Thursday, December 31, 2015


Coffee shop discussions always start with the weather and it doesn’t have to be bad weather.  In fact, this fall’s excellent late weather on the East Slope lulled me and others into believing that we had more time to prepare for winter than was actually true.  There was talk about an “open winter.” 

Then my sewer line to the street was blocked or collapsed, but at least the ground wasn’t frozen.  The town dug up the half towards the street and two plumbers looked at the house-side.  One used a giant roto-rooter.  I did not know that my side of the sewer was Orangeburg and neither did he.  Roto-rooters buckle Orangeburg.  The bill was $345, but luckily I have a little Christmas money.  Sullivan came to look at replacing the Orangeburg and managed to get the flow restored so long as I don’t throw TP down it, so I save the wads in a bucket and burn them in my little garage wood stove.  He couldn’t dig it up right away because the town of Brady contracted for new water meters with some fancy out-of-state operation that screwed it all up and he was helping to get their water back by Christmas.  They tell me most of it is fixed now.  The Valier crew was monitoring the weather and dumped a lot of sand into the open trench just in time to prevent freezing.

The alley.

Northwestern Energy supplies both our electricity and gas.  They took advantage of the weather by replacing the town power poles.  There were a few gaps of nearly an hour with no electricity, but the crews tried to time them so they didn’t interfere with meal preparation.  I was glad to see the improvement because dirty electricity interferes with computers — gaps and surges are not good for them.  I wondered what it was doing to the telephone lines which I suppose were on the same poles.  And you saw a photo of them from my kitchen window where the cats took careful notes.

The next problem was that my carbon mono detector operates off the house electrical circuits and if there’s an interval, it screams like a banshee.  The work on the poles was setting it off.  I couldn’t distinguish what was poles and what was gas and began to have worries.  I’m using the floor furnace.  Part of the reason I keep this old-fashioned heat is that it works by convection so I’m not at the mercy of electricity.  But I’ve lost friends to carbon mono.  I ordered a battery operated monitor.

Then, just in time for Christmas, we were abruptly in  winter: below zero temps and snow.  My little old pickup refused to start.  The headbolt heater wasn’t working, somehow.  But I had bought a battery charger and it worked.  I thought.  By then it was late in the day so I ran the engine for a while (everyone in town runs their engine for a long time in the mornings, esp. the big diesel pickups) and figured I could get back to do my first-of-the-month big grocery buy the next day.  But the next day the battery hadn’t held a charge enough to start the engine.  I had to get a new battery or stop driving.  The problem is that if the pickup won’t start, I can’t get to a town big enough to stock a battery and batteries can’t be sent UPS or whatever.  I spent a good part of the day trying to revive this battery, but then I remembered that I had joined AAA.    

I had noticed their car insurance rates: HALF what I’ve been paying in Cut Bank for the last ten years.  So I switched.  I have never made a claim.  The insurance woman was insulted and billed me fifty bucks for what she said was coverage I hadn’t paid for.  I pushed that back on my monthly bill cycle twice.  She sent it in for collection without calling me, I’m sure in hopes of hurting my credit.  The collection agency called me as early as was legal on the day after Christmas and I just put it on my VISA.

My VISA is supposed to be for my teeth because I can never predict what’s needed or how much it is.  Now my problem turned out to be that the dentist’s practice, which was owned by a local health care organization, got involved in a wrangle because of a new manager from back East who wanted to force modern practices.  That meant enclosing the receptionist behind a locked door and eliminating all the mounted heads that the dentist and his wife had collected in the field.  I do not have morbid ideas about trophies: I was married to a taxidermist.  In fact, our previous dentist was the one in this same office who sold the younger man his practice.  Now both dentists have left.  I haven’t found another one.  These local practices, which used to be one dentist and one helper, are now half-a-dozen young women doing peripheral things for which one is billed.  They INSIST.  To them it’s not about teeth: it’s gums.  They expand their territory all the time.  Now they've started talking ear/nose/throat.  They want total access.

Something similar happened at the local doctor clinic.  There is a glamorous Physician’s Assistant who let people think her Ph.D. was an MD and a second less-glamorous MD on a different day — she IS an MD.  My previous doc is in Great Falls, which you can guess is a problem with my dubious pickiup, but the last straw was when this prom queen PA said she would not renew my meds unless I did exactly what she said.  I do not want a doc with control issues who is racking up billing hours.

When people think about moving to a small country town where everyone is full of rural wisdom and high character, they don’t think about this kind of stuff.  It doesn’t occur to them that one might have only one bathroom and one vehicle.  They don’t even think about what’s under the ground.  I’m told that plumbing infrastructure across the state is like the trees:  the same thing was done by everyone about the same time with the same materials and now decades later the corroded galvanized water lines all over Montana start splitting and all the aged-out silverleaf cottonwoods are crashing in the high winds.  The only town mechanic is hospitalized with kidney disease and the only town grocery store is full of local political issues.  

So now this guy sends an email.  He got my name off a list of Northwestern University alumni in Montana and wants to get us all rounded up so we can watch TV football and drink beer together.  He’s a writer — a journalist with a speciality in sports.  Luckily, he lives in Billings which is over 300 miles away.  He does not grasp how different we are.  Good thing, that!  At my much later U of Chicago graduation ceremony the speaker advised us that no matter where we hid, the alumni association would find us.  Both universities are after me to donate.  They sold me that degree so I'd tithe to them the rest of my life.

While I was between phone calls and slow realizations due to watching YouTube explanations of car batteries, I was continuing to follow the Ken Burns “Roosevelt” series on Netflix.  Wars, Depressions, suicides, alcoholism, power-mad mothers-in-law, polio — heck, it was just like everyone’s lives.  It’s all struggle with intervals of smooth sailing — some of them pretty short.  Friends and helpers, lovers and pups and relatives, they come and they go.  As long as we don’t run out of cat food or TP, everything will work out just fine.  Eventually.

Sure enough, now it's Thursday and Greg brought up a new battery, installed it right in the driveway, and told me my previous battery was too small.  For years I've thought it was my starter failing!  Now I turn the key and it's zoom zoom, instead of sputtersputter.  

In minutes I was on my way to Cut Bank for grub.  The wind is coming up -- I started under bright cloudless sky and came back in rising wind, snow snaking and sometimes sheeting across the highway.  I only forgot to buy two things: envelopes and cat treats. 


For a long time I’ve been trying to figure out how to talk about this subject in a way that isn’t moralistic or hierarchical.  I can’t figure out how to escape the cultural encumbrances, esp the stigmatized ones.  Anyway it’s a set of concepts more felt than analytical which is not so much a problem for me as much as for those trying to understand what I mean.  This is only another attempt.

We are so locked into the ideas of ranking and best and awarding of privilege and compensation accordingly that it’s almost impossible to think of synergy, fittingness, reciprocity and ecology,  

But try.

Think of overlapping circles, Venn diagrams if you like.  Circles for parenting, nursing, teaching, feeding, and the people who do those things.  (Ignore culture- based gender assignments.)  Now think of counselors who provide specialized advice like how to get into college or find a job.  Another sort of thing might be leaders of what we used to call “growth groups” where people with issues in common sit together and try to work them out, to understand and possibly change.

Change focus a bit.  It’s Sunday in a Protestant non-liturgical church and the people are singing and praying together with clergy as sort of orchestra leader who preaches to provide a theme and images.  Now a liturgical church where the leader is a kind of performer doing prescribed near-magical actions.   And now a confessional where a moral and spiritual advisor speaks privately in a ritualized conversation with a barrier between the two.  (In some Asian versions the barrier is simply that the priest and petitioner are sitting on the floor with an offering between them in a large space where a lot of people are present.)

Now change the context to physical intimacy.  A person performs a sexual act, maybe quite stylized and prescribed or maybe just “doin’ it.”  Usually paid.  Or there may be performance without interaction.  The goal is arousal to climax and resolution.

Change again.  This time the arousal is hoped to take the person into a virtual world.  “Virtual” has nothing to do with being virtuous.  It refers to a coherent alternative reality.  Brains can do this spontaneously or can be manipulated as in hypnotism.  It can be organic, imposed by a tumor or chemicals.  Young children do it to escape abuse and so do adults in incredibly traumatic circumstances.  In our society, medically, these are thrown together as dissociations.

In other cultures the virtual worlds may be shared in imagination and elaborated with metaphor.  Our culture is so rigid and prescribed, that many people are interested in “going” to cultures that provide other options.  They go to medicine men or peyote cultists or gurus in India.  One form imagined by Western people is called a “shaman.”  There are two versions: one is sort of an all-purpose wizard who is bizarre and possibly sequestered, meant to be inscrutable and uninterpretable, magical, capable of causing mysterious effects.

The other is quite formal, as defined by anthropologists visiting circumpolar regions.  This person is like Rome’s Charon, one who accompanies death.  In the Greco-Roman context, he has a boat to cross the river Styx.  In the circumpolar context, he rides a skeletal horse capable of jumping an abyss at the bottom of which are piled up bones of the dead.  But he can sometimes bring the dead back.  Charon cannot.  It can’t be accomplished by love as Orpheus discovered.   In fact, the circumpolar Shaman is understood to have died himself, to have had his bones removed and replaced by quartz.  Before brushing this off as fantasy, consider that today many people are walking around on ceramic replacement hips. 

The most recent physics does not reject the idea of virtual worlds, but actually premises their existence — not somewhere else in our familiar space and time, but in a different state or dimension which is somehow present but undetectable with our own physical equipment for our own physical “reality,” which is only considered real because most of us are detecting approximately the same waves of electro-chemical impact in the same spatial arrangement.  Those who are living in a different reality will be urged to come back to be with the majority, even if their “world” is coherent and based on their own experience.  Not everyone has a single coherent identity.  Brains are capable of organizing several identities in the same tissue.  How and why is unknown now, but it seems related to self-splintering trauma.

People living in confusing times are not likely to welcome the ideas that there is no “reality” nor is identity stable, but rather is a process that it is constantly reassembling itself on many levels: physical, emotional, memory-based, role-based, aspirational, relational — virtual.  And yet, most people, given a little space and support, will maintain and present a “self” that other people can know and love.

But it is not necessarily a word-based or even consciousness-based self.  Rather it is controlled at the connection between skull and spine from evolved creature-functions in the whole body and possibly sent along through functions of neurology and metabolism to a culturally agreed-upon version of reality.  But it rests in the animalness of the person and keeps them alive through the night while the consciousness roams the galaxies of virtuality.  We call them “dreams.”

All this may be seamless and healthy if things are going well.  If not, the result may be depression, self-harming, violence, withering — as the legal definition goes, “capable of harm to self or others.”  It can be extremely subtle, to the point of not being detected by others, even if they are trained and searching.  Down at our most basic kernel of being, each is alone in the body.

There is a lot of writing and talking about all this, and now we can add research done with the aid of instruments of detection.  But the detection equipment, like fMRI or screened interpretations of oxygen consumption cell-by-cell or even optical fiber implants that flash colors, are finding something “real” as molecules and atoms doing something.  There is still no detection of “spiritual” or “virtual” matters except in terms of the reactions of tissue, real cells supported by real blood with all its controlling hormones.

But perhaps we underestimate the uses of empathy, so that what goes on in one person can be “felt” by another closely attending person who is willing to allow such a possibly painful thing.  But I would not want to deny or reject that it’s possible.  In fact, I think it is the growing edge of being human that may preserve the species.  

If all the instruments and experiments cannot touch the reality of empathy, then how do we know about it?  Stories.  We share our selves with stories.  They might be danced, painted, sung, or applied to the walls with spray cans, but they tell ourselves who we are.


When I finish a post, I often swing it by Aad de Gids, the Netherlands poet, philosopher and psychiatric nurse, because he is so much better educated than I am when it comes to philosophy.  Besides my night is his day and when I wake up, he has left a bit of ecstatic elucidation that I love.  It's always a kind of poetic storm of words.  This is what he said this time:

"precisely in its evasiveness, it can be described"  "the words organise themselves around what seems disappeared and form an emblem with which they convey what is evasive" (frankfurt school). they already in the 40s of the last century articulated what escaped logical empiricism (contradictio in terminus), logical positivism (popper,russell), analytical mathematicism, reductionist semantics. 

Then henceforward, Mary uses still the findings of all philosophical, neurophysiological, liturgical, theoretical, progressive comparative theology plus the ones radicalising even the "frankfurter schule": the poststructuralists, to try to get at last a grasp of what tends to escape, reductionist "findings" of what is now called: governments-financed economy-empiricist, societal conventionalist, answering to the average common denominator scores, the "discovered" uniconsciousness, unipersonality in deceptively funky language transponded psychologies as psychiatries, other western centered antropocentered MODELS OF EXPLANATION.

Then in reading this note one gets a clear grasp what in these archaic models of definition is reduced (even vanished)  which could have been surfaced with other modes of experience, roomier and
worldlier and definitely more modern. Those are new forms of consciousness, in more ritualistic or collective forms, consciousness not solely located in one individual or even in one place, even at an "outside" where the means of expression tend to indicate outervisceral but also precisely visceral and not solely cerebral, consciousness, empathy, sense of communality, the animality of a cogent socius, new forms of expression, intercultural or transcultural neopostforms of interreligion or transreligion, interphilosophy or transphilosophy.

These archaic modes of explanation (capitalist, post communist, islamist, euro-american westerncentered) get good press and are supported by the journaille streams of disinformation and
subsidised modes of research of niches and seclusive elements of what is in broader perspective to be seen.

And it IS seen (and FELT) as is documented by new modes of neurophysiological research and new invigorative philosophical science: theoretical and "somatic" and "societal" thought about the omissions of "regular science"....

Wednesday, December 30, 2015


The word “homeostasis” is one of those Latinate multi-syllabics that suggest things it should not.  I’ve been looking for synonyms and right now I like this one:  “constancy.”  As a quality, it is meant to mean “unchanging,” but in terms of human life, it’s not possible to eliminate all change so maybe the word that works better is “consistency.”  Or self-faithfulness.

Life in mammals is not meant to be unvarying, but it must stay within limits or risk becoming damaging to life.  Those limits are of various kinds:
     Oxygen, calories, blood content, and other physical qualities
     Temperature, intact skin, discarding waste, movement
     Environmental, freedom from disease, movement, contact
     Psychological: autonomic, brain, hormonal
     Social: relationship, legal, education, culture

These are limits from side-to-side, often described as the banks of a river.  One must stay in the river to survive.  There is a geological term: “thalweg” which means the deepest center of a stream-way, but the truth is that it’s not possible to resist forces that push from side to side, except one MUST keep off either bank or die.

The river comparison is also useful in terms of flow.  Consider “headwaters” which is the area from which the water gathers in little trickles, gradually becoming bigger and faster.  Life sets terms of gathering-up and momentum, but can stop and pool until it is deep.

The creation of a human being begins with a big egg and an onslaught of little sperms.  Only one sperm gets through the skin of the egg and successfully winds together with the half-strand helixes of genes organized into chromosomes.  They might not do that task well enough to start growing.  A simple little clot, they will pass away. 

80% of miscarriages occur in the first 12 weeks of pregnancy.  The reason in about half of the failed pregnancies is chromosomal abnormality, a broken plan.  If the mother is over forty years old her eggs are as “experienced” as she is, and success is affected by what has happened.  The next reasons might be in the support system: a bad attachment to the wall of the uterus or one in the wrong place, or the egg may have begun to grow in the fallopian tube where there isn’t enough room.  To some degree there must be negotiation between the immune systems of the mother and the baby, or the mother’s body will reject the zygote.

The horizon of birth has become blurred by our ability to support a fetus not quite ready for birth.  At the time of birth, the baby is meant to be able to self-maintain basic homeostasis of the body, given that it has food, warmth, and cleanliness — basic care.  Even then, there might be “crib death” or simply a failure of small parts to develop.  Sometimes something major doesn’t unfold, like the cerebrum of the brain, the most recently evolved layer that contains speech and other functions.  Such a baby is often lovely, but inert, and cannot live long.

At about 3 years a baby begins to have a “theory of mind” and to see causes.  This is roughly equivalent to baby animals beginning to hunt, to explore, and to separate from the parents.  By the age of three most children are walking, talking, and have considerable manual dexterity.  They are relating to trusted others or showing their independence by shouting “no.”

At about 5 to 7 years the child builds the ability to solve problems.  Given an environment fortunate and tolerant enough, a child this age could act like an adult in some ways, taking care of itself even in a household of neglect and abandonment.  This will leave many parts of the child undeveloped and will force it to compensate in ultimately damaging ways.  

At the moment I have in my household a half-grown kitten that nearly starved to death in the past.  He is uncontainable and ruthless when it comes to searching for food or taking it away from other cats.  But he is very seductive and coaxing when wanting something from me. Predators play and play hard for long periods of time.  Eaters of vegetation mostly do childhood gymnastics without focusing on other creatures, but predators are both preparing for combat and for hunting.  This Striped Terror jumps to the tops of things, creeps under and behind things, and loves chasing the smaller kitten, the Dust Bunny.  I’ve caught ST standing on the cookstove twice in the last half-hour.  Luckily, nothing is cooking.

The Striped Terror and the Dust Bunny

But the cat does not stop this behavior once it is fed and full.  Its sleep is instantly broken if there is any hint of activity that might mean food.  The Striped Terror earned his name by being combative, destructive (because of reaching under, knocking over, and getting carried away in play), and inventively resourceful.  He does things that are beyond what the other cats might do.  My house rewards this, as it is a yard full of fallen branches, a garage of saved boxes and jars, indoor surfaces with paper piles and small objects like paper clips and paint brushes, and un-prompt dishwashing.  The two pre-existing ancient cats sleep through everything, but if the Striped Terror bothers them, they are literally sharp in their reaction -- tooth and claw -- which he regrets and remembers.

The Striped Terror came from nowhere but I suspect lived in a house for a while.  He wants to drink from the toilet and stubbornly believes there is a door where there is none, which means his mental map is not adjusted to this house.  Because of the weather patterns in Valier, all the house doors open to the south side, but ST thinks there’s a door on the north side, so maybe he’s come from somewhere far enough away to have a different climate.  Maybe he came as a stowaway.

The Dust Bunny

The Dust Bunny, born in the back shed, was developmentally messed up because of some kind of disease or trauma when he was very tiny.  At one point he was just a head and the body of a sparrow and I thought he would die.  He was missing for weeks, and then one day appeared with his mother though she wasn’t pleased.  So he claimed the Striped Terror, who was from about the same birthing season, but twice his size.

The DB’s mother was a runt, unusually small, and she was very attached to her mother, Patches.   I called her Smudge, a little gray shadow in the grass at her mother’s heels.  I can’t go near the Dust Bunny, who is even vaguer and fuzzier than his mother, but he is devoted to the Striped Terror, who mothers the little fellow.  They sleep on the bed — in fact, on me, with the comforter in between — but if the DB sees my head or hand, he’s gone.  Still, DB watches ST very closely and imitates him and ST loves to be petted and cuddled.  This pairing up is done by at-risk kids and even adults.  If these cats were dogs, they might join a pack. 

So now we have the same teleological problem as every living creature.  Successful constancy, in terms of a whole life, is usually defined by where it is going.  For the sake of the species, the goal has to be making more examples of the creature, but that might be achieved at the sacrifice of some of them.  We don’t mind that — if the creatures are rabbits or chickens — but we DO mind when it comes to humans.  If we know them.  We pretend we don’t and if the pretense is broken, we don’t like that one bit.  We don’t even like thinking about what happens to housecats.  These are cat boys who will fight the tough local Toms.

There’s no use in doing reparative work for youngsters of any kind if there’s no life for them when they reach adulthood.  But changing society in order to find roles is tough when the roles themselves are in such a storm of change.  College professors and doctors are finding life tough, too.  The cats are missing several one-time niches.

The good old days

No one wants more pet cats — we’ve all got enough and there is an outcry against them from bird lovers.  Wheat farmers still need more feral cats who will keep down rodents as they’ve done since the invention of granaries millennia ago.  These days attrition among feral cats around farms is very high because the predators who once ate rabbits or pheasants now can’t find any because of the way wheat is raised, constantly plowed and poisoned.  Therefore the predators eat cats.  It is a role with a short script.  I do not like to think about hawks eating the Striped Terror or the Dust Bunny.  But this is exactly what we are doing to feral children, letting them be destroyed by predators.  We even begrudge them the drugs that help them endure it.

None of the classic questions of philosophy are beyond a seven-year-old’s understanding. If God exists, why do bad things happen? How do you know there’s still a world on the other side of that closed door? Are we just made of material stuff that will turn into mud when we die? If you could get away with killing and robbing people just for fun, would you? The questions are natural. It’s the answers that are hard.
-- Eric Schwitzhebel

Tuesday, December 29, 2015


A new “research stream” (actually two) has opened up to address “Developmental Trauma Disorder.”  This diagnosis doesn’t come from being in battle or surviving a terrifying incident like a fire or assault, but rather tries to understand the deficits or digressions that come from the prevention or damaging of the normal steps of development from conception to adulthood.  This is rich territory for stories of what caused which deficits, how the child coped, how adults reacted, and how it all worked out.  (Think Dickens.) 

Our interest in people who are wrenched out of their previous contexts, or weighed down by increasing burdens related to poverty or drugs, is very strong.  Ordinary misery, not so much. The media loves the dramatic and shocking dimensions or gets very sentimental, which doesn’t always lead to helpful reflection.  Our media is also suffering from DTD.   But quietly, behind the scenes, we seem to be learning more about how to be human and how to raise human children.

In the past, such bottlenecks in the development of creatures -- remember that we're in the midst of one of the six mass extinctions on this planet -- have triggered mutations and evolutions, both physical and cultural.  Without deliberately meaning to, we may be creating the next kind of human beings.  It appears that the developments already beginning — that is, new characteristics that contribute to survival — may be along the lines of empathy, the ability to understand each other.  “Mirror cells” may be only a beginning, one cell at a time, that could develop into an organ.  But there are always several streams of development at once and one stream seems to be surviving by callousness, emptiness, bullying, greed, and unconsciousness.

On the other hand, statistical changes like smaller penises and earlier menses may mean that our out-of-control use of estrogen-like molecules are saturating the world.  I’m told that our sewage lagoon might be required to filter certain human-changing molecules along with the shit that our bacteria eat now.  But what bacteria will eat insulin and estrogen?  They say this will be extremely expensive.

How much of developmental troubles have nothing to do with chemistry, but are produced by the way we raise children?  Or more accurately, neglect to properly raise them.

Here’s a rather exhaustive list of characteristics from a down-loadable document:

This paper is written by Bessel A. van der Kolk, MD who is a major leader in the field.  The sub-title is “Towards a Rational Diagnosis for Children with Complex Trauma Histories”:

Complex disruptions of affect regulation
Disturbed attachment patterns
Rapid behavioral regressions
Shifts in emotional states
Loss of autonomous strivings
Aggressive behavior against self and others
Failure to achieve developmental competencies
Loss of bodily regulation in the areas of sleep, food and self-care
Altered schemas of the world
Anticipatory behavior and traumatic expectation
Multiple somatic problems from gastrointestinal distress to
Apparent lack of awareness of danger and resulting self-
    endangering behaviors
Self-hatred and self-blame
Chronic feelings of ineffectiveness

Here’s another set from “Trauma and Attachment: The John Bowlby Memorial Conference Monograph 2006”  edited by Sarah Benamer, Kate White

When trauma emanates from within the family, children experience a crisis of loyalty and organize their behavior to survive within their families.  Being prevented from articulating what they observe and experience, traumatized children will organize their behavior around keeping the secret, deal with their helplessness with compliance or defiance, and acclimatize in any way they can to entrapment in abusive or neglectful situations.  (Piaget, 1954)

Bessel van der Kolk

Boston University Medical Center psychiatrist Bessel van der Kolk, MD seems to be the main investigator.   Van der Kolk has published extensively on the effect of trauma on development of mind, brain and body. He has found connections to dissociative problems, borderline personality disorder, self-mutilation, and a wide range of other issues.  Some suggest oppositional defiance.

This article was on the website.

A new diagnosis for childhood trauma?
Some push for a new DSM category for children who undergo multiple, complex traumas.
By Tori DeAngelis
March 2007, Vol 38, No. 3

“There are two research streams:  Children who experience interpersonal trauma show a disrupted ability to regulate their emotions, behavior and attention.  This does compare to animals deprived of caregiving, which means they are anxious, highly reactive to stressors, and as adults less likely to explore their environments.”  This sounds very much like many low-income rez kids, who try to create a defensive cocoon that is familiar, if painful.  To them that’s the only thing that feels like reality.  Or safe.

“The other research area shows that much of children’s later ability to think clearly and solve problems in a calm, non-impulsive way stems from their experiences in the first five to seven years of life.”  Check out the general tumult over political issues: highly emotional and totally without evidence.  This is endemic in the whole United States.

This is not Teddy Roosevelt.
Who raised this man?

In addition, the team is including the latest findings on the neurobiological consequences of traumatic interpersonal stress. For instance, studies show that women abused as children who recall memories of abuse or are confronted with stressful cognitive challenges have strong reactions in brain areas that signal threat, but reduced mobilization of brain areas related to focusing attention and categorizing information, Ford's notes in his paper.

Finally, the group is piecing together information on how complex interpersonal trauma can differentially impact each stage of development, says Pynoos. It also is incorporating the fact that effects of early trauma can spill over into other stages, even if those traumas have stopped occurring, he notes.

In 2007, in broad brush form, here is what children must show to be considered to have the disorder, according to a May 2005 article in Psychiatric Annals (Vol. 35, No. 5, pages 401-408) by Boston University Medical Center psychiatrist Bessel van der Kolk, MD, a leader of the National Child Traumatic Stress Network interest group that is spearheading the effort:

Exposure: Exposure to one or more forms of developmentally adverse interpersonal traumas such as abandonment, betrayal, physical or sexual abuse and emotional abuse. May also experience subjective feelings in relation to this trauma, such as rage, betrayal, fear, resignation, defeat and shame.

Dysregulation: Dysregulated development in response to trauma cues, including disturbances in emotions, health, behavior, cognition, relationships and self-attributions. Behavioral manifestation could be self-injury, for example; cognitive manifestation might appear as confusion or dissociation.

Negative attributions and expectations: Negative beliefs in line with experience of interpersonal trauma. May stop expecting protection from others and believe that future victimization is inevitable.

Functional impairments: Impairment in any or all arenas of life, including school, friendship, family relations, and the law.

Henri Nouwen

Helpers are probably not very effective if they learn these lists and characteristics by reading or classwork without identifying these elements in their own identities. (They are universal, but vary in strength and compensation.)  But people who are too deep in struggle with their own developmental issues may not be helpful yet because it takes so much energy.  See "The Wounded Healer" a classic and beloved book by Henri Nouwen, who discusses this in a non-punishing way.

If people come in from one culture context and try to address these issues according to what works “at home,” they are likely to fail until they can construct some internal map of the people they are “helping,” a map of emotion and meaning rather than academic study or even observation close-up.  "Nice" educated people who try to help kids with complex and intense DTD issues will not "get" this and yet they are often the ones assigned to do this task, whether or not the kid wants it.

Monday, December 28, 2015


Multiple identities
Why isn't it an advantage?
Maybe it is.

The kids used to call it “spacing out.”  They would say, “I’m spacing on what an adverb is.”  Or “he’s a space cadet.”  And if I lost my line of thought, “You’re spacing out, Mrs. Scriver.”  Usually interpreted as a kind of loss of consciousness, it’s really more like an electrical brownout when something is sapping all the energy before it gets to the normal goal.  If we all knew about it, it must be more common than people think.  Maybe it's a matter of how intense it is.

Human society, just like other animal societies, often keeps order through peer pressure.  If someone is acting a little different or responding to causes other people can’t sense, they may be challenged or even punished.  They might be accused of deliberately making trouble.  Teachers who watch a set of students in a classroom see faces that might show daydreaming or might demonstrate a petit mal seizure.  Unsophisticated teachers will not know the difference and may react in damaging ways.  Likewise the other students. 

It’s possible that dissociation might be produced organically in the brain: malfunctioning electro-chemistry in synapses, molecules missing atoms or folded wrongly, outside chemistries interfering (drugs), rhythms garbled.  If the phenomenon is happens a lot and interferes, it probably ought to be investigated medically.  The intense hormonal changes of pregnancy or the drastic introduction of chemotherapy can induce “fog” to thinking or even throw the person into another interior reality.

If the “under mind” is wrestling with strong feelings or ideas or new information that needs to be resolved, it can put everything else on hold.  Onstage an actor knows this and when depicting something powerful will not move for a few seconds to show that everything is going to processing.  We recognize this.

Years ago I paid a counselor to talk me out of going into the ministry.  She failed.  (She also lost her marriage and became a torch singer.)  Sometimes when we were talking, she would ask what she had said and what it meant to me — because she said I suddenly looked as though she were speaking Chinese.  She taught me that it meant that I was “spacing” because she had said something I needed to process.  She taught me to try to recognize what had just happened and therefore to explicitly ask for time to process the feelings.  This works.  It appears that I pick up more information and emotion than I can keep up with, esp. in meaningful situations.  This was probably the most important thing she taught me.

Sometimes one can actually feel through the autonomic nervous system the emotion thrashing away in the breathing, heartbeat and other viscera.  Sometimes it is like entities wrestling with each other and sometimes, if the tip of a tentacle appears in the consciousness, one can seize it and pull it out for observation.  This can happen in therapy, in dreams, and in poetry.  Metaphors help.

"Would you marry me?"

My movie last night was “The Golden Door,” an Italian film about emigration to America at the turn of the 19th century.  (Excellent!)  The protagonist has been told that in America there are rivers of milk and he quite likes the idea.  We are shown what he imagines as if it were an actuality.  We are used to this in movies since so many show “flashbacks” and the like — a glimpse of another reality and then a return to the mainstream.  In fact, modern life in the “fast lane” is so tachistoscopic and mixed-context that we easily recognize it.  

In older movies, people are sometimes depicted as losing control and even contact with reality when something traumatic and intense happens.  The another character (usually a man) will slap the dissociating person (usually a woman) across the face and she will say, “Thanks, I needed that.”  This is not recommended.

Consciousness is honored and privileged so much that we lose the value of being attentive to feelings, so that part of the brain, even in the forebrain, is suppressed. But it’s as though the metaphorical “operating platform” is the site of a riot of concepts that cannot produce anything ready for consciousness.  At least not daily conventional consciousness.

The Five Dissociative Disorders

The SCID-D can identify whether a person is experiencing one of the five types of dissociative disorders. The first four are 
dissociative amnesia, 
dissociative fugue, 
depersonalization disorder and 
dissociative identity disorder (previously called multiple personality disorder). 
The fifth type of dissociative disorder, called dissociative disorder, not otherwise specified, occurs when a dissociative disorder is clearly present, but the symptoms do not meet the criteria for the previous four.

The five disorders can be distinguished from one another by the nature and duration of their stressors, as well as the type and severity of the symptoms. A brief review of each dissociative disorder is presented below.

Dissociative Amnesia
A defining characteristic of dissociative, amnesia is the inability to recall important personal information. This common dissociative disorder is regularly encountered in hospital emergency rooms and is usually caused by a single stressful event. Dissociative amnesia is often seen in the victims of single severe traumas such as an automobile accident (forgotten details might include one's actions immediately before an auto accident in which the person with the disorder was involved). The condition is often seen in wartime; witnessing a violent crime or encountering a natural disaster may also trigger dissociative amnesia.

Dissociative Fugue
Like dissociative amnesia, dissociative, fugue also is characterized by sudden onset resulting from a single severe traumatic event. Unlike dissociative amnesia, however, dissociative fugue may involve the creation of a new, either partial or complete, identity to replace the personal details that are lost in response to the trauma. A person with this disorder will remain alert and oriented, yet be unconnected to the former identity. Dissociative fugue may also be characterized by sudden, unplanned wandering from home or work. Typically, the condition consists of a single episode without recurrence, and recovery is often spontaneous and rapid.

Depersonalization Disorder
The distinguishing characteristic of depersonalization disorder is the feeling that one is going through the motions of life, or that one's body or self is disconnected or unreal. Mind or body may be perceived as unattached, seen from a distance, existing in a dream, or mechanical. Such experiences are persistent and recurrent, and lead to distress and dysfunction. Chronic depersonalization is commonly accompanied by "derealization," the feeling that features of the environment are illusory. It should be noted that characteristics attributed to depersonalization disorder must be independent of any kind of substance abuse. It should also be noted that depersonalization as an isolated symptom may appear within the context of a wide variety of major psychiatric disorders. For example, mild episodes of depersonalization in otherwise normally functioning individuals have been reported following alcohol use, sensory deprivation, mild social or emotional stress or sleep deprivation, and as a side effect to medications. However, severe depersonalization is considered to be present only if the sense of detachment associated with the disorder is recurrent and predominant.

Dissociative Identity Disorder (previously called Multiple Personality Disorder)

Dissociative Identity Disorder (DID) occurs in people with varied backgrounds, educational levels, and from all walks of life. DID is believed to follow severe trauma including persistent psychological, physical, or sexual abuse during one’s childhood. In this condition, distinct, coherent identities exist within one individual and are able to assume control of the person's behavior and thought (American Psychiatric Association, 1987). Unlike depictions in sensationalistic movies, most people with DID do not have dramatic shifts in personality and only persons very close to them are aware of mood swings.  In DID, the patient experiences amnesia for personal information, including some of the identities and activities of alternate personalities. Some people with DID experience subtle memory problems, and may only appear to have memory problems associated with attention deficit disorder. 

 DID is often difficult to detect without the use of specialized interviews and/or tests, due to: 
1) the hidden nature of the dissociative symptoms, and 
2) the coexistence of depression, anxiety, or substance abuse which may mask the dissociative symptoms, and 
3) feelings of disconnection that are often difficult to verbalize.

Because people with DID may experience depression, mood swings, anxiety, inattention, transient psychotic like states, and may self-medicate with drugs or alcohol, they are frequently diagnosed as having solely bipolar disorder, major depression, attention deficit disorder, anxiety disorders, psychotic or substance abuse disorders. Studies indicate that previous diagnoses in these areas are common to people with DID. 

It is not uncommon for a decade or more to pass before a correct assessment of DID is made. Research with the Structured Clinical Interview for Dissociative Disorders has identified five distinct dissociative symptoms experienced in individuals who have DID (see section above, Five Dissociative Symptoms.) 

Though DID is the most severe of the dissociative disorders, this disorder  can respond well to specialized psychotherapy which focuses on understanding the dissociative symptoms and developing new constructive ways of coping with stress.  Medication can be used as an adjunct to psychotherapy, but is not the primary form of treatment.

Dissociative Disorder Not Otherwise Specified

Dissociative Disorder Not Otherwise Specified (DDNOS) is an inclusive category for classifying dissociative syndromes that do not meet the full criteria of any of the other dissociative disorders. A person diagnosed with Dissociative Disorder Not Otherwise Specified (DDNOS) typically displays characteristics very similar to some of the previously discussed dissociative disorders, but not severe enough to receive their diagnoses. DDNOS includes variants of Dissociative Identity Disorder in which personality "states" may take over consciousness and behavior but are not sufficiently distinct, and variants of Dissociative identity disorder in which there is no amnesia for personal information. 

Other forms of DDNOS include possession and trance states, Ganser's syndrome, derealization unaccompanied by depersonalization, dissociated states in people who have undergone intense coercive persuasion (e.g., brainwashing, kidnapping), and loss of consciousness not attributed to a medical condition.

Naive persons will often interpret consciousness changes as balkiness or not paying attention.  Therefore the first descriptions of syndromes or disorders are often pejorative.  People will shout, possibly strike, and exclude those who exhibit this behavior.  Or if it’s mild, they may deny it, refuse to admit it exists.

Ganser syndrome is a rare dissociative disorder previously classified as a factitious disorder. It is characterized by nonsensical or wrong answers to questions or doing things incorrectly, other dissociative symptoms such as fugue, amnesia or conversion disorder, often with visual pseudohallucinations and a decreased state of consciousness. It is also sometimes called nonsense syndrome, balderdash syndrome, syndrome of approximate answers, pseudodementia, hysterical pseudodementia or prison psychosis. This last name, prison psychosis, is sometimes used because the syndrome occurs most frequently in prison inmates, where it may represent an attempt to gain leniency from prison or court officials.

The examples given of Ganser Syndrome are not very enlightening.  “When asked how many legs a horse has, they will answer five, which shows that they understand the question and are close to the right answer.”  I don’t think that demonstrates anything of the kind.  It could be anything from neurological inaccuracy to a creative definition of “legs.”  Also, I would not discount the Alzheimer’s patients tendency to give teasing or deflecting answers to hide problems that are worrisome, undefined by the person suffering from them.

Emigration "The Golden Door"

In “The Golden Door,” officials try to test the Italian-speaking peasants to see if they are sane and competent.  They ask, “how many legs does a horse have?”  The confused peasants can’t figure out why anyone would ask such a thing when it’s perfectly obvious.  In the tangle of conflicting realities, injustice appears and fearful indignation on all sides.  

This is in miniature what many nations are facing with waves of immigration.  We face it in classrooms and court rooms daily because separate generations are as different as separate national origins.