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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Pfinstegg on April 30, 2006, at 12:35:54
I went to a conference yesterday given by Dr. Douglas Watt of Boston University. It was enitled "Affective Neuroscience". Much of the first part had to do with which parts of the brain light up on fMRI's during various states of loss, attachment disruption and depression (in small primates mostly, but also in humans after various relationship losses). What was so amazing to me was how DEEP in the brain those parts were- they were about as far away from our rational, problem-solving cortexes as they could possibly be- in the basal ganglia, upper brain stem and nearby areas. Practically in our necks!
Then he talked about what implications this had for effective clinical practice. He had a simple model in mind- that depression equals attachment disruption. The primary model was an initial lack of secure attachment to a loving and responsive mother; all other things, such as physical or sexual abuse, were thought to cause depression. anxiety or panic- not too important which- because they cause a loss of trust and attachment also. He said that as evolution progressed towards larger and larger brains, social attachments became more and more important in order to protect our brains (100 billion neurons!) as they are growing. He said that the disruption of attachment and trust causes a lot of changes in brains- with the stress cascade (excessive cortisol) being the most well-known, but with other things, such as increased glutamate, increased Substance P, altered immune systems, etc. also being important although less well understood.
He said that the fact that attachment disruption causes unfavorable changes in such basic parts of our brains- the parts that we share with all animals who take care of their young- birds, reptiles. as well as all mammals- meant to him that it is often impossible in psychotherapy to use words and thinking in constructive ways to change something that is wordless. He feels that the best psychotherapy involves the development of the deepest possible attachment, which occurs through gaze, body language, a caring, comforting tone of voice, as well as the reliability of the therapist in committing to BE THERE, listening attentively and empathically. Complex interpretations involving a lot of cortex didn't seem to rate very high with him. He didn't seem to have a very high opinion of medications either, overall; he thought the three most important things were, first and foremost, the attachment to the therapist, and secondly, such things as aerobic exercise. play and meditation. He said that exercise raises BDNF at least as well as any of the AD's.
Aren't these the things which seem most important to us all, too? The intense search for a meaningful attachment to the right therapist seems to be the single most important underlying theme here. The people fortunate to find that KNOW that it is helping them tremendously. According to Dr. Watt, that's because the relationship is changing our brains in a healthy way. The people who get well enough to have the energy for exercise also find it very helpful. And regaining the ability to play seems to happen naturally when depression lessens. Not so many people mention meditation, but perhaps it's something we could consider more.
There's not really anything so new or startling here- except that it was said so clearly by such an eminent person, who had the fMRI slide documentation to back up what he was saying! I'd love to know what you all think.
Posted by annierose on April 30, 2006, at 14:20:24
In reply to A conference report..., posted by Pfinstegg on April 30, 2006, at 12:35:54
Thank you for sharing your thoughts on the conference. Very very interesting.
>>>He feels that the best psychotherapy involves the development of the deepest possible attachment, which occurs through gaze, body language, a caring, comforting tone of voice, as well as the reliability of the therapist in committing to BE THERE, listening attentively and empathically.<<<<
I feel my T does employ the above "techniques", except when I lay down, I down see her gaze or body language, although I sense it by the tone of her voice. From another conference you wrote about last summer I gathered that looking eye to eye is important from time to time --- that the brain responds to the T's comforting gaze. I'm at a place that I find that excruciating difficult, if not impossible. I even cover my face with my hands. She used to ask if I had a headache, "No," I reply, "just being here makes me so self-conscious."
>>it is often impossible in psychotherapy to use words and thinking in constructive ways to change something that is wordless<<<
Wordless --- that resonates with me too. I think it was Daisy's T that talked about one sub-conscious talking to anothers in the therapy room. I do think that happens in strong theraputic relationships. It's a special connection from one soul to another, heart to heart.
Everything you wrote about makes sense. Exercise is so important to my mental health. And the days I find time to go to yoga are my best --- exercise combined with meditation --- a double whammy of happiness. I often tell my friends, yoga is my second favorite form of therapy.
Are you adjusting to going 3x per week? How is that going?
Thanks again for checking in and sharing all your insights.
Annierose
Posted by Pfinstegg on April 30, 2006, at 14:51:59
In reply to Re: A conference report... » Pfinstegg, posted by annierose on April 30, 2006, at 14:20:24
Thanks for replying, Annie. It sounds like you are receiving a lot of the important things. I'm not lying down, now, but when I was, I "felt" a huge emount of body language and voice tone which felt so caring, just as you are.
Truthfully, I haven't adjusted too well to cutting down on the hours, or to being asked to sit up all the time. It has felt like a sort of abandonment. At one time, I felt we were so well-attuned, and I did feel securely attached- now I do feel much more alone, and it is harder. I'm just trying to do my best with it. I don't know if this is the start of termination, or not. I don't get much response when I get up the courage to say anything about it. Well, at least I have had a wonderful experience with him, even if it didn't last as long as I would have liked.
Posted by eyes2ursoul on April 30, 2006, at 17:45:09
In reply to A conference report..., posted by Pfinstegg on April 30, 2006, at 12:35:54
Hello - I'm new here and just read ur post. I hope you dont mind me rersponding, as im not that clever, or even sure if i'm allowed to respond to your post since you seem to know each other well the three of you, and i'm just new.
The thing is I just wanted to say, as i've been hanging around these boards for a while now, and think ur conference report threads are some of the best ive ever read here or anywhere, re this sort of subject material.
All the info you said about the attatchment and the protection of the brain cells and even distruption of the immune system in a chil who has no secure safe bond/attachment. I just think it makes sense. I dont know much, but i know when something speaks to the deeper parts of me, and you have spoken, and given me a feeling of comfort from your insight.
so, thank you! Thank you very much for sharing the things you did. I for one will treasure the info you have shared.
Kind regards
eyes2ursoul
Posted by eyes2ursoul on April 30, 2006, at 17:52:41
In reply to Re: A conference report... » Pfinstegg, posted by annierose on April 30, 2006, at 14:20:24
Hello there -
I'm sorry if i'm intruding again, i hope not though.
It's just that i wanted to say how much i am also very pleased to read all the things you ahve shared about the best way of repairing the problems with no secure attachment in therapy being through gaze and soft voice tones, and empathic listening and all the other things you said.
I feel very lucky beacuse i have a good therapist who does all those things with me, and i'm so very blessed/happy to know that its the best thing she can do to help me.
The attachment being one of the major reasons i'm in therapy. I've been three years with my T and she is wonderful.
I just wanted to let you know that you have helpe d me soooo much today by sharing your conference posts.
THANK YOU SO MUCH FOR ALLOWING ME TO LEARN FROM YOUR EXPERIENCES. i AM TRULY GRATEFUL, AND HOPE IF YOU DONT MIND TO PERHAPS HAVE SOME MORE DISCUSSIONS ON THIS SUBJECT IN THE FUTURE WITH YOU GUYS?
take care
Posted by Pfinstegg on April 30, 2006, at 19:19:28
In reply to Re: A conference report... » Pfinstegg, posted by eyes2ursoul on April 30, 2006, at 17:45:09
Thanks for your lovely message! Going to a conference like the one i just went to, with all of the amazing new information laid out in front of us in the form of functional MRI slides, lets us all know that what we feel instinctively about our relationships with our therapists has a profound, real truth- it's really there, lighting up in the most primitive, and important, parts of our brains- important in terms of our feelings of well-being and basic safety- which allows us to live as fully and rewardingly as possible.
It's wonderful to hear that you have a therapist who understands these things so well, and is providing what you need so well, also.
Posted by eyes2ursoul on April 30, 2006, at 20:33:35
In reply to Re: A conference report... » eyes2ursoul, posted by Pfinstegg on April 30, 2006, at 19:19:28
> Thanks for your lovely message!
The pleasure was all mine!
Going to a conference like the one i just went to, with all of the amazing new information laid out in front of us in the form of functional MRI slides, lets us all know that what we feel instinctively about our relationships with our therapists has a profound, real truth- it's really there, lighting up in the most primitive, and important, parts of our brains- important in terms of our feelings of well-being and basic safety- which allows us to live as fully and rewardingly as possible.
Wow!! must have been really something eh... were there really slides showing all the info of what is taking place in a patient/clients nuerological systems during intensive attachments in good psychotherapy, coupled with the long term effects on a child from a cold and negative attachment?
>
> It's wonderful to hear that you have a therapist who understands these things so well, and is providing what you need so well, also.Thank you !
I always have felt that she (my psychologist) is a gift from God sent into my life to help repair and heal the parts of my that had been buried alive or even completely killed off.
Well you know hat they say ' ur never too dead for a resurrection'
My theraPy with this woman has been steady and i will not even attemp to verbalise the things that have taken place in myself througgh the hard work being put into it.
Some thing are just better left unsaid, right!
But what I like about talking about this with you is that u have reasl scientific approach to whats going on in the theraputic relTIONSHIP COUPLED WITH instinct and intuitive knowledge.
I find you rather delightful!!!
My therapist gazes right into my eyes and I feel a great deal of warth in the connection there.
Not too get too carried away on the sexual energy and all that, though i do my fair share of that sort of thought and talk.
but this what ur descirbing is different, and i feel that its what i need to help me understand the beauty of the truth of ther amazing love and caring that is healing .
How do you suppose its even possible for someone else who is doing a job to have this kind of connection and influence and positive effect on another person?
is it just as heart surgeons can save a mans life doing their job, or a fireman pulling a child from aburning building?
I think they are sort of good guardian angels -
pls dont mis understand me im not zany or wacky i just trying to convey the enormity of the wonderous effects a good theraputic alliance can hve on the patient/client.
do you think its possible the therapist is beneiting in some major way too from the alliance with a particular client whom they are working so closely with, and connecting as much as possible in the terms you have described were taught to you at the conference; gentle voice tone, eye contact, and that feeling....
Hope you are interested enogh to keep writing to me Sir, i do like our conversation very much!
once again many thanks
all the best
and looking forward to hearing from you and your thoughts on any matter but especially this one at this timely moment in my life.
Take care
Posted by annierose on April 30, 2006, at 22:22:12
In reply to Re: A conference report... » annierose, posted by Pfinstegg on April 30, 2006, at 14:51:59
I am sadden to hear how difficult the adjustment to 3x per week has been. It scares me when I think about the future. I wonder why your T is hesitant to discuss termination with you. Does he specifically ask you to sit up now? If so, maybe he wants to move your therapy in a different direction - or try a different approach. Maybe he wants you to explore the possibility of termination by talking about it with him. Maybe he is waiting to hear more from you about where you are at with it.
I swing wildly from "I love therapy" to "I hate going". We talked a lot about what that means, why those feelings are coming up now, etc. It has settled some. It's interesting how my brain keeps scanning the surface, trying to find criticism in her voice, re-visiting past hurts to justify the "don't get too attached". But in quieter moments, I feel the connection and the reassurance in her voice. It's a process like no other. It's certainly not for the faint of heart.
I hope you find your connection again. I'm not so sure he is letting you go just yet, maybe just letting you feel your oats.
Posted by Pfinstegg on April 30, 2006, at 23:23:49
In reply to Re: A conference report..., posted by annierose on April 30, 2006, at 22:22:12
Yes, it's definitely different- less intense and interactive. I do try to bring everything up- thar's me-and I do talk about the lessened connection, and how sad I feel about it. But I don't think it's coming back- perhaps that part is over now. I wish I had a few more oats to actually feel! Anyway, when the therapy was at its most intense and absorbing, it was wonderful-it meant the world to me, as it does to you. I try to keep that in my heart. And the people who know me best feel that I'm definitely better (DH especially), so what I'm going through may be mostly a grief reaction. And those do end, I think...
Posted by Daisym on May 1, 2006, at 2:34:25
In reply to A conference report..., posted by Pfinstegg on April 30, 2006, at 12:35:54
Sounds like a great conference! I'd love to see the slides.
As you know, I've taken on a Master's degree fellowship program studying Infant mental health concepts and the overriding theme in everything we've studied is attachment, secure base, attachment, attunement, attachment - rupture-repair...and more attachment. Our list of professors over the next year is pretty impressive and includes both Daniel Stern and Dan Siegel. I'll get to spend three full days with each picking their brains about -- well, brains! :)
Bringing my own personal experiences to this work has been interesting and very painful at times. But because I've already read so much trying to understand my own feelings for my therapist, I'm way ahead of the class in my belief in the healing aspects of a relationship.
I'm sure you and your therapist will get back in sync again, even as you move toward termination. There are times that I know that I need my therapist less, and I find that I miss him at these times, even as I know that this is what all this work was for. Being healthier and more secure comes at a certain price. I have to guard against not wanting to get better because I'm afraid of losing this relationship. In a recent conversation about exactly this, my therapist asked me to consider the idea that as I heal, I could use therapy for growth and support instead of "just" for recovery and solace. It is a scary idea because if I don't desperately need him so much, won't he give my spot to someone else? I told him that there must be at least 10 of me waiting to take my place on his couch.
He said there was only one "daisy" and no one could take my place. *sigh* It was exactly the right thing to say.
Thanks for sharing. Nice to see you posting.
Posted by Pfinstegg on May 2, 2006, at 10:59:23
In reply to Re: A conference report...a hello 2 u sir! » Pfinstegg, posted by eyes2ursoul on April 30, 2006, at 20:33:35
What you are describing sounds so good and healing. I wouldn't worry one bit about the sexual feelings which are coming up now. It's just part of an amazingly full relationship. If you are gay, it would be very natural; but, even if you are not, it would be natural, too, as part of such an intense therapeutic relationship. However, you DO have to talk about them- that's the deal in therapy, as you know!
Just to keep things a bit straight, I'm a woman, married, with two sons.
This is the end of the thread.
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