Trauma and the mind–body relationship

This focus on vitality affects provides a useful opportunity for us to pay further attention to the mind-body relationship, particularly from a psychoanalytic perspective. Khan (1963) recognizes the impact that traumatic experiences of normal development have on both the mind and the body of the developing infant. Among the many important features of these observations is the psyche—soma connection, the mind-body integrative perspective and listening stance, which is also reflective of Reich’s (1942/1973,1945/1972) earlier recognition and attention. James (1960) refers to this functional identity as “the reciprocity of mental and motor reactions in the basic constitution” (p. 291).

Farber (2006) has noted a similar relationship, especially concerning selfhood, saying, “The body speaks of that which cannot be said in words, of secrets, lies, and trust that has been broken” (p. 2). Janssen (1996) adds a traumatic element, noting that chronic bowel inflammation may be seen to reflect an “affective dysfunction [that] is expressed as a ‘scream turned on the body’” (p. 80).The body serves as the container, expression of, and representation of the traumatic moments of our lives.

Khan’s (1964) proposition presents his awareness that the impingements impact “pathogenic reactions” (p. 273) in the body as well as in the mind and that there is an interdependent relationship between the nature and intensity of that impact. This is consistent with Reich’s (1942/1973) assertion that the psyche and soma are functionally related, akin to his even stronger contention that they are each “functionally identical” (p. 270) to the other. Intrapsychic disruptions have their counterpart in physiological manifestations, and physiological presentations stand as expressions of intrapsychic disruptions.

Today these assertions are commonly understood to relate to the neurochemistry and brain function (Cozolino, 2006; Damasio, 1994,1999; Levine, 1997,2005; Rothschild, 2000, 2003; Schore, 1994, 2003a, 2003b, 2003c; Schore & Schore, 2008;Siegel, 1999,2003,2007;Van der Kolk, 1987). However,Janet (1907), Lowen (1958/1971, 1967, 1970, 1972a, 1975, 2005), Mancia (1981), McDougall (1989), and Reich (1942/1973,1945/1972), among others, have recognized the relationship manifesting in all the different levels of biological function, including the cellular, organ, and muscular levels. With this broad perspective, we see the full range of physiological counterparts being represented as within the Affect component of the ORU, in concord with the emotional dimensions that we are more used to recognizing as affects, such as love, hate, anger, sadness, jealousy, and shame.

There are two other important features ofKhan’s (1963) description of cumulative trauma, in which he specifically addresses the mother’s “engineered exploitation of instinctual and ego dependence” (p. 298). First, he acknowledges the aggressive, attacking, predatory, and usurping nature of the mother’s interaction with the infant (however unconscious that might be) and specifically with the infant’s instincts, ego functioning, and dependency. Second, he affirms the interactive nature of the mother—infant dyad, supporting Winnicott’s (1952/1992) assertion that there is no baby without a mother. In so doing, Khan attests to the dynamic effect of that relationship upon the somatic and intrapsychic experience of the infant, as well as upon that infant’s reality foundation. A principal factor, in this context, is McDougall’s (1989) recognition that “a baby’s earliest reality is its mother’s unconscious” (p. 39-40).

Bromberg (1991) observes that dissociated experience “exists as a separate reality outside of self-expression and is cut off from authentic human related myths and deadened to full participation in the life of the rest of the personality” (p. 405). However, I find that the experience is symbolized unconsciously, in unthought knowns (Bollas, 1987) and nonverbal language (Damasio, 1994,1999; Lowen, 1958/ 1971, 1967, 1970, 1972a, 1972b, 1975, 2005; Keich, 1942/1973,1945/1972). Such experiences are primitive in the sense that they relate to developmental periods that predate the use of language and to processes ofS-A-O organization that prenatally begin to become differentiated into constellations of contingencies.4

It is important to recognize that dissociated experiences exist at an unconscious level and are expressed non-linguistically through the language of self structure, the constellation of ORUs that develop contingently to create the character structure, and the defenses that protect against the surfacing of those experiences into consciousness. As Bromberg (1991) states, dissociated experience exists in the affective realm

as a dis-integration of the affect state associated with the trauma, so that the experiences linked with that state of mind have no self-authorized “voice” within which they can be communicated. What could not originally be said could not come to be thought, and what cannot now be thought cannot come to be said.

p. 407

However, it is not only affect states that may be dissociated, but also the thoughts that are connected with those affect states.

The recognition of an impulse to act reflects a thought that lacks verbal language, like when an assault victim walks down the street and jumps back in fright as he passes by an open doorway. In flashback to prior experience and in unconscious traumatic re-enactment, in that moment, he is experiencing himself to be under attack from someone coming out of the doorway, though no one is there.

While Bromberg concentrates on the dissociative experience of later development and adulthood, the same processes of dissociation exist in preverbal experience and subsequent ramifications and manifestations in later developmental experience and challenges. The links of the self structure that have the potential to make those things known or felt are subject to attack by the Sorg and are made to be not known and not felt. Some of the dissociation operates on the potential precipitants and initiators of thought and language, including Affect subcomponents such as emotional feelings and their counterparts in the somatic realm, especially those which exist on the level of cellular and neuronal activity.

At this deepest of levels, if the threshold for stimulus recognition is set to exclude particular stimuli, those stimuli cannot be processed, and therefore there is nothing to be thought or said because nothing has been recognized as felt. We may view this as a negative hallucination.While the experience may not be symbolized in thought or language, it continues to be symbolized in the body/mind’s operating system that has set these thresholds so as to preclude recognition and subsequent response and in the internal program by which the system operates. The code of that program is the symbol, the unthought known, the sign that says, “Off limits,” blocking off that part of the mind where the split-off Self (that is to say, split off because of its intolerable subcomponent) of dis-integrated S-O experience is warehoused.

Bromberg (1984) notes how in these primitive states of mind, where intrapsychic rules of safety predominate, those laws are superimposed on external reality, therefore predominating in our processing and interpretations of external encounters. In this manner these internal laws and belief systems have greater influence on future intrapsychic growth and development than do external events.

What is especially significant in terms of understanding traumatic experiences of normal development is that these intrapsychic formulations are constructed on the substructure of those primitive beliefs. We live our lives in the context of those intrapsychic realities, rather than in any consensually validated external “reality.”

The realities of our experience are continually and unconsciously cross-matched with our internal dogma about ourselves—who we are and who we must be—and the intersubjective and relational rules upon which the universe operates. Whatever gaps there are between the two must be bridged with Self-coherent (which means Other-tolerated) rationalizations and meaning-making, the foundations of which rest on our prior experience, both intrapersonal and interrelational, with all of their traumatic contributions. These moments and all of their symbolic manifestations are essential for us to be able to acknowledge and attend to, because they formulate the basis upon which our thoughts rest.

As Bromberg (1995) states.

Sometimes self-preservation is accomplished almost or entirely at the expense of growth, and the individual is removed from full involvement (sometimes from all involvement) in the here-and-now experience of life. For certain people, here-and-now experience—the living present—cannot, in fact be mentally represented without the felt danger of traumatization. They, in effect, live in a frozen past, a world in which they are defined primarily by their attachment to a configuration of discontinuous, concrete states of consciousness, each an embodiment of a discrete representation of self.

p. 182

But I maintain that self-preservation occurring without any need for any loss of growth is either assimilation or not actual self-preservation. For example, when the baby’s cry to be fed is not responded to immediately, he may cry louder. His mother may now hear the cry, and feed him within his range of tolerance for hunger. His efforts to preserve his self by being attended to and being comforted have met with success, and so his Sorg need take no action “at the expense of growth.” Quite to the contrary, as his growth continues along its previously existing line, it is enhanced because his self-preservative capacities have proven effective. His sense of competency, agency, self-efficacy, confidence, coherence, and self integration are all reinforced, and he is able to continue to further embed those aspects of selfhood.

On the other hand, whenever preservation of self, in any of its manifestations of selfhood, is accomplished “at the expense of growth,” trauma has occurred. The natural progression of growth has been traumatically interrupted. Moreover, these self-preservative experiences of trauma are commonplace in the course of normal development.

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