Art, imagination, shame, morality and power ……                       The images will be posted soon

“Encouraging creativity and nurturing the imagination are some of the most neglected aspects of modern education systems….we let their [children’s] imaginations starve… Children enter school gifted with a rich imagination and they graduate with stunted and stifled imaginations.” Eugene Trivizas

 “It is no accident that experiences of shame are called self-consciousness. Such experiences of shame are characteristically painful. They are usually taken as   something to be hidden, dodged, covered up _even, or especially, from oneself. Shame interrupts any unquestioning, unaware sense of oneself. But it is possible that experiences of shame, if confronter full in the face may throw an unexpected light on who one is and point the way to who one may become. Fully faced shame may become not something primarily to be covered, but a positive experience of revelation” Helen Merrell Lynd

“The shame topic opens up into the whole notion of internalization, and who you become, and are you integrated or fragmented? Are you more like an archipelago or a unified continent in terms of your self-structure? And what do you do with these islands, as it were, that have been, you just took in, you drank them, you internalized them with mother’s milk when you were a year old?” Rick Hanson

 “Curiously enough, if we primarily try to shield ourselves from discomfort, we suffer. Yet when we don’t close off and we let our hearts break, we discover our kinship with all beings.” Janina Fisher

Today’s post includes a new painting I’ve been working on, a TED talk by Eugene Trivizas, notes on the Being Well podcast by Rick and Forrest Hanson that focuses on some of the many ways we can view and understand shame, especially, unnecessary shame, and also, a few short videos with shame related topics. I have written about shame before, especially, trauma and toxic shame, but topics can never be discussed extensively in any one post or article, and there are always so many aspects and perspectives to explore.

Eugene Triviza’s talk with the title, Let’s Imagine, [https://www.youtube.com/watch?v=tx67UwCrqkU] focuses on the value of myths, fairy tales and imagination, and on the necessity to cultivate and nurture our children’s innate capacities to imagine and be creative. Imagination is what allows children to be themselves, to be inventive, to thrive, and also, to understand things like science and mathematics. A scientist he mentions once said: “To invent you need just a good imagination and a pile of junk.”  Trivizas has said that “education should aim not so much to impart knowledge – given that knowledge nowadays is easily accessible – but to cultivate children’s creativity and imagination, so that this knowledge is employed in innovative ways and that fairy tales “transmit the message that we are able to overcome the limitations of our roles, our environment and our existence”. They “offer children the hope that we can defeat the dragons and the monsters that threaten and oppress us.”

In the video Trivizas refers to a study where people were asked to describe all possible uses of paper clips. 98% of the younger children came up with more than 145 possible uses. As they got older the number decreased significantly and adults were able to come up with 10-15 uses at the most. Eugene Trivizas is an author of children’s books and playwright. He has written something like 150 books. One of his most well known book is The Three Little Wolves and the Big Bad Pig, which reached the second place in the American best seller list for picture books and has won many distinctions. He believes that the stereotypes of good and evil which are propagated through children’s books are often wrong and they lay the foundations for prejudice against minorities, as well as breeding many other social ills. He tackles issues of war, violence, prejudice and bullying in his books for children of all ages. For instance, the issue of racist genocide is tackled in The Last Black Cat, where members of a secret superstitious sect are convinced that black cats bring bad luck and consequently decide to exterminate them, supported by financial circles that trade cat traps and political leaders who find black cats to be convenient scapegoats for their disastrous policies.

Trivizas has studied law and economics and is a professor of criminology in England. Another interesting fact about Trivizas is that in 1997 he won a legal battle against Coca Cola for unlawfully appropriating his intellectual property, preventing the company from registering in Greece the title of his TV serial and comic-strip books, Fruitopia, as a trademark for beverages.

I became familiar with Triviza’s books more recently. Actually I was gifted one of his books by the kids at an Internship context. The book has the title: Amy and the Banana Skin. Amy or Anna in the Greek edition drops a banana skin in the street on her way home from school, but when she gets home she starts feeling deep shame, guilt and unbearable remorse. She starts thinking of all the possible catastrophes that might occur. Maybe a pastry chef will step on it and slip followed by many assistant pastry chefs loaded with pastries or a general on parade with an army marching behind him will all come tumbling down or even a bride followed by the groom and the wedding procession, and so on. Amy’s imagination goes wild and unable to bear this she decides to sneak out of her house at night to return to the “crime scene” to pick up the banana peel. Always anticipating the worst she imagines herself being locked up in prison:

“Firefighters, police / investigators and traffic wardens will come. / They will point to me and say: There she is. This Anna threw a banana skin. / I will be dragged to prison in chains / and I will spend my life / in a dark cell….”

She soon finds out that the banana peel in the middle of the street has definitely triggered events, but not the way she had expected…. The people of the town, including the mayor, will not only thank her, but also, award her with the key and lock of the town….

Speaking of shame and other related emotions and states like guilt and remorse this week’s Being Well  podcast [https://www.rickhanson.net/being-well-podcast-changing-your-relationship-to-shame/] touches upon many aspects and adjacent topics to shame. Rick and Forrest Hanson begin by talking about the biological roots of shame and how it evolved to help primates and humans survive, even escape death in certain circumstances. They refer to Paul Gilbert and others, who have pointed to the ways in which shame is rooted in submission behaviors of monkeys and other primates, and presumably early humans, in which there’s the movement of a looking away, of getting small, and avoiding really aggressive conflict. In the wild this behaviour can be effective in not getting exiled from the band and surviving the more aggressive Alpha males and passing on genes.

It is true that shame may still prevent us from getting exiled from certain groups or from being punished. On the podcast shame is also referred as the “exile emotion” because it can prevent exile from the group. They describe how when people go through a major process of internal change, it almost always brings them into intense conflict with the groups that they are a part of, because all groups seek to stay the same to preserve their homeostasis. This can happen for those who change major aspects of identity, but also in smaller ways as people decide, for instance, that their friend group or job or family structure or religious group or outlook on life or something else is not healthy or right for them anymore. Shame can arise, but also, shaming tactics can be inflicted on people to prevent them from rocking the boat or moving on or doing things differently and even protecting themselves.

They also discuss shame and impropriety, which raises the question of who makes those choices, who defines what is improper and why do they do so, and also, the psychological process of internalizing these often shame inducing messages. They claim that a lot of this unnecessary and often toxic shame can be traced back to our early upbringing, and more broadly to the Victorian era culture and Freudian ideas rooted in the Victorian era. Conservative western religious contexts, with beliefs of being born in shame and sin, also contribute to unhealthy shame and disempowerment. Many messages about our worth and about what is proper or right come from authority figures of different kinds invested in certain outcomes, and many of our early models of morality are likely to be driven by our early relationships at home, at school, in church and in society in large. They refer to Erick Erickson’s work of developmental stages, the second early developmental stage, in particular: shame or autonomy, which has a lot to do with toddlers’ toilet training … It is that phase where young children’s attempts for exploration and autonomy are either encouraged or stifled.  Rick Hanson says: “So you think about body shame, private parts, bodily wastes being revealed, this should be kept out of sight, this should be pushed away, and then you can have a broader societal view, which is, again, very Freudian and very cultural to its time, basically civilization contrasted to savagery…. And it’s really interesting for people to reflect on whatever might be relevant for you in your early childhood experiences. And then you can think about not just physical things that leak out, but what about emotions, the desires that are supposed to be hidden….”.

They do talk about the better known relationship between shame and trauma. Unfortunately, when we have being traumatized, mistreated or abused we end up carrying shame and unjustly internalizing others’ projections because that is how our brain / body respond to trauma. This kind of toxic shame, unlike healthy shame or remorse and moral sensibility that rise from the awareness that we have done something wrong, is unnecessary and unhealthy. They distinguish between guilt based on some wrong doing and being overly self-conscious about hurting others. This second kind of guilt is usually based on a lie, and this is especially true for people who have grown up in cultures of guilt, often with a religious framing around it, or a cultural framing around duties and loyalties. Rick Hanson suggests that as adults it serves us to step back from all these various beliefs, or rules, or standards and ask ourself – “Is somebody lying to me here?” We can ask ourselves is this shame being driven by any kind of objective sense, of appropriateness or morality or is it perhaps driven by our unconscious and unexamined schemas.

As discussed on the podcast because it is human beings that define many shoulds and don’ts it is important to reflect on them and check their current validity. Without being moral relativists it is wise to engage in some level of inquiry and to establish our own integrity system, which may to some extent differ from our family’s, culture’s or religion’s integrity systems.

Some of the many questions suggested on the podcast:

What’s my integrity system? What’s my moral basis? Who decides what being good looks like? Who decides what moral behavior looks like? What are the big themes in your shame story? What are the categories of things that activate a really strong feeling of shame for you? When did shame start getting attached to that other thing, that idea, that category, that way that you are? Did that happen pretty early on? Is it a more recent development?

Aspects of the emotion of disgust are also explored, which Rick Hanson notes is  neurobiologically, evolutionarily, pretty close to shame. From our own experience we may be aware that in overly oppressive and judgmental cultures there is a lot of disgust and loathing of the Other. Rick Hanson says: “…we feel that others are disgusting, others should be ashamed of themselves……” We think “They ought to be guilty, they ought to have remorse, they’re doing bad things, they’re bad, they’re wrong, I’m morally superior to them…..”  Essentially this has little to do with morality and goodness, and more to do with power and control. It is suggested that “we turn it into a morality play because morality is a wonderful lever that we can apply to people to curtail their behavior. That’s the mechanism, that’s the fulcrum.” If this is taken further it can lead to dehumanizing and objectifying of the Other and from that place it is easier to attack and harm other people. One form of shame is identity related shame, which applies to groups that society has attached a variety of labels to do with their worth or goodness and even right to exist. In her book On Shame And The Search For Identity Helen Merrell Lynd claims that shame hinges upon the clashing of different social or moral ‘values’ in specific places and times, emphasizing the trauma experienced by members of communities marginal to dominant culture: those most likely to feel shame are those made to feel ‘inappropriate’ by dominant cultural norms.

This relationship between shame,, morality and power starts early on. Of course, it is necessary and totally unavoidable to teach children values and model behaviours for them. Rick Hanson says: “to get children to internalize reasonable societal standards – we stop at red lights, that’s an important thing, we try to take care of the youngest among us, and we try to be kind – you know, there’s a place for that internalization, but, just like you say, what happens when it goes too far….” This is the reason why it is important to distinguish our own core integrity system, become conscious of our own standards and the impact we have on other people from systems of morality in the service of power. Often people have been gaslit in their family and culture. Every so often it is desirable to reflect on how we may have at times not acted accordingly to the values that are close to our heart due to unskillfulness or being unaware and ignorant. And also, to learn about the larger systems we are part of and the larger societal influences at play.

Mindfulness can be one way in unpacking our shame stories, both through awareness of bodily sensations like nausea and bodily pain and through awareness of thoughts and beliefs. Because shame and other emotions have evolved in community healing requires community. On the  podcast it is suggested that healing takes place in “community and relationships, including special beings who affirm you, and see value in you, and good in you, not because they’re flattering you or working you for some price they want, but because they genuinely witness in you that which is good and worthy.” Finding other forms of social support outside of the groups that one is currently a part of or the group that one might be making an exit from is also important.

Other topics mentioned on the podcast are: shame in relationship to group belonging, generosity of forgiveness and skillful correction when that is possible, although, as they say, “there are things in our life that we can’t fix with the person that we wronged back in junior high school”, for instance. They also mention the ‘Shame Proneness Scale’, different people vary in how shame-prone they are, how to disrupt unhelpful narratives about ourselves, about other people, about the world, through what they call the process of reverse engineering to understand where the story came from so that we can make a more active choice in the here and now about whether or not we want to hold on to it.

A few short videos on different ways to view and / or work with different aspects of complex emotions like shame and guilt. They are, one could say, complementary to the podcast material.

Some of my earliest readings on trauma and shame were Dr. Janina Fisher’s articles and website material. In this short video at: https://www.youtube.com/watch?v=yxpUGOu_yjE she shares 3 interventions drawn from neurobiologically-oriented therapies.

In this video at: https://www.youtube.com/watch?v=FPZHqImgUZ0 Dr. Pat Ogden provides an introduction to the relational nature of shame from a sensorimotor psychotherapy perspective, the link between shame and systemic oppression, how to work with the parts of our psyche or body that carry the shame.

In this video at: https://www.youtube.com/watch?v=qQiFfA7KfF0 Brene Brown, PhD, talks about shame, empathy and human connection and how shame disrupts our connection to others, whereas qualities or capacities like empathy and courage support us in this process.

In this short TED talk at: https://www.ted.com/talks/june_tangney_what_s_the_difference_between_guilt_and_shame professor of clinical psychology, June Tangney, mentioned in the Being Well podcast, discriminates between constructive guilt and crippling shame so that we can learn to identify and deal with these difficult emotions.

“One cannot hope to understand the phenomena of psychological distress, nor begin to think what can be done about them, without an analysis of how power is distributed and exercised within society” David Smail

“Women are socialized to suppress feelings of anger and frustration that are often natural outcomes of interpersonal conflicts…. this socialization process leads many women to experience negative psychological and physical reactions because they are fearful of expressing their thoughts and feelings….. Comstock refers to these dynamics as “prohibitions against anger”…” Jean Baker Miller (in Allen Ivey, Michael D’Andrea & Mary Bradford Ivey)

“Dialectics allows opposites to coexist, you can be weak and you can be strong; you can be happy and you can be sad. In the dialectical worldview, everything is in a constant state of change…” Marshia Linehan

 “…. I no longer see these disorders as distinct, but as individual manifestations of overwrought, amygdala-driven and dysregulated nervous systems. Just as emotion” Sebern F. Fisher

“Live it, say it, the “I can” that changes lives / all that you ask for, is where you’re afraid to go….” (Lyrics from Vasilis Lekkas’ song)

The artwork is by Vaso Katraki

In today’s post I’ll be mildly and briefly touching on some difficult and thorny topics, which require a lot more space for discussion. I’ll also refer to a song, a film, a book and a meditation session.

One of the positive things of living on a Greek island in the summer apart from the natural beauty, the sea and the long warm days are the many cultural events in open spaces. Last week I went to Vasilis Lekkas’ concert, which took place in the garden of an old mansion under a star lit sky among trees that have probably stood there for over a century. At some point the lyrics of one of the songs I hadn’t heard before caught my interest and got me thinking:

Live it, say it, the “I can” that changes lives / All that you ask for is where you’re afraid to go… / Don’t bow (to pressure)… don’t bow… / But dreams are keys that open cells … There are no prisons on earth that can lock the psyche… / Live it, say it, the “I can” that changes lives / all that you ask for, is where you’re afraid to go…. /  Live it, say it, the “I can” that changes lives / you wear wings, but they will open if you say that you dare… to fly, to fly…

I thought about the lyrics and of how maybe this common metaphor of “spreading your imaginary and symbolic wings to fly” often used to represent the realisation of dreams or reaching goals might not be the only relevant metaphor. Perhaps a more useful or complementary image could be to be rooted in the earth, like a tree, rooted, connected and resilient in the eight worldly winds that may sweep through and around you, touching the ground, present in the here and now, alert to current reality, but also the past, undistracted, awakened to broader levels of inner and outer realities. From this place, I think, there are more chances of being free and of fulfilling dreams and potential.

Speaking of wings a little while ago I watched a documentary film: Take These Broken Wings, directed by Daniel Mackler, featuring Joanne Greenberg, who had been diagnosed with schizophrenia, and after much trauma and suffering in the mental health system, went on to become a best-selling author of I Never Promised You a Rose Garden, and to write many more books (I have briefly referred to her in an older post), and Catherine Penney a survivor, of a traumatic childhood, whose symptoms were labeled schizophrenia, but was supported to heal from both her trauma and her symptoms or / and maladaptive responses. She went back to school and become a clinical nurse. The film also includes interviews with: a) Peter Breggin, psychiatrist, critic of shock treatment and psychiatric medication and advocate of replacing psychiatry’s use of drugs and electroconvulsive therapy with psychotherapy, education, empathy, love and other human services, b) Robert Whitaker, journalist and author – three of his books cover the history and practice of modern psychiatry, who has won numerous awards for science writing, was shortlisted for the 1999 Pulitzer Prize for Public Service for a series of articles questioning the ethics of certain psychiatric research, and Bertram Karon, psychoanalyst, psychotherapist and author. The film raises questions in relation to diagnoses, over use of medication and misinformation and, more helpful ways of viewing symptoms or clusters of symptoms. Ultimately, I think it is important to ask: Why are the symptoms here? & What happened to you? as Mate Gabor, among many others, often says, and most importantly How can we help without harming you or taking your agency away?.

Somewhat related to the above is Dr Marsha M. Linehan’s book Building a Life Worth Living. In her teens Marsha Linehan was subjected to electroconvulsive therapy, seclusion,  heavy medication and cold pack therapy. This is what she writes about cold pack therapy: “[it] involved being stripped naked, wrapped tightly in wet sheets that had been stored in a freezer, and strapped to the bed with restraints. You would lie there, immobile, for as long as four hours…. Most people find the discomfort and physical constriction so unbearable that the mere threat of the therapy is sufficient to discourage problem behavior…. The nurses had a simple but effective method of issuing such a threat. If we were talking instead of going to sleep, for instance, the nurses would rattle ice cubes in a metal container. That usually brought instant silence.” Linehan writes she was twice erroneously diagnosed. In reading her story we see that the symptoms and behaviours she displayed after she had entered the institute [not before she was sent there] were similar to today’s diagnostic criteria for borderline personality disorder, and also, that her stay there brought about severe memory loss.

During her time in the institute she made a vow to God to get out of that hell and help others get out too. She describes how this happened: “Thompson Two had a piano at one end, an upright piano, and I spent a lot of time playing. I had been an accomplished pianist at school, and I hadn’t yet lost that part of me on my descent into hell. Later, though, after I had multiple rounds of electroconvulsive therapy…… I lost my memory of just about everything and every person and, sadly, also my ability to read and remember musical notes and to play the piano. Playing the piano had always been a way to express my emotions. I still carry the hope that one of these days I will play again. It was at the piano that I later made my vow to God….. that I would get myself out of hell and that, once I did, I would go back into hell and get others out. That vow has guided and controlled most of my life since then.” A good friend that Linehan had made while in that clinic, Sebern Fisher, also went on to become a therapist and write a book on neuro-feedback and developmental trauma.

After leaving the institute when she was 20 years old, she went on to study. She earned an M.A. in 1970 and a Ph.D. in 1971, in social and experimental personality psychology, and then went on to develop Dialectical BehaviourTherapy, which according to Linehan is a behavioral treatment program, not so much an individual psychotherapy approach. Linehan is a researcher and professor of Psychology and Behavioral Science, has written many books and earned many awards. In addition to her work in psychology, she is also a trained Zen meditation teacher. In the foreword for her most recent book: Building a Life Worth Living, Dr Allen Frances, Professor Emeritus of Psychiatry and Behavioral Sciences, has written: “The therapy Marsha created is called Dialectical Behavior Therapy. DBT is the most effective treatment for highly suicidal and self-destructive people, often people diagnosed with borderline personality disorder (a terrible term, but we seem to be stuck with it). In the past half century there have been just two really influential clinical innovators in the field of mental health…… in 2011, the editors of Time magazine named DBT one of the 100 most important new science ideas of our time. That she has made this major contribution to psychology, a field previously dominated mostly by men, is testament not only to her intellectual creativity but also to her determination to overcome all obstacles. Many people come up with good ideas but don’t have what it takes to get them into the world. Marsha has the charisma, energy, commitment, and organizational skills to turn dream into reality. In myths the world over, heroes must first descend into the underworld, where they are faced with a series of epic challenges to be overcome before they can prevail in their heroic life journey. Once they succeed, they return to their country bearing some special new secret of life…..”

There is now a need for a constructive critique of practices, structures and power. David Smail claims that “One cannot hope to understand the phenomena of psychological distress, nor begin to think what can be done about them, without an analysis of how power is distributed and exercised within society” (cited in MacLachlan, McVeigh, Huss & Mannan, 2019). Another point to consider, as I’ve mentioned in previous posts, is the ineffectiveness of a biomedical understanding of health, addiction and mental distress that continues to dominate the relevant social discourse and current practices. Miriam Greenspan discusses three general myths from which many health practitioners and psychotherapists operate when working with people, in particular, women: a) “it’s all in your head”, and in doing so “avoid directing attention to the oppressive and unjust stressors that occur within women’s workplaces, families and other important interpersonal relationships.” The second myth is the medical model of psychopathology, which suggests that “all emotional pain can be treated the same way one would treat medical problems-with prescription and medication” and in doing so little time is spent on the contextual basis of personal problems. The third myth is the doctor as“The Expert”, which perpetuates the power imbalance between the patient or client and the health professional (cited in Allen Ivey, Michael D’Andrea and Mary Bradford Ivey, 7th Edition).

Also, we need to remember that patriarchy acts as an overarching oppressive force defining power structures, discourse, and dissemination of information of acceptable behaviour, girl’s and women’s behaviour in particular. There is now a lot of material concerning the DSM and the validity of some diagnoses and part of it is a feminist critique that suggests that women’s experience of oppression and inequality has been pathologized for centuries. For instance, women’s anger is pathologised irrespectively of circumstances, violence or oppression, whereas, it is rather encouraged in men. Comstock refers to these dynamics as “prohibitions against anger”…” (cited in Jean Baker Miller (in Allen Ivey, Michael D’Andrea & Mary Bradford Ivey). Girls and women are conditioned into certain gender roles from a young age and are often expected to adjust, not speak up or rock the boat, which can lead to intense distress. When women express their need for autonomy or their indignation and anger they are labeled rebellious, promiscuous, hysterical or otherwise. This disempowers women and leads to the burying of emotions, numbness and disempowerment.

I’ll provide an example from my own experience to clarify how women are conditioned from early on to be overly polite and accommodating, and also, how there are subtle and less subtle ways that society silences women or undermines their sense of safety. This particular memory came to my mind after hearing psychotherapist, Marisa Peer, provide an example from her own life of a similar experience in a talk about how to reframe experiences and make new meaning of events. So, I was in my late teens returning from some class or other when a tall man around thirty with very short hair stood behind me on the train and started talking to me. I ignored him knowing that I would be getting off soon. To my surprise he got off too and started following me continuing to chat. It wasn’t dark, I was in my neighbourhood so I turned around and asked him to leave me alone, but he ignored me. As we approached my house I started feeling some low grade fear wondering if he would actually follow me up to the front door of my block of flats and even if it was a good idea to go home. When I finally got to the door he stood close behind me as I was trying to unlock the door hoping that once I’d shut the door he would leave, but he firmly held the door open and stepped inside. I was left trying to figure out whether to go up the several flights of steps in the semi-dark or take the lift. The lift seemed a better option and I didn’t believe he’d have the nerve to get in, but he did. Meanwhile, it never occurred to me to knock on a neighbour’s door or demand he get lost… because I kept thinking “what if he gets aggressive” and “what will people think”. Even though I’ll end the story here I will say that his stalking did not end that day. There were a couple more incidents. At the time it occurred I could not yet classify it as harassment or stalking. I didn’t have the vocabulary. Only much later was I able to  reframe the experience. It was only in retrospect that I realised that apart from it being an unhealthy and sexist behaviour on his part, it was a fear inducing power game not that uncommon.

As mentioned above, one issue to consider is that mental distress in society is mostly understood through a biomedical lens. Lafrance and Mckenzie-Mohr (2013) postulate that “distress is medicalized, understood as an expression of individual dysfunction” Moreover, one needs to look at the history and development of the Diagnostic Statistical Manual of Mental Disorders (DSM). The DSM has contributed to medicalising our understanding of human experience and distress and has shaped the language that we use to talk about emotional and mental distress, responses to trauma and even human experiences like grief. In their paper on gender and diagnosis, published in 2008, K. Eriksen and V. Kress write:”…… both men and women have been hurt by previously unquestioned diagnostic systems. In fact, many authors have pointed out the stigmatizing effects of diagnostic labels; the classist, sexist, racist, and homophobic assumptions embedded in both the ICD…. and the DSM-IV-TR…….; the resulting pathologizing of behaviors that may be normative within particular gender contexts; and the under-diagnosing of problematic behaviors…… In this article, we report gender-related concerns about diagnosis, including those related to the prevalence of diagnoses by gender, sex bias in diagnosis, the problematic impact of particular diagnoses on women, and the impact of socialization and social conditions on diagnosis…”

There has also been considerable critique about the relationship between psychiatry and the pharmaceutical industry, and consequently, the over reliance on the use of medication, which requires a biomedical model of explaining health in general and the need to over-pathologise and de-contextualize human experience.  Psychiatry has been described as anti-feminist having contributed or colluded in practices that today would be considered as barbaric and violations of rights. All in all, patriarchal structures, upper white male middle class values and beliefs and a biomedical model of understandings of mental distress have pervaded psychiatry and psychology. Of course, mental health fields do not speak with one voice and progress is being made as science progresses and new research and more integrative approaches are formulated. There are a lot of voices, there is greater dissemination of information, and also, women and marginalised groups are now, to one extent or another, also part of the conversation.

Concerning “Borderline Personality Disorder”, in particular, there are those in the field that consider it a meaningless label and because there is a great overlap with complex post traumatic stress it is suggested that this description of the experience would be more helpful and would also shed light on the fact that a lot of serious mental distress or maladaptive behaviours stem from prolonged trauma and hostile environments. Incorporating the concept of trauma could move the emphasis away from the individual to include their external environment. The literature also reveals that there are those arguing that BPD is a “gendered diagnosis”, with women being diagnosed at a much higher rate than men. In order to understand how BPD was constructed and why women are diagnosed, I think something like nine times more frequently, it is essential to explore the link between patriarchy, power and dominant discourses of mental distress. Also, this lack of consideration of stereotypical notions of gender, on the one hand, and life circumstances, on the other, can result in biased research and conclusions.

It is suggested that rather than reducing the experience of women to medical symptoms, there is a deep need to change our oppressive, biased and unreasonable society, and also, take into consideration the upbringing of many girls across the world and the impact of oppression and social contexts from early on. Behaviours developed early to survive and protect the self in often threatening or invalidating environments are then in adulthood stigmatized and labeled out of context. Literature suggests that women who receive a BPD diagnosis have often experienced trauma and abuse, so viewing them as survivors would facilitate healing and change. Also, evidence on the effectiveness of medication is controversial. Apart from Marsha Linehan’s approach mentioned above, other psychotherapies like narrative therapy and feminist therapy have been found to be effective in exploring gender issues, power structures in society and women’s positioning, creativity, and insights into relational dynamics and ways of empowerment. Dialectical Behaviour Therapy (DBT) has four components “mindfulness (being aware of one’s emotions, distress), distress tolerance (tolerating and accepting difficult situations or emotions), emotional regulation (using techniques to reframe thoughts and shift emotions) and interpersonal effectiveness. It might also be necessary to engage in trauma work along with DBT or at some later point in order to heal at a deeper level. DBT has been critiqued for neglecting to pay attention to the oppressive power structures that have contributed to a person’s life experiences and context. Trauma work can also prevent women from seeing the broader power relations that are affecting their lives or stifling their movement. Ultimately, integrating a feminist approach and contextualizing people’s lived experiences can always complement and increase the efficacy of the therapeutic process and the process of empowerment.

I will end the discussion of this huge topic here even though there is a lot more to consider.

I’d also like to share a meditation for those who meditate from Kara Jewel Lingo, a meditation teacher, who is interested in blending spirituality and meditation with social justice. At the age of twenty-five after her studies, she entered a Buddhist monastery and spent fifteen years living as a nun. She became a Zen teacher in 2007. She has also written a book. In this particular meditation she mentions a common symbol of a wheel found in Asia with eight spokes and a hole in the centre or an inner wheel. This wheel image also represents the Eight Worldly Winds (I referred to above), which are four pairs of opposites: pleasure and pain, praise and blame, gain and loss, fame and disrepute. It seems like a helpful metaphor for life. We all universally hope for the positive things and fear the other four. The wheel is always turning, the wind is always blowing, and more or less, we get a taste of all eight experiences in different forms and to differing degrees.

https://www.youtube.com/watch?v=UXdhEwzCBDQ&t=387s

Finally, some fun resources for the summer for both those who will get the chance to go on vacations and those who won’t. The relevant research seems to reveal that “fun is an essential key to our well-being, one that needs to be defended against the encroachments of work and other responsibilities.”

https://corpmail.otenet.gr/?_task=mail&_action=show&_uid=51072&_mbox=INBOX&_safe=1&_caps=pdf%3D0%2Cflash%3D0%2Ctif%3D0

Emotions…..                                             

“We become free by transforming ourselves from unaware victims of the past into responsible individuals in the present, who are aware of our past and are thus able to live with it. Most people do exactly the opposite. Without realizing that the past is constantly determining their present actions, they avoid learning anything about their history. They continue to live in their repressed childhood situation, ignoring the fact that it no longer exists.” (From The Drama of the Gifted Child by Alice Miller)

My Eyelid                             

Come sleep, take it (the child) / place it on silk / quietly  

And from honey milk / let the staircase of your dream be wide

My eyelid is closed / ah! my lucky one / Don’t rise morning star / don’t be scared.

Lullaby by Chronis Aidonidis and Nikos Kypourgos: https://www.youtube.com/watch?v=A-HTQb5KA6

(Lovely Greek lullaby, rhythm and rhyme, and even tenderness, have sort of been lost in translation)

In the previous post I referred to a podcast in which Dacher Keltner talks about his exploration of pro-social emotions like: awe, gratitude, empathy, compassion and others, and how they are tied to our capacity to live a life of meaning, the connection between emotions, ethics and power, about compassion and those, who are in some sense wired to be able to tap more easily into empathy and compassion. Keltner also tells us a bit of how he ended up focusing on emotions in his work. He writes: “the field (this is the mid-80s) was really in what’s called the cognitive science revolution: the mind is a computer, the process is information, there are algorithms. That’s how we make sense of the world. I really felt that emotion was missing in our conceptualization of the mind and the body… There were two critical events that happened to me. The first is my grad advisor, Phoebe Ellsworth—who’s a brilliant scientist. I did a project showing that with little brief changes in emotion, if you feel sad, for example, you just look at the world differently. It’s like this lens upon reality. And then the second big transformative experience… was she enabled me to get a postdoc after my PhD at Stanford with Paul Ekman [a pioneer in the study of emotions and their relation to facial expressions. Ekman has conducted seminal research on the specific biological correlations of specific emotions, trying to demonstrate the universality of emotions]. I learned from Ekman the brilliance of Darwin and just the incredible wonders of how we express emotion in the body and in the face and in the voice….. the field really started to change in the emotion revolution. There were people like Jonathan Haidt who argued that our sense of morality, freedom, justice, caring, equality, those are ancient emotional tendencies that you see in non-human primates.”

I’d like to add that even though I did a masters’ programme a little over a decade ago, this over-emphasis on cognition and cognitive behavioural therapeutic modalities, at the exclusion almost of other important human experiences like emotions, sensations, early experiences, and above all, circumstances and context, was still very much part of the whole atmosphere, Keltner speaks to how things have changed in the field and how the importance of our emotions in our life is being studied by scientists and researchers. He writes: “People like Jonathan Haidt saying our sense of meaning and purpose and right and wrong comes out of the gut and our feeling. And then neuroscience. There’s new thinking by Solms and colleagues that our sense of self and meaning really is not in the cortex where we think about things, it’s really in the sub-cortex down by the brain stem, in the periaqueductal gray, where that attaches the sense of meaning to what we see in the world, and it’s rooted in feeling.” He also notes how academia is a very adversarial peer review-based process and the he has experienced pushback for his work. He writes: “Wow, I tried to be kind and not go out and undermine other people’s work,” but that happens to me. How do I keep close to this philosophy of kindness? It’s a continuing work in progress…”

In terms of the importance of emotions in her book, The Drama of the Gifted Child, Alice Miller writes that all children  have a primary need from the very beginning of their life to be regarded and respected as the person they really are at any given time. She clarifies that when we say “the person the child really is at any given time,” we mean emotions, sensations, and their expression from the first day onward. In an atmosphere of respect and tolerance for feelings, the child, in the phase of separation, will be able to give up symbiosis with the mother and accomplish the steps toward individuation and autonomy, which are prerequisites for the healthy development. Our access to our emotional world, our capacity to stay with emotions and the knowledge stored in our bodies is a prerequisite to healing, growing and changing. Miller claims that the repression of childhood pain and emotions influences not only the life of an individual, but also the taboos of the whole society. She writes that we can never undo the damage done in early years, but we can change and gain our lost integrity by choosing to look more closely at the knowledge that is stored inside our bodies and bringing this knowledge closer to our awareness. And even though this path is neither easy nor pain free she believes that it is the only route by which we can free ourselves from dysfunctional beliefs, repressed emotions and the invisible prisons of our childhood.

Miller clarifies that this truth and process is not only relevant to people who have had a very difficult early life or people who are aware of their traumas, but also to those that might believe that they had a good childhood. For instance, she explores the roots of many common adult strategies and behaviours, many of which are viewed as positive and condoned socially. She writes: “Their access to the emotional world of their own childhood, however, is impaired— characterized by a lack of respect, a compulsion to control and manipulate, and a demand for achievement. Very often they show disdain and irony, even derision and cynicism, for the child they were. In general, there is a complete absence of real emotional understanding or serious appreciation of their own childhood vicissitudes, and no conception of their true needs — beyond the desire for achievement. The repression of their real history has been so complete that their illusion of a good childhood can be maintained with ease.”

Miller also discusses prevalent or mainstream toxic pedagogic methods like not picking up a baby while crying to avoid spoiling it, or health providers encouraging scheduled feedings and training babies to not wake up during the night, and so on, that have been part of the upbringing of many generations. Mate Gabor describes his mother’s internal emotional struggle trying to abide with her physician’s instructions and not pick him up while he was desperately crying as a baby. In her book, Of Woman Born: Motherhood as Experience and Institution, Adrienne Rich writes: “…..she [the mother] is, in fact, expected to prepare them [her children] to enter that system without rebelliousness or “maladjustment” and to perpetuate it in their own adult lives. Patriarchy depends on the mother to act as a conservative influence, imprinting future adults with patriarchal values even in those early years when the mother-child relationship might seem most individual and private; it has also assured through ritual and tradition that the mother shall cease, at a certain point, to hold the child— in particular the son— in her orbit.”

In her chapter, The Mother as Society’s Agent During the First \years of Life, Miller says that the things that make us sick are those things we cannot see through, society’s constraints that we have absorbed through our parents’ eyes. She writes: “No amount of reading or learning can free us from those eyes. To put it another way: Many people suffering from severe symptoms are very intelligent. They read in newspapers and books about the absurdity of the arms race, about exploitation through capitalism, diplomatic insincerity, the arrogance and manipulation of power, submission of the weak, and the impotence of individuals — and they have given thought to these subjects. What they do not see, because they cannot see them, are the absurdities enacted by their own mothers when they were still tiny children. Oppression and the forcing of submission do not begin in the office, factory, or political party; they begin in the very first weeks of an infant’s life. Afterward they are repressed and are then, because of their very nature, inaccessible to argument….” We cannot change this nor awaken to more reality until our own early reality and conditioning have been faced and experienced. It is only then that as Miller says: “building up new illusions and denials in order to avoid the experience of that reality disappears. We then realize that all our lives we have feared and struggled to ward off something that really cannot happen any longer; it has already happened, at the very beginning of our lives while we were completely dependent….. to free ourselves from these patterns we need more than an intellectual awareness: we need an emotional confrontation with our parents in an inner dialogue.” So, we need to feel our emotions and this is neither easy nor is it encouraged in our emotions phobic society.

In relation to how social structures and contexts interfere with the mother-child relationship and bond Miller also focuses on our birthing practices in the West. She emphasizes the need to not separate mothers from their newborns, which is still a common practice in many hospitals and maternity clinics. Miller writes: “If a woman is to give her child what he will need throughout his life, it is absolutely fundamental that she not be separated from her newborn, for the hormones that foster and nourish her motherly instinct are released immediately after birth and continue in the following days and weeks as she grows more familiar with her baby When a newborn is separated from his mother— which was the rule not so long ago in maternity hospitals and still occurs in the majority of cases, out of ignorance and for the sake of convenience— then a great opportunity is missed for both mother and child. The bonding (through skin and eye contact) between mother and baby after birth stimulates in both of them the feeling that they belong together, a feeling of oneness that ideally has been growing from the time of conception. The infant is given the sense of safety he needs to trust his mother, and the mother receives the instinctive reassurance that will help her understand and answer her child’s messages. This initial mutual intimacy can never again be created, and its absence can be a serious obstacle right from the start.” In the book mentioned above, Adrienne Rich provides a much more extensive historical and political analysis of the evolution of the birth practices across historical contexts, especially, in the West, and the consequences for both women and children.

Miller expands on the benefits of supporting mother child bonding from the first moments. She writes: “A woman who has experienced bonding with her child will be in less danger of mistreating him and will be in a better position to protect him from mistreatment by the father and other caregivers, such as teachers and babysitters. Even a woman whose own repressed history has been responsible for a lack of bonding with her child can later help him overcome this deficit, if she comes to understand its significance. She will also be able to compensate for the consequences of a difficult birth if she does not minimize their importance and knows that a child who was heavily traumatized at the beginning of his life will be in particular need of care and attention in order to overcome the fears arising out of more recent experiences.”

At the moment I’m reading Secrets of the Sprakkar, which is an ancient Icelandic word meaning extraordinary or outstanding women, by Eliza Reid, the Canadian wife of the president of Iceland, which is considered the planet’s finest country for women in terms of rights and gender equality. Reid describes how all prenatal care in Iceland is managed by midwives rather than doctors and the Nordic, hands-off approach to pregnancy and childbirth because pregnancy is viewed as a normal and natural state, and extensive research indicates that in low-risk pregnancies, there are fewer medical interventions during midwife-led births than those directed by a physician. Iceland also has one of the lowest C-section rates of higher income countries, at about 16 percent of all births and some of the best overall birth outcomes in the world. She writes: “Iceland does a lot of things well when it comes to having babies. There is an emphasis on the natural process of birth, from soft lighting in the delivery rooms to plenty of pain relief options before an epidural is (sometimes grudgingly) approved….. In most straightforward births, no one is in a rush to remove the baby to record details like length and weight, leaving the infant instead to rest and warm up on its mother’s chest.”

From cradle to death our experiences are in part socially constructed and determined. Eliza Reid herself is the biological mother of four, something she had never anticipated. She writes: “Had I stayed in Canada, I doubt I would have been so prolific in offspring. But in Iceland, somehow, it just seemed so easy to have a child— and then another, and another, and another. Here, comprehensive, midwife-led prenatal care is free of charge; even the nominal fees that usually accompany medical appointments and procedures in Iceland are waived. My husband and I each took several months of parental leave, during which we received payments from the government. When we returned to work full-time, our children were first cared for by a licensed child minder and then at a preschool a five-minute walk from our house, both of which were heavily subsidized by the city of Reykjavík. With these supportive systems in place, we didn’t need to prioritize financial considerations when deciding the size of our family.”

At a collective level this process of acquiring emotional awareness is important because as Miller writes experiencing our legitimate emotions is liberating, not just because of the discharge of long-held tensions in the body but above all because it opens our eyes to past and present reality and frees us of lies and illusions, helps us uncover repressed memories and dispel attendant symptoms. This is empowering without being destructive. Repressed emotions can be resolved as soon as they are felt and understood, and then the need to scapegoat others or project our anger, contempt or hatred on others dissipates. She writes: “The future of democracy and democratic freedom depends on our capacity to take this very step and to recognize that it is simply impossible to struggle successfully against hatred outside ourselves, while ignoring its messages within. We must know and use the tools that are necessary to resolve it: We must feel and understand its source and its legitimacy. There is no point in appealing to our goodwill, our kindness, and a common spirit of love, as long as the path to clarifying our feelings is blocked….The mistreatment, humiliation, and exploitation of children is the same worldwide, as is the means of avoiding the memory of it. Individuals who do not want to know their own truth collude in denial with society as a whole, looking for a common “enemy” on whom to act out their repressed rage.”