I’m at the UCLA/Lifespan Learning Institute’s Attachment Conference. This year it’s called The Healing Power of Emotion: Integrating Relationships, Body, and Mind. Today, about 500, tomorrow and Sunday, about 1000 people will sit in a ballroom while a firehose full of information is directed at us. We will try to swallow all that we can. At the end of the day, there is a panel discussion of the participants. They take questions from the audience and from each other. Sometimes it’s very scholarly. Sometimes, it’s almost a brawl. The brawl, of course, is more fun.
Stephen Porges started off the day with a lecture on his research: "Application of Polyvagal Theory to Clinical Treatment". Most of it was in understandable English, because Porges is a U of Illinois professor and knows how to teach. According to the conference bio, "his polyvagal Theory of Emotion led to the discovery of an integrated neural system that regulates social engagement behaviors." His lecture today focused on the need for face-to-face interactions for bonding to occur. When there’s a violation of the interaction—someone doesn’t make eye contact, when a supposed intimate is speaking, the speaker experiences distress: anger/shame/alienation. Safety creates proximity creates contact creates bonding. There might be more bonding in sleeping together than in sex. Porges commented on the dysfunction in the Seinfeld rule, "No sleepovers!" (We know that those people were all attachment disordered!)
I can’t recount the whole lecture, but I can give you tidbits:
- Facial muscles go down to the heart. Talking, listening, and smiling calm us down.
- Two vagal nerve systems. The old one, from lizard days, shuts us down completely. It’s the one from which we can swoon, be literally scared shitless, or become selectively mute, when distressed.
- The new vagus is linked to face and is protective of mobilization systems. It works socially.
- Our nervous system can relax us through the meyelinated vagus, if we are experiencing safety; mobilize us, through the sympathetic and adrenal system, if we sense dangere, or completely immobilize us, through the old, lizard unmeyelinated vagus, if we think our life is in danger, feigning death like a mouse fooling a cat. (Doug, out birding during the day, caught and pet a horned lizard, who didn’t move at all. It was in the immobilization vagal phase.)
- Social behavior enables us to function better.
- Social engagement systems: prosody (tone and music of our voices), gaze, facial expressivity, posture during social engagement, mood, affect, and behavioral state regulation.
- Environment can be interpretted, based on our state.
- Borderline cutters, in a study, lost vagal control of their hearts while watching emotional videos. Controls, did fine.
- Very autistic kids attend to low (more frightening) tones. They stay scared and "mobilized" most of the time and try to soothe by doing weird stuff, not be connecting with others. If you play them music with all the low tones filtered out, over time, they will become socially engaged, like normal kids. I saw the video, it was way cool.
Then there was Dan Siegel, talking, again, about mindfulness. At last year’s conference he was gushing about a meditation retreat, as if he’d invented it. I love Dan Siegel. He’s brilliant, sweet, a great lecturer, a good writer, and a wonderful clinician. But I wasn’t the only one shaking my head at his response to what I’ve been doing/knowing for 25 years. He is compiling research on what meditation actually does. He will be big in making it even more mainstream.
- He spoke about getting clients to become aware of the SIFT, Sensations, Images, Feelings, and Thoughts.
- He teaches mindfulness to clients so that they can change their states.
- Contingency: Person A sends a signal. Person B perceives, decodes and responds in a timely and effective manner. (That’s how you get healthy attachment or a good therapy.)
- Mindfulness training is great for ADHD. (I’m going to send my ADD clients to meditation class when I get home.)
- Mindfulness is: The capacity to be present as an experience is happening; Non-reactivity; Not clinging to judgements; The ability to label & describe one’s internal state; and Self-awareness, awareness of one’s awareness.
Then there was Pat Ogden. She was a student of Peter Levine, who has taken his work farther, by bringing in more of an attachment slant. I’ll write about her in a few months, when we read her book. Her videos, when they worked, were inspiring.
The final speaker was Robert Neborsky. He’s loud, brash, and does the scariest and possibly most effective brand of therapy that I know about, Intensive Short-Term Dynamic Psychotherapy. He showed a video of his work, excerpts from a 15-hours-in-one-week therapy with a hunkered-down guy, a middle-aged abuse survivor. He carefully pushed the guy through every defense against affect, every time. He took no prisoners. He went for the kill. And within hours, he had the client enacting killing his horribly abusive father, and getting over his affect phobia. The therapy looked horribly mean and the client didn't act like he was being abused. He was having breakthroughs all the way through the work. In the break afterward, people had lots of reactions, from admiration, to "Take his license away."
At the panel discussion, an audience member, from a psychoanalytic background, shared his distress about Neborsky’s work. "It left no room for the client. . ." There was scattered applause. Dan Siegel and Bob Neborsky both lauded the questioner for his bravery, then spoke about the efficacy of the technique. (Short Term Dynamic Therapy has been well researched. It works.) Neborsky said that his clients look good, even many years later and reiterated his rule: "Longer therapy is not better therapy." He talked about his "holding" coming from his spot-on interpretations. And that clients love him and love the work.
Neborsky’s ideas about good therapy:
- Strong alliance
- Help clients confront what they avoid
- Revive Hope
- Create a sense of mastery over Past, Present, and Future
- The patient owns the therapy.
- The therapist is a biofeedback loop, and helps the client recognize, feel and structure his anxiety.
Therapy doesn’t work when there’s
- Too much talking and not enough feeling
- Too much defensive feeling and not enough thinking
- A failure to help the client regulate anxiety
- A failure to generate anxiety
- A collusion with the client’s defense.
- Giving too much (over-involvement)
- Giving too little (under involvement)
The most fun question of the panel discussion: A man described how Pat Ogden was able to express her dismay over her video breaking down, take care of the audience, take care of herself, switch to another hard drive and seamlessly use an unedited video for the presentation. He asked Pat how she handled the situation with such grace, then asked Dan Siegel how Pat handled the situation with such grace. Siegel’s answer: "Mindfulness."