflective periods, their results become particularly manifest in deficits of reflective or representative functions required for establishing a narrative identity.  Narratives can only be constituted if one is able to imagine one’s own as well as others’ intentions, aims and motives as guiding their actions and explaining their behaviour.”  Fuchs 2007, 383

But we must not neglect the added complications during the 3-6 year old stage of actively applying ToM.

“To the extent that borderline individuals have difficulties in taking the perspective of others, they should also have difficulties in developing coherent identities.”  Fuchs 2007, 383

Empathy studies make a distinction between cognitive perspective taking and empathy – see empathy chapter.

This makes my mother’s childhood stories particularly fascinating to me.  She advances mental energy in describing switches between perspectives which take into consideration the reader of the story as well as the characters involved in the story.  She was aware of the internal context in her stories as well as the external ones.  This makes me wonder if she was not somehow gifted and extraordinarily sensitive to such interplays.

Yet I overlay on top of my mothers’ stories a sense within me – perhaps through some empathic connection – of her being alone in the world of her mind, especially in consideration of the last of her stories in her “series.”

“Narrative identity obviously implies the ascription of meaningful and intelligible intentions to oneself and to others.  The development of this capacity, however, basically depends on the affective attunement, empathy and secure attachment between the infant and the caregivers.  Only if the child’s experiences meet adequate understanding, mirroring and labeling by others can they be integrated into a coherent understanding of what it means to be a self with intentions, wishes, goals and a basic temporal continuity.” Fuchs 2007, 383

I have been sensitized in my readings to distinguishing between the stages that belong to what we would refer to infant brain development and those that belong to childhood.  I draw that line at age 2, at which developmental experts suggest that a self is already formed.  After that, in my thinking, this self – if it exists in its own right – forms increasingly more complex networks based on meaning, intelligible – intelligence, and continued semantic labeling of experience as an interactive reality between self, environment and others.

If the former stages were rocky and inadequate, and then the later stages are brutally interrupted and intervened with, all manner of confusion will arise within a child’s mind.

Author refers to Fonagy “Attachment and borderline personality disorder” J Am Psychoanal Assoc. 2000; 48: 1129-1146 – “The securely attached child sees that ‘the caregiver represents him as an intentional being, and this representation is internalized to form the self’ [32 – Fonagy noted here].”  Fuchs 2007, 383

Well, nobody ever saw me as an intentional being.  Only that I intended harm.  And how is any of this going to connect back to PTSD?  I can see the parallels between having nobody to empathize with traumas even in adulthood, and that an inability to reflect upon the experiences of trauma from a perspective that does not involve a contamination of the self with the experience – yet when the experiences remain unlabelled and confusing, as this author is saying of the child who becomes a borderline?

“His experiences remain unlabelled and confusing, all the more so since there is often a contradiction between the parents’ verbal utterances and their abusive behaviour.  As the states of mind the child perceives in his caregiver seem too threatening, he is increasingly led to retreat from the (383) mental realm [32].  Traumatic experiences that cannot be symbolized are particularly apt to impair the development of ‘mentalizing’ capacities [31].  As a result, the intentional states of others remain a foreign, dark and potentially hostile world, leading the patients to premature conclusions about malicious intentions of others and to a fundamental insecurity in their relationships.  Since an understanding of mental life and a continuous narrative commentary on one’s experiences also provide the link for establishing the continuity between one’s past, present and future, the development of autobiographical memory and identity is seriously impaired.”  Fuchs 2007, 384

I suspect that the development of PTSD following any trauma is paralleling this trajectory.

“As a consequence of the mother’s inability to mirror, modulate and label their affective experience, the infants are not able to adequately perceive, represent and thus self-regulate their emotional states [33].  Moreover, they cannot evoke internalized images and memories as a source of self-soothing, nor maintain a sense of relatedness with reliable others in the face of emotional stress.”  Fuchs 2007, 384

PTSD is in conflict with self-soothing.  The inability to regulate the emotions is in the brain circuitry.

“Intolerable negative affects in particular have then to be expelled and externalized as belonging to others, where they can be hated and fought, a mechanism commonly called projective identification.”  Fuchs 2007, 384

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“…inner emptiness, numbness and alienation are the result of being split from oneself:  Experiences that cannot be integrated into a historical coherence of life, but are abandoned each time for the sake of new ones, can leave only emptiness behind, however intense they may be.  Such experiences remain meaningless, too, for they could only gain meaning against the background of an overarching concept or direction of life.  The loss of time as a continuum that extends into the past and the future creates a now without depth.”  Fuchs 2007, 386

There are traumatic experiences that we cannot absorb, digest or integrate.  They recirculate themselves in PTSD rather than vanish with abandonment.  They are meaningless because they teach us nothing new we can use to better our lives.  We are cut off from the survival value of these learnings because we are cut off from our species and have little to personally offer toward the continuation of our line.  I suspect that these traumas cannot gain meaning unless they are placed against our evolutionary background – they do not belong to us personally.  We need to keep our self in line, in the line of evolutionary progression and wisdom of the body toward survival.

Today sis Cindy told me about the research on how pollution and environmental toxins is altering phenotypes that are being passed to future generations and causing diseases in adulthood.  How wise are we?

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TRANSGENERATIONAL SELFHOOD

We like to think, particularly in America, that having an independent self is our birthright, that we are born and then like some windborne seed we are uplifted by the winds of our separate lives and cast off into the future of our own lives, independently capable of making of ourselves whatsoever we wish.

In a form of metacognition I am in agreement with Peter Fonagy that what we acquire and are in actuality is a form of a transgenerational self.  The only reason we can think of a self at all is because the direction of evolution has prepared us, as the carriers of all the successes our species has acquired thus far, to consider ourselves consciously as separate from the whole of life.  But that ability to be this aware is a gift that needs to be used wisely and with consideration, because it can be removed from us, whether we wish to consider and believe this possibility or not.

All we have to do is look around us and notice the variations of selfhood that exist both within our own culture and without it – in other cultures as they are vanishing over the horizon of the past.  Americans as a whole do not with themselves to be members of a tribe.  We are lucky if we are even connected to a family at all in today’s world where the definition of family has had to change as rapidly as memory allows.  Yet we remain a social species.  That is our species by design.  If we do not wish to be connected to others the way nature designed us to be, then we can go right ahead down the road we are headed and the variations to the norm can become the norm.  But we better look into the future with our eyes wide open so we are not surprised and full of complaints when what we wished for comes true.

We need to only look into the pot where the so-called mental illnesses among us are brewing to see that distortions of connections with caregivers from birth create different brains which are then transmitted down the generations through their offspring – and sooner or later the deviations that are thus originating among us will supplant and then erase all that we accomplished as a species through the last six and a half million years.  Yes, evolution can go backwards.  But that does not lead to a good life.  It leads to a bad one, a less than whole one, with complications, repercussions and consequences that we cannot erase as easily as we created them.

We cannot disconnect ourselves from one another any more than our heart can disconnect itself from its network of veins and arteries, and expect to stay alive.  Whether we want to realize it or not, the best thing we have going for us right now is that there are so many of us because sooner or later there will have to be another natural selection processes that will in itself decide the future of our species.  The question will be, “Who can adapt to what?”

We cannot go about destroying the world we live in and expect that our species will continue on without paying a price, a heavy price. And every person who has been born into this world without adequate caregivers to greet them knows what a portion of this price is.  They pay it with every breath they take, and they do so with a stranger version of a self at the helm than most “normal” people can imagine.

And yet this version of a self HAS existed before.  Back there, back when, back before the human species took control of its care of infants consciously.  We applied our ability to choose and claimed to nature that we knew better how to care for our young than the rest of nature did.  We did not make mistakes in this regard.  Our prevalence upon this earth is proof of that fact.

Somewhere in the past of our species, somehow, we acquired the ability to make conscious choices.  We assume that we are all equal in this ability.  Not true.  Our ability to make informed, wise and conscious choices evolved back then in a group of people just as it evolves in us individually from at least the moment we are born – and in fact, long before we are born because we are tied in our genetics to everything that has happened to our species in the past.  From the experiences of our species’ past, and from our personal experiences as we grow our brains from birth, comes the foundation of our abilities – or lack of abilities.  If we are not provided with the interactions appropriate for our species to take the best of our combined heritage into the future, we have to take a different path and will have a different journey.

We cannot arbitrarily extend our reach into the future and magically partake of evolution that has not yet occurred in our past.  We are standing on the rungs of a ladder as they have been constructed for us by our ancestral accomplishments.  We cannot reach above ourselves and grab onto rungs that have not yet been created.  Those rungs are for the future generations, and we are preparing for them what they will have to live with then.  Right now we have to take account and be responsible for our segment of history.  It can be no other way.  And because we are all connected today, as we have been in the past and will be in the future, the end result will not be disconnected from the whole of what we are carrying with us now.

It is as if we stand with our hands held together as a great marching wall of humanity, moving from the past into the future one breath at a time.  All of us.  Together. It has always been so, even when there were so few of us that we could hardly be counted upon this earth.  But we made something of ourselves, something righteous and something to be reckoned with.  One breath at a time.  And somewhere back in our past, as a species, we marched through an invisible barrier and accomplished what had not been accomplished before.  Somebody, somewhere, made their first conscious choice.

And where I believe we need to look to find the center of the amazing abilities that we posses as a result of our evolutionary process is where it all starts for all of us – with the mothers.  I believe that is was only because our interactions with our physical environment reached a point of benevolence, where we learned how to use tools and to hunt meat and plants in an adequate measure to provide for ourselves.  In this environment of safety in regard to our basic need fulfillment, women and infants/young children were protected and cared for by women to such a degree that their interactions with their children were able to foster a creative and productive interaction to facilitate the expansion of our brain and its capacities.

Life is an interactive process, and advancement is the direction life takes us all.  Women had the time and the protection and the nurturance and protection that enabled them to pay attention and to play with their offspring in such a way that the abilities within the human brain were developed as much as possible in that first arena, and as these children grew to adulthood the new expansion of their potential found expression in increasingly adaptive interaction with these early human environment.  The increased size and complexity of the human brain came from a genetic mutation that was used among the people and was found beneficial to them by enhancing their competitive accomplishments to an ever greater extent.  With this increase in use and growth of the brain, the genetic mutation on the FOXP2 gene found a useful home in the human brain which again allowed our species to expand our successful expansion of abilities.

That women evolved to interact with infants specifically toward the fostering of language abilities is recognizable in the useful and particular version of baby speech – pitch, intonation, range and pattern that is accepted like a key into a lock inside our infant brains toward the development of speech and the use of language.  From this interaction over time, cognition became increasingly available to us through the application of words we could use flexibly and fast to communicate not only with others, but eventually we used it to communicate within ourselves.  And the possibility for having a self was born.

The concept of cognition is tied to its mothering female roots in our language.

COGNATE

Function: adjective

Etymology: Latin cognatus, from co- + gnatus, natus, past participle of nasci to be born; akin to Latin gignere to beget – more at  KIN

Date: circa 1645

1 : of the same or similar nature  : generically alike

2 : related by blood;  also   : related on the mother’s side

3 a : related by descent from the same ancestral language  b of a word or morpheme   : related by derivation, borrowing, or descent  c of a substantive   : related to a verb usually by derivation and serving as its object to reinforce the meaning

COGNITIVE

Function: adjective

Date:1586

1 : of, relating to, being, or involving conscious intellectual activity (as thinking, reasoning, or remembering)  *cognitive impairment*

2 : based on or capable of being reduced to empirical factual knowledge

COGNITION

Function: noun

Etymology: middle English cognicion, from Anglo-French, from Latin cognition-, cognitio, from cognoscere to become acquainted with, know, from co- + gnoscere to come to know – more at  KNOW

Date:15th century

: cognitive mental processes;  also   : a product of these processes

KNOW

Function: verb

Inflected Form: knew  \*n* also *ny*\ ; known  \*n*n\ ; knowing

Etymology: Middle English, from Old English cn*wan; akin to Old High German bichn*an to recognize, Latin gnoscere, noscere to come to know, Greek gign*skein

Date: before 12th century

transitive verb

1 a (1) : to perceive directly  : have direct cognition of  (2) : to have understanding of  *importance of knowing oneself*  (3) : to recognize the nature of  : DISCERN  b (1) : to recognize as being the same as something previously known  (2) : to be acquainted or familiar with  (3) : to have experience of

2 a : to be aware of the truth or factuality of  : be convinced or certain of  b : to have a practical understanding of  *knows how to write*

3 archaic   : to have sexual intercourse with

intransitive verb

1 : to have knowledge

2 : to be or become cognizant –  sometimes used interjectionally with you especially as a filler in informal speech

-knowable \*n*-*-b*l\  adjective

-knower \*n*-*r\  noun

-know from : to have knowledge of  *didn’t know from sibling rivalry – Penny Marshall*

We come to know life through the body of mothers.  We come to know our species first through our interaction with our mothers.  As a species, I believe we were first able to accept the future of our language-use abilities through our interactions with our mothers, who were no doubt well provided for and protected during the times surrounding pregnancy, birth and young child rearing by capable men.

To the degree that we are choosing individually and a species to put into affect changes in the way mothers interact with their infants and young children we are pursuing a continuing process of increasing alternative directions of providing for the birthing “rites – rights” of the members of our species.  We cannot account for the full picture of our social conditions unless we consider what these choices are that are being made as well as what the possible and real consequences of the choices are.  There has never been a time when there has not been a consequence for a choice made, a decision enacted.  We live in a world with biophysical rules and laws.  We cannot live, for example, without air, water and food.  We can alter ways in which we meet these needs but there are consequences for even these choices.  To enable our species, Homo sapien sapiens, the Wise Ones, to continue on this planet, we have to pay attention to what we are doing.  Ignorance does not lead to bliss.  It never has and it never will.  Being alive is too great a challenge and involves too great a risk for us to walk down a stupid path and expect to get away with it.

I suggest that the wisdom available to any single one of us is 100% of who we are.  The remainder of this wisdom being taken over unconsciously and automatically by our body balances whatever percentage of this wisdom is available to us consciously.  For every degree we are responded to appropriately as infants (within a healthy body), we are being given an equivalent  degree of freedom to use as a separate individual self for the rest of our lives.  Never were we designed to achieve 100% conscious control over every aspect of our existence.  But if we want expanded abilities to make choices as people separate mentally but connected physically to our species, we have to achieve those abilities through interaction with our earliest caregivers.

The implicit promise of responsibility in our species’ evolution is that men and women, in cooperation with one another, would take care of us consciously better than nature could do it unconsciously for us.  It is against the inherent logic of nature that we can have it both ways, or any old way we choose.  The choices are limited by our biologic heritage.  Our brains will grow the way they are directed to grow by the interactions we have with our early caregivers.  They are determining the creation of our brains.  If they harm us we get harm-filled brains.  If they take care of us, we get care-filled brains.  From those early years of experience onward, we will be working with what we were given long before our brains were developed, or evolved enough, to have conscious memories of the experiences that formed our brains, our nervous systems, our immune systems, in the first place.  What more can I say?  In optimal conditions we will end up with a fully functional self.  In less than optimal conditions, we will not.  Plain and simple, like it or not.  Our conscious response-ability is determined for us to the largest extent.  What we attempt to do with what we have been given is ours, to the best of our ability.  But we all have to understand and accept that we have been formed by circumstances that were beyond our control.  The greater the early threat in our environment, the greater will be the body’s automatic response to life for a person in the future.  We can whine all we want, act pitiful and remain ignorant and neglectful of the facts of the natural world, but we cannot escape.  Not as long as we are here sharing our portion of life on this planet.

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Bouvard et al 2001

Abstract – French article on responsibility

Appraisal of inflated responsibility for harm, cornerstone of Salkovskis’s cognitive theory for obsessive compulsive disorder – aim of study to validate French translation of the R scale – compared 50 subjects with OCD, 37 patients suffering from social phobia and 183 controls on a responsibility questionnaire (R scale) –

“The cognitive hypothesis of Obsessive Compulsive Disorder (OCD) specifies two levels of responsibility related cognitions:  responsibility assumptions (attitudes) and responsibility appraisals (interpretations).  The R scale evaluates the responsibility assumptions.  Such attitudes should reflect the more generalized tendency to assume responsibility in a given situation, particularly situations involving intrusions and doubts.”

….Only patients with OCD had significantly elevated score on the “need to prevent risks” compared to the non-clinical group….the two subscales of the R scale  did not discriminate OCD patients and social phobic subjects. (“belief that one has power to harm” (shared with social phobia) and “need to prevent risks”).

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Friday, August 22, 2008

A woman born 12-23-37 moved into the Y yesterday.  I knew she was trouble from her phone calls, calling from Santa Cruz, CA.  I took pity on her and told her we would hold a room open for her until the 25^th.  I met her today when I went back to work, having taken 2 days off to stay home and write.

She is a full blown borderline, no doubt.  Her reality is so external that it spins around her like a galaxy, enveloping all within her range in her lunacy, her machinations, her pity, her projections, and her rage.  She is so like my  other.  I cannot tolerate being near her.  But today I have a glimmer of a sense of what hell it was spending 18 years from my birth with a woman who was even madder than this one.

I do not want to minimize the horror of life of being the child of such a woman.  It is beyond my conception to know how I survived.  I simply had no choice.

There is simply no way to be nice to this woman today.  She is incapable of understanding anything.  She carries a dark and frigid wind that sucks the life out of all around her into a swirling void of blackness that has no end.  Being near her is like standing at the open gates of a hell so abysmally empty and voracious.  Clutches of talons ten times my size.  I shut the office door in her face today.  She never heard a word I said to her, so absorbed, so completely preoccupied, occupied, with her own desperation, yet at the same time she stand outside her frail pathetic body with a leering sneering screeching siren’s call of doom.  So malevolent.  So incurable.  So hopeless.  Such a perversion.  Her brain does not work right.  There is no more accurate way to put it.  Yet she is still alive, her body still carries her, barely, through each moment at a time.

I wish I could describe what I know of these people, but to do so would beckon me too near, again, what I only escaped from with my physical body, not my mind.  Every breath my mother could possibly breathe through me, she did.  Icy cold, death breath of oblivion that will not blissfully arrive.  Always the escape was held at bay.  Always the death was cept at bay, though it would have been a blissful alternative to my living hell.  Her living hell.  Her hell she lived through me.  Such mothers rip the living organs out of their children and replace them with hatred.  They take the fresh flesh of their pure born children and blow putrification through every single pore.  They rip the hair away and leave the bare bone of skull; they steal the very words from our brains before they are learned and formed, they steal the very sense of time from our souls on this earth.

I would say such people are not safe.  They are dangerous, more dangerous than any living other being on this planet, because they deprive the innocent of their lives.  You need a crucifix to enter near them.  As if such a tinny thing could assist in any way the victims that are their children.

My mother was as toxic as any poison devised by the efforts of nature or of human.  They are a walking curse themselves upon the earth, because somebody ruined them.  They stink.  Yes.  I will be harsh.  My mother should have served her sentence of no less than 14,190 years.  There is no sentence, obviously, given within the limits of this plane of life that could ever extract back from my mother what she stole from me.  And, yes, the same is true for whomever it was that stole her goodness from her along with her life.

My mother was the near perfect epitome of evil incarnate.  I do not say that in anything but the natural way.  She had a brain designed by hell to live in hell and by all goodness left in this life I wish it had not been so.  But it was so.  It was so.  She was not only the mythological mother than knifed and bludgeoned her child to death.  She delighted in consuming it alive.  Not a shred of flesh would have she left intact so desperate was her condition.

Humans have evolved through some hard, hard times, but never did we do this surviving alone.  This being alone is a new event, one we created when we opted to take from nurture the reigns of parenting our offspring.  This is our risk when our chosen way goes badly in an environment that threatens us with extinction with the next breath we inhale, before we have a chance to exhale.  When trauma rips time away from us, catching it and not letting go, there is no past and there is no future and the moment we are trapped in is always our last.

Yes, it defies logic.  There is no logic in a brain that has lost its connection with itself.  When everything human within it has slid over the edge and keeps right on sliding.

We like to think as humans that we are somehow separate from our biological functioning – a form of childish magical thinking – denial – at best, stupid and ignorant at worst.  Many stressed and distressed mother animals of all other species abandon or kill their offspring if their own bodies signal to them that their own lives are in danger – in a malevolent or toxic, distressful environment, it is better to destroy young and live to better times to have more offspring.  That makes biological sense – until we apply human attitudes and beliefs.

In nature’s way, sometimes the weaker offspring are eliminated by direct death caused by the mother or indirectly through abandonment and neglect.  (I have research on primate violence toward infants…)

Borderlines presentations, I suspect vary according to degree of brokenness and intelligence along a continuum with mild symptoms on one end of demanding self-centered rather spoiled-like sucking of energy and attention from others.  All share in common a repetitive pattern of extending their desires for attention from others in a radiating circle around them with minimal or zero capacity for ownership of their actions or intentions.

Weaker borderlines on one end of the continuum, are less sophisticated than the more advanced versions in their insidious expansion of demand out into the world around them, perhaps appearing to be “innocent,” childlike, passive-aggressive, sarcastic, consistent, needy psychic leeches, relentless, persistent, chronically lonely, rejecting ownership of intention or consequence, narrowly focused on immediate attention and demanding that their emotional needs be met NOW by a select focus on a few willingly available and participating others within their sphere.  These people will give up rather than pursue a likely source of life force.  They are more timid, than the more advanced borderlines and operate with skills simple and primitive, more like a bug eating plant would possess. Their needs are simpler, they exert as little actual effort as possible to obtain what they want, and they have multiple abilities and skills they can use to self-soothe.  In this way they can appear to “go dormant” in the pattern of their cycles.  They tend to be “victimish” rather than “perpetratorish.”  The “ish” part being indicative of their lack of vitality and sluggish energy levels, which make it easy to deflect these borderlines without having to marshal and implement strong resistances to their efforts and actions.

The more advanced borderlines are more verbally aggressive and more intelligent at manipulating conversation and at causing conflict in others within their sphere of influence.  All the other traits above apply plus the additional component of intensified application of persistent effort behind the very thin, but effective, veneer of either innocence or self aggrandizement.  They can pretend, on self-serving occasions, to be concerned with the needs of others, but in reality their own agenda is all that matters.  They are experts at smoke and mirror tricks, and are more competent and therefore confident in their abilities to manipulate others.  They are vampires with a fluctuating appetite, satiated they will back off, empty again and they will go on the hunt for more.  Their field of operation is wider than the weak borderline’s because they are more masterful in their technique and abilities.  These borderlines will back off through humiliation.  Their next attacks, however, will be fueled by the rage of such humiliation and will further justify their unconscious motives and attempts at compensating themselves even further through a self-justification process that enables them to proceed without conscience.  Their working methods include blaming and shaming others, as well as appearing helpless and innocent of fault in every situation where they have instigated others into irritability or retaliation.  The mercurial “slipperiness” of the borderline condition is in full operation in the midline borderline.  You will be able to clearly feel the dark forces of unconscious manipulation if you let yourself.  Every time you find yourself making an excuse for their behavior, you are participating with them in their competently orchestrated manipulation of others around them.

The most advanced borderlines (deteriorated even further in degree from healthy well-being) are outright cannibals and would devour and consume, with a side component of extreme rage, anyone and everyone outside of themselves.  They have a voracious appetite and are never satiated or satisfied, nor do they have any working knowledge of self-soothing.  They are masters at projection and hold very little, if any, internal representations of their own states of mind or affects.  Their reach into the world around them, with no ability to conceive of a future, is an adamant, determined, desperate adaptation to destruction of an operational self.  These people are dangerous to those who are creep magnets, or have what my friend Anne refers to as “creep appeal.”  The tendrils of their psychological energy projections wander in self-seeking fashion swiftly and constantly into the area around them.  If they detect weakness, lack of vigilance, or vulnerability of a crack or a fissure in the self-boundary of anyone around them, they will infiltrate mercilessly any arena that they can to obtain whatever they want.  These people are completely unaware, lacking self-reflective abilities, and have a completely fractured and fragmented reality created by a void where an operational self-as-agent should have been constructed.  I believe this last group includes many who had ,as children, creative and imaginative abilities (perhaps gifted) that served as gasoline to a raging fire when the causal event or chains of events of betrayal trauma happened to them during Theory of Mind developmental stages.  I also believe that their infant attachments were completely insecure with their primary caregiver but over-dependently formulated in regard to any other available attachment figures on the stage of their early lives in a compensatory fashion. They had a fragile, vulnerable and precariously constructed sense of themselves as “good” in an overly conditional environment.  These children attempted to control adult responses that should have been freely given to the child but were instead withheld and inconsistently doled out in ways that were unpredictable to the child.  I believe that these children put a great deal of concentrated effort into trying to understand their world.  They can never be faulted for lack of effort.  They tried as hard as a child can possibly try, applied themselves to the business of survival that was energy and effort that was stolen from their own process of just being a child and of going through necessary developmental stages.  The degree of their effort was the best that nature supplied them with.  They used every resource available to them to create an imaginative house of cards as defense against an onslaught of adult neglect, abandonment, unavailability, inconsistent, inadequate and insincere praise and reward, multi-sphere abuse, outright violence (frequent or sporadic), and finally suffered betrayal from a person or persons that the child desperately depended upon for meager sustenance on many levels.  The final betrayals that obliterated the child are almost always of the nature of sexual assault.  These willing and eager-to-please children were trammeled upon, trampled upon, invaded and crushed.  They have, in reality, been driven to madness and I believe that we will find a transgenerational epigenetic adaptation in their phenotype offered them the only opportunity available to them in their survival of what they could not endure.

But I also know in all cases the progressed borderline is dangerous, and the toxicity of their adaptations can be transmitted directly to children.  Their cannibalistic construction prevents them from being able to modulate or regulate not only their own emotions, but their mental processes and resulting actions.  The operation of their brain has been altered from normal.  Their brains do not work beneficially.  They were created for and in a malevolent world that is beyond what we would ever consider even remotely safe.  We cannot turn the other cheek to these people.  We cannot excuse, rationalize, explain, justify, minimize, deny or condone the reality of who and what their childhood traumas have made them into.  They are less safe around children than would be a rabid wolf.  Untreated, they can accomplish nothing but destruction and transmission of their toxicity to their offspring.  They may conceive and bear children into the world, but in no sense can they mother or nurture, and their condition is contagious to their children.  My assessment is a judgment of risk of threat and danger to others, especially children, rather than a statement of condemnation.  We cannot lie on our couches and prop our head up on a bent elbow and suggest from a distance what might solve these critical problems.  We have to stand up and take clear and strong action to protect the children of all borderlines, especially those born to the cannibals.  If these mothers do not actually physically kill their offspring, they will destroy the health of their brains and minds, and will rob their children of fully-functional abilities to live a good life.  I know this.  I had one for a mother.

So I see the first classification of borderline as whiners and cajolers (irritations); the second as ‘threateners’, scammers and petty thieves (misdemeanors); the third category are murderous criminals if left to their own devices around children (class A felons).  They will vindictively and maliciously pass on, whenever possible, what was given to them.  I also see the three main degrees of borderline in terms of availability of conscious, aware, self-reflective choice making abilities.  While perhaps appearing to operate in normal fashion, these conditions reflect increasing degrees of reactivity outside the range of conscious control.

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The degrees of borderline operational capacities can be assessed by the degree of either overt or covert (subliminal) operation.  I believe that increasing levels of innate intelligence combined with degrees of damage during infanthood and young childhood determine the extent of destructive power of the person without a self in a body that we can encounter in our journey through life.  They thrive on niceness etiquette.  They can also thrive on rejection because the flag that is waved in their face only serves to challenge and therefore instigate their efforts further.  A borderline will never give up.  Their brains are built to pursue, not to retreat.

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Talking to Cindy tonight, she mentioned how when she is stressed, particularly emotionally, it’s like something slip ‘backwards’ and she loses ground in being able to make fast assessments and instant reactions and actions toward strange people that come into the bookstore.  Some of the terms that came up in our discussion:  we have a lot to lose, don’t bounce back like when young, become embroiled in interactions that suddenly seem less clear and more complicated than usual, find self making excuses for how other people are rather than just not tolerating them being around; get foggy, insidious interactions, edges become blurred between self and others, shared realities, remember to row one’s own boat, things get muddled, inability to make clear decisions, find self “being nice” in a different way – codependency.

All self – other problems, empathy problems, theory of mind problems – I believe multi-tasking (which is really inaccurate because of the brain’s bottleneck, but it usually goes through the cue so fast we hardly notice) becomes cumbersome – there’s information in the cue that is from the past that is just too unwieldy and inappropriate for today but too complicated to sort out – like a log jam –

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Sometimes I have a strange time sensation that somehow seems familiar from childhood.  On the weekends I take my friend’s Chihuahua home so he doesn’t have to stay alone in the auto shop.  He’s in his later years, being nine years old, and is one of my favorites.  He gets bath first thing Friday evening, and I have a spot with a special blanket for him to sleep with me at night.  Every weekend, though 5 days have passed in between, when he first settles into his spot he lays on his back so I can rub his tummy.  There’s something about that activity that is always the same, and every time it is like no time has passed since the last time he was on that blanket in that position and I am rubbing his tummy – which he absolutely loves.

Nights when I do my twenty minute workout with the corresponding DVD playing, I am again aware of that sensation, like no time has passed since the last time I was standing on that rug in front of that TV doing those exercises.

I think it’s part of the depersonalization, derealization I experience, that those specific incidents put me in alignment with my SELF for those few moments, and every other experience I have had in between vanishes like it never happened.  Like all the work that goes into the making of a movie that we don’t see when we watch it.  We only see the movie.

I wonder if the ritual of smoking cigarettes is similar, an action that is performed basically in the same way every time, and is consistent in that regard no matter where I actually am when I smoke it.

Is that sense of connection with myself what normal people feel all the time as time goes by and they are living that time?  It is like I don’t exist any other time, like I am an illusion or some faint memory no more than a faint whist of mist or smoke.

Sometimes I feel it when I first lay down in bed at night.
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Saturday, August 23, 2008

Siegel 1999

“”Feeling felt” may be an essential ingredient in attachment relationships.  Having the sense that someone else feels one’s feelings and is able to respond contingently to one’s communication may be vital to close relationships of all sorts throughout the lifespan.  Such attachments foster the interactive sharing of states, which facilitates the amplification of positive, enjoyable emotions and the diminution of negative, uncomfortable emotions.  The attuned communication within attachment relationships allows such interactive amplification (272) and diminution to occur.  The outcome is that each member of the pair may “feel felt” by the other.  For the developing child, the secure attachment relationship provides the amplification that heightens pleasurable states and allows the child to engage in the self-regulation needed to diminish unpleasurable ones.”  Siegel, 1999, 272-273

This book is tied in its foundation to this foundational condition of “feeling felt.”  I can never go back to my birth and build this condition into my brain as the foundational component is was been designed by human evolutionary history to be.  I believe that this condition is the essential nutritive environmental soil that the seed of self germinates in – the soil that feeds and fosters this germination.  Without the condition of feeling felt, a self within a newborn infant cannot germinate appropriately and will therefore not be an available asset around which all other developmental stages of the human being are meant to unfold.

Malevolent and deprived conditions from without hence deprive the infant self from normal development within.  Without the feeling felt experience from first brain development onward, the self will be impeded in its ability to feel its connection with itself, and therefore in its ability to feel others.  Social species-specific optimal brain development requires optimal social interaction during brain formative stages.  Without this felt connection given to the infant by others, the self as ipseity will be left out of proper brain functioning for the lifespan.

I do not believe that the fundamental correctness that was absent during brain formation stages can ever be  created in the same way later on once the brain has made its internal adjustments both to the absence of the felt self and to the maliciousness of the environment that caused this deprivation to occur in the first place.  To suggest that fundamental brain growth losses can later be corrected is as ridiculous as suggesting that a person can replace a limb once it has been lost – at least given our current knowledge.

In the Back to the Future movie when Doc holds the two separate ends of the hot electrical cables one in each hand, and then connects the two together, we see a metaphor for the feeling part of self being connected with the ipseity self.  That connection is supposed to be made between consciousness of self in the inner world with self’s experience in and of the external world.

I have the practical ability of ipseity where I can say “I told myself” this or that and know what I mean semantically.  But that operation is hollow and happens inside of me in an alone place in a way that is difficult to describe or explain.  It makes me think of the WWII cartoon drawing of “Kilroy was here” for some reason, head with big nose draped over a line drawn as a wall with two hands worth of fingers on each side of it, as if we assume in some way that the individual self showed up before anyone else was there and we come along later and find the markings left within us of that self and marvel with puzzlement, asking “How did my self get here before I did?”

Only for those of us created in malevolent worlds, Kilroy wasn’t there when we later arrived to take on the task of being the agent-in-command of our existence.  We can apply effortful control as an add-on, additional process we use in our mentalizing each present moment we are aware, but we will never have what others simply take fore granted as a result of the safe and secure interactions they had with loving caregivers from the moment of their birth.  We were deprived of the natural process of becoming a self; we can “act as if” we have one and act along through life, but some kind of vital connection within us is missing.  And in missing the feeling of feeling felt within the brain leaves us unable to feel our self, robs us of the feeling of being a person, leaving us disconnected on a feeling level from ourselves, from others, and from the world.  We call this dissociated, depersonalized and derealized.

“Kilroy was here” let others that followed know that a “friendly” was there before them, like carved love letters in the bark of an old tree’s trunk, there’s a sign that time has been passing from then until now.  We can tell that once in the past someone was present at that time and place, and in our passing we notice them in a version of a shared memory.  I had no shared memories as an infant and child that did not involve trauma.  I could leave my mark nowhere, could only see myself reflected in the loving eyes of my little brother, John, who at around the age of 7 slashed his own mark as Zorro’s “Z” everywhere he could think of.

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As a result of no other feeling felt experiences except those with John who was 14 months older than me, and a few periodic disconnected experiences of having been brought out into “public” viewings – which included those few with my father and with my grandmother until my mother could abort even those — I lack the glue that would stick my life as a lived experience to my self as I move from past to future through the present moment.  This dis-ability is passed on to us through our wounded and deeply troubled mothers.  In the perpetual crisis state of being alive there are not enough resources in the brain to allow ongoing necessary processes along with the process of having a self.  We cannot perform this feat of balance both within ourselves and in interaction with the external world.

If you are wakened in the middle of the night with your house engulfed in raging flames, you are not going to stop and tidy up the bed clothes or make sure the dishes are washed in the kitchen before you make your escape.  If a tornado is bearing down upon you, you will not take the time to first stop and shine your shoed or make a phone call to wish someone you love a happy anniversary.  To people like me, and like my mother, having a connection between my self and my self would be such a frivolous inappropriate luxury that there is not time for in our emergency realities.  We are never wholly in a safe haven of shelter that allows the luxury of a self relationship to come alive, let alone thrive.

Processing of information in the brain is based first and foremost on continual appraisal of ongoing operations that guarantee survival of the body.  All else can wait.  Having a continual conscious connection with the self is not a necessity.  We know this because our growing brain never created a space or time for the development of a self between the body and the external environment that perpetually threatened us with loss of life.  The felt self did not find space in ongoing working memory except in the most fundamental ways.

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I can fill the pages of this book with objective data and factual information related to the topic of how our childhood forms us and what the risks are when we are exposed to traumatic events, no matter what our age.  Yet I want to express the broadest possible base for us to operate from in our considerations – what is most important and therefore most true.  My operational position then has to be not, “What is most human about humans,” but rather “what is most unhuman about some humans when deprived of their birthrights?”

What I consider to be most human about humans is not at the level of “what is the meaning of life”? or “What is the meaning of myself in my life?” but is rather, “What is the meaning of the meaning of myself in my life to me?”  We might think these are selfish speculations, but without the ability either to ask or to answer them, true selfishness is born and separation form the main species we belong to is crystallized as separation and fundamental aloneness.

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As a child of about seven I held two equal sized mirrors facing one another and tried as hard as I possibly could to adjust them so that I could see the unending perpetual reflection of each reflecting one another, yet no matter what I tried, in order to see between the mirrors I always had to tip them a little, and that tipping created a curved tunnel that I could not follow with my eyes.  If I could have found a way to place myself in between those mirrors as they faced one another perfectly I would have been able to see infinity.  But even they I know my own head would get in the way and I would see nothing buy my own reflection staring back at me.

Now I enquire not what was the meaning of that little girl’s actions as she focused so intently on positioning those mirrors she held in her hand with all the simplistic complexity of a seven year old.  She was driven and curious and determined and hopeful and challenged and frustrated and disappointed.  What I now want to know is why is she still left there standing in that Anchorage apartment bedroom with the painted metal triple bunk bed and the single and double painted pink dressers and the pink eyelet valance above the café rod pink eyelet curtains as the spring morning’s late sunlight lit up the toes of her shoes?  Why did she get left there, why is it an effort to assign to her a name, why can I not claim her into the self I try to be today?  Why is she still trapped there as alone as she was that day, trapped in space and time, never having left there to travel into the future with me?  She never put those mirrors down.  She never walked away out of that room and into her life.

Yet she is no different from all the millions of past versions of Linda that remain frozen in that same way, left behind like crumbled bread crumbs dropped as markers for a journey I could not complete then and cannot complete now.  I can walk backwards and forwards along my own path as if it belonged to somebody else.  Each separate memory like a bubble, like a word on this page, surrounded by blank space, life footprints left behind in soft mud.

I ask what was the meaning of the mirror action then, what is the meaning of it to me now?  What is the meaning of the memory of that action?  Each separate instant we move into our futures increases the line of mirroring mirrors mirroring mirrors within my brain as my own experience of my own life I never quite was able to live – because I could not feel myself living it.  Yet nobody else has this string of events connected to them.  Everyone has their own individual ones.  I know that, intellectually.  But if I cannot feel my own life I cannot truly begin to imagine what living a life feels like to anyone else.

I suspect that those who operate with a brain system built within a safe and secure universe do not have “another self” or a whole series of other selves left like litter along the road behind them.  I imagine others have a connected continuum, with all their assorted and various experiences linked all together.  They do not have to experience on their inside, within their own mirroring-of-self-mirroring process, the disappointing break of having another separate self that looks back in detachment as if considering a series of movies just watched, none of them having anything to do with the watcher except for the watching.

I suspect that what I might have is my current self as an additional self aware of the moment but not affectively connected to any one past self.  This additional self that I have was forced into existence by unbearable violence in my infanthood and childhood and has remote viewing capacity that keeps it in touch with but dissociated from any other experience I have had.  Today as I write this I think I can see in my own past when this break occurred most definitely and definitively.  Before this experience I believe that I had a self inside of me that struggled to move along in response to Linda’s wishes and commands, without too much thought as I was not quite four when this event happened to me, an event that I most graciously refer to as “The Toilet Bowl Incident.”

I can describe this from the inside of the body of the four year old girl that was beaten that day.  I can describe it from the perspective of watching it happen as if to someone else.  But at this moment I realize what one single part of this experience really did to me.  It created and developed a split between the me that had to remain involved with the pummeled tiny body crumpled on the bathroom floor with her tear streaked cheek resting on the smooth cold white bathtub.  I can see that little girl, I can see through the eyes of that little girl, as at the split instant the violence stopped and my mother turned away from me and lifted her foot in her first still rage-filled step toward the bathroom door an almost tangible beam formed from my eyes to the sunny blue outside the bathroom window above the toilet.  It is as if there was a solid connection made with one part of me being involved with being at the one end of this beam like being the end of a rainbow – and another part of me that hopped onto that beam and escaped on it out the window.

In that split instant a split in time occurred and a split in me, and some part of my self moved into the future.  She only has to be an infitesimally tiny fraction of a second ahead of me.  She popped into my future and she stayed there.

The brain operates as an anticipation machine, continually anticipating the future.  Our self monitoring mirroring self, if designed in a safe and secure environment, never has to leave to go ahead to scout out danger and send back the warnings. Any expanded sense of the present we are allowed and able to enjoy and appreciate comes to us as a result of a sense of confidence in safety that we can trust, that we will be able to respond adequately if threat appears or we will have someone near us to help if we need them.  When all has gone well one does not have to have an advance guard future self out there ahead of us sending messages, continually scanning for us.  Those who never have had an illusion of safety were never true innocents in the first place.  Without that sense of safety and confidence one cannot relax into a sense of well-being.  We have to pay attention.  It is only unshaken, unchallenged, unbroken confidence and trust in the safety of the world and in safe passage through it that we can be alive in the moment moving each instant into the future.

Yet trauma is a part of life – and to a point most people, including young children, adapt with resiliency and can return to a place of comfort and trust.  But for those of us who never had that sense of safety in the first place, there is no safe place to return to.  So I have to rely on this future self who is out there remembering the future back to me, sending me smoke signals from the path up ahead of me like mirror flashes from the side of a distant hill, letting me know one way or the other what the risk of threat is likely to be that will meet me. Sending smoke signals into the air – I have to watch for them and be alert, and know what they mean when I see them.

This gives me an altered connection to my current instant, operational self in the body of the present.  My body is both the receiver of the information and the reactor to it – a full time job.  But in that split between the me in this body now and the future scout protector-warner me in the future is a great dissociation.  There is a physical sensation of being in a time warp that ceases for me only in a very few select instance such as petting the dog’s tummy when we first go to bed at night or when doing my workout, or those rare times I have been able to float at will in the pools at the hot springs.  (Attachment experts talk about a preoccupied-with-the-past attachment pattern, but I suspect that the insecure disorganized/disoriented variety is more a preoccupation with the immediate impending possibilities of the future).

Only rarely does this future scanning self relinquish its share of brain resources and attention so that I am allowed a kind of backwash release from a chronic sense of vigilance and a certain very brief sense of quiet results – a kind of calm stillness that increases the “space” within me to include or encompass by body and my awareness in the present instant.

I suspect that PBD actually develop a kind of explosive destruction of the self connection that sends their energy out in all directions in the present, rather than having a split off single future self.  These issues probably relate to the mentalizing component of borderline treatment programs designed to help them stay focused within themselves in the present moment.  But for me, at least, that focusing does nothing to create a felt sense of myself because even if I pay very close attention to my fingers on the keyboard at this instant, my future self is not with me in the experience in any way.  She is remote from me, at a distance, and that distance is in the future.

I cannot hold onto that self with force of will or with intention any more than I could both eat a hummingbird and still hope that it would land and remain in the palm of my hand. My future self goes where I can only follow.  She uses her own set of mirrors to mirror back to me what she discovers so that this me, the one in the body, can at all possible points avoid pain and suffering.  But this did not work when I was a child.  What happened was that I never anticipated my mother’s next mean move against me, no matter what.  I never anticipated it and I never expected it, hence I was never prepared – except on those times I had to carry my report card home to her and I sat on the bus with my stomach in turmoil from terror. And it did not work for me as an adult and I was diagnosed with aggressive advanced breast cancer.  I did not expect or anticipate that, either.  But I do expect that when neuroscientists really discover what the brain is actually doing with PTSD and with dissociation, they will find that the resting circuits of the brain including the precuneus are not operating the same for people like me as they work for those who have been able to integrate lesser experiences with trauma.  When the trauma starts at birth and continues unabated, as it did for me for 18 years, I believe the neural circuitry did something very adaptive and creative having to do with the sense of the self and body in time and space.

++

As an example of how the future self might work for me, I finished on the tennis court as the last bell of the day rang at Rincon High School the winter of my 9^th grade year we spent in Tucson.  I cut across the soft green lawn and through the school parking lot on my walk home.  Shortly after I left the lawn and headed across the pavement, I remember lifting my foot into the air to place it behind the bumper of a parked car on my right, and in the next split instant I was standing 15 feet away.  The car I had been stepping behind, and the car parked directly across behind it in the parking lot, had each been put into reverse at the same time, and their drivers, without looking, and stepped on the gas and violently rammed into one another. I watched, calm and unscathed, from my place of safety with no idea how I had gotten there.  It all happened faster than you can clap your hands together.

I had no memory of movement from when I was lifting my foot into the air for the step behind that car.  To my knowledge, I never completed it.  I have no memory of my foot hitting the pavement.  I knew, by my sense of timing that I should have been in the exact center of that bumper as those two cars impacted. As fast as they were moving and as hard as they hit, I should have been over there, crushed, cut in half, bloody and dying.

It was only logical to me that I had been teleported or transported somehow through space and time to my spot of safety.  Perhaps I was in a black out, but why just forget everything from that half step into air that I never saw completed to the point of my standing, both feet on the pavement, turned and facing the cars as they crashed?  I was not remotely out of breath.  My heart was not pounding.  I was not shaking.  I had no sense of fear.  I felt some detached curiosity and mild wonderment, and some cool version of appreciation that this “miracle” had occurred.  And as the drivers were getting out of their cars, screaming at one another in rage, I calmly turned and walked away.  I never told anyone about this.  I did not even retell it to myself for many, many years though I never forgot it.  It has just happened in my reality, with me in the “movie” no differently than everything else that always just happened.

At the exact instant of impact the Linda that was standing there watching with her feet firmly planted in safety, should have been in mid-stride behind that car, and those two bumpers should have met one another through the flesh of her body. Then there would have been no Linda to stand there watching.  Yet the Linda who turned and walked away left behind the Linda that had been standing there  watching, who felt equally as unreal to me as the Linda that hadn’t been cut in half.   They all feel equally as unreal to me now as the Linda that is sitting here doing this writing will feel to me tomorrow.

I have only some version of an explicit awareness and cognitive agreement that all of these Linda’s are connected and related to one another – even the invisible one that did not die.  It is a closer connection and relationship than can exist between any other two people because we are all related in this one single body.  The common sharing of this one body called Linda is what keeps us attached to one another.

++++

I would like to make one of the more important points of this book here now.  When anyone, anytime makes reference to one of the “self” concepts, including (!) self concept, self worth, self esteem, self will, self ANYTHING, please remember that people like me cannot conceive of the self the same way as people can who either had a secure attachment from birth, or even one of the insecure organized attachments from birth.  People like me who have the insecure disorganized, disoriented attachment patterns struggle to have a coherent self to reference to or with.  We have conditional time and space series of selves who are only remotely and tenuously connected to one another through the experiences of being attached to one another in this lifetime in a single body which all of them/us share.

I am different from a borderline in that I do not need to unconsciously project aspects of my “self” out into the world and onto other people and thus contaminate relationships in present time.  I believe that a borderline at one time had at least the remnants of a felt connection with their main self and had an internal feedback system that was quasi operational before it exploded into as many pieces as there are human connections in their lifetime.  A borderline has an emotional “felt” connection with others in these interactions, which are really transactions with the borderline doing all the “trans-ing!”  They are like bats with broken sonar systems.  The signal is always being sent out by the borderline, but nothing ever comes back except their own imaginings and their own feelings.

What happened to me at the time of The Toilet Bowl Incident was not a betrayal trauma such as I suspect a borderline requires to end up in the their condition.  The only beginnings of an operational Theory of Mind I had by the age of four applied not to the adult world, which could not have possibly made any sense to me, but was rather one based on interactions both with my brother, John, 14 months older than I was, and with my sister, Cindy, who was two years my junior.  At the Toilet Bowl, my sense of self-as-agent did not explode with a tremendous “Big Bang” and henceforth spew sad bits of rubble out into perpetual orbit.  No.  My connection with my self simply snapped; an instantaneous silent, indeterminable snap.

+++++++++++++++++++

7/7/2007

Toilet Bowl

We are probably living in the house in Altadena. My sister, Cindy was a little over 2 and I was just 4.  My baby sister, Sharon, had already been born.  I remember the living room of the house, where the kitchen was, where the hallway was, and where the bathroom was half way down the hallway on the left coming from the living room.

My mother always kept an immaculate house, probably cleaner than any you can even imagine.  Everything sparkled all of the time, including the bathroom, including the toilet bowl.  One day I went in there to use it, but when I opened the lid I saw something in the bowl I had never seen before.  I didn’t know what it was, I just knew it was beautiful.  I just stood there looking in awe, and then I ran off to find my little sister so I could share with her the beauty that I had found.

There we were on hour knees looking inside the toilet.  I will tell you what was there, even though at the time I did not understand what it was.  There was a ball of hair taken from a hairbrush and dropped into the toilet, and not flushed.  I had never seen anything like it.  The sun was streaming into the room from a window above the toilet and the sink at exactly the right angle so that the light passed through the wad of hair and made the most amazingly beautiful reflection on the porcelain on the sides and bottom of the bowl.

I cold see a mass of lines, some darker than others, but hooked to them somehow were tiny little glistening circles of light.  I didn’t understand air bubbles.  I didn’t understand reflections of course, but there had never been anything this beautiful before my eyes in my life.  I found that if I blew on the hair mass the whole pattern would shift and glide around, and that made it even more special.

There I was showing my little sister what I had discovered when my mother walked by the bathroom door with a load of folded laundry in her arms.  Mother shrieked like a wild woman and threw the laundry up in the air and as it hit the floor she was already in the bathroom grabbing Cindy by the arm.  She yanked her away from me and shoved her out the door as she grabbed me by the hair and began slamming my head and my face into the toilet bowl.  She was screaming, “How could you!  You are trying to kill your own sister.  You murderer!  You horrible child!”

Of course I couldn’t hear much of what she was saying as the water filled my eyes and my nose.  I gulped water and swallowed it, in a panic, as my skull crashed into the porcelain.  I was terrified.  I still remember this clearly.  One of those flashbulb memories.  I didn’t know what was happening or why.  My mother was the most out of control that I had ever seen her.

When she tired of shoving my head in the toilet she just resorted to slapping, hitting and punching me anywhere on my body she could reach.  She screamed and howled as she beat me.  Finally, exhausted, with “Don’t you ever go near your sister again!  If I ever catch you so much as talking to her……I don’t know what I’ll do but you will be sorry.”

She threw me with all her strength against the wall and the edge of the bathtub, and then kicked me before she stormed out of the bathroom and slammed the door.  At that instant, crumpled into a heap on the floor, I looked up at the incredibly blue sky that I could see up out the bathroom window, and I felt still.  I felt calm.  I felt quiet.  I felt both very far away and distant at the same time I felt every hurt and throbbing in my body.

What I know now as I go back to this memory is that who was waiting there for me after this beating was finished was not my guardian angel in any detached sort of way.  It was me, myself, my own soul, my own guardian-angel-named-Linda that I joined with, and that joined with me.

I also know that this soul is the one that was supposed to be growing with me, growing into my body as my body grew.  Growing into life with Linda, into my relationships, into my experiences, infusing itself with “growing down into the world,” but that was not, in my case, ever allowed to safely happen.

I believe that some children start this process and only make it so far into their childhoods “growing down” into their body and into the world and into their lives before they suffer some terrible betrayal, become “tricked” as one borderline woman put it to me not long ago.  I believe that my mother was one of these betrayed children and it broke her.  They reach a point where something snaps and they lose touch with everything – most importantly with the part of themselves that knew their WHOLE angel.  Once that connection is severed, the evil can come through.  And I don’t mean evil as “presented by the devil.”  I mean evil as in when the goodness is gone because the wholeness is broken, and nothing is left to show in the world but all of the pain and all the confusion.  The partially formed connection to self, formed in the brain through mostly-safe world interactions, goes far far off track and is not likely – as in my mother’s case – to ever return.

My betrayal, on the other hand, happened at the moment I was born.  I was not tricked.  I knew I was not welcome, wanted or safe from the very start of my life in this world.  I never developed a connection between my self and my soul that  was forged under mostly-safe conditions.  I could not, therefore, break in the same way as did my mother.  And I didn’t.

++++++++++++++++++

DISSOCIATION

I am not putting dissociation under symptoms because I consider it a “condition” that cannot be a symptom of itself.

++++

Labinsky, Blair & Yehuda, 2006

abstract

Mt Sinai School of Medicine, NY

Longitudinal 8.11 years later

Significant main effect for time and group by time interaction, reflected marked decline in Holocaust survivors, particularly those with PTSD for dissociation

“Different symptoms related to PTSD show different trajectories of change with age, with dissociation appearing to be less prominent with age.”

I would think that a complicating factor would be additional exposure to trauma, as well as childhood long-term abuse.

++++

Simeon et al, 2003

Abstract

Mt Sinai school of medicine

“In contrast to the noradrenergic dysregulation described in PTSD, little is known regarding noradrenergic function in dissociative disorders.”

Preliminary study to investigate basal norepinephrine in depersonalization disorder (DPD) – 9 subjects with DPD – lifetime PTSD compared to 9 healthy controls

Groups did not differ significantly in plasma norepinephrine levels

DPD group demonstrated significantly higher urinary norepinephrine, only prior to covarying for anxiety

And DPD group also demonstrated a highly significant inverse correlation between urinary norepinephrine and depersonalization severity

Norepinephrine and cortisol levels were not intercorrelated

CONCLUSION:  “…although dissociation accompanied by anxiety was associated with heightened noradrenergic tone, there was a marked basal norepinephrine decline with increasing severity of dissociation.  The findings are in concordance with the few reports on autonomic blunting in dissociation….”

++++

Saxe et al, 1993

Abstract

Trauma clinic, Harvard med school

110 consecutive admissions to state psychiatric hospital

RESULTS:

15% met criteria for a dissociative disorder –  used the Dissociative Experience Scale — had higher rates of major depression, PTSD, substance abuse, and borderline personality than did the comparison patients —- also revealed higher rates of childhood trauma –

chart reviews revealed that dissociative symptoms had been largely unrecognized prior

CONCLUSIONS:

High proportion of psychiatric inpatients have significant dissociative pathology that is underrecognized by clinicians.  “The proper diagnosis of these patients has important implications for their clinical course.”

++++

Foote et al, 2006

Abstract

Bronx, NY psychiatric outpatient

231 consecutive admissions in inner-city hospital-based outpatient psychiatric clinic, mean age 37 years – 147 women, 84 men – all offered interview

29% of the 82 patients interviewed received dissociative disorder diagnosis

6% diagnosed with DID

all DD+ compared to DD- were significantly more likely to report childhood physical abuse (71% versus 27%) and childhood sexual abuse (74% versus 29%), but the two groups did not differ significantly on any demographic measure including gender

chart review showed only 5% of patients with the DD diagnosis had been previously identified and diagnoses

extremely high prevalence rates for childhood physical and sexual abuse were present in the overall study population

++++

Karadag et al, 2005

Abstract

Istanbul, Turkey

Dissociative disorders among inpatients with alcohol or drug dependency – used the Dissociative Experience Scare – screened 215 consecutive inpatient admissions to dependency treatment center of large mental hospital over a 1-year period of time

Of patients, 36.7% had a Dissociative Experiences Scale score of 30.0 or higher

Prevalence of DSM-IV dissociative disorders was 17.2%

………on the average, 64.9% of these patients’ dissociative experiences had started 3.6 years before onset of substance abuse.

DD patients were younger and mean duration of their remission periods was shorter

DD patients tended to use more than one substance, drugs used more frequently than alcohol

Frequency of BPD, somatization disorder, history of suicide attempt, and childhood abuse and neglect occurred more often in the DD group than non-DD group

significant predictors of a dissociative disorder diagnosis:  history of suicide attempts, female sex, childhood emotional abuse

Significantly more DD patients stopped their treatment prematurely

++++

Evren et al, 2007

Abstract

Istanbul, Turkey

111 consecutive admissions to inpatient dependency treatment center – Dissociative Experiences Scale used, given interviews, etc

9% found with DD – 9 of these 10 DD symptoms predated onset of alcohol use

….among this 9%, female gender, younger age, history of suicide attempt childhood emotional and sexual abuse and neglect were more frequent

……………had somatization disorder, borderline personality disorder and lifetime major depression more frequently

considerable number of remaining patients reported a high level of dissociative experiences

“Although the probability of having a comorbid dissociative disorder was not higher among alcohol-dependent inpatients than among the general psychiatric inpatients, the dissociative subgroup had distinct features.  Many patients without a dissociative disorder diagnosis (predominantly men) provided hints of subtle dissociative psychopathology.”  [not described in abstract]
++++

Sar et al, 2000

Abstract

Istanbul, Turkey

Psychiatric outpatients in Turkey – 150 consecutive outpatients admitted to psychiatry clinic of U hospital screed

15.3% with a DES score greater than 30 interviewed

12% received diagnosis of DD

83.3% of the dissociative patients reported neglect, 72.2% emotional abuse, 50% physical abuse, and 27.8% sexual abuse during childhood

dissociative disorders are not rare among psychiatric outpatients – usually underrecognized

“Neglect was the most frequently reported type of childhood trauma, suggesting the importance of other childhood experiences in addition to sexual and/or physical abuse in the development of dissociative psychopathology.”

++++

Sar et al, 2006

Abstract

Istanbul, Turkey

Nonclinical population, 1301 college students screened for borderline personality disorder and reported childhood trauma

80 with diagnosis of BPD and 111 nonborderline students were evaluated for dissociative disorders by interviewer

RESULTS:

Prevalence of BPD was 8.5%

Significant majority of 72.5% of these had a dissociative disorder

rate was only 18% for comparison group [was this still a random portion of the 1301?]

Childhood emotional and sexual abuse, physical neglect, and total childhood trauma scores had significant effect for BPD

Emotional neglect and diminished minimization of childhood trauma [?] had significant effect for dissociative disorder [I can’t figure out what this means…]

CONCLUSION:

A significant proportion of subjects with BPD had comorbid dissociative disorder

Lack of interaction between dissociative disorder and BPD diagnoses for any type of childhood trauma contradicts the opinion that both disorders together might be a single disorder.

“Recognizing highly prevalent but usually neglected Axis I dissociative disorder comorbidity in patients with borderline personality disorder may contribute to conceptual clarification of this spectrum psychopathology.”

++++

Gast et al, 2001

Abstract

German

Frequency of dissociative disorders among psychiatric inpatients in Germany, to investigate the relationship between childhood trauma and dissociation

115 consecutive admissions to psychiatric clinic of a university hospital

German version of the Dissociative Experience Scale, score higher than 20, 21.7%

1 diagnosed with DID, 3 with DD and one with depersonalization disorder

significant positive relationship was found between the severity of childhood trauma and dissociation – “Dissociative disorders are common among German psychiatric inpatients.”

++++

Muler et al, 1998

Abstract

New Zealand

Randomly selected sample of 1,028 individuals – completed interviews and measurements

Many had experienced occasional dissociative symptoms

6.3% of the population suffered from 3 or more frequently occurring dissociative symptoms

among these, rate of childhood sexual abuse was two and one-half times as high, rate of physical abuse was five times as high, rate of current psychiatric disorder was four times as high as the respective rates for other subjects

………..physical abuse and current psychiatric illness were directly related to a high rate of dissociative symptoms but sexual abuse was not

…….influence of sexual abuse was due to its associations with current psychiatric illness and with childhood physical abuse

……childhood physical abuse was not directly related to current psychiatric illness, association appeared to be mediated by its link to childhood sexual abuse

CONCLUSIONS:  small proportion 6.3% of general population suffer from high levels of dissociative symptoms

Calls into question the hypothesized direct relationship between childhood sexual abuse and adult dissociative symptoms [in general population]

++++

Draijer & Langeland, 1999

Abstract

Amsterdam, The Netherlands

Examined level of dissociation in relation to childhood trauma (sexual/physical abuse, witnessing interparental violence), early separation from a parent, and perceived parental dysfunction

160 consecutive admissions to general psychiatric hospital in The Netherlands

administered the Dissociative Experiences Scare and Structured Trauma Interview

RESLUTS:  mean DES score was 17.4

18% scored beyond 30

26.4% reported early separation

30.1% had witnessed interparental violence

23.6% physical abuse

34.6% sexual abuse

11.7% reported rape before age 16

42.1% reported sexual and/or physical abuse

level of dissociation was primarily related to reported overwhelming childhood experiences (sexual and physical abuse)

….when sexual abuse was severe (involving penetration, several perpetrators, lasting more than 1 year), dissociative symptoms were even more prominent

……….highest dissociation levels found in patients reporting cumulative sexual trauma (intrafamilial and extrafamilial) or both sexual and physical abuse

………in particular, maternal dysfunction was related to the level of dissociation

……….data analysis indicated that severity of dissociative symptoms was best predicted by reported sexual abuse, physical abuse, and maternal dysfunction

CONCLUSIONS:  findings indicate that dissociation, although trauma-related, is neglect-related as well.  This implies the importance of object relations and attachment in the diagnosis and treatment of patients with dissociative disorders.”

++++

Halligan & Yehuda, 2002

Abstract

Mt Sinai School of Medicine, NY

adult offspring of Holocaust survivors are at increased risk of PTSD

87 Holocaust survivor offspring and 39 comparisons completed DES and assessments of trauma exposure, psychopathology and parental PTSD

……….dissociative symptoms were elevated in individuals with current PTSD, but not in those with past PTSD or with the risk factor of parental PTSD

……………dissociative symptoms were also associated with forms of psychopathology other than PTSD

RESULTS:

“The results suggest that dissociative symptoms are related to current psychiatric symptomatology, including PTSD, rather than representing an enduring trait or preexisting risk factor for the development of PTSD.”

++++

I do not intuitively believe that dissociation lessens with age in dissociation disorders.  Researchers are saying that it does diminish with age as a symptom of PTSD.  I do not yet understand how the two are related – dissociation as a symptom of PTSD, and dissociation as a disorder of its own.

++++

Simeon et al 2007

Abstract

Mt Sinai

Find where I put this info on dissociative disorders, PTSD

+++++++++++++

Sierra et al 2002

Article

“Complaints of patients with visual hypoemotionality are indistinguishable from those of patients with “visual derealisation”.  [see hypoemotionality with melatonin under biological clock]  There is also a phenomenological overlap between “asomatognosia” [lacking awareness of paralysis] and the symptom of “body alienation”, which is a central feature of depersonalization.”

Phenomenological similarities between visual hypoemotionality and derealisation “…suggest that a disruption of the process by means of which perception becomes emotionally coloured may be an underlying mechanism in both conditions.  Likewise, phenomenological overlaps with asomatognosia suggest that depersonalization might result from parietal mechanisms disrupting the experience of body ownership and agency.  These findings give validity to the notion that DP and DR may have distinct neurobiological mechanisms.

Depersonalization (DP) and derealization (DR) – DP “…often described as an “alteration in the perception or experience of the self so that one feels detached from, and as if one is an outside observer of, one’s mental processes or body.” (1)”

DR “…involves “an alteration in the perception or experience of the external world so that it seems strange or unreal”  It is not known if the differentiation between DP and DR has any neurobiological validity

DP/DR may be a non-specific response to brain insult

…….location of brain lesions might play only an indirect role

…….”… intense anxiety has been shown to trigger DP/DR…”  Sierra 2002 p 530

“…the phenomenological similarities between DR and visual hypoemotionality and between DP and asomatognosia….contention that the study of neurological phenocopies of DP/DR might help tease out those symptoms with more neurobiological grounding from those more psychosocially determined.”  Sierra 2002 p 530

“Emotional hyporeactivity to visual stimuli (visual hypoemotionality) has been described in some patients with prosopagnosia (an inability to reconise familiar faces)…Patients with visual hypoemotionality complain that what they see lacks vividness and emotional colouring, and their narratives resemble those of patients with DR.  Visual hypoemotionality is thought to be a consequence of a right basal occipitotemporal lesion or bilateral basal occipitotemporal lesions, thought to disconnect visual from temporal-limbic areas….”  Sierra 2002 p 530

head trauma patient, in addition to prosopagnosia, inability to endow visual perception with emotional feelings

Interviewer:  “What is it for you to look at flowers, or a landscape?”

…………”Patient:  “Flowers to me have lost their essence, I fail to see them as part of nature.  They have become almost synthetic, artificial, I seem to lack a kind of knowledge, no, it’s not really a knowledge, rather a certain clarity to see nature itself.  I fail to see the flower in all its authenticity.”

Interviewer:  “What about landscapes?”

…..”Patient:  “Just as with flowers, there is also an emptiness to landscapes.  I cannot appreciate them.  I cannot grasp the beauty of nature.  I lack a kind of lucidity, a lucidity in my vision that would normally allow me to appreciate it; its colours, the temperature of its colours so to speak.  I cannot think of a right word to explain it.  I just cannot enjoy that sense of beauty that nature brings.”  Sierra 2002 p 530

“The above complaints were specific for the visual modality.  In fact, he noticed increased emotional reactivity to auditory information.”  Sierra 2002 p 531

This is similar to the way I feel about humans – a kind of dumb-numbness, distancing, detachment, lack of direct connection to and with – perhaps a lack of a specific kind of emotional memory about people because I never got to learn it in the first place – so it’s not that I forgot it

“The phenomenological overlap between the experiential narratives of patients with DR and with visual hypoemotionality, suggests a common underlying mechanism – namely, a disruption of the process by means of which perception becomes emotionally coloured.  It is our contention that the latter may result in a qualitative change in the experiencing of perception, which is then reported by the subject as unreal or detached.”  This experience can be modality specific – as is usual also with DR that it’s the visual field  Sierra 2002 p 531

For me it is more than that – it’s at the very center and no modality can reach it – Perhaps with those of us with early severe trauma histories, the emotional perceptions related to people are entirely fearful and terrifying.  Therefore we have no true ability to connect a positive feeling to people.  Assuming that secure attachment histories and positive emotional experiences with humans are completely entwined with one another in the neural circuitry of the brain – a history of the reverse experiences creates a reverse pattern of experience so that contact with humans HURTS and is to be avoided – if not physically, then in the brain as avoidance of feelings connected to humans – the overwhelming negative feelings = numb and detached.

qualitative change in the experiencing of perception, which is then reported by the subject as unreal or detached – if painful and terrifying are the only programmed associations with humans, then the “qualitative change” required to experience positive feelings in relation to humans feels, for us, as unreal and detached.  Our brains learned differently…

‘HEMIDEPERSONALISATION”:  asomatognosia as a model for depersonalisation”

asomatognosia refers to alteration of body awareness, patient denies ownership of a limb usually after right parietal brain lesion

“Early neuropsychiatrists drew attention to its phenomenological similarity with DP (loss of feelings of agency – that is, the feeling that one is not in charge of one’s movements; and loss of body ownership feelings are central features of DP) and used the term “total asomatognosia” when referring to patients with DP….Alternatively, other authors have referred to asomatognosia as “hemidepersonalisation”…”  Sierra 2002 p 531

other areas of interest regarding this feeling of agency is in childhood as an infant obtains self as agency, which evolves all the way through early childhood – related to mirroring also and the feeling of “feeling felt” – and the loss of sense of self as agent in the midst of peritrauma – connected also to learned helplessness and loss of control

asomatognosia often retains an “as if” quality – as if I have no leg – result of parietal lesion

…………..lack of agency feelings

.patients with asomatognosia often experience global 9not related to one hemibody) distortions in body experiencing – lack of body ownership feelings – related to DR

maybe we are obtaining this sense as a culture, cut off as we are from our bodies!

“Our two cases [hypoemotionality and asomatognosia] suggest a double dissociation between DP and DR-like symptoms in patients with brain damage – that is, patients with visual hypoemotionality – do not complain of DP; and patients with hemiasomatognosia do not report DR.  These findings, and the fact that temporal and parietal lesions seem to reproduce (531) different components of the DP syndrome, suggest that different phenomenological components of the DP syndrome might have distinct neurobiological substrata.  In keeping with our findings, a recent PET study found that patients with DP differed in relative glucose metabolic rate from comparison subjects in portions of the sensory cortex in the temporal, parietal, and occipital lobes….”  Sierra 2002 p 533

“A recent model of depersonalisation proposes that inhibititory mechanisms on emotional processing underlie the experience of unreality, and hence support the view that a functional corticolimbic disconnection is present in DR….suggests that the phenomenological differentiation between DR and DP has neurobiological validity.”  Sierra 2002 p 533

++++

[refer also to the PTSD genetic research]

Kuhn et al 2006

Abstract –DISSOCIATION

“This small-scale study investigates the relationships between the heart rate of motor vehicle accident survivors presenting in the emergency department (ED) and acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) symptom severity. It also examines the relationships between the survivor’s heart rate in the ED and peritraumatic dissociation and peritraumatic distress reported 2 weeks posttrauma. Fifty motor vehicle accident (MVA) survivors were assessed 2 weeks, 1 (N = 42), 3 (N = 37), and 6 months (N = 37) post-MVA. The heart rate in the ED predicted self-reported ASD symptom severity and clinician-rated PTSD symptom severity at 6 months but not at 1 or 3 months. Survivors’ heart rate in the ED was significantly correlated with peritraumatic dissociation but not peritraumatic distress. These findings support the role of elevated ED heart rate as a predictor of both ASD and chronic PTSD symptom severity and may help to clarify the discrepant findings of previous research.”

++++

Ozer et al 2003

Abstract

“A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met criteria for inclusion in a meta-analysis of

7 predictors:

(a) prior trauma,

(b) prior psychological adjustment,

(c) family history of psychopathology,

(d) perceived life threat during the trauma,

(e) posttrauma social support,

(f) peritraumatic emotional responses, and

(g) peritraumatic dissociation.

All yielded significant effect sizes, with family history, prior trauma, and prior adjustment the smallest (weighted r = .17) and peritraumatic dissociation the largest (weighted r = .35). The results suggest that peritraumatic psychological processes, not prior characteristics, are the strongest predictors of PTSD.”

++++

Briere, Scott & Weathers 2005

Abstract

Evaluation of peritraumatic dissociation and PTSD and less-investigated phenomenon:  trauma-specific dissociation that begins during or after an event and continues until the time of assessment (persistent dissociation)

…………two studies, 52 local community participants and 386 community members with histories of exposure to at least one traumatic event

…………”In both studies, peritraumatic dissociation, persistent dissociation, peritraumatic distress, and generalized dissociative symptoms were associated with PTSD

………….when other variables, especially persistent and generalized dissociation were taken into account, PTSD no longer related to peritraumatic dissociation

persistent dissociation was a strong predictor of PTSD

.”These findings suggest that it is less what happens at the time of trauma (e.g. disrupted encoding) that predicts PTSD than what occurs thereafter (i.e., persistent avoidance).”

++++

Birmes et al 2003

Abstract – France

…examined the power of peritraumatic dissociation and acute stress symptoms in predicting posttraumatic stress disorder (PTSD) symptoms. METHOD: Thirty-five assault victims were assessed with the Peritraumatic Dissociative Experiences Questionnaire within 24 hours of the assault. Participants were reassessed 2 weeks after the trauma.

RESULTS:

Peritraumatic dissociation and acute stress symptoms were correlated with later PTSD symptoms and diagnosis.

Together, peritraumatic dissociation and acute stress symptoms accounted for 33% of the variance in PTSD symptoms.

CONCLUSIONS:

These results support earlier findings that peritraumatic dissociative experiences and acute stress are robust predictors of PTSD. Such symptoms may be of use for identifying at an early stage individuals at highest risk of remaining symptomatic. Future studies should investigate the predictive power of specific peritraumatic and acute stress disorder symptom clusters.

++++

Johansen et al 2007

Abstract – Norway

BACKGROUND: Victims of violent assault experience diverse post-event emotional problems such as post-traumatic stress disorder (PTSD), and they may have multiple emotional problems. The aim of the present study was to evaluate the prevalence and predictors of PTSD in a longitudinal design. METHODS: The levels of physical injury, perceived life threat, prior experience of violence, peritraumatic dissociation (PD), acute PTSD, perceived self-efficacy and perceived social support are considered possible predictors. This study had a single group (N = 70), longitudinal design with three repeated measures over a period of 12 months. Questionnaires used were: Impact of Event Scale-15 and 22 (IES-15 and 22), Post-Traumatic Symptom Scale-10 (PTSS-10), Peritraumatic Dissociation (PD) 7-item self-report measure, Social Provisions Scale (SPS) and Generalized Self-Efficacy scale (GSE).

RESULTS:

Results showed a high prevalence and severity of PTSD on all outcomes, for instance 31% scored as probable PTSD-cases and 14% as risk level cases by IES-15 at T3. Either injury severity or prior experience of being a victim of violence predicted PTSD in this study. Early PTSD predicted subsequent PTSD, and perceived life threat was a predictor of PD. Furthermore, lack of perceived social support was a predictor of PTSD symptoms at T3. In addition, low perceived self-efficacy was a predictor of PTSD and influenced perceived social support at T1.

CONCLUSIONS:

Our results showed that experience of non-domestic violence may cause serious chronic emotional problems, and therefore it is important to be aware of early symptoms indicating needs for special follow-ups.

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Fossati et al 2003

Abstract – France

OBJECTIVE: The authors used functional magnetic resonance imaging (fMRI) to define the neural regions mediating self-referential processing of emotional stimuli and to explore how these regions are influenced by the emotional valence of the stimulus.

METHOD: Ten healthy subjects were presented with words describing positive and negative personality traits during fMRI scanning in three different conditions. In the self-referential processing condition, subjects judged whether they thought each trait described them. In the other-referential processing condition, subjects judged whether the stimulus described a generally desirable trait.

…. In the letter-recognition control condition, subjects indicated whether the word contained a specific target letter.

RESULTS: The self-referential condition induced bilateral activation in the dorsomedial prefrontal cortex,

…………….Activation in the right dorsomedial prefrontal cortex was unique to the self-referential condition regardless of the valence of the words, although positive words produced a more robust activation than did negative words

………………. In the self-referential condition, differences between the processing of positive and negative words were seen in regions outside the medial frontal cortex, with reductions in the insula, temporal and occipital regions, and inferior parietal regions associated with negative words.

whereas the other-referential condition induced activation in lateral prefrontal areas.

. CONCLUSIONS: A widely distributed network of brain areas contributes to emotional processing. Among these regions, the

right dorsomedial prefrontal cortex

is one main area mediating self-reference.

By providing a personal perspective in the evaluation of emotional stimuli, the right dorsomedial prefrontal cortex may mediate cognitive processes, such as those involved in psychotherapy, that guide self-regulation of emotional experience.

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Fossati et al 2004

Abstract – Toronto

Words processed with reference to the self are generally better remembered than words processed in semantic terms. An account of this phenomenon, labeled the Self Reference Effect (SRE), is that the self promotes elaboration and organization of encoded information. Although a few neuroimaging studies associated self-referential encoding with activations of the medial prefrontal cortex, no previous study has investigated the neural correlates of remembering emotional words encoded in an SRE paradigm. The main goal of this study was to define with fMRI the neural correlates of the successful retrieval of negative and positive personality traits encoded in a self-referential mode. Functional MRI scans were acquired for 11 subjects as they recognized positive and negative emotional personality traits adjectives encoded in a self-referential condition, a semantic condition and in a phonemic condition.

The correct recognition of self-encoded personality traits engaged dorso-medial prefrontal cortex and lateral prefrontal regions, premotor cortex, parietal and occipital cortex, caudate and cerebellum.

The specific recognition of self-encoded negative personality traits involved greater neural activation in the right extra-striate region than the recognition of positive personality traits.

Our fMRI findings suggest that specific processes may operate at both encoding and retrieval to subserve the SRE. Unlike self-encoding, the retrieval of personality traits is modulated by the valence of the stimuli with greater activation for negative words. Our results indicate that personally relevant words may signal important emotional clues and support the notion of a widely distributed set of brain regions involved in maintaining the concepts of self.

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Piefke et al 2003

Abstract – Germany

Autobiographical memory relies on complex interactions between episodic memory contents, associated emotions and a sense of self-continuity along the time axis of one’s life history.

The neural correlates underlying autobiographical memory are known to primarily comprise areas of prefrontal cortex, medial and lateral temporal cortex, as well as posterior cingulate and retrosplenial cortex.

By contrast, the effect of encoding and/or storage parameters such as the emotional tone of the memories retrieved or the length of the time-interval between the initial encoding of information and retrieval remains to be clarified. Using blocked design functional MRI and statistical parametric mapping, we investigated the impact of remoteness (factor 1: recent, remote) and emotional valence (factor 2: positive, negative) on the neural correlates of autobiographical memory retrieval.

Changes in neural activity (P < 0.05, corrected) related to autobiographical memory retrieval (irrespective of remoteness and emotional tone) relative to baseline were observed bilaterally in medial and lateral temporal, temporal-occipital, posterior cingulate and frontal cortices.

Recent (relative to remote) memories were associated with differentially increased neural activity bilaterally in the retrosplenial cortex and the hippocampal region, whereas remote (relative to recent) memories did not show any statistically significant differential neural activations.

…….. Positive (relative to negative) memories bilaterally activated the orbitofrontal cortex, the temporal pole, as well as medial temporal areas, with the activation peak being in the entorhinal region.

By contrast, negative (relative to positive) memories differentially increased neural activity in the right middle temporal gyrus only.

The data suggest differential functional roles for temporal, prefrontal and retrosplenial regions during autobiographical memory retrieval depending on the remoteness and the emotional valence of the memories retrieved.

……….. In particular, our findings support the ‘classic’ model of long-term memory processing, which suggests a time-limited differential involvement of the hippocampus in memory consolidation.

Interestingly, the observation of such a time-dependent involvement of the hippocampal region in memory consolidation corresponds to the course of retrograde amnesia observed in demented patients, with the loss of recent memories appearing during early stages of the disease when conspicuous neurofibrillary changes are restricted mainly to the hippocampal and parahippocampal regions. Only during later stages, as the neurofibrillary changes spread out to neocortical association areas, do remote memories also become impaired. We conclude that the brain regions involved in autobiographical memory retrieval are influenced by the triggered memories’ emotional significance and their relationship to the individual time axis.

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Burianova & Grady 2007

Abstract – Toronto

This study sought to explore the neural correlates that underlie autobiographical, episodic, and semantic memory.

…Autobiographical memory was defined as the conscious recollection of personally relevant events,

….episodic memory as the recall of stimuli presented in the laboratory, and ….semantic memory as the retrieval of factual information and general knowledge about the world.

Our objective was to delineate

…..common neural activations, reflecting a

….functional overlap, and

…unique neural activations,

….reflecting functional dissociation of these memory processes.

We conducted an event-related functional magnetic resonance imaging study in which we utilized the same pictorial stimuli but manipulated retrieval demands to extract autobiographical, episodic, or semantic memories.

The results show a functional overlap of the three types of memory retrieval in the inferior frontal gyrus, the middle frontal gyrus, the caudate nucleus, the thalamus, and the lingual gyrus.

All memory conditions yielded activation of the left medial-temporal lobe;

however, we found a functional dissociation within this region.

The anterior and superior areas were active in episodic and semantic retrieval,

whereas more posterior and inferior areas were active in autobiographical retrieval.

Unique activations for each memory type were also delineated, including

…medial frontal increases for autobiographical,

….right middle frontal increases for episodic, and

….right inferior temporal increases for semantic retrieval.

These findings suggest a common neural network underlying all declarative memory retrieval, as well as unique neural contributions reflecting the specific properties of retrieved memories.

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Greenberg et al 2005

Abstract – Duke U, NC

Functional MRI was used to investigate the role of medial temporal lobe and inferior frontal lobe regions in autobiographical recall. Prior to scanning, participants generated cue words for 50 autobiographical memories and rated their phenomenological properties using our autobiographical memory questionnaire (AMQ). During scanning, the cue words were presented and participants pressed a button when they retrieved the associated memory. The autobiographical retrieval task was interleaved in an event-related design with a semantic retrieval task (category generation). Region-of-interest analyses showed

greater activation of the amygdala, hippocampus, and right inferior frontal gyrus during autobiographical retrieval relative to semantic retrieval.

In addition, the left inferior frontal gyrus showed a more prolonged duration of activation in the semantic retrieval condition.

A targeted correlational analysis revealed pronounced functional connectivity among the amygdala, hippocampus, and right inferior frontal gyrus during autobiographical retrieval but not during semantic retrieval.

These results support theories of autobiographical memory that hypothesize co-activation of frontotemporal areas during recollection of episodes from the personal past.

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Ryan et al 2008

Abstract – U of AZ

Whether or not the hippocampus participates in semantic memory retrieval has been the focus of much debate in the literature. However, few neuroimaging studies have directly compared hippocampal activation during semantic and episodic retrieval tasks that are well matched in all respects other than the source of the retrieved information. In Experiment 1, we compared hippocampal fMRI activation during a classic semantic memory task, category production, and an episodic version of the same task, category cued recall. Left hippocampal activation was observed in both episodic and semantic conditions, although other regions of the brain clearly distinguished the two tasks. Interestingly, participants reported using retrieval strategies during the semantic retrieval task that relied on autobiographical and spatial information; for example, visualizing themselves in their kitchen while producing items for the category kitchen utensils. In Experiment 2, we considered whether the use of these spatial and autobiographical retrieval strategies could have accounted for the hippocampal activation observed in Experiment 1. Categories were presented that elicited one of three retrieval strategy types, autobiographical and spatial, autobiographical and nonspatial, and neither autobiographical nor spatial. Once again, similar hippocampal activation was observed for all three category types, regardless of the inclusion of spatial or autobiographical content.

We conclude that the distinction between semantic and episodic memory is more complex than classic memory models suggest.

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Sunday, October 19, 2008

I want to write a minute here about my experience today on my 40 minute walk.  Earlier I encountered the research on Alert, orient and reorient, which I will deal with here along with the startle response.  But I am not quite ready for that, still being in the attachment section writing about our neurological response to faces.

My cell phone rang while I was walking, a little over half of the way back to the house.  They took the rails out a year ago, part of the “rails to trails” project – black rocks out there, actually from the copper smelter down at Douglas years ago, slag rocks, but thankfully black, because the light an with black markings rattle snakes show up against that stone, as the huge fat one did a week ago that let me know I have to be paying attention out there walking, not walking after the sun has already disappeared behind the western mountain ridge.

I listen to music through headphones, did not see that first snake as I came across the little bridge until I was less than five feet from it.  It jumped a little, I jumped a little, he didn’t move, I did.  Slowly, watching it as it was on the edge of the trail.

Today, after I answered my cell phone and told Ramona I would call here when I got back to the house, I was distracted from my “watching.”  A few seconds later a light tan color caught my eyes on the right of the trail against the black stone – I want to describe what I watched my brain do as if it was a movie – or I was in the movie.  First I saw the light tan laying there.  Next I noticed that it was beautiful.  Next I noticed that it looked like transparent tissue paper with a pattern – both on itself and in the way it lay in curves against the stones, part of my brain said fish scales, part said paper – realize that memory operates in “informing” all of our experience, so my dissociable memory was pulling these things together in the way it had them associated together, evidently, as I continued to walk.  I hadn’t stopped moving, kept my same pace.  (An empty stocking, footless sock, but an attractive one, like something silk.) Eventually – all of this still happening on a time scale of seconds, I got past the beautiful paper fish scale, lucky me I found this part to the point where my brain said, “That’s a snake skin.  A snake shed its skin here.  How remarkably undamaged it is, not a flaw, so perfect, such a gift, I am going to pick it up.”  And on some level my body had already marshaled itself to begin to reach down, bending slightly at the waist,, extending hand and fingers toward that beautiful “paper fabric.”  I vaguely somewhere wondered how at this time of the year a snake would shed its skin, or shed it right here, leaving it light sandy tan against rocky black.  Only after all this did my brain bother to include the fact that a rattlesnake was actually living in this skin.  I swear, it was like a movie in time watching the snake morph slowly into its own skin, taking on dimensions other than flat, going from something frail and fragile into something fat and round , into something very much alive.  And yes, with the potential of danger.  The interesting thing is, this order is how I actually SAW the snake.  It transformed before my eyes, or rather, inside my mind.  Spooky.

Yet even once I realized it was a snake, it was still magnificently beautiful, like it was in another world, a perfect world.  Which it was.  It was in its world, THE world.  Perfectly balanced pattern of dark and light, magnificent detailed tail ending itself as the narrowest part of that stillness as it “watched” with its own way of watching, being quite poor in its eyesight – as if mine had started the encounter with good eyesight? (Vision and in-vision – envision)

It all went along smoothly in its own time line, yet like in a dream.  I wasn’t afraid.  Caution did finally appear.  I moved smoothly and fluidly to my left and watched it there as I walked safely by it.  The phone call had interrupted my watching and I had to dissociate into a talking on the phone person who was not “multi tasking” where I was…and my mind did not come back from that interruption instantly or appropriately.

I just told my sis Cindy about this, and she mentioned that most people would see a snake skin and think it was a snake, but not the other way around – seeing a snake and thinking it was just a skin!  It makes me laugh for sure, but how strange to watch one’s brain work like that, in a dream, in a movie.  I told Cindy last night that when I am out there walking that track that’s no longer a track, it is so beautiful and peaceful.  I feel – with the derealization and depersonalization that I have, that I am walking through a postcard.  I know it’s about memory, because when I come back from my walk it’s like I never went.  That experience is totally cut off and dissociated from me being here in the house.

I could suspect that part of this brain activity is related to the chemotherapy effects, but I also suspect that like in the show “Junkyard Wars” my brain from birth had to jerry rig itself together to operate in a “normal” world while being built in a topsy-turvy world with a bare hint of what normal was.

We take for granted what our brains do, how they operate.  I have to focus.  I have to tell myself to WATCH out for snakes out there.  They are very real, and very real in mid-October as the light and the temperature changes, and they will come to find the heat of those black rocks, using their snake intelligence and wisdom.  Even though the nights are above 60 right now, and the days are warm, they know what’s coming, and they will keep themselves warm on the edges of that trail.

I see jack rabbits out there.  I was a pair of road runners.  I saw another rattlesnake, smaller than the first one.  In a different place.  I think part of this is my corpus callosum damage, so that information does not transfer itself from hemisphere to hemisphere in a normal way.  Neither hemisphere was created correctly through experience, and they sure don’t operate normally together, either.  I am so right brain it’s scary.  A beautiful tan pattern piece of tissue paper, be damned!  So I need to not only tell myself to watch out so I don’t step on one of those rattlesnakes out there.  I have to tell myself not to reach down to pick one up.  Go figure.

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It reminds me of the feeling I had the night the storm blew all the roofing off the apartment we were moving into, when Jered was 3 weeks old, and with the wind I could not shut the windows, kept sucking them out as the rain blew straight in across the room and sucked all the ceiling tiles down and water pouring in from the ceiling, I could not find the baby.  Kerensa, calm, found him.  I was useless, like in the twilight zone, “Where’s the baby?  I can’t find the baby!”  Distraught, confused.

It makes me wonder how I’ve pulled off even “remotely normal” all these years, until this cancer and this chemo.  This experience with the snake – a child’s mind.  A young child’s mind.  Like when I saw the hair floating in the toilet bowl when I was four – something beautiful, all those pretty circles attached to those lines – air trapped bubbles clinging along the hair lines, reflected shining glistening bubbles down at the bottom of the toilet bowl.  Showing Cindy.  Mother.  Drowning sister in the toilet, so much pain.

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Only now I have/am my own watcher.  I can remember the snake skin with the snake in it almost from two points of view.  The one that was “there, then” and the one that is “here, now.”  Here and now remembers the one who remembered the one that saw the skin with the snake in it.  It is only through an application of “logic and reason” that I know these people are all the same person.  Time and memory distortions from the inside of dissociation.

This must be like the mirrors, the one who remembers the remembering one remembering – all would be gone, poof!  If the one was to be bitten by the rattlesnake.

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