@Louise Godbold posted:

They say never meet your heroes. Why? Because human beings are flawed and will always slide off those pedestals we create for them. I know a well-respected female mental health professional who once had an awful experience with Bessel. She met him after the JRI split and says he is changed. She forgives him. If she can, I think we should extend towards him kindness and the possibility of change - isn't that the heart of being trauma-informed?

I have never read anything as insightful as The Body Keeps the Score. Let's give credit where it is due. This is what he'll be remembered for, not the outworkings of his own trauma that hurt people. 

Talking of credit where it's due, thank you Michael for these amazing resources that must have taken you a lot of time to reproduce here. Like Jane, I'm a science nerd and will enjoy reading them. 

And Victoria, you are right - it is not just trauma but all kinds of environmental things that cause epigenetic changes. 

Thank you for the interesting read, everyone. So glad to be part of this community.

Lou

I LOVE this conversation and all the resources.  Thank you, Michael. I will totally nerd out on them! 

I would like to add to Michaels' comment that I really really really struggle, especially in light of the anti-racist consciousness, that our field is dominated by old white men.  Let me name a few that I have great respect for:  Dr. Bruce Perry, Dr. Gabor Mate, Dr. Peter Levine, Dr. Stephen Porges, Dr. Laurence Heller, Dr. Jack Shonkoff, Dr. Ross Greene, etc and they hold the reigns tight - in terms of power.   Yes, we can point to a few women or people of color that garner international recognition (i.e. Nadine Burke Harris), but the fact remains that the aforementioned individuals and others like them still hold the most power in the field.

Again, this isn't to take away from their work or the ways in which they have helped to enlighten millions of us, but the fact remains that those with the "most say" "most credit" and "most visibility" is not a reflection of gender and race superiority.  It's a reflection of patriarchal, white supremacy structures that mostly afforded these men the most opportunity.  Additionally, when I first entered this work, I kept asking - literally asking people - why wasn't there more obvious collaboration among these distinguished voices in order to raise consciousness faster.  "Why aren't we leveraging the whole for more change?" I actually asked this question directly to Dr. van der Kolk at one of his conferences (privately).  He was immediately defense mobilized and dismissed my question by saying, "I have been bringing the best and brightest minds to my conference for 30 some years..."  He didn't get what I was asking.  I asked the same question in my training with Dr. Levine's institution.  Why weren't "these men" working more collaboratively to puncture mass consciousness about this matter?  I was told "egos get in the way."  "Emily, there's a lot of ego in the field of traumatology."  Really?  S.H.I.T,... 

I know that ACES Connection has really leveraged the whole; THANK YOU!  Thank God you exist.  Where would so many be if we didn't have this platform? Where would I be if I didn't have this platform?  

I would be sitting in my bedroom, reading Bessel's work with tears streaming down my face, thinking, "How long must the suffering go on? How long?"

If you eat a specific food, that will cause specific epigenetic changes.  If you smoke cigarettes, that will cause specific epigenetic changes.  If you use psychiatric drugs, that will cause specific epigenetic changes. Some of these epigenetic changes happen to the gametes.  Many epigenetic changes happen to the developing organism starting from the time when the sperm meets the egg ie from the time of conception through one's entire life to the time of death.  

Every experience we have impacts our bodies through epigenetic mechanisms which just means that promotor regions on DNA get modified so that DNA is made into protein to affect the structure and function of the body (or to prevent a protein that would otherwise be made from being made) in very unique combinations related to experience.  This is necessary so that the organism can survive in the environment that  organism finds him or herself developing in. 

The genetic make up that we are born with (22 pairs of somatic chromosomes and 1 pair of sex chromosomes) doesn't provide enough variability to allow the human (or any biological organism) to adapt to the environment one finds oneself in.   Every experience we have affects us via epigenetics. 

Some experiences like the Dutch Hunger Winter have been found to affect gametes.  I am not sure that good and reproducible science, has shown completely which of these gamete changes can be reversed by a different environmental experience in offspring.

Also - some people who have experienced trauma do Neurofeedback to attempt to calm down their nervous systems.  I would like to suggest, that EVERY EXPERIENCE we have is Neurofeedback and operates ultimately through epigenetics.   The most natural neurofeedback that all people are exposed to and the most impactful on the developing human organism from the time the sperm meets the egg up to the age of 3 is human experience.  

It is through this human experience that the greatest contribution to "intergenerational transmission" (of behavioral traits) is made. 

@Emily Read Daniels posted:

I LOVE this conversation and all the resources.  Thank you, Michael. I will totally nerd out on them! 

I would like to add to Michaels' comment that I really really really struggle, especially in light of the anti-racist consciousness, that our field is dominated by old white men.  Let me name a few that I have great respect for:  Dr. Bruce Perry, Dr. Gabor Mate, Dr. Peter Levine, Dr. Stephen Porges, Dr. Laurence Heller, Dr. Jack Shonkoff, Dr. Ross Greene, etc and they hold the reigns tight - in terms of power.   Yes, we can point to a few women or people of color that garner international recognition (i.e. Nadine Burke Harris), but the fact remains that the aforementioned individuals and others like them still hold the most power in the field.

Again, this isn't to take away from their work or the ways in which they have helped to enlighten millions of us, but the fact remains that those with the "most say" "most credit" and "most visibility" is not a reflection of gender and race superiority.  It's a reflection of patriarchal, white supremacy structures that mostly afforded these men the most opportunity.  Additionally, when I first entered this work, I kept asking - literally asking people - why wasn't there more obvious collaboration among these distinguished voices in order to raise consciousness faster.  "Why aren't we leveraging the whole for more change?" I actually asked this question directly to Dr. van der Kolk at one of his conferences (privately).  He was immediately defense mobilized and dismissed my question by saying, "I have been bringing the best and brightest minds to my conference for 30 some years..."  He didn't get what I was asking.  I asked the same question in my training with Dr. Levine's institution.  Why weren't "these men" working more collaboratively to puncture mass consciousness about this matter?  I was told "egos get in the way."  "Emily, there's a lot of ego in the field of traumatology."  Really?  S.H.I.T,... 

I know that ACES Connection has really leveraged the whole; THANK YOU!  Thank God you exist.  Where would so many be if we didn't have this platform? Where would I be if I didn't have this platform?  

I would be sitting in my bedroom, reading Bessel's work with tears streaming down my face, thinking, "How long must the suffering go on? How long?"

Emily!!! Yessss! So well expressed.  Thank you 🙏🙏🙏🙏

@Lisa Geath posted:

If you eat a specific food, that will cause specific epigenetic changes.  If you smoke cigarettes, that will cause specific epigenetic changes.  If you use psychiatric drugs, that will cause specific epigenetic changes. Some of these epigenetic changes happen to the gametes.  Many epigenetic changes happen to the developing organism starting from the time when the sperm meets the egg ie from the time of conception through one's entire life to the time of death.  

Every experience we have impacts our bodies through epigenetic mechanisms which just means that promotor regions on DNA get modified so that DNA is made into protein to affect the structure and function of the body (or to prevent a protein that would otherwise be made from being made) in very unique combinations related to experience.  This is necessary so that the organism can survive in the environment that  organism finds him or herself developing in. 

The genetic make up that we are born with (22 pairs of somatic chromosomes and 1 pair of sex chromosomes) doesn't provide enough variability to allow the human (or any biological organism) to adapt to the environment one finds oneself in.   Every experience we have affects us via epigenetics. 

Some experiences like the Dutch Hunger Winter have been found to affect gametes.  I am not sure that good and reproducible science, has shown completely which of these gamete changes can be reversed by a different environmental experience in offspring.

Also - some people who have experienced trauma do Neurofeedback to attempt to calm down their nervous systems.  I would like to suggest, that EVERY EXPERIENCE we have is Neurofeedback and operates ultimately through epigenetics.   The most natural neurofeedback that all people are exposed to and the most impactful on the developing human organism from the time the sperm meets the egg up to the age of 3 is human experience.  

It is through this human experience that the greatest contribution to "intergenerational transmission" (of behavioral traits) is made. 

Brilliant!!!!! 🙌🤓🙌

Hi Emily

On one of "The Better Normal" webinar on Racial Health I posted several resources from Black psychologists concerning intergenerational trauma by likes of my favorite black family therapist and psychologist, Ken Hardy (a follower, in part, of Murray Bowen) and (Joy Deguy, for example). They never made it on "official" resource lists, so I will repost some of them now.

I was orignally trained in Social Work and my undergraduate training required that I minor in minor studies- I chose "African American Studies" and was introduced many of the great minds in that field through their works.

In one course, we watched a video by social psychologist, whose name escapes me (this was in 1989). Her research concerned the internalized self-image of White versus Black children and her instruments were two identical drawings of Little Bo Peep except for one had a White face and one had a Black. The respondents were White and Black young children and they were asked to describe both pictures.  The disturbing results were that both the White and Black children, girls and boys, all describe the White Bo Peep in superlatives, while the Black Bo Peep was decribed with negative adjectives.

This trauma- an assault on the self. It's described in the social psychology and sociology literature from the symbolic interactionalist approach, especially Charles Cooley's "Looking Glass Self. 

https://lesley.edu/article/per...e-looking-glass-self

We see it in literature as exemplified in Toni Morrison's "The Bluest Eye" where the little girl believes she is treated so poorly because she doesn't have White features.

The Bluest Eye pdf

https://docs.google.com/viewer...YmE4MDgwMThkM2QzNDc5

Yes, there needs to be a presence of Black therapists in prominence. Not only do they have the research behind them- they have the lived experience.

You shouldn't have to wait, like I had to, to be in a psychology graduate program to be exposed to Ken Hardy, Dr, Deruy or Michelle Alexander, who I fond after graduation. Mass incarceration, that Prof. Alexander writes about in "The New Jim Crow," is also an assault on Black families resulting in intergenerational trauma. The White men you mention are perfect example of neoliberal, post-colonial, structuralism that is over-focused on individuals at the expense of seeing the bigger picture of traumatogenics. Those marco-level issues are what needs to addressed on the participants in #BlackLivesMatter ubderstabd very well.

https://www.vanderbilt.edu/ctp/The_New_Jim_Crow.pdf

Ken Hardy on The Assaulted Sense of Self

https://www.youtube.com/watch?...6A5oecUWM&t=122s

Dr. Kenneth Hardy - Truama

https://www.youtube.com/watch?v=h5mtPXRAKf8 

..Revealing White Privilege and Healing Racial Trauma with Dr. Kenneth Hardy

https://www.youtube.com/watch?...ssA1b0yo&t=6941s

https://www.youtube.com/watch?v=vlqx8EYvRbQ&t=2s

 

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Epigenetic adaptations can can be phylogenically adaptive or not so.  The research is there from numerous studies.

Thanks for your kind words, Emily! I agree that some egos have really gotten in the way of collaboration. But we're showing the way that collaboration works faster and better, thanks to everyone who participates in ACE Connection and continually demonstrates its power!!

Michael, thanks for all your resources. We'll mine them for our anti-racism resources, so that they get more eyeballs. Thank you for highlighting Ken and Joy's work; they have taught me so much over the years.

@Michael McCarthy posted:

I respect van der Kolk and Judith Herman's destigmatizing of borderline personality disorder- which was, and still is, over-diagnosed in especially women who have significant trauma histories. His contention that CBT (with 30-plus varieties) is ineffective in ludicrous. He engages in cherry-picking of research (what is known to people like myself, with years of training as a scientist-practitioner knows as "confirmation bias"). I could go into a lot more, but there is ongoing litigation and as a person from a family full of attorneys, I'm not going into any details on their advice.  I've never said van der Kolk made no contributions. I'm saying a New York Time's bestseller does not meet the rigors of science. I wlth stating that I was socialized with the value that the custodian deserves as much respect as a Nobel winning scientist. How we treat others is a great indicator of the contents of our soul. van der Kolk's contention that the relational aspects of therapy are insignificant says more about him, than the reams of extant research to the contrary.

It's not possible to end child adversity or create a peaceful, non-violent world without understanding what the developing infant and child needs to form a secure personality and without providing these developmental requirements to every infant and child.  Children develop a secure personality through a compassionate, responsive, reciprocal, empathic relationship with parents and other adults.   When this doesn't happen, we develop personality structures that aren't compatible with a peaceful world (Borderline, Narcissistic, Psychopathic, Avoidant, Histrionic, Schizoid).   

Babies need what babies need in order to develop prosocial personality organization.  There are no convenient shortcuts. 

These personality organizations, whether characterized by society at large as good or bad, are transmitted generation to generation to generation unless there is some intervention.  The totality of experience creates dynamic epigenetic changes in the organism which lead to changes in structure and function of the developing human including through neurons that "wire together and fire together."   This process is essentially learning.   Every developing human is learning through dynamic epigenetic switches which are turned on or off by characteristics of the environmental what he or she needs to know to best survive the environment (including the parents) that he has been born into.  

"A picture emerges of a developmental pathway characterized by the confluence of effortful control and other self-regulatory skills arising in the context of a nurturing and securely rhythmic and predictable relationship between child and caregiver. The interaction of the benevolent, empathic, and attentive caregiver with the child yields growing self-regulation, the predominance of positive over negative affect, the beginnings of conscience, and increasingly smooth interactions with peers. This path of normal development is disrupted by an environment characterized by physical or emotional neglect and physical or sexual abuse. In such cases the child demonstrates negative affect, poor self-regulation, disruptions in conceptions of self and others, and disturbed relations with peers. No developmental studies of patients with borderline personality have yet been conducted, but this emerging picture resembles the adult presentation of BPO with its identity diffusion, preponderance of negative affect, poor self-regulation, and compromised relations with others."

PSYCHOTHERAPY FOR BORDERLINE PERSONALITY Focusing on Object Relations

I think I mentioned James Framo's object relations based transgenerational family therapy approach. Unlike typical object relations psychoanalysts, Framo rightfully believed the whole family needs to be involved in the therapy.  Many psychoanalysts would dismiss family members as merely "collateral"  and primarily used for data collection.  I prefer Herman and van der Kolk's less stigmatizing term "Complex PTSD" to borderline personality disorder (BPD), although there is evidence from Scandinavian studies that BPD has a robust genetic predisposition.  My contention is that people with both BPD and C-PTSD (if they are indeed distinct) require compassionate, empathetically attuned treatment.  There are successful therapy outcomes using approaches that don't label people with either BPD or C-PTSD.

https://books.google.com/books...ge&q&f=false

CBT skill-deployment is pretty much worthless if the person is already in fight or flight.  If you have been raised in an unsafe family, even good things like interpersonal intimacy can put you in fight or flight ("I better not trust this-- it will blow up in my face").  If you have been abused as a child then the natural naughtiness of a normal kid might be triggering because you possess no model to deal with it normally or calmly.

Dr Allan Schore (UCLA neuroscientist) says that in the first 2-3 years, "The right brain of the mother becomes the right brain of the child."  It is the mother's right brain skill set (of self modulation, insight into the baby's feeling states, empathy, helping the baby calm down or perk up.)  Providing this help is "external co regulation."  From experiencing the patterning of how our Mom helps us feel better, we gradually learn how to help OURSELVES feel better (emotional self regulation).  

So, you do need to help the parents learn how to mirror the baby and read the baby and respond to the baby from a calm, empathic place.  

The good news is that you can teach a mother to 'mother' better -- through modeling / information.  A la Nurse-Family partnership.  And if you can support breastfeeding, it reinforces that dyadic care.

Which CBT are you talking about- there are 30-plus varieties- PE, CPT, MBCT, compassion-focused therapy, reciprocal inhibition, TF-CBT, DBT, ACT, Behavioral Activation, Beck's models, REBT, ABA, systematic desensitization, David Burns model, Stress Inoculation Therapy, Self-Instructional Training, Narrative Exposure Therapy, etc, etc. The IPNB people are long on hypothesizing and very deficient in hypothesis testing.  Much of what they call research was based of finding from fMRIs, notorious for test-retest reliability and temporal resolution issues. BTW, even they have abandoned mother-blaming terms and have supplemented "mother" for "caregiver."  Mother-blaming decontexualizes women and sees them out of the ecological space.

I'm not arguing that Dr. Dan Siegel and his colleagues have not made contributions (I'm trained in the Mindsight approach). I'm saying the extant research, free of confirmation bias, does not support the conclusions that CBT, in its many varieties, doesn't work. The concept of equinfinality (that all approaches work) has been upheld in study after study.  It would very sloppy research design to portray CBT, the first, second and third waves, in monolithic terms. How would you know what it is that you are studying? CBT could help them with that erroneous all or nothing thinking. 

One of the most effective ways of stabilizing a crisis to the point where any therapy is effective is good old fashioned needs assessment and resource brokering. It's very hard for anyone to be present for therapy when shelter, food and are necessities are not available.

Hey Mike,

I agree with Laura above.   There  are too many people who come to be "parents" after generations of neglect, absent, aggressive and rejecting parenting practices that they experienced beginning in infancy themselves.  These "parents" can't regulate their emotions because they haven't had a regulating other there for them.  They dissociate a lot and can often experience the needs of an infant as terrifying or even Rage Provoking.   Most of them will not know how to regulate a new baby.  They will not know what a baby needs developmentally.    They never had their own basic needs met. 

These folks certainly aren't going to be able to talk to an aggressive and arrogant, know it all therapist and complete  some worksheets about their automatic negative thoughts and have that work for them or their kids in real life as they dissociate to a rage state when a baby cries.   These people need someone there to show them how to recognize infant cues and to model SENSITIVE parenting (someone who responds timely and appropriately to a baby's cues instead of roughly putting the baby down in a crib and slamming the door and walking away or propping a bottle and just leaving a crying infant alone).   

A mother who rejects her infant especially when this happens over and over and over is doing serious damage to that baby's developing brain.    Babies HAVE to have loving interactions with adults who help them learn to regulate emotions starting from the time of birth.     A childhood full of these kinds of experiences devoid of love and filled only with contempt, rage and hate just doesn't respond to CBT.   CBT cannot take Posterior, Right Excess Beta and lack of alpha brainwaves and normalize that.   CBT cannot fix greater Right Hemispheric Beta than Left Hemispheric Beta (because of Left Hemispheric arrested development).   CBT cannot normalize Left Frontal Alpha and Theta Excess or fix a Beta Reversal.

Thanks 

Hi Lisa

ACEs Connection provided information on a wonderful seminar today entitled, "Virtual Training: Fatherhood Engagement & Social Connections." I wish I could have made it, but I have clients today.  The ACEs Connection has many opportunities for excellent trainings.

As to the ACEs score, I assess client's current functioning and their level of reactivity and also other standardized instruments that are have better reliability and validity than the ACEs questionnaire. It doesn't measure the all important protective factors that mitigate between trauma exposure and effects on functioning.
 

"Credentials" do not establish credibility for the majority who are just down to earth people trying to figure out how to survive a very messed up world.

I have met people from Harvard and Yale (doctors) who I wouldn't let near my dog and I have met people who have not graduated from High School that I would trust with my life. 

Also: Here is a gift.  We can both (all of us everywhere) we can all listen.

https://www.youtube.com/watch?v=Vu6rcvcG1XA

I have worked with court-ordered clients and, of course, they need to be engaged in the therapy process too. I've found that treating them like human beings works best, and that the same processes that work with facilitating a therapeutic alliance with any client works with those people as well. Of course, I cannot breach confidentiality and give names of people and families I've worked with.

As a CASA I have participated in the relational component of healing...  I think any therapist using any model who can connect emotionally with the client and show them unconditional positive regard will be a healing therapist.  However 'connect' is a "big if" when you are talking about a traumatized child.  

My CASA youth had a parent with serious mental illness for 12 years.  After 4 years of CBT therapy, followed by a suicide attempt, I became her 3rd CASA when she was 16.  I studied up on therapies for CPTSD trauma and advocated like a tiger to get her access to Neurofeedback.  It took a year+ to get permission. 

I told her that as her CASA I thought it was important for her to be aware of existing trauma therapies other than CBT, that she could avail herself of in the future if desired.  We met 2 NF people and an EMDR person.  One of the NF people was someones she connected with, so she did about 35 sessions of it which CHANGED HER LIFE.   

After about 8 sessions, she began dropping into her emotions and connecting the dots of her life, writing powerful poems, being willing to be comforted.   35 sessions, the total treatment, is about 20 clinical hrs.  Her depression remitted totally.  Currently at a UC, on track to graduate.  Good friendships.  3 years at same job.  Still close to former foster family.   

The right brain is programmed by implicit-- not explicit--  learning.  CBT uses L brain methods to talk to  R brain.  R brain responds better to somatic methods, NF, relational methods, co-regulation through dance/synchrony, etc.  Stuff that activates R brain. 

Hello Laura

Would you mind telling which type of the over 30 approaches under the CBT rubric was used. Francine Shapiro, the creator of EMDR borrowed heavily from cognitive-behavior approach. The concept of subjective units of distress (SUDs) was created by South African psychiatrist and father of behavior therapy. As someone trained in EMDR, I know we use the identification of negative cognitions (ND) and positive cognitions (PD) throughout the protocol. Wolpe also created what is known as "reciprocal inhibition" which pairs somatic, progressive relaxation with disturbing experiences of fear and anxiety in a process known as "systematic desensitization." 

DBT, ACT and the Beck model all emphasize relational aspects of treatment, as does compassion-focused therapy. They also mindfulness and meditative practices and do not teach a reliance of a therapist to treat ongoing symptoms, but emphasize routine practice of what is learned in therapy. Let's face it- we are all exposed to stressful and traumatic situations all the time.  You might want to view this video by Judith Beck on therapeutic relationships. She mentions "Rogerian counseling skills." Years before Dan Siegel emphasized the essentials of empathic attunement for neural integration, Carl Rogers identified the central role of empathy in therapy.

https://www.psychiatrictimes.c...ive-behavior-therapy

He took his person centered model on the road to troubled spots in the world that were embroiled in conflict like Northern Ireland and brought together waring factions in Central America.  The La Jolla group, held annual events and workshops and the person centered practitioners were among the first to address multiculturalism and the promotion of  understanding between groups. Rogers was nominated for a Nobel Peace prize his works. It's way past time to resurrect his work to address some of the troubles in the world and our country now. I t's also an apt metaphor concerning the waring factions in the therapy world- based not on science, but commercialism and salesmanship

https://www.latimes.com/archiv...1-vw-1185-story.html

Science has demonstrated time and again that:

1) There has been no improvement in treatment outcomes for decades.

2) There is statistically significant difference in treatment outcomes between the major approaches to therapy. 

You may want to investigate the research from this group:

https://www.sepiweb.org/?#:~:t...hods%20of%20inquiry.

Or this approach

https://psychology.iresearchne...%207%20See%20also%3A

Good luck in your studies. I appreciate your anecdote. Anecdotes alone are not science.

@Jennifer Sweeney posted:

This was a fascinating discussion! Thank you so much for asking, Victoria!

Thanks @jennifersweeney. I appreciate the support.  I recently just joined ACES connection and this was my first time posting a question on the forum:  1st times are always a bit intimidating !!!

It was Trauma Focused CBT.

Another beauty of NF is no efforting and (when effective) rapid.  Not just my CASA kid.  Read Sebern Fisher's book.  

The NF therapist my CASA kid saw was a CBT therapist -- who picked up NF because, "I could help a lot of people with CBD, but there was a population that I simply couldn't help, and I wanted to help them too"

CBT sorry!