09 Oct Transference Remembering in Psychotherapy
“Transference is also an assimilation of what might happen in the future if we act on the impulse in the here and now, also as mirroring of the past”
Such reenactments are crucial disclosures about un-integrated, un-symbolized unformulated experience. Understanding the unconscious communication within a reenactment is often pivotal point in relationships or romantic relationship with a traumatized adult, in particular a sexually abused adult. Seen in this light, enactment is a way for a loved one to allow himself/herself to be known by co constructing, with his/her partner, a means of living out a new, less disabling version of the original trauma. In this co construction, cognitive symbolization of trauma occurs when the trauma is reenacted within a romantic relationship, reproducing the original interpersonal context but not leading to the original outcome. Once this happens, dissociated experience is transformed to internal conflict and human relatedness, which are more available for verbal consideration in psychotherapy or and in the relationship. By working through reenactments in the relationship with a skilled coach thus gradually obtaining access to the various multiple dissociated self-states which is liberating but also allows us to experience a much richer fuller life experience and helps us to love deeply.
Recurrent themes affecting the transference/countertransference {conflict} with people in relationship who have suffered trauma in early childhood, start with the a wariness of the relationship and the dangers involved in intimacy. In addition, dependency, reliance and counter dependent and counter phobic defenses tend to emerge, often-cloaked in overt idealization of the relationship or partner. In this idealization, you may expect your partner to be all attentive, nurturing, and non abusing parent who will heal and undo the trauma.
“Transference is the source of conflict but also expression of conflict”
Behavioral reenactments in relationships allow us to communicate previously dissociated and therefore unsymbolised, material to our loved ones. By exploring verbally what has been communicated through behaviour via conflict repair thus initiating a process by which the dissociated material becomes encoded in language, and therefore available for conscious consideration. Behaviours associated with a reenactment in the relationship are unconscious messages from one to another and to him/herself about a traumatic past. They represent an attempt to bypass the need for symbolized experience. Reenactments are most likely to occur when we might have a reduced capacity for self-reflection, another result of being unable to verbalise traumatic experiences that were never encoded when they first occurred, as a result of not having a present witness to their pain. Memories became trapped encased within a wordless world. Incapable of articulating what has never been symbolised verbally, we repeat behaviourally or reenact an aspect of this dissociated trauma.
The exploration of the reenactment is embedded in the romatic relationship. Each partner is both the magnet that draws out the reenactment and the architect of a transitional arena in which the partner experiences of self and other can be reconfigured in more harmonious ways.
In seeing relationships this way, thus relationships rely upon the hope that lovers together will become enmeshed in complicated reenactments of early unformulated experiences with significant others, that can shed light upon our current interpersonal and intrapsychic difficulties by reopening them in the romantic relationship, prematurely foreclosed areas of experience. If the reenactment is to be integrated as other than the original trauma, however something essentially different must happen which we call a corrective emotional experience. The relational models of transference and countertransference {Relational Conflict} are reenactments of different aspects of the dissociated relationships involved in victimization by a parent or a caregiver. The more trauma experienced in childhood, the more complicated the conflict and the greater difficultly with repair. Often abusive aggressive and painful reenactments are an inevitable part of the relationship with an abused especially sexually abused person and also an inevitable part of the working through in a romantic relationship with a sexually abused partner.
“We learn about normal function through pathology when things are working right you don’t notice them. Transferences comes to observation when it is maladaptive and non flexible”
Conflict is often Transference – countertransference reenactments in relationships which are vehicles for communication to each other about the internal relational experience of the child as he/she was being abused. As such they are powerful tools but they are also forceful and often coercive catalysts in the romantic relationship. Reenactment compels the coulples to experience each other’s original reactions to abuse, reactions that are dissociated aftermath to a deeply traumatic childhood experience. To heal the partner of the trauma, the other must experience that trauma in some way. The reenactment may be symbolic of the abuse but the feelings engendered in the relationship are very real. Theses may include helplessness, impotence, rage, inadequacy, shame, guilt, idealisation, omnipotence, overstimulation, humiliation, torture and fear, all internal states with which the couple is very familiar. Thus helping each other whose relationships and personalities are organised by dissociation involves a challenge psychological encounter with the trauma that caused the dissociation in the first place. We can can easily feel traumatised under such circumstances as strong reenactments and conflict in the relationship, yet it is important to remember that neither reenactments nor conflict reactions to them are necessarily mistakes rather they are unavoidable phases in the working through of traumatised dissociated people or unavoidable phases in the working through of a romantic relationship with a traumatised dissociated partner. A large premise of interpersonal neurobiology is that the brain is also pursuing healing. So we are compelled to reenact creating conflict in order to invoke a repair.
Transference
“The road to an increasingly secure relationship is usually and exceedingly rocky one precisely because the defenses we use to avoid the painful past often wind up provoking it’s recreation in the present.”
It has commonly been noted that a previously abused or neglected child who is now an adult in relationship tends to identify with their abusers and then to be transferentially
abusive/neglectful to their partners within the interpersonal/romantic relationship. In doing this they are repeating with their partner what happened to them as children. The abuse-victim relational configuration is particularly upsetting conflict within a romantic relationship because of its ubiquitous intense transference and countertransference enactments.
“The being who is the object of his own reflection, in consequence of that very doubling back upon himself, becomes in a flash able to raise himself into a new sphere. In reality, another world is born. Pierre Teilhard De Chardin”
4 stages of Transference Remembering in Romantic Relationship.
1.Relational memories from the triangular family life of the four to six-year-old child are generally revived by means of words, stories, symbols, and impulses that were painfully repressed at the time;
2.The self-consolidation and self-fragmentation relationship memories from the three-year-old relationship era are later remembered in the ways that people seek out, demand, and utilize or fail to utilize self-confirming interpersonal resonances in the present;
3.The four to twenty-four month relational bonding memories become available in the romantic interaction through the affective ways in which we experience each other and our interactions as good, ideal, and enhancing or as bad, abandoning, and damaging;
4.The relational traumas from the last trimester of intrauterine development and the first four months after birth are somato-psychically recalled later in life by people coming to experience intimate trust relationships as being characterized by cruel neglect, terrifying rejection, and life-threatening, body- shaking, and mind- shattering confusion and hatred which become systematically projected into the therapeutic/romantic situation and onto the person of the therapist and/or romantic partner.
At Trauma Recovery Institute we attempt to get to the root of your life challenging symptoms, discomfort, illness and maladaptive behaviours. This is not another talk therapy, we specialise in personality disorders & complex trauma and focus on the brain, body, mind, diet, lifestyle, relationships and most importantly the nervous system where trauma is held. The definition of trauma is experiences that overwhlem our capacity to cope. Trauma effects all areas of the brain and all bodily systems often manifesting as cancer, IBS and a host of other chronic illnesses and pain syndromes which can not be otherwise explained.
Trauma can be conceptualized as stemming from a failure of the natural physiological activation and hormonal secretions to organize an effective response to threat. Rather than producing a successful fight or flight response the organism becomes immobilized. Probably the best animal model for this phenomenon is that of ‘inescapable shock,” in which creatures are tortured without being unable to do anything to affect the outcome of events. The resulting failure to fight or flight, that is, the physical immobilization (the freeze response), becomes a conditioned behavioral response.
In his book, Affect Regulation and the Origin of the Self, Allen Schore has outlined in exquisite detail the psychobiology of early childhood development involving maturation of orbitofrontal and limbic structures based on reciprocal experiences with the caregiver. Dysfunctional associations in this dyadic relationship result in permanent physicochemical and anatomical changes, which have implications for personality development as well as for a wide variety of clinical manifestations. An intimate relationship may exist, with negative child/care giver interaction leading to a state of persisting hypertonicity of the sympathetic and parasympathetic systems that may profoundly affect the arousal state of the developing child. Sustained hyperarousal in these children may markedly affect behavioral and characterological development.
Many traumatized children and adults, confronted with chronically overwhelming emotions, lose their capacity to use emotions as guides for effective action. They often do not recognize what they are feeling and fail to mount an appropriate response. This phenomenon is called alexithymia, an inability to identify the meaning of physical sensations and muscle activation. Failure to recognize what is going on causes them to be out of touch with their needs, and, as a consequence, they are unable to take care of them. This inability to correctly identify sensations, emotions, and physical states often extends itself to having difficulty appreciating the emotional states and needs of those around them. Unable to gauge and modulate their own internal states they habitually collapse in the face of threat, or lash out in response to minor irritations. Dissociation and/or Futility become the hallmark of daily life.
“We use our minds not to discover facts but to hide them. One of things the screen hides most effectively is the body, our own body, by which I mean, the ins and outs of it, its interiors. Like a veil thrown over the skin to secure its modesty, the screen partially removes from the mind the inner states of the body, those that constitute the flow of life as it wanders in the journey of each day. The elusiveness of emotions and feelings is probably . . . an indication of how we cover to the presentation of our bodies, how much mental imagery masks the reality of the body” – Damasio
Trauma Treatment
Effective treatment needs to involve (1) learning to tolerate feelings and sensations by increasing the capacity for interoception, (2) learning to modulate arousal, and (3) learning that after confrontation with physical helplessness it is essential to engage in taking effective action. Introception is the process of embodied mindfulness, and in neuroscientific terms it is becoming aware of visceral afferent information (bodily sensations)
Being traumatized is continuing to organize your life as if the trauma was still going on unchanged and every new encounter or event is contaminated by the past. After trauma the world is experienced with a different nervous system, a survivor’s energy now becomes about suppressing inner chaos at the expense of spontaneous involvement in life. These attempts to maintain control of these unbearable physiological reactions can result in a whole a range of physical symptoms such as autoimmune diseases, this is why it is important in trauma treatment to engage the entire organism, body, mind and brain. Deactivation of the left hemisphere of the brain has a direct impact on the capacity to organize experience into logical sequences and to translate our shifting feelings and perceptions into words. Without sequencing we cannot identify cause and effect, grasp the long-term effects of our actions or create coherent plans for the future.
When something reminds traumatized people of the past, their right brain reacts as if the trauma were happening in the present but because their left brain may not be working very well, they may not be aware that they are re-experiencing and reenacting the past, they are just furious, terrified, enraged, shamed or frozen. After the emotional storm passes, they may look for something or somebody to blame for it, for their behaviour, they may say,
“I acted this way because you looked at me like that or because you were late”. This is called being stuck in fight or flight.
In trauma recovery where the left hemisphere is activated through speaking of the traumatic past and making sense of what happened within a safe environment, the left brain can talk the right brain out of reacting by saying that was then and this is now. This can only happen when safety is establish through attunement with a therapist where the amygdala is down regulated, this can often take some time for traumatized people as the amygdala tends to stay in a heightened state of arousal ready for fight or flight even years after then traumatic event or experience. Even the slightest detection of a threat can cause extreme arousal of this system. Minor stimuli will illicit major responses.
This is why it is important to engage the left and right-brain in trauma recovery, whilst body based interventions are absolutely imperative and ofcourse right brain to right brain affect reglation is critical for rewiring the nervous system contributing to long term character change and critical for trauma recovery, these interventions may be undermined should they exclude left-brain based activities. Body based interventions such as dance; massage and yoga are a fantastic adjunct to psychodynamic psychotherapy. Lazar’s study lends support to the notion that treatment of traumatic stress may need to include becoming mindful: that is, learning to become a careful observer of the ebb and flow of internal experience, and noticing whatever thoughts, feelings, body sensations, and impulses emerge. In order to deal with the past, it is helpful for traumatized people to learn to activate their capacity for introspection and develop a deep curiosity about their internal experience. This is necessary in order to identify their physical sensations and to translate their emotions and sensations into communicable language—understandable, most of all, to themselves.
Traumatized individuals need to learn that it is safe to have feelings and sensations. If they learn to attend to inner experience they will become aware that bodily experience never remains static. Unlike at the moment of a trauma, when everything seems to freeze in time, physical sensations and emotions are in a constant state of flux. They need to learn to tell the difference between a sensation and an emotion (How do you know you are angry/afraid? Where do you feel that in your body? Do you notice any impulses in your body to move in some way right now?). Once they realize that their internal sensations continuously shift and change, particularly if they learn to develop a certain degree of control over their physiological states by breathing, and movement, they will viscerally discover that remembering the past does not inevitably result in overwhelming emotions.
After having been traumatized people often lose the effective use of fight or flight defenses and respond to perceived threat with immobilization. Attention to inner experience can help them to reorient themselves to the present by learning to attend to non-traumatic stimuli. This can open them up to attending to new, non-traumatic experiences and learning from them, rather than reliving the past over and over again, without modification by subsequent information. Once they learn to reorient themselves to the present they can experiment with reactivating their lost capacities to physically defend and protect themselves.
Trauma and the Nervous System
Exposure to extreme threat, particularly early in life, combined with a lack of adequate caregiving responses significantly affect the long-term capacity of the human organism to modulate the response of the sympathetic and parasympathetic nervous systems in response to subsequent stress. The sympathetic nervous system (SNS) is primarily geared to mobilization by preparing the body for action by increasing cardiac output, stimulating sweat glands, and by inhibiting the gastrointestinal tract. Since the SNS has long been associated with emotion, a great deal of work on the role of the SNS has been collected to identify autonomic “signatures” of specific affective states. Overall, increased adrenergic activity is found in about two-thirds of traumatized children and adults. The parasympathetic branch of the ANS not only influences HR independently of the sympathetic branch, but makes a greater contribution to HR, including resting HR. Vagal fibers originating in the brainstem affect emotional and behavioral responses to stress by inhibiting sympathetic influence to the sinoatrial node and promoting rapid decreases in metabolic output that enable almost instantaneous shifts in behavioral state. The parasympathetic system consists of two branches: the ventral vagal complex (VVC) and the dorsal vagal complex (DVC) systems. The DVC is primarily associated with digestive, taste, and hypoxic responses in mammals. The DVC contributes to pathophysiological conditions including the formation of ulcers via excess gastric secretion and colitis. In contrast, the VVC has the primary control of supradiaphragmatic visceral organs including the larynx, pharynx, bronchi, esophagus, and heart. The VVC inhibits the mobilization of the SNS, enabling rapid engagement and disengagement in the environment.
The Dorsal Vagal State and manifestation of
autoimmune disorders
People who are in the dorsal vagal state a lot which is the state when the amygdala is activated due to a detection of a slight threat in the environment consciously or unconsciously through neuroception and the traumatized person goes into a state of learned helplessness or what is called dissociation or freeze response which is an unconscious conditioned fear response, the body’s reflex to an internal or external stimuli from a cue of an original trauma. This will activate all the viscera, your heart, your lungs, your colon, your stomach, all of these are run unconsciously by the dorsal vagal nucleus and if you have syndromes where you are in the freeze response a lot, the dorsal vagal nucleus will be hyperactive and you will get syndromes of hyperactivity within the viscera and that can be characterized by Irritable bowel disease, colitis and other autoimmune diseases.
These are cyclical diseases which means they oscillate between sympathetic and parasympathetic nervous system meaning the symptoms come and go which is why the medical profession very often can not diagnose the problem or refer to it as psychosomatic meaning it is a condition of the mind when in fact it is actually emotionally driven physiological conditions of the gut and the brain. Problems with the gut are common with people who have had trauma, it is the physiology of trauma that drives these conditions and so if you heal the trauma you can heal the disease. These conditions are also referred to as neurosomatic, which means they are brain based conditions, physical conditions caused by abnormal function of the brain.
“An Excerpt from world expert neurophysiologist Dr. Robert Scaer”
The Amygdala is the agent of fear conditioning, it stores emotionally based memory positive and negative, it is also the gate keeper for responding to threat by activating the fight or flight response, when the fight or flight response is not successful, such as you can not escape the traumatic event, the body goes into a freeze response. The freeze response is predicated by the effects of early childhood experiences, the freeze response is also called dissociation. When dissociation happens you are dysregulated, Dissociation is based a lot on what happened in childhood that allowed you to develop the brain in a way to prevent that from happening too easy. This has to do with Allan Schore’s work on attunement, the part of the brain that controls this regulation of autonomic nervous system and emotional system, which is the orbital frontal cortex. This develops in a healthy attuned infant and shrinks in a neglected infant. We need a developed orbital frontal cortex to regulate us over our lifetime and prevent us from going into freeze states and dysregulation. Helplessness is the essential ingredient for the freeze response.
The freeze response is a motor action, which perpetuates the escape behaviour in a way that erases all the procedural (Implicit) memory of that trauma. If you have a threat and don’t discharge the freeze response, you are conditioned thereafter to any body cues related to that traumatic event.
At Trauma Recovery Institute we attempt to get to the root of your life challenging symptoms, discomfort, illness and maladaptive behaviours.This is not another talk therapy, we specialise in complex trauma and focus on the brain, body, mind, diet, lifestyle, relationships and most importantly the nervous system where trauma is held. The definition of trauma is experiences that overwhlem our capacity to cope. Trauma effects all areas of the brain. The major impact is on three brain networks called the Default Mode Network, the Salience Network and the Executive Network. The Trauma Disease Model states that all disease is a state of abnormal cycling of the autonomic nervous system to the extremes of both sympathetic and parasympathetic dominance.
The Role of the Therapist in transforming attachment trauma:
Healing into wholeness takes the active participation of at least one other brain, mind, and body to repair past injuries – and that can be accomplished through a one-to-one therapeutic relationship, a therapeutic group relationship or one that is intimate and loving. In exploring the “age and stage” development of the right hemisphere and prefrontal cortex in childhood, we discover how the presence of a loving caregiver can stimulate certain hormones, which will help support our growing capacity for social engagement and pleasure in all of our relationships. Brain integration leads to connection and love throughout our entire life span. At trauma recovery institute we bring a deep focus to the role of Neuroscience in restoring the brain’s natural attunement to Secure Attachment. Our brain is a social brain – it is primed for connection, not isolation, and its innate quality of plasticity gives it the ability to re-establish, reveal and expand one’s intrinsic healthy attachment system.
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