Trauma & Art

Edited 10/08/2023

“A new day tainted with old ways.”

“Slowly, it dawned on me that nothing was more important than stopping violence toward women—that the desecration of women indicated the failure of human beings to honor and protect life” Eve Ensler

Most posts in this site are related, to some extent or other, to art or trauma. Today’s post is no exception, but I will be touching upon the very difficult topic of FGM / C (Female Genital Mutilation or Cutting), and thus, it could be triggering or overwhelming for people. I have not included descriptions of the variety and types of procedures included in FGM or graphic descriptions, but  the topic itself and some of the videos suggested below might be triggering. This post is mostly an introduction to increase awareness and maybe inspire people to do their own research and reach their own conclusions.

I have since the previous post been diving in and out of a variety of material and sources, reading some, skimming through articles, watching available videos or documentaries,  exploring art like poetry and fiction. My exploration has been focused more on breadth than an in depth analysis because I myself have found it somewhat difficult and I believe that unless someone is very cynical or completely shut down emotionally this type of trauma and reality are not easy to consider. Even the statistics are overwhelming. Statistics from the World Health Organization (WHO) show that more than 200 million girls and women alive today have undergone FGM in 30 countries in Africa, the Middle East and Asia, where FGM is practiced widely. Worldwide the number is much higher. FGM is mostly carried out on young girls between infancy and age 15 although it can take place later and more than once!. During her TEDtalk Leyla Hussein provides some numbers:  24 thousand girls are at risk in Britain every year, half a million women in Europe have undergone the practice…..  [https://www.youtube.com/watch?v=uiTaA0o-7gY].

I will begin with extracts from a poem I found in the UNICEF and United Nations website pages:

A Poem for the International Day of Zero Tolerance for Female Genital Mutilation

The sun cuts through the morning sky.  //   It’s a new day tainted with old ways.
She sits, quiet, pensive, trying to be brave.  //   She thought she was ready but her beating heart betrays her……..

Hands that once loved and nurtured, now turn hard and cold.
Grandmas, Aunties, Mothers.  //  Carrying on a tradition that maimed them for life.
But still it must be done, the woman’s cross to bear.

PAIN, pain, pain.  //  It shatters her innocence and numbs her dreams.
A pain so deep it lasts a lifetime.  //  It cuts through her future, trimming it down to size.
Until there’s nothing there, just memories of what could have been.

STOP. Rewind. Erase. / / It’s a new dawn.  //  Blades replaced by books and pens.
Fears turned into aspirations.  //   Despair to HOPE.

No more shall she suffer in the name of religion.  // No more will tradition violate her rights.  //  We must defend and protect her childhood.

Arise young girl, a new day has come.

 

 

 

 

 

 

 

 

 

 

The United Nations (UN) clarifies that female genital mutilation (FGM) comprises all procedures that involve altering or injuring the female genitalia for non-medical reasons and is recognized internationally as a violation of the human rights, the health and the integrity of girls and women.  Tragically, millions of women have undergone some type of procedure at least once in their life. It is now well known and proven that girls who undergo FGM face both short-term complications such as excruciating pain, shock, excessive bleeding, anemia, infections, and difficulty in passing urine and walking, post traumatic stress and dissociative trauma responses, as well as, devastating long-term consequences for their overall physical, psychological and reproductive health.

It is known that although it is primarily concentrated in 30 countries in Africa and the Middle East, FGM is a universal problem, practiced widely in some countries in Asia and Latin America, and persists amongst immigrant populations living in Western Europe, North America, Australia and New Zealand. In Victorian societies some of these procedures were routinely carried out to ensure the ‘chasteness’ of women.  So, these practices have taken place in white Western societies as well, at least up until the 60s. The current findings suggest that although there are hot spots and places where it is extensively practiced, it is in fact a global issue. Skimming through the literature and research articles one soon understands that it occurs in European countries and other Western countries for several reasons, one being the fact that when people immigrate to other countries they very often carry their customary practices with them.

Activities, initiatives and research are, to some extent or other, taking place in many European countries.  For instance, the objective of the research work conducted by Ivana Hrvatin and her team in Slovenia was to review literature published the last decade on FGM consequences, describe and assess the theoretical and methodological approaches to treatment options and the different methods that aim to stop or reduce the continuation of FGM. They found that globally the prevalence is declining, as many actions from legal to community based programmes are being proposed. They discerned that the many known consequences, can be divided, as mentioned above, into short and long term. They found that there are treatment options documented in the available literature, but the quality of these studies were poor. Even so, there are both treatment options and guidelines of how to treat women with FGM, but health care professionals need to become both informed and sensitive to treating it, and also, able to inform women about the possible consequences and legal aspects. Finally, efforts need to be made to raise awareness and encourage open communication in society.

Specifically, the UN suggests that over the last 25 years, the prevalence of FGM has declined globally and that it could be eliminated by 2030. The Orchid Project, a British charity, also promotes a message that FGM / C can end within a generation.  Orchid Project have stated that FGC can end through the idea of “organised diffusion”, where change is led by communities, and the process of dialogue between communities leads to social change. They cite similarities between how footbinding ended and FGC and how the right conditions can motivate mass change: “As with footbinding, public declarations of abandonment are vital to solidify any commitment to ending FGC. When a group of people stand up and publicly declare that they will no longer practice FGC, they are held accountable by everyone.”

The eradication of entrenched longstanding practices would require a joint effort by governments, institutions and organizations. Men would need to be informed and convinced of the detrimental effects of these practices deeply rooted in patriarchy, the need to control women and ignorance. Through open communication and raising of public awareness, secrecy, denial or dissociation of the pain and the consequences, but also the fear of being ostracized by their communities if they decide differently, could be overcome. “Their [Men’s] voices and actions can transform deeply rooted social and gender norms, allowing girls and women to realize their rights and potential in terms of health, education, income, and equality.” (United Nations website).  As one can understand breaking the heavy silence around FGM is imperative. One basic factor that upholds it is the imposed silence around it. It is important to remove the fear of death, punishment, stigma and ostracizing. Hibo Wardere author of the book,  Cut: One Woman’s Fight Against FGM in Britain Today writes: “There is an old Somalian proverb which says: ‘You can’t hide a dead body from its grave’. Its meaning? You can’t hide from your problems. Abuse thrives in secrecy, whereas out in the open it wilts and dies. The more we can bring abuse of any kind out into the world, where we can examine it and talk about it, the more likely we are to see the back of it.”

FGM is condemned by a number of international treaties and conventions. Article 25 of the Universal Declaration of Human Rights states that “everyone has the right to a standard of living adequate for health and well-being,” and this statement has been used to argue that FGM violates the right to health and bodily integrity. Defining FGM as a form of torture brings it under the rubric of the Convention against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment. Moreover, regarding FGM as a traditional practice prejudicial to the health of children and minors, it violates the Convention on the Rights of the Child.  Fortunately, national legislations against FGM are also in place in many countries, but further coordinated and systematic efforts that would engage whole communities and would focus on human rights, gender equality and the consequences suffered by girls and women, and ultimately families and communities, are required to eradicate FGM.

An important early voice against FGM was that of Fran P. Hosken [born in Austria, 1920-2006], an American designer, writer, feminist, and social activist, who founded the Women’s International Network in 1975, and published a journal on women’s health issues that became known, in particular, for its research into FGM in an attempt to end the practice. Hosken became aware of the problem in the early 70s when she went to Africa as an urban planner. The Hosken Report [1979 / over 400 pages] was the result of extensive research and field work that established that more than 74 million women and female children are mutilated by female genital operations in Africa alone. They found that the operations were also practiced in many parts of the Middle East and Indonesia and Malaysia where they were performed at the time in a less damaging form. This paper lists the countries where instances of FGM had been reported and includes case reports from many countries. The ethical issues posed by genital mutilation are also discussed.

Hosken critiqued patriarchal power and theories of misogyny that underlie many of these practices. She was the first to link domestic violence and FGM. She wrote: “What needs to be examined is what influence such customs have on the character formation of boys who learn such behavior from their fathers.”  She believed that liberty concerns all and she believed in the individual’s rights to health and bodily integrity.  She rejected cultural relativist “tolerance,” and opposed the growing trend to “solve the problem of FGM” through medicalization. Through emphasizing the threat to health rather than gender inequality, some advocates hoped to avoid the aggression or resistance that direct attacks on patriarchy could evoke and believed that pointing out the negative physical consequences of FGM would suffice to bring about change. However, she discerned the fact that even though the medicalization of FGM/C, proposed by some health professionals, could reduce the incidence of its complications and remove the torturous pain during the process, it would not reduce the long term complications of FGM. She also claimed that its performance violated the code of medical ethics, and ultimately, it would result in a setback in the global efforts to eradicate this harmful practice.

Even though I have no doubt in my mind that FGM is a form of violence, a means of control that is detrimental to women’s health and psychological well-being with effects rippling out into the familial and broader social environment, I can understand where the people that perceive FGM as a rite of passage and a practice culturally approved and steeped in tradition may come from and the multiple underlying reasons. It is therefore, important to formulate culturally sensitive plans of action for the total eradication of female genital cuttings because ultimately, when all is said and done, they are forms of mutilation, a violation of basic human rights with severe physical and emotional consequences. As one African survivor and activist for the eradication of FGM noted… culture is music, art, food….. I would add that it definitely is not violence passed down from one generation to another. Additionally, there is no religious book or scripture that proposes FGM. It is a means to control and to keep subjugated.

I also read Greek and Cypriot articles I found online. ΑΓΓΟ is the Greek term for FGM. There was a lot of emphasis on the fact that the medicalization of FGM is not a solution.  According to Dr. Christina Kaili [researcher and program coordinator at the Mediterranean Institute for Gender Studies and Specialist Scientist at the Department of Social and Political Sciences of the University of Cyprus] “there are indications that at least in three European countries, namely the United Kingdom, Italy and Switzerland , doctors or traditional healers have mutilated girls. There are many other countries where doctors may be practicing this practice illegally. The European Parliament and the World Health Organization have condemned the medicalization of the practice. With or without anesthesia, FGM violates the rights of the woman / girl. Doctors do this either out of ignorance or out of fear of interfering with what they misunderstand as “cultural tradition”. European countries must develop guidelines for the training of doctors, midwives and gynaecologists; thus combating the ignorance that characterizes their decisions. Repeating the practice after childbirth cannot be carried out under any circumstances, as it is against Medical Ethics, puts the woman’s health at increased risk and is a criminal act in some EU member states.”

As I mentioned above, FGM does not only hurt girls, from infancy on, and women, but its diverse effects ripple out. For instance, according to the World Health Organization (WHO), FGM exacts a crippling economic as well as human cost. (https://www.who.int/news/item/06-02-2020-female-genital-mutilation-hurts-women-and-economies)  Dr Ian Askew claims that “FGM is not only a catastrophic abuse of human rights that significantly harms the physical and mental health of millions of girls and women; it is also a drain on a country’s vital economic resources.” It has been calculated that the total costs of treating the health impacts of FGM would amount to 1.4 billion US$ globally per year, which for individual countries would near 10% to 30% of their entire yearly expenditure on health on average.

ART: Books, Films, Documentaries

** Two filmmakers, Nabaz Ahmed and Shara Amin, spent almost a decade reporting the greatest taboo subject in Kurdish society: female genital mutilation. Τhey persuaded people to talk about the effects of FGM and the film they made helped get the practice outlawed in 2011 and decrease the practice by over 60%. The story of their decade-long fight against FGM has been made into a documentary by the Guardian and BBC Arabic (https://www.theguardian.com/society/video/2013/oct/24/fgm-film-changed-the-law-kurdistan-video)

**  The film, A Girl from Mogadishu, is a true story inspired by the life and work of  activist Ifrah Ahmed. The film follows Ifrah from childhood in a refugee camp in Somalia where she was born and subjected to FGM, to Ireland where she is eventually given political asylum. She then goes on to become one of the world’s foremost international activists against gender-based violence.

** The film Efun (Flesh) by Anita Abada from Niigeria was part of the WHO Film Festival and it won the 2021 prize for health educational film for youth

** The documentary CUT: Exposing FGM  by Dr John Chua. In this film we understand that FGM is not an African or non Western country problem only, but since Victorian times it has been practiced in White cultures and societies, too. Dr Renee Bergstrom talks about her experience of FGM in 1947 at the age of three performed by a doctor. We get to learn about famous proponents of these practices like Dr Isaac Baker Brown and Dr John Harvey Kelloggs [19^th and 20^th century].

** American writer Alice Miller brought the issue of FGM to the attention of the public in 1992 with her novel, Possessing the Secret of Joy.

To conclude, one cannot consider or discuss FGM without touching upon the darkest and deepest wounds of society. One cannot discuss or think about FGM without including gender inequalities, sexism, racism, patriarchy, control and social and economic oppression. FGM is in some sense a means to massively generate post traumatic stress. It does not harm the victims only, but spreads like a virus and compromises the growth and thriving of families and communities.

July 18th, 2023

A biopsychosocial approach

“Much of each brain’s circuitry at any given moment in adult life, is individual and unique,  truly reflective of that particular organism’s history and circumstances” Antonia Damasio

The infant who has attained calm attention has taken a first gigantic step on the road to fulfilment of her human potential” (Stanley Greenspan, cited in Mate)

“Although we think of attention as a function of the intellect, its deepest roots are in the subsoil of emotion.” Gabor Mate

Today’s post is about a book I’ve been reading by Gabor Mate: Scattered Minds: The Origins and Healing of Attention Deficit Disorder (2019). It also includes three new drawings inspired by Greek actresses of the past and a poem  by late  actress and poet Katerina Gogou.

Look how the roads get lost by Katerina Gogou (1981)

Look how roads get lost   /   within humans
how cold the kiosks  get   /   from the wet newspapers                          how the sky  /  is punctured  by the cables

And how the sea ends / from the weight of the ships
how sad the forgotten umbrellas stand   / on the last ride

And the mistake of the one that got off  /  at the wrong stop
the clothes left at the drycleaner’s  /  and your shame
after finding the money two years later / to  ask for them
how little by little  /  gradually, methodically  / they shape us
so that we determine our position in life  /  depending on the style of the chair

 

 

 

Gabor Mate is a retired physician, writer and speaker. His analysis in this book is, according to his own words, an attempt to synthesize the findings of neuroscience, developmental psychology, family systems theory, genetics and medical science, cultural and social trends and his own personal experience as a husband, parent and successful and respected family doctor, who was diagnosed with ADD in his fifties.  His three children have also received the diagnosis.  Before I go on I’d like to say that I think that the book could also be read as an example of how to avoid simplistic explanations and how to apply a more holistic biological and psychosocial approach to analyze and explore many facets of human experience.

A great part of the book is an exploration of the contributory factors. In the introduction Mate states that he believes that it is not, as often stated, a matter of genes or bad parenting; however,  both genes and parenting play a role. He believes that there is in ADD a predisposition [making it more likely depending on circumstances], not a genetic predetermination. He states that as many other things genes can be activated or turned on in the environment, but there can also be protective factors in the environment. He explains that although diabetes is considered to have a heredity component this cannot account for the pandemic among Canada’s native people and North American populations, for instance.  He also discusses problematic aspects of research findings in twin studies. He writes: “Neuroscience has established that the human brain is not programmed by biological heredity alone, that its circuits are shaped by what happens after the infant enters the world, and even while it is in the uterus. The emotional states of the parents and how they live their lives have a major impact on the formation of their children’s brains, though parents cannot know or control subtle unconscious influences.”

Broadly speaking the major features of ADD are poor attention skills, deficient impulse control and hyperactivity.  Mate describes how this higher level of distractibility can foster chaos and lack of order both in our lives and physical spaces. However, he clarifies that absentmindedness [and all other manifestations of ADD] are on the continuum of normal human traits and life would not be possible without our being able to shut out a large number of stimuli. Also, ADD can be situational, which is interesting and important to consider, especially, for students in educational contexts. Distractibility may not be consistent in all areas or subjects and one can have a hyper concentrated attention when it comes to subjects and activities they’re interested in or when the environment is conducive to learning.

In chapter 14, distractibility is discussed in relation to natural defenses and responses like fight- fight-freeze and dissociation and what happens when an infant through chronic distress and non optimal experiences needs to resort to these too often. Mate writes the infant cannot exist in a state of chronic negative arousal with adrenaline and other stress hormones pumping through its veins all the time, it needs to block it out, but the survival value of these psychological defenses are short lived. If this happens too often it becomes the default setting in the cerebral apparatus of awareness. Mate writes that nobody is born with “attention” and that being attentive is a skill like language or locomotion that children acquire through their relationship with the environment.

Hyperactivity is unregulated high arousal, appropriate in the young toddler. However, it is meant to be a stage and not a state that the child gets stuck in.  Mate claims that throughout our life it continues to be a human response during times of high anxiety, but again it’s not meant to be a constant state. It is usually expressed by difficulty keeping physically still, but can also take forms that are not obvious to the observer,  and it is not a requirement for diagnosis. He claims that it may be absent in a minority of cases, especially in girls. He writes that people with ADD experience their mind as a perpetual motion machine. They may have an intense aversion to boredom and higher levels of procrastination. Other manifestations of ADD might be rapid speaking, hopping from one topic to the other, and difficulty being succinct and brief when expressing an idea.

In chapter 5 Mate explores another feature that might be present, which is time illiteracy or what others have termed as time blindness and which can be a source of distress for people with ADD. This could involve always being late and rushing, believing one has all the time in the world and not being able to calculate the time required for an activity or living as if only the present exists and nothing else needs to be taken into account, often neglecting to consider the consequences of actions. The chapter also focuses on poor emotional regulation and impulse control and presents the neuroscience behind impaired ability in these areas. For instance, a major task of our prefrontal cortex is inhibition – the evaluation and selection or inhibition of the myriads of sensations and impulses reaching it from the environment, our body and lower brain centers.

Mate asserts that in ADD the cortex is functioning at a semidormant level, which explains the use of stimulant medications. He also clarifies that a complex condition like ADD cannot be traced in one part of the brain and in a later chapter he discusses the implication of specific areas like the orbital prefrontal cortex (OPC), which among other things is the centre of the brain’s reward and motivation apparatus and is also connected with the vision centers of the cortex that play a role in visual spatial orientation mentioned above.  He describes his own difficulty conceptualizing in three dimensions or divining the spatial relationship of things. The OPC also stores the emotional effects of experiences, and first and foremost, the infant’s interaction with primary caregivers, which become an unconscious model for all our later emotional interactions, for better or for worse, until we can become aware of and disrupt the patterns.

Mate uses vignettes from patients, friends and his own experience to describe what living with ADD might feel or look like for different people. As I read through the book I could not help thinking that there was an overlap between what was described and discussed here and other diagnoses like post traumatic stress or other clusters of symptoms / experiences, and that maybe ultimately, our priority should be the healing, resolving or managing of whatever experience or cluster of characteristics people present with that are causing them problems, discomfort or difficulty in living more optimally, especially, in our contemporary societies. As I mentioned above,  I felt that a lot of what is discussed in the book goes beyond ADD and provides a holistic perspective of examining or viewing our human experience.

Early on in the book Mate critiques the DSM for defining ADD for its external features,  which are referred to as symptoms,  not the emotional meaning in the lives of those that experience it because as he notes “The DSM is concerned with categories not with pain” (Dan Siegel). He also writes that what begins as a problem of society and human development has become almost exclusively defined as a medical ailment. He points out that even if in many cases medication can help, especially for a certain period, the healing that the ADD experience calls for is not a process of recovery from some illness. He suggests that “ADD defies categories of normality and abnormality. If anyone who exhibits any trait of it were to be diagnosed with ADD, we might as well put Ritalin in the drinking water…” and that learning about the psychological and biological mechanisms of ADD only gives a map to the self, but the map is not to be confused with the journey.  Our aim should be once we recognize this map to support the child, for instance, to fulfill its potential.

In chapter 3 Mate refers to the skepticism about ADD and the actual prevalence of ADD because all features of ADD are found to one degree or another in the non ADD population, and that lumping a group of personality features in a psychiatric manual  does not establish pathology. He quotes L.J. Davis who writes in relation to current psychiatric diagnostics and manuals that “every aspect of human life (excepting of course the practice of psychiatry) can be read as pathology.” In relation to “the spreading like wildfire fire” diagnosis of ADD mostly in countries like Canada, Northern America and the UK, Mate asks the question: Are children being drugged to suit the convenience of adults?

He writes; “Even for those, such as myself, who recognize the existence of the neurophysiological and psychological impairments conjointly named Attention Deficit Disorder / ADD, there are legitimate questions to be asked about the way it is diagnosed, how it should be understood and about its treatment, as well as, the tendency to bury many problems under tons of medications, preferring to ignore the social and cultural causes of people’s  stressed mental states, and the blaming of shortcomings or problematic experiences on biology and chemical imbalances. Therefore, it is important to wonder about the reasons there is so much emphasis on biological explanations and oversimplification of complex processes, and also, to realize that we need to tease apart layers of causality and dig below the presenting neurochemistry, for instance.  Mate quotes Dan Siegel who has remarked “We hear it said everywhere these days that the experience of human beings comes from their chemicals.”

As I said a big part of the book is devoted to exploring the causes that can contribute to or turn on any inherited predisposition for ADD. Through his personal narrative Mate points to the environmental roots of attention deficits and to the fact that love is not enough when parenting. In chapter 4 he writes about how unexpressed emotional conflict and unresolved grief and ignorance can result in unintentionally passing down from generation to generation less than optimal experience. He is candid about his own workaholic tendency, distractedness, feeling of duty towards the whole world, intense need to be liked, all of which provided him with a constant adrenalin rush, but had a negative impact on his family. He situates himself in relation to dynamics in his own marriage and family life, to show how despite the love  unresolved traumas and conflict of parents can have a less than optimal impact on their children, and also, how through a lot of hard work and new awareness his family was able to navigate this and be at a different place today.

Also a significant perspective presented by Mate in the book is the importance of viewing the ADD experience through developmental lens because as he claims once we recognize ADD as a problem of development (arrested in younger modes of functioning) rather than pathology, we are taken to a different direction from the illness model. For instance, hyperactivity is a normal stage of maturation of a child, but in ADD stages become states. When we recognize that time sense, self regulation and self motivation, for instance, are nature driven developmental tasks we can ask more appropriate questions like:

What conditions are needed for human psychological and physiological maturation and what conditions could inhibit or interfere with this growth process?

Mate cites child psychiatrist Stanley Greenspan who says “So few children grow up in truly optimal circumstances that we have no idea of what the parameters of development really are.”  The concentration of developmental problems may be both due to circumstances and to the fact that people are affected differently by similar conditions depending on their sensitivity level and temperament. Also, he reminds us that no two siblings grow up in the same environment since circumstances and parents change. In addition, we need to take into account that often parents have different unconscious attitudes towards each of their children and that siblings experience their parents differently.

There’s a chapter in the book on sensitivity, in which Mate explains that what is transmitted genetically is not ADD, but sensitivity and that the existence of sensitive people is an advantage to humankind because it is this group that best expresses humanity’s creative urges and needs. Mate claims that there would be valid and powerful evolutionary reasons for the survival of genetic material coding for sensitivity, and therefore, it is not a weakness or disease that is being inherited but a trait for intrinsic survival value to human beings. Furthermore, it has been observed that people on the continuum of ADD can have strengths like creativity, curiosity, conversational skills, high energy, hyper focus, spontaneity, nonconformity and resilience. They can be imaginative, inventive and resourceful.

In chapter 8 Mate analyses how basically the microcircuitry of the brain is formed by influences during our early years and that even the brains of identical twins will differ in terms of the shape of their nerve cells or the numbers and configurations of their synapses. He explains how our genetic potential for brain development can find its full expression only if circumstances are favorable. He describes what a favorable environmental for an infant might require. Apart from nutritional needs and shelter requirements, a secure safe and not too stressed emotional atmosphere is also necessary [which he notes is most likely to be disrupted in Western / industrialized societies] in order for the maturation of the human brain and nervous system to take place. He writes that one significant reason for the disturbingly high prevalence of ADD conditions in Western countries, especially, in North America, is the gradual destruction of family by economic and social pressures. He quotes Hallowell and Ratey to suggest that culture can feed and reinforce ADD and make ADD driven behaviours seem desirable and rewarding.

This chapter leads on to the next on attunement, which is the component of a larger process called attachment, which is essential for survival. The drive for attachment is part of the very nature of warm blooded animals in infancy, especially of mammals. Mate interestingly notes that ADD may equally stand for Attunement Deficit Disorder and that “attachment promotes attention, anxiety undermines it.” He highlights the fact that one-to-one attuned parenting is the ideal situation for child development in the early years, something which is not supported in most industrialized (Western) societies. He clarifies that the need of the young child for close parental contact does not mean the ghettoization of women at home. He also describes how he has made sense of his ADD traits in the light of his own early years and how being separated from his own mother for a short period of time as a newborn during the World War II impacted him and his mother. He adds that we don’t need a war and genocide for mothers to be stressed out and fathers to be absent or for women to be burdened with the full responsibility for the family’s emotional well being or for trauma to have occurred.

“The generations are boxes within boxes…”

Chapter twelve delves into intergenerational dynamics and how both positive and negative experience is passed down from one generation to another. He writes: The family as an institution has been put under enormous strain by vastly powerful forces in our society and culture. If we want to find the source of ADD that is where we need to look, but the family is the most immediate environment to act on us….  He concludes that in order to understand ourselves and our childhoods, we need to consider the positive and negative effects that our grandparents’ unconscious processes, attitudes, behaviours and circumstances had on our parents. When we do this we eventually realize that blame becomes meaningless and what is more important is the making sense of our experiences and the disruption of patterns.

To conclude, the second part of the book is focused on the possibilities of healing or growing out of ADD. However, I will end the post because it has evolved into a lengthy narrative.