Whores & Madonnas

Thursday, March 4th, 2010 | Best of MeadowLark | No Comments

Note: This article was first published in the Winter 2003/04 issue of MeadowLark, the magazine for alumni of The Meadows.

Whores & Madonnas
By Maureen Canning-Fulton, MA

A friend of mine, who knows about the therapy I do with female patients in the area of sexual dysfunction, had sent me a movie review. He wanted to know how I would react to it. The review was of The Magdalene Sisters, a film by Scottish director Peter Mullin that had debuted in London in February 2003 and opened in New York in August. The review by Mary Gordon, a distinguished essayist and novelist, ran under the headline, “How Ireland Hid Its Own Dirty Laundry.”

The film follows three young Irish girls who, in 1964, are sent to one of the Magdalene Asylums, institutions founded in the 19th century, primarily in Ireland, and run by nuns. They housed girls who got pregnant outside of marriage or who were considered too sexual, too flirtatious or even too active. With the legal consent of their fathers, they were incarcerated in these asylums, which doubled as laundries.

The kind of outrageous injustice that sent the women there is shown in the opening scene at a raucous Irish wedding. A young woman named Margaret is lured away from the party by a cousin who rapes her upstairs. He returns to the festivities and continues to drink with the other men.

When Margaret comes down, she is flushed and disheveled and so clearly upset that a girlfriend shows concern. We see their lips moving as Margaret tells her what happened. The friend accosts the young man, shouting at him, and then goes to an older man for help.

Margaret just sits there, her eyes darting as the gossip makes its way around the room. It becomes increasingly obvious that Margaret, rather than the young man, is being singled out as the problem. She’s the one who will be punished, not the rapist. The next day, Margaret is packed up and shipped off to one of the Magdalene laundries.

Always exploited and, in many cases, sexually abused, Margaret and the other victims work, unpaid, seven days a week, 364 days a year, with only Christmas off. Most of the laundries had closed by the 1970s, but the very last did not close until 1996; 30,000 women had passed through their doors.

In her review of The Magdalene Sisters, Gordon writes, “Didn’t any of the women who escaped or left legitimately (any adult male relative could rescue them) tell anyone — a family member, a friend, a sympathetic confessor — what they had endured? The answer seems to be no, and the explanation lies in the particular flavor of Irish shamed silence. The moral horror of the Magdalene laundries is that the abuses perpetrated were not the outgrowth of simple sadism or even of unmindfulness, but of the belief that they were intended for the victims’ own good.”

The grotesque and terrible injustices suffered by these women, while all different, reveal that they were victims not so much of deep, unflinching religious beliefs, but of a deep-seated contempt for — and fear of — female sexuality.

When I read this article, I was personally touched. It reminded me of my own Irish Catholic heritage, and how my mother was so ashamed of her sexuality. On another level, I was reminded of the widespread malaise in our country that makes women either whores or Madonnas; it is one of the poisonous results of America’s shaming of female sexuality.

I remember when we were growing up in the ´70s, all of the girls were getting bikinis, wearing halter tops and baring their midriffs. I really wanted to be part of that scene and to be part of my peer culture. My mother absolutely refused. I had to beg her to get a two-piece swimming suit, because, for my mother, bad girls do those kinds of things — good girls don’t.

Speaking to my mother’s history and culture, the review of The Magdalene Sisters addresses the Irish belief that women’s sexuality is shameful, and the fact that men control the issues of women’s sexuality. They control it to the exclusion of a woman’s own humanity.

In America today, women’s sexuality is afflicted by what I call the “Madonna-Whore Split.” There are good girls and bad girls; and sinful girls should be shunned. The Madonnas are the childbearing wives and daughters. We put them on a pedestal, and we can’t think of them as being sexual and “sexy,” because we need them be pure and virginal like the Madonna herself. Then we have the whores: the girls “we can play with.” These girls are promiscuous and sexual, and we think of them as wrong and bad. And by calling them wrong and bad, we make them scapegoats and transfer our sexual shame to them. We think they are kinky curiosities, seducers and nymphos. These labels dehumanize them. Our contact with them is physical only or based in pornographic imagining — there is no intimacy. We think they are beneath us, while it is we who have paid the price of grandiosity by denying their humanity and our own lust. We cannot have them in our everyday lives. In our everyday lives, we want Madonna, and our women have learned to be Madonnas — all at a terrible cost.

In other words, we have J-Lo and Britney Spears acting that out for us, becoming sexual caricatures. In our culture, they become icons, but we do not let the sexuality that they imply, and which we affirm with their celebrity, take place in our own bedrooms. That would be shameful.

In our culture, the burden of sexual shame is most brutal to the women whose Madonna-hood has been forced upon them by the male dominance of sexual mores, as so vividly portrayed in The Magdalene Sisters.

I see this all the time in my practice; women come in who have the “Madonna-Whore Syndrome.” I ask them if they have ever had an orgasm, and they tell me they never have. I ask why. They tell me they don’t enjoy sex. I ask if they have ever masturbated, and they tell me no. They don’t know how to masturbate, and the idea sounds dirty and shameful. They tell me they are afraid to try.

Some women who come in are the other extreme: women who have acted out and are the bad girls. They feel shamed and dirty. Often they are depressed because of this shame, because of their inability to embrace the human reality of their sexuality and to know how they have been abused.

We have been conditioned to deny the human totality of our sexuality. This is no less a delusion than denying our reason, compassion, hunger or need for friendship and intimacy. So sex becomes this horrible split between the pure and the sinful. Why is it that many women cannot have fun with their sexuality? Why is it they cannot freely orgasm? Why is it they cannot feel good about their bodies? It is because of the shame. Because good girls don’t do that.

We Americans are not really looking at this cultural shame; we are not really addressing what goes on in women’s bodies, minds and souls, and what they want sexually. Because most women don’t know. They have been shamed out of their sexual gift, and this shaming away of female sexuality is epidemic.

Certainly the women I treat are not getting a sexual education rooted in the fullness of their perfect-imperfection — that acceptance of the truth about their humanity that enables self-esteeming sexual vitality. I don’t think we are aware of how we have scapegoated women and how we have not allowed them to be the full sexual human beings they were created. The Magdalene Sisters will powerfully compel us to such necessary reflections.

An Expense of Spirit and a Waste of Shame

Thursday, February 18th, 2010 | Best of MeadowLark | No Comments

Note: This article was originally published in the Summer 2005 issue of MeadowLark, the magazine for alumni of The Meadows.

An Expense of Spirit and a Waste of Shame

By Lawrence S. Freundlich

There is so much about her that I admire. Her knowledge of Western culture is vast; she is one of the best-read individuals I have met — including at the highest levels of academia — and she seems to remember it all. But her book learning hasn’t isolated her from the world. She has a rich social life. She attends premier art openings and theater and music events. Her circle of friends includes the business, cultural, and social movers and shakers in America and Europe. Many of them have been her lovers.

But all of these virtues are awash in alcohol. She has partied all over the globe and left a trail of real and metaphorical broken glass and stained gowns. She is famous or infamous (depending on whether she is your friend or your foe) for her scurrilous mockery of pomposity among the rich and powerful. She is afraid of no one. She is welcome in as many circles for her sanitizing iconoclasm as she is unwelcome in others for her preposterous rudeness. For some she is a culture hero — for others a dreadful boor. She has not spared her several husbands or children the spectacle of her shaming grandiosity.

When I was drinking, this woman and I were often in one another’s company, bonded by alcoholic gaiety and amused by one another’s provocative hostility. Neither of us would have recognized a boundary violation if we were hit over the head by it.

When I sobered up, after I had worked hard at making what I learned at The Meadows a part of my life, I came to see my friend for the adult wounded child she was, and my heart went out to her. I was particularly touched by her admiration for my own recovery. Because she often expressed how much of a better person I had become, I thought that I could lead her down the path of recovery.

I wanted very much to change her — to make her want what I had. I encouraged her to tell me about her upbringing, and she did. It was a very painful tale in which the false empowerment of privilege and the disempowerment of abandonment left their morbid residue of grandiosity, shame, and worthlessness over all her relationships and trapped her in alcoholic denial of her own immaturity.

During a recent vacation retreat at her home in France, at which several of us were her guests for a few days, we were the recipients of her usual hectic generosity. Then the liquor began to do its work: slurred speech, repeated anecdotes, insults, confused lectures. She was always on stage, leaving hardly any air for me to breathe. Once again, I was the little child in the presence of his shaming parents — too frightened to speak the truth for fear of being abandoned. I should have left, but I did not. Instead, I sulked silently, and my carried shame began to grow like a tumor. My authentic self shriveled. I masked my worthlessness in a constant interior monologue of contempt for her bad behavior, when it was my own shame, fear and powerlessness that were torturing me. Before the week was over, I alternated between wanting to scream in her face or hide in my room with my head under a pillow.

In the months since that sad event, I have reflected on how ill-advised it is for us recovering people to think we can save friends and partners from their addictions. Since so many recovering people have had childhoods in which their wounding involved not being heard, they are vulnerable to post-traumatic stress when their active friends and partners mock their advice by continued dysfunction. When they inevitably fail to understand us, our own shame wounds are opened, and it is we who put our recovery in danger.

The model upon which our recovery is based will often leave us feeling on the outside.  This loneliness is not a personal failure. Accepting it is the difficult but healthful gift of having become a mature adult. The wound of “not being heard” creates an abnormal need to hear things discussed intelligently and straightforwardly. I say “abnormal” because such boundaried and conscious behavior in relationship is abnormal for the species. We may be forced to accept our need for and insistence on boundaried and conscious relationship as an idiosyncrasy spawned by our own trauma histories. To fall into self-pity because we harbor a delusional notion of recovery according to our standards is an expense of spirit and a waste of shame.

The First Step is for the addict to take — we cannot take it for him. No one took it for us. If modeling sober behavior for our addicted friends does not lead them in the right direction, perhaps the only other thing we can do is to pray for them. Prayer, after all, doesn’t require their understanding or willingness.

Healthy Sexuality One Step at a Time

Thursday, February 4th, 2010 | Best of MeadowLark | No Comments

Note: This article was originally published in the Summer 2005 issue of MeadowLark, the magazine for alumni of The Meadows.

Healthy Sexuality One Step at a Time
By Maureen Canning

There is a saying in AA that reminds newcomers “to fake it until you make it.” The belief behind this advice is that you can act your way into good feelings – that proper behavior nurtures healthy emotions.

Boundary practice, which is the practice of sober behavior,  relies on this insight. As Pia Mellody has said, ”Boundary practice re-creates the conditions under which truth and respect are possible.” During the “re-creation” stage, sober behavior is consciously practiced and may seem unnatural, since we still are feeling the uncomfortable emotions associated with our disease. But despite our discomfort, we notice that the results of our acting sober are all positive. Positive builds upon positive and, at last, boundary practice yields a satisfactory (healthy) portion of inner peace.

In therapy, recovering sex addicts discover that what they think of as sexual pleasure is, in fact, the reduction of anxiety they feel when they use manipulative sex to obliterate or ameliorate the fear, shame and powerlessness wired into them by childhood sexual abuse. Disconnection from the authentic self has caused them to make a monumental mistranslation in which danger, intensity, fear, shame and powerlessness have come to mean “sexual pleasure.” Undoing this perversion of emotional truth and recovering for addicts their Authentic Selves are the aims of recovery. When in recovery, we reconnect to our Authentic Selves, we feel the safety that we lacked as children. In this feeling of safety, we begin to build what I call “congruent” selves, in which, on all levels of our being, we move toward living in the truth and taking the first steps toward healthy intimacy in relationships.

One Step at a Time
Sex addicts had to disconnect with their feelings as children, because to acknowledge the betrayal of their parents’ role of caregivers would have been overwhelmingly threatening. So they adapted, stuffed their feelings, and lost contact with the care and nurturing they genuinely wanted and needed. Since sexual urge is the energy source of our selfhood, sexual abuse caused them to lose contact with their creative identity. In order to get back in touch with their healthy needs and wants, they have to rediscover what it feels like to be authentic – free of traumatic intimidation – and vulnerable. This reconnection will be a careful and specific process of reflection and practical exercise. It is a step-by-step process. The goal is to rediscover, in the everyday events of our lives, the healthy bond between pleasure and sexuality. Only then will it be possible to see how spiritual truths and sexual energies are connected at the highest level of our being.

For example, music is one thing that can provoke the awareness of such positive bonds between bodily sensation and pleasure. When you connect with music that seems to speak to you, that is the kind of restorative reconnecting between pleasure and self-esteem that I speak of. The music and who we really are seem to be congruent; we fit together as part of a force greater than ourselves.

Another example of an activity, which, like music, reconnects us and makes us feel whole, is sensuous dining. You go into your favorite restaurant and order your favourite food, and, in that moment, you are so present and connected with the experience of taste, smell, texture and comfort that you feel complete. You feel that pleasure is what you deserve. Pleasure loses its connection to danger.

People damaged in this way must be coached in the techniques of self-care and pleasure if they are to recover from sexual addiction. I coach recovering sex addicts to identify the everyday things that give them pleasure. It might be burning incense, the sound of a fountain they listen to as they sleep, or bedroom walls, newly painted in a color that is soothing. As they act practically and habitually to cater to their sense of pleasure, they reawaken their sensitivity to pleasure and learn that it does not have to come with fear, intensity, powerlessness and shame. They learn that pleasure is not the reward of manipulation and control; it is something they deserve, in and of itself, and only because they are precious. They learn that the experience of pleasure exposes them to no danger. But it can be terrifying for sexually addicted persons to open up to such restorative activities. Their original fusion of pleasure with abuse makes the opening of oneself to pleasures as innocent as music, eating or decorating the house in favourite colors, a traumatic pathway back to pain and shame.

This is where the maxim “to fake it until you make it” is put to work. Overcoming the reluctance to listen to our favorite music, to linger over our favorite foods, to decorate our rooms in our favorite colors, soon bears fruit. We learn that pleasure does not need to plunge us back into memories of abuse. We may feel anxiety when we pleasure ourselves in these healthy ways. But we do it anyway, with a little help from our recovering, healthy, like-minded friends – friends with whom we can share our fears and our reluctance to let go and become vulnerable.

The goal of sexual recovery is not to make music, food or interior decorating healthfully available to the recovering addict. The goal is to liberate the sexual energy at the core of our being. When I talk about sexuality, I am not just talking about genital contact. I believe that sexual energy is the core of who we are; it is our life force, our passion and our creativity. From this sexual core of our being resonates our unique selfhood.

Dissolving Fear and Nurturing Joy: the Personal Story of a Recovering Agoraphobic with Panic Disorder

Thursday, January 21st, 2010 | Best of MeadowLark | No Comments

Note: This article was originally published in the Summer 2005 issue of The Meadows‘ alumni magazine, MeadowLark.

Dissolving Fear and Nurturing Joy: the Personal Story of a Recovering Agoraphobic with Panic Disorder

By Charles Atkinson, MA, MSW, LCSW

Hello, my name is Charles Atkinson. I am a 55- year-old recovering agoraphobic with panic disorder. The term “agoraphobia” derives from the Greek language. The interpretation of “agora” is marketplace, and a “phobos” is defined as flight. Hence, agoraphobia literally means “flight from the marketplace.” Further examination of the word agora reveals it was not only a place of intense commerce where goods were sold and bartered, but also the social hub of town for the exchange of exciting new ideas and concepts. Consequently, an agoraphobic could not venture into the marketplace for fear of overstimulation in unpredictable and chaotic surroundings. Therefore, at an unconscious level, the marketplace represented to the agoraphobic a mirror image of his childhood environment.

Today, the definition of agoraphobia has been refined to include an avoidance of a specific place or situation in which one feels trapped and may experience embarrassment. The terms “panic attack” and “anxiety attack” can be applied interchangeably. Panic attacks occur when the sympathetic nervous system goes into overdrive and generates a cognitive distortion of second-order fear, or “fear of fear.” This emotion of fear is felt on both the conscious (physical) and unconscious (emotional) levels. The results are panic attacks that feel as if the sufferer is going to lose control, go crazy or die.

It is not fully understood if agoraphobia with panic disorder has its fundamental inception in biology or is a learned behavior. I believe this disorder has its roots in both theoretical paradigms. However, additional schools of thought can be applied.

Dr. Shelley Uram, a Harvard-trained psychiatrist at The Meadows, helps articulate a layperson’s perspective of how the neuropsychiatry model of the mind and body adapts to stress and trauma. She explains that our amygdala is located in the limbic system of the brain. The limbic system is located in the midbrain, where our emotions originate. Constant stresses, such as childhood traumas, rattle and sensitize our amygdala, which is also referred to as the “smoke detector,” a moniker indicative of its function. It does not gradually activate the sympathetic nervous system for the fight or flight response. It spontaneously stimulates the adrenal glands to flood the body with adrenaline. This results in a state of arousal for the body and mind. If the brain continually perceives the message of an external threat, whether real or imagined, it will create an internal state of perpetual hypervigilance and angst. It is analogous to revving your car’s engine to the highest RPMs while in park.

Pia Mellody’s longtime work in the area of trauma and addictions has resulted in a behavioral model called “Developmental Immaturity.” This model addresses the problems of being relational and achieving intimacy. To gain a better understanding of Pia’s model, imagine a tree.

The roots of the tree are the childhood traumas, including physical, sexual and emotional abuse. The trunk of the tree allows the core issues of immaturity to fester and impede personal growth. These core issues include problems with self-esteem, boundaries, reality, dependency and containment. The branch of the tree denotes the secondary symptoms of unmanageability. This is the stage when addictions, depression, fear and panic disorders appear. The leaves of the tree represent the final outcome of all of the dysfunctional stages and an inability to establish and maintain healthy intimate relationships.

My first panic attack occurred at age 27, six weeks after I was married. It as if I were losing control, going crazy and having an emotional breakdown. A visit to the emergency room ensued. The hospital medical staff said I was having an anxiety attack, gave me a tranquilizer and sent me home. Not only did I feel emotionally trapped and ill-equipped to engage in an intimate relationship, but the sense of overwhelming fear and impending doom was ever-present. I tentatively speculated that marriage was the problem. It was too incomprehensible to think that the problem was endogenous to me. So began my journey through life, filled with hidden shame, fear and depression spanning the next three decades.

After two years of visiting a myriad of psychotherapists and experimenting with numerous psychotropic drugs, I was still battling depression, fear and anxiety. Fortunately, at 29, I found a psychologist who diagnosed my condition as agoraphobia with panic disorder. He explained that my disorder stemmed not from my perception of marriage, but from the cognitive distortions and childhood trauma embedded in my psyche due to physical abuse. Recalling the physical abuse experience was so powerful that it felt as if my heart and soul were being suffocated. I could not address my childhood abuse issues.

However, as I developed more psychological ego strength and better coping skills, I gradually reflected back to my childhood. I was physically battered multiple times between the ages of 5 and 13. I tried unsuccessfully to stave off my father’s abuse with my feeble attempts to express anger. My retaliation was met with scorn, disdain and an escalation of violence. This violence would trigger my body to mobilize and prepare my internal milieu for the most primitive response: survival.

Today, my father would be labeled a “rage-aholic.” His impulsivity and inability to contain his rage were equivalent to a ticking time bomb, ready to explode at any time, for no reason. Since I was the oldest male child in the family, I was the focal point of his outbursts. This dysfunctional
behavior perpetuated the male rite of passage in our family. The sins of the father were being passed to the next generation as an acceptable form of discipline.

After decades of therapy, I found that the model that helped me grasp and understand my problems most clearly was Pia Mellody’s. Her approach illustrated that my father had an extreme failure in maintaining his boundaries, contributing to my feelings of being exceedingly vulnerable and without boundaries. His constant verbal and physical abuse was an edict to our family; he was the boss. If he was in the perennial position of one-up, we were always one-down. Being one-down all the time obviously had a negative impact on my self-esteem. Also, he emphatically and without question demanded obedience, putting himself in a position of omnipotence. This eventually distorted my reality, dislodging me from the spiritual path to my higher power. My father was continually on the verge of being out of control. His lack of control influenced my behavior, as I always tried to be in control and perfect.

As a survival technique, especially during the physical battering, I dissociated my emotions from my body. If I felt any feelings, I cognitively appraised them as anxious feelings. This psychological tactic of turning my anger at my father into anxiety within myself allowed me to function in a chaotic and unpredictable home.

Consequently, after decades of dissociating from my feelings, convoluting and twisting my emotions, I was unable to identify and appropriately express emotions. Therefore, every time I had a feeling, I assessed it as anxiety – and only anxiety. This increasing accumulation of stress and inappropriate processing of emotions provided a fertile environment for the onset of panic attacks. Pia Mellody would call this psychological process “carried feelings” or “carried shame.” More pointedly, during my father’s rage attacks, I felt shame, and he was shameless. As a vulnerable child, I symbolically swallowed all of his emotional frailties and inadequacies. The psychological process of feeling my shame, fear and anger, plus my father’s feelings, was too overwhelming. A panic attack was the result of the carried fear and shame.

Healing the sins of the father is a Herculean effort. Many therapists employ traditional talk psychotherapies, which are extremely helpful. However, traditional talk therapies primarily engage the higher cortical portions of the brain. Some research indicates that childhood trauma seems to be locked in the more primitive limbic system. One of the most effective ways to access the limbic system of the brain is through modalities that stimulate the midbrain, or our seat of emotions. An example of this modality is guided imagery used to re-experience the childhood trauma as an adult. Pia Mellody uses this technique and others that bridge both portions of the brain, the frontal cortex (thinking) and the limbic system (feeling).

In closing, the abatement of the carried feelings is not the end; it is the beginning of one’s spiritual path. Ironically, recovery is not only achieved with the dissolution of fear, but with the nurturing of joy.

The Electricity of Carried Shame

Thursday, January 7th, 2010 | Best of MeadowLark | No Comments

Note: This article originally appeared in the Fall 2005 of MeadowLark, the magazine for alumni of The Meadows.

The Electricity of Carried Shame
By Lawrence S. Freundlich

Children need and expect love and nurturing from their parents. This expectation is built into the genes of the human infant, who needs affirmation and protection as much as milk and warmth. Pia Mellody believes that, when parents fail in their role as caregivers to their very young, such behavior is “shameful,” – essentially the betrayal of trust between infant and parent.

The reason most parents who act “shamefully” do so is not because they are overtly evil, but that they are “immature” and have become baffled and/or overwhelmed by the complex and emotionally taxing task of parenting a young child. This is not an unusual human phenomenon. Most of us have had to deal with the inheritance of immature parenting. Some of us have been immature parents ourselves.

The irritation that parents feel with their children may be expressed through anger and/or neglect. Such demeaning behavior gives the parent relief from the stresses of caring for the child. However, it makes the child feel frightened or worthless. The child thinks that something is wrong with him and becomes, in Pia Mellody’s phrasing, “allergic to his own humanity.” The mechanism by which this “allergy” is transferred from parent to child is what Pia identifies as “carried shame.”

It is important to differentiate one’s own shame from Pia’s concept of “carried shame.” Pia views shame to be both a gift from God and a legacy of abuse. When it’s a gift from God, the experience of our own natural shame makes us aware that we are fallible. But shame as a legacy of abuse (“carried shame”) has to do with the devastating and crippling experience of induced shame, as it diminishes our sense of inherent worth, making us feel less valued than others. According to Pia, “When we experience our own shame, we believe that someone has seen us as we really are – human and imperfect. When we feel our own shame, we know we are not a god or a goddess. Our own shame makes it possible to be relational, a gift our body gives to us, as we have to consider the impact that our behavior has on other people.”

When Pia and Pat Mellody first began to discuss the concept of “carried shame,” Pat provided a useful metaphor from the physics of electricity. He likened the transfer of a parent’s shaming of a child to what happens when one coil of electric wire is placed next to another coil, and one coil is charged with an alternating current. The adjoining coil picks up the energy from the charged coil, even though the coils are not touching. Since human emotions, like electrical currents, are energy fields, they can be transferred from the person who is feeling the emotion to another person in close proximity. Of course, the emotional energy must be powerful enough for effective transfer (in physics, this is called “induction”).

It was Pia’s startling insight that the emotion of shame reaches the crucial “voltage” for “induction” when the person acting shamefully does not acknowledge that his/her behavior was shameful. The shame energy unabsorbed by an act of conscience or contrition has no where to go but out into the atmosphere to be picked up by the “adjoining receptor”; that “adjoining receptor” is the child. The child then feels the parent’s shame as if it were his own. What he feels is not the result of something that is wrong with himself, but something that is wrong with his parents. If the child were a mature, rational adult, he would recognize that his feeling of shame could not be alleviated by trying to figure out how he himself is inadequate, worthless, or “bad.” The mature, rational adult would have to learn how, in Pia’s terms, “to release the carried shame.”

I believe that “carried shame” is one of the more difficult concepts in recovery. Many of us acknowledge that we are “shame-based,” and we try to modify our behaviors so that we can have a sense of value. While the effects of carried shame live within us, the origins of shame do not belong to us, and attempting to fix our shame identifies the wrong transmitter. The shame belongs to the original shamers. And it is only by releasing it that we can rid ourselves of carried shame.

Many of us feel uneasy at the prospect of laying the blame of disastrous careers on our parents. We have been taught to take personal responsibility for our failures. Didn’t our parents try as hard as they could to raise us? As culturally admirable as such reflections may seem, they are psychologically delusional. A child is in no position to take responsibility for his parents’ shamelessness.

It has been the experience of many patients at The Meadows that the release of carried shame contributes to a sense of balance and moderation. And yet, we have come to understand that some pathways back to the pain of our carried shame traumas can, from time to time, be triggered. It is at these painful moments that we can shield ourselves from the effects of the voices of the past. We have learned to take time out, we have learned to breathe into the pain, and we have learned the skill and art of boundaries. We have learned that our pain is not evidence of our worthlessness. And, if we can do these things most of the time, we are reminded that we are okay, even if it has been a long journey back to believing it.

Remembering Who We Are: Tools to Gain Clarity

Thursday, December 24th, 2009 | Best of MeadowLark | No Comments

Note: This article was originally published in the Fall 2005 issue of MeadowLark, the magazine for alumni of The Meadows.

Remembering Who We Are: Tools to Gain Clarity

Kathleen O’Brien, LCSW

“I want to change, but I don’t know how.”

How many times have you heard yourself utter these very words? Most people come to counseling knowing that their lives need to change, but they often don’t feel confident enough in their abilities to make that happen.

Confusion about what is most important can lead, at the very least, to poor choices and mildly co-dependent behavior and, in the extreme, to serious addiction problems.

It doesn’t work for us to behave in ways that go against our own values. We can suffer depression and/or anxiety when we ignore what we believe to be most important. We then “treat” our unhappiness with self-destructive behaviors, such as dysfunctional relationships, substance abuse, irresponsible spending and so forth. One poor choice leads to another, and soon we find ourselves at the bottom of a very deep hole.

That downward spiral is daunting, to say the least. My experience both personally and professionally has shown me that, in order to make a significant life change, we need to remember who we are, i.e. to have clarity about what we value most.

The truth is that most people know intuitively what is most important to them. When a client finds herself in a predicament, I ask what she would tell a son or daughter to do in the same situation. Almost without fail, she has an instant answer for the problem at hand. It is as though she can access her wisdom for someone else’s benefit (especially her child’s), but not for her own. It’s not that she doesn’t know the answer; she just doesn’t feel entitled to act on her own behalf. As a result, she usually doesn’t develop the skills necessary to get her needs met in a healthy way.

Take a few moments to ponder the following:

• If it did not matter what other people thought, what would you do differently in your life?
• If you knew for certain that you had only a limited time to live (by the way, this is always true), how would you spend that time?
• If you were to die tomorrow, how would your obituary read? Think about what you would be remembered for at this point in time. Who would mourn your passing? What would have been your greatest contribution to the world?

The point here is to focus on remembering who you are. Pia Mellody calls this “remembering that you are precious.”

Over the years, I’ve tried many techniques to help clients clarify how they feel and what they value. I call this “accessing one’s own wisdom.” Here are some techniques I’ve found helpful:

• Write about it. Keeping a daily journal makes it next to impossible to fool yourself for long. There is nothing like hearing yourself complain day after day to get you moving. I speak from experience on this one!
• Consider the best and worst possible outcomes. If the worst happened, how would you deal with it? If you have trouble here, ask yourself what you would tell someone else to do. Sometimes people get stuck because they believe that it’s abnormal to experience pain. They think that life is supposed to be happy all the time. Part of becoming an emotionally mature adult is learning to endure the normal pains of life without resorting to addiction.
• Define what you consider to be universal values. These are the so-called “bottom line” ways of being in the world, e.g. honesty, family, health, integrity, adventure, friendship, love, success, etc. Once you have your own list, take a look to see how closely you are living according to these values. Do your actions match what your heart and mind tell you to do?
• What would other people be surprised to know about you? This is a powerful question to ask yourself – and often very revealing. The answer may offer clues about what you really value.
• Ask someone you trust to write a eulogy for you. It is interesting to get a peek into how others see you.
• Make a collage. Go through old magazines and find pictures that appeal to you; it doesn’t matter why you find them appealing. Trust that your unconscious is leading you to discover more information about yourself. When you find these pictures, rip them out and paste them onto poster board. Place the collage in a place you will see often. What does it tell you about yourself?
• Get away from your problems for a while. Distance can give us a different perspective. Rent a funny movie. Do something physical, such as walking, running, hiking, etc. Experience the nurturance available in nature. A walk on the beach or in a forest can expand perspective and lead to inner calm.
• Look at what you like to do for fun. The way you spend your free time (and your money) can tell you a lot about what you find important.
• Think about how your ideal life would look. Where would you be? What would you be doing? Who would be in your life? Ask yourself why you aren’t doing these things. Try to own the choices you’ve made. It is easy – but not particularly useful – to blame others when it comes to change. How do you want to do things differently? Who might help you?
• Try acting as if you feel confident and competent. What stops most people are negative attitudes such as futility (“nothing ever works anyway”) and fears, including the fear of failure. In reality, we are limited mostly by what we believe is possible. Expect a lot from yourself (and others, too). Define for yourself what your “best effort” would be. Are you doing that? If not, why not?
• Meditate! Use meditation to access your own spirituality. This is not about religion, but about accessing that part of you that needs to connect to your inner self. There is no single way to do this. A class can help you get started. Some medical insurance companies offer meditation classes to help improve health and general well-being.

In conclusion, remember that the way to heal yourself is to know who you are and to live according to what is true for you. When a person acts in truth, it resonates down to the cellular level. You are your own best healer!

Fall/Winter Edition of MeadowLark Now Available

Wednesday, December 16th, 2009 | Best of MeadowLark | No Comments

The Fall/Winter 2009 edition of MeadowLark, the magazine for alumni of The Meadows, has just been published. This issue contains several feature articles:

• The Intimacy Factor by Pia Mellody and Lawrence Freundlich
• Recess Revisited: A Recovery Behavior by Diane Detwiler-Zapp
• Perceptions Create Realities by Charles Atkinson

Also included this issue in are staff spotlights, alumni contributions, a featured workshop (Sexual Recovery), free lectures, and other educational opportunities.  MeadowLark is available in both HTML and PDF formats.

Science and Ancient Wisdom: Treatment Here-and-Now

Thursday, December 10th, 2009 | Best of MeadowLark | No Comments

Note: This article was originally published in the Summer 2008 issue of MeadowLark, the alumni magazine of The Meadows.

Science and Ancient Wisdom: Treatment Here-and-Now

Before reading further, take 20 to 30 seconds to do this exercise: Let your gaze leave this article and let your eyes look around wherever, and at whatever, they want – just 20 seconds or so. (Really, try it, and then come back to reading.) People in my Somatic Experiencing® (SE) Trauma Treatment courses who try this are surprised that, in a very short time, they feel noticeably more relaxed, peaceful, and in the “here-and-now.” Some say they should do this all the time!

Thanks to the forward-thinking people at The Meadows, the connection between trauma and addiction is better understood and more effectively treated. Part of this treatment at The Meadows’ extended-care facilities consists of working with the trauma-resolution skills of Peter Levine’s Somatic Experiencing®. The relationship between trauma and the exercise you just tried is that, according to Bessel van der Kolk, post-traumatic stress is fundamentally a disorder in the ability to be in the here-and-now. This means that the state of- the-art in trauma therapy is no longer intense regressive or cathartic therapy. Instead, state-of-the-art therapy is the process of becoming alive to the moment.

For those I train in SE, like those at The Meadows, working in the here-and-now is a cornerstone of clinical theory and practice. When doing his dissertation decades ago, Peter Levine met Stephen Porges and explored his research. Porges’ “Polyvagal Theory” (Porges, 2001) shows how one pathway of the nervous system engages freeze and another relates to social engagement. Levine discovered how to work with the transition of the nervous system through these phases (freeze and engagement), as well as the phases of fight and flight. This is SE. This article’s focus is on the engagement phase, which must be integrated into all other nervous system phases.

While Porges’ emphasis is based on single linear phase transitions, in SE we work with non-linear and rapid cycling states, for instance, freeze and fight, or flight and orientation. Traumatic symptomology such as intrusion of fight, flight and freeze means that the past has become the present. Flashbacks are the classic example of such disorientation—innocuous cues can trigger an all-out response. In other words, the person temporarily experiences a state that is disconnected from the actual here-and-now environment. One of the antidotes to this traumatic recollection is orientation. I provisionally define orientation as “connecting to the environment through the senses” — in other words, coming back to our senses. This is a broader understanding of engagement than social engagement, per se. For clients whose early life experiences were marked by trauma and abuse, social engagement is actually a trigger for fight, flight and freeze. In this process of orientation, rather than being inundated with a cycle of feelings, thoughts, and sensations associated with unresolved trauma, the client’s attention can be directed to the reality of the environment that is available through the senses. Typically we see decreased blood pressure and decreased heart rate, as well as the subjective experience of greater relaxation and interest. In other words, it is the difference between stopping to smell the roses and reliving getting stuck by a thorn!

With many severely disoriented clients, much of the initial therapeutic work (in addition to establishing rapport) consists of the stabilization that comes from establishing better cognitive pathways or habits of here-and-now sensory attention. In attending to the sensory experiences of the external world, physiological mechanisms for assessing safety are allowed to occur without undue influence from traumatic memory. The mechanisms of this assessment are far too important, in a survival sense, for the slow processing of linear thought or conscious effort. Porges aptly names this subconscious process of safety assessment “neuroception” (Porges, 2004). Thus, a natural orientation to the external environment via the senses facilitates the neuroception of safety.

This approach is receiving increasing scientific and popular attention (Time Magazine: Mind & Body Special Issue, January 27, 2007, pp. 55ff). Whether incorporated into CBT, DBT or meditation, the role of the observer is crucial. The process of orientation is fundamental to this cognitive activity. However, many traditions that recommend observation may not adequately reinforce with clients the importance of orientation to the outer versus the inner environment. For those with significant disorientation, it is nearly impossible to track the interior landscape without being involuntarily drawn into what SE terms the “Trauma Vortex.” The involuntary and repetitive attraction to this “vortex” is the disruption of the approach-avoidance system, and it is one of the dynamics that underlies addiction and compulsive behaviors in general. Although somatically informed therapists draw from Levine’s work, they often make the mistake of inviting clients’ attention to the inward sensate experience, without consideration to the vital criteria that indicate whether a client can negotiate such attention without reactivating and reinforcing trauma states. For instance, one of the most common beginner’s mistakes is when a therapist asks an anxious client to focus on that sensation in the body. For some clients, this can work well and provide a sense of relief and transition to a more relaxed state; for others, this can lead to further discomfort and other states of disintegration. It is vital for the therapist to immediately and accurately assess the client’s capacity in order to determine the appropriate intervention. Without such assessment skill, the safer route is to begin with external orientation, which can stimulate the innate orienting response and build stability.

Once relative stability is attained, a balance of interior and exterior attention can be facilitated. Then a more neutral and practiced observation of the range of experiences can be enjoyed, as the attention can shift naturally between affective experiences, both positive and negative. (This fundamental process at the heart of SE is known as “pendulation,” which I discussed briefly in the Summer 2006 edition of The Cutting Edge) This natural swing between polarities is the normal condition of the balanced nervous system. And interestingly, the resulting integration that comes from this innate oscillation is a broader and more nuanced life in the here-and-now. The experience brings awareness, presence, and a greater ability to experience life on its own terms, without undue constriction or elation. Obtained after significant work of attending, this resulting state can yield an expanse of awareness with an increasing ease of relation and a connectedness to everything that is. This state, known among meditative adepts, is simply our human mind freed of its overlay of conditioning hewn by survival networks related to approach-avoidance. Freed from the dominance of an ill-conditioned approachavoidance paradigm, one enjoys engagement with what is now, new and alive. And so, as clinicians, we can orient to the fact that we live in a time of opportunity, when mind and body are becoming reacquainted, and when science can shake hands with ancient wisdom.

References
Hoskinson, S. (2006) “SE’s Systemic View of Functional Reward Systems.” The Cutting Edge, Summer 2006. See TheMeadows.com.
Porges S. W. (2001) “The polyvagal theory: phylogenetic substrates of a social nervous system.” International Journal of Psychophysiology, 42, 123-146.
Porges, S. (2004) “Neuroception: A subconscious system for detecting threats and safety.” Zero to Three [Online] National Center for Infants, Toddlers and Families. No. 5, May. See zerotothree.org.
Stengel, R. (Ed.). (2007). The brain: A user’s guide [Mind and body special issue]. TIME, 169 (5).

ABOUT THE AUTHOR
STEVEN HOSKINSON, MA, MAT
Under the auspices of Hoskinson Consulting in Encinitas, California, Steven Hoskinson, MA, MAT, is an international consultant and trainer for clinicians and trauma treatment providers. Steven is a Senior International Instructor for the Foundation for Human Enrichment and has done research in creativity, myth and spirituality. His perspectives include evolutionary, developmental, cognitive-behavioral and systems approaches within a mindfulness framework. Other major influences include personal mentoring with Peter Levine, PhD, more than 20 years of experience in the contemplative arts, and a decade as a practicing aikidoist. www.HoskinsonConsulting.org

The Triggering Effect

Thursday, November 12th, 2009 | Best of MeadowLark | No Comments

Note: This article originally appeared in the Spring/Summer 2009 edition of MeadowLark, the magazine for alumni of The Meadows.

The Triggering Effect
By Claudia Black, PhD, MSW

Article excerpted from newly released CD Triggers and DVD The Triggering Effect.

Triggers are specific memories, behaviors, thoughts and situations that jeopardize recovery – signals you are entering a stage that brings you closer to a relapse. The process is much like riding a roller coaster that loops over itself. Once the roller coaster car gets to a certain spot in the track, a threshold is met, there is no turning back, and it starts the downward loop.

t is very likely you have heard your husband, wife, partner, mother, father, boss, a friend, attorney or even a judge say, “What were you thinking?” The answer is: you weren’t thinking.

The inability to recognize the impact of your behavior, the willingness to risk what is significant in your life, and in this case, the quick lapse into old behaviors in spite of good intentions appear to be connected to brain chemistry. Addiction hijacks the brain. The reward/pleasure center holds captive the thinking center.

The good news is that the brain has plasticity. That means, in treatment and recovery practices, you can learn skills to calm the brain’s emotional responses and reactivity area. You can learn to avoid triggers that activate the emotional area, and you can learn to enhance the decision-making area so you can rationally think through decisions, rather than respond impulsively and from such a strong emotional basis. But it takes time for the brain to be rewired, and it gets rewired with the repetition of new skills and new ways of thinking; hence, we strongly urge ongoing involvement in aftercare and other support systems.

Willpower alone is not a defense against relapse. Recovery is achieved, maintained and enjoyed through a series of actions. Learn to identify your triggers and, with each, identify a plan that anticipates and de-escalates the power of the trigger. With that, your reward is another day of sobriety with endless possibilities.

Five common triggers are:

1. Romanticizing the Behaviors
Romanticizing involves a tunnel focus on the positive feelings you associate with the behavior; it involves glamorizing using behaviors and, in the moment, totally forgetting about the negative consequences.

Getting overwhelmed at times is to be expected, but it’s very easy to slip into romanticizing without any insight as to how you got there. At that moment, you enter a slippery zone, touching the trigger. While romanticizing is itself a trigger, it often occurs in tandem with an external trigger such as noises, sights, sounds or even tastes. You could be watching a movie and the next thing you know it is depicting the power of alcohol, drugs and sex in a positive way, and you are romanticizing. Or you’re listening to the radio and an advertisement for a drug comes on, and you think about your pain pills as the commercial goes on to tell you how much better you’ll feel, and off you go. Or you’re watching a ball game on TV and can almost smell the popcorn and peanuts, and you see the spectators drinking large cups of beer and everyone is smiling like it’s only a good time.

Take a few moments to think about how you romanticize your addictive behavior. What do you find yourself thinking about? What is the romanticizing covering up? What are you forgetting to take into account?

2. Feelings
Addicts have used their behaviors and substances for years to separate from their emotional states. And there is so much to feel — guilt for how your behavior has hurt others, sadness for your losses, anger with yourself, fear of what is in front of you, shame for thinking you are inadequate, not worthy. You can act out in response to every feeling imaginable.

You lessen or get rid of feelings when you own them, talk about them or, in some cases, engage in problem solving. It is when you try to divert, ignore, and numb that you get into trouble. Feelings are a part of the human condition and you can’t escape them. Recovery is the ability to tolerate your feelings without the need to medicate or engage in self-destructive or self-defeating behaviors and thoughts.

Recognize the gifts that come with feelings. Feelings are cues and indicators telling you what you need. Loneliness tells you, in your humanness, you need connection; fear can offer you protection, sadness offers growth, guilt is your conscience, offering direction for amends. It is critical for you to have this insight and, more importantly, to start to take ownership of the feelings when you have them.

3. Loss
Coupled with the trigger of feelings is the fact that those feelings are often associated with loss. By the time you get to recovery, you have had multiple losses in your life, often related to childhood, many times due to being raised with abuse, addiction, mental illness, etc. While you may have experienced trauma within your original family, pain of loss may be from a specific situation.

You may have experienced the loss of relationship with your parents or children, the death of friends or family, abortions, or career or work opportunities missed. As an addict, you are likely to have experienced losses related to health issues. Perhaps you have Hepatitis C, HIV, or injuries due to accidents.

It is not that you are suddenly thinking about these losses, but there may be a trigger. Perhaps you are in treatment and you see other people’s children come to visit, and you have three kids and you don’t even know where they live. Your daughter tells you that your ex-husband has just moved in with someone else. The goal is not to dwell on your losses, to not live in the pain and anguish. This is what happens when you don’t acknowledge them and what they mean, triggering you back to your using behavior. With some losses, you can only grieve and ultimately come to find some meaning from your experience; with others, in time, you can attempt to repair damaged relationships.

4. Resentments
Resentment is also a feeling, but I think it warrants its own place as a significant trigger. Resentments are like burrs in a saddle blanket; if you do not get rid of them, they fester into an infection. Resentments are often built on assumptions, i.e., “When you don’t look at me, I assume you think you are better than me.” “When you don’t include me in a social gathering, I am assuming you think I am not good enough to be with you and your friends.” Resentments are also built on entitlement, which is a form of unrealistic expectations and impatience.

Unrealistic expectations + impatience = resentments.

Move from resentments. When assuming, check it out. Put yourself in someone else’s shoes (it may allow expectations to be more realistic). Identify and own the feelings the resentment is covering (often it’s a cover for feelings of inadequacy and/or fear). Be willing to live and let live.

5. Slippery people, places or situations
You need to identify specific triggers – the people, places, and situations that are high-risk. Slippery people could be your ex-lover, certain family members, or past using/party buddies. A slippery place might be a bar you used to frequent, a casino, or an area in your community where you cruised – in essence, any place that triggers a positive association about the use of your drug of choice. Slippery situations could be an emotionally charged social gathering, such as a wedding, family event, or vacation.

Medication may be a trigger for which you need to be accountable. While there are situations when medication is needed, you are at high risk to abuse. You need to be proactive in how you are going to cope with this situation, because it is likely that your brain is going to remember a good feeling, saying more is better. Again, there are situations when medications are necessary, but self-diagnosis and/or self-prescribing only create a recipe for disaster.

What are the people, places or situations that are potential triggers? What provides safety for you to not be triggered? What triggers can you avoid? While some decisions around triggers are absolute, others are not necessarily in place for the rest of your life. Know your triggers and plan accordingly. In the face of a trigger, what do you need to do? What do you need to tell yourself? To whom can you reach out for support and/or problem solving?

Today in recovery:

1. Practice staying in the present; don’t sit in the past or project into the future.
2. Validate the gifts of recovery for the day – practice gratitude daily.
3. Identify, build and use a support system – you need to stay connected. History and experience have proven time and time again that recovery is not a solitary process and cannot be sustained in isolation.
4. Trust that your Higher Power is on your side.

Would You Marry Yourself or Someone Like You?

Thursday, October 29th, 2009 | Best of MeadowLark | No Comments

Note: This article originally appeared in the Spring/Summer 2009 edition of MeadowLark, the alumni magazine of The Meadows.

Would You Marry Yourself or Someone Like You?
By Debra L. Kaplan, MA, LAC, LISAC

Many magazines today offer practical advice and “how-to” strategies to pursue the man or woman of our dreams. Let’s face it: Sexy taglines and catchy subtitles make for good print copy, but they do little to help us build healthy, sound relationships. By projecting our wants, expectations or intentions onto our partners-to-be, we serve only to foreshadow the inevitable relational demise. It is as if we incorporate our obsolescence from the very start.

“How is that possible,” you may ask, “when I’m doing all the right things, paying close attention to selecting my partner, and looking at what he or she has to offer the relationship?” While I admit that these words sound counterintuitive, first consider this proposition:

Would you marry yourself or someone like you? Do you like the person you are – and that which you have to offer – enough to marry yourself?

Some time ago, I put this question to a client. In his plunge toward self-pity, he began to lament the state of his personal affairs, citing one futile relationship after another. “I don’t know what else to do,” he said with exasperation. He cynically sneered, “Just when I think I’ve found someone ‘special’ and things are going ‘swell,’ she leaves me. How does this happen that I pick women who cheat on me, time after time?”

That’s when I asked him to humor me, as I was about to ask a question that might sound strange. “Geez, no,” he answered. “I wouldn’t marry anyone like me!” He went on to state that he was amazed that anyone liked him at all. That response, or a variation of it, often followed when I posed the question to clients.

Courage to look at our own fallibility and dark sides goes a long way in building healthy relationships – not just in romance, but in all of our personal interactions. Knowing our dark sides involves embracing those aspects of ourselves that cause us shame or guilt. While our tendency might be to bury or dismiss the parts that we don’t want to acknowledge, this undermines the positive changes and inner strength we strive toward.

Initially, our tendency might be to assess what our partners bring to the proverbial party – without assessing what we have to offer. Are we emotionally available? Do we remain open to constructive criticism and risk being known, or do we defend ourselves into isolation, staunchly committed to our self-righteous deception? Is it okay to be lonely just as long as we are not “wrong”?

These are hard yet essential questions. Only when we like ourselves will we attract the same positive energy in others. The journey to know spiritual peace and fulfillment is an inside-out endeavor.

The first step begins with defining what we want to change about ourselves – and being honest about who we are. If we are too close for honest introspection, we can start by observing others’ behaviors. Those behaviors we find uncomfortable or unpleasant reflect our internal barometers. Essentially, by noting unlikable behaviors in others, we face reflections of our true selves.

Defining what we want to change takes an honest assessment of what we reject in ourselves. How often are we drawn to attractive people while believing, deep down, that we are not equally attractive? When we accept and love our own qualities, we form the strongest foundation for intimacy.

By taking that simple but profound step, we begin the enlightened journey toward inner peace and fulfillment. As propositions go, there is no better partner with whom to say “I do!”

ABOUT THE AUTHOR
DEBRA L. KAPLAN, MA, LAC, LISAC
Debra L. Kaplan is a practicing licensed therapist in Tucson, Arizona. She integrates her training with Pia Mellody into her work with CPTSD and co-occurring addictions.