Tag Archives: attachment theory

Who Cares

 

Been gone from this for a while. Several reasons: I wrote two blog articles for psychecentral.com, both of which called for some extra time and attention. Next, I’ve thought to give Blended some time to breathe—that is, to let the six or so entries devoted to it a chance to sink in. Fat chance, I think sourly, which leads me to the most personal reason for my absence: a certain discouragement and torpor. Nothing special, just the standard writer’s self-importance, feelings of petulance…immaturity.

Another priority was the preparation for January 4th, my latest chance to talk Tommy before an audience. I’d been wanting to present at Mechanics’ Institute (MI) in San Francisco for ages, and I said as much at the outset of my talk. Thursday night I had my moment before an eager crowd of sixty, there because of MI’s capable marketing team. I got paid nothing for my time and labor. That’s what I’ll say if the tax or music copyright watchdogs ever ask, and the truth is I’m not doing it for the money. The reason I talk is the reason I write. I want someone to hear me. I want an audience.

“Are you ready to rock?” exhorted my host, the activities director at MI. She’s a nice woman, supportive and interested. More than myself, even, she’d observed the potential for a discussion about The Who’s Tommy to bring out the fans amongst the MI membership. Actually, I’m not sure how many in the crowd were MI members. Maybe that doesn’t matter, but I’m grateful someone knows what people want to hear. Anyway, six o’clock on Thursday rolled around. I knew my material, was ready to talk, and as I stood in the wings, waiting for the audience to take their seats, I felt close to stardom, I think. I almost noticed how it felt, rather like I did in Santa Fe in August. Then I began.

Fifteen minutes in, all was going well. My voice, ordinarily dry and halting when speaking to groups, felt limber and relaxed. I paced languidly before my audience, gazing out casually, leaving pauses for effect, breaking into a slight lilt when reciting pertinent song lyrics. I stared over heads a lot—a technique designed to limit distraction, preempt anxiety. I played one or two samples of songs from Tommy—did my arm-windmilling bit, aping Pete Townshend, The Who’s songwriter and creative engine. The darkened room at MI made eye contact difficult. The few pupils I did meet seemed attentive and expectant, yet respectfully patient. An hour ahead of a promised Q & A session, I sensed the gathering of opinion. There was a handful of voices in the audience ready to challenge, to question or to share. I had suggested such an exchange at the beginning, right after the host’s rockin’ announcement. These people at MI: they weren’t like the staid crowd at the Creativity and Madness Conference in Santa Fe. They might have known less about psychology than doctors or therapists. Indeed, they likely gave less than a shit about John Bowlby or Melanie Klein, or James Masterson and Allan Schore. But they did care about Tommy. They had a lot to say about The Who.

Some just wanted to share how they’d been at Woodstock, and watched in amused awe as Pete Townshend stuck his knee into Abbie Hoffman’s groin. A political comment, sort of. Another man chuckled as he relayed a Jimi Hendrix/Who anecdote. I played along, knowing it would be the infamous Monterey Pop episode wherein the two bands tossed a coin to see who would get to play first, blow hippie minds and make rock history destroying things. One is meant to guffaw in concert at these tall tales, finding humor in the macho interplay of legendary rock stars. Truth is, I find this kind of jocular reminiscing slightly painful. After all, what I’d shared was, as far as I was concerned, a rich, layered analysis of a celebrated pop icon, yet still the kind of treatment The Who had thus far been denied. I didn’t want to merely reminisce with fellow fans. I wanted to muse with them, bring a sense of historical texture, intellectual interest wrapped in love and passion. I wanted to spark thought on something they had enjoyed over time but not truly examined.

Thankfully, the storytellers weren’t the only faction in the audience. One or two had read Townshend’s autobiography, Who I Am, and wanted me to speculate on how Tommy related to its author’s history of child abuse. Questions like this were a welcome challenge, but it was nothing compared to a penultimate query that has stuck with me since. Seated behind a man who had shared apocryphal stories about The Who’s early Mod days was a slender, brittle, middle-aged woman. Wearing a frown, she raised her arm, waited her turn, but upon being called, made a chiding comment that The Who were “a band for men”, and further offered that their love songs, few and far between as they were, seemed fraught with themes of abuse and exploitation. Punctuating this comment was a leading question directed at me: as a therapist, surely I thought (The Who) an unbalanced and harmful icon (something like that). Through the dim light, I looked into this woman’s angry eyes, saw the withering incomprehension of a staunch Beatles fan, a feminist revealing her barely male-tolerating ire. I didn’t want to answer her question per se. I wanted to spend another hour on the subject.

Collecting my thoughts, I noticed that we were towards the end. My host, the MI events organizer, might have glanced at her watch. I thought of “Sally Simpson”, a lesser famous song from Tommy that some critics abhor, for reasons I’ve never understood. The song is about a girl who falls in love with the guru-like Tommy character from afar, and gets hurt trying to touch him at a speaking event. Stood before the crowd at MI, with the seconds spinning by, I knew what I wanted to say at my slightly parallel event. I just had to organize myself. Moments later I was sharing an anecdote: a story about the inspiration for “Sally Simpson”; an incident in 1968 when The Who supported The Doors on tour, and Townshend witnessed the uber-petulant Jim Morrison kick a female fan in a melee. The incident sparked Pete’s sympathy, plus a memory, perhaps, of how he’d once envied the attention other bands (like The Beatles) garnered from screaming, clinging girls. The Who’s early songs were as female-bashing as anyone’s, I admitted on their behalf to that angry-looking woman in the MI crowd. But the following lyrics from “Sally Simpson” show what Tommy and great rock n’ roll are all about, ultimately:

She knew from the start

Deep down in her heart

That she and Tommy were worlds apart

But her mother said never mind, you’re part is to be what you’ll be

 

We grow up

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The ultimate risk of addiction treatment

 

In the field of addictions work, so-called, it is common for practitioners and later patients who integrate ideas to cast addiction as a problem of emotion.

The addictive personality is one who is pleasure and novelty seeking, and risk taking, it is said. Risk-taking except in the area of intimacy, wherein he/she is likely avoidant. Psychoanalytic theory, attachment theory, and a host of techniques derived from either, are supported by neurobiological research, which affirms that unconscious process, communication that occurs implicitly, via eye contact, body language, and voice prosody, is mediated via the prefrontal orbital areas of the brain, and nurtured (or not) in human beings during early childhood development. The role of the therapist in our society, not unlike that of the early caregiver in some respects, is to serve as an auxiliary ego, using words, reflection, tone and physicality: to connect.

Addicts and trauma survivors would appear to have something in common: a penchant for disconnection, or dissociation, as trauma researchers indicate. John Bowlby, the founder of attachment theory in the latter half of the twentieth century, offered that psychoneurosis derives from protracted separation anxiety: that children deprived of maternal care first protest, then despair, and then finally exhibit detachment, which is characterized by dissociation, a state of disembodied escapism. What latter day research indicates is that infants and toddlers’ levels of the steroid hormone cortisol maintain elevated levels when a caregiver is either absent or insensitive. If such a child is deprived of all caregiving, cortisol levels stay chronically high and therefore children will develop passive parasympathetic strategies of dissociation. Habituation of the brain to the opioid-releasing state of dissociation thus becomes a “default mode” of affect regulation. The result: a predisposition to addictive behaviors, and insecure attachment in the form of an unresponsive, intimacy-avoidant personality.

This perspective is a paradigm shift for many seeking treatment for problems of substance abuse, sexual acting out, food addiction, and such, because society’s inclination is to externalize the problem of addiction: it is the substances that are addictive, for example—not so much that a predisposition within an individual exists. Meanwhile, sex addiction is a term used by some to exert an alternative, moralistic argument against sexual promiscuity, or alternative sexual lifestyles, rather than an assessment term that draws attention to a mood or mind-altering use of behavior. Food addiction is a label that is likewise criticized for being a thinly veiled attack upon the obese, especially obese women. The problem with labels is that they elicit persecutory anxiety, especially in those prone to what Melanie Klein once termed the paranoid-schizoid position, a primitive stage of childhood development. The benefit is that labels, like any succinct form of communication, draws quick and urgent attention to problems that merit just that.

The reason why the paradigm shift is important is so that preventive measures can flourish. Education is of course important, but education in the cognitive, Socratic sense is only the beginning, not the end of the intervention. We can, as we have for decades as a mental health community, provide appropriate medical care for those whose dependencies (to opioids and alcohol, for example) merit such monitoring and focus; we can concurrently and thereafter dogmatize that the consequences of addiction (jails, institutions, and death, to quote 12-step programs) are prohibitive; we can gingerly (or not) shame addicts into realizing that their behaviors are self-centered and immature, and we can impose various consequences based upon the premise that imposing limits will alter behavior (actually, limits are a good idea, but are mostly beneficial for friends and family—not as an agent of change in treating addiction). But for real change, the following is necessary.

Consciousness. Structure. Honesty. Time. Consciousness comes first. Not consciousness of the problems outlined in the last paragraph. There’s plenty of consciousness-raising about that already. Consciousness of feeling states, beginning perhaps with bodily sensations, as mirrored, amplified, and sometimes spoken to by an observant other, perhaps a therapist: someone who will monitor the moment-to-moment reactions of the patient; modulate closeness, sensitive to the fears that may manifest as withdrawal, whether the person is aware of their defenses or not. Structure comes in the form of routines: go to therapy, 12-step meetings, work and family obligations, etcetera—those necessary things to do to support growth and recovery. Time: the re-building of this afflicted self takes time, patience, and ongoing consciousness, about things like bodily sensations, feeling states that are felt and not—about that which has been driven underground, into the unconscious, and otherwise discharged via behavior.

This recovery process is another kind of risk. The biggest risk of all: to re-attach.

 

Graeme Daniels, MFT

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