Working with Traumatic Memories to Heal Adults with Unresolved Childhood Trauma

Neuroscience, Attachment Theory and Pesso Boyden System Psychomotor Psychotherapy

Jonathan Baylin, Petra Winnette

• Publisher: Jessica Kingsley Publishers
• Year: 2016
• Print ISBN: 9781849057240
• eBook ISBN: 9781784501822
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

What potential does psychotherapy have for mediating the impact of childhood developmental trauma on adult life?

Combining knowledge from trauma-focused work, understandings of the developmental brain and the neurodynamics of psychotherapy, the authors explain how good care and poor care in childhood influence adulthood. They provide scientific background to deepen understanding of childhood developmental trauma. They introduce principles of therapeutic change and how and why mind-body and brain-based approaches are so effective in the treatment of developmental trauma. The book focuses in particular on Pesso Boyden System Psychotherapy (PBSP) which uniquely combines and integrates key processes of mind-body work that can facilitate positive change in adult survivors of childhood maltreatment. Through client stories Petra Winnette and Jonathan Baylin describe the clinical application of PBSP and the underlying neuropsychological concepts upon which it is based.

Working with Traumatic Memories to Heal Adults with Unresolved Childhood Trauma has applications relevant to psychotherapists, psychologists and psychiatrists working with clients who have experienced trauma.

Part I

BACKGROUND

We open this book by providing a context for further discussion on therapeutic change and Pesso Boyden System Psychomotor therapy. We focus on normal development, the importance of attachment and the role of memory in this process. Then we introduce how early trauma interferes with development. With this background we can understand the origin and nature of trauma-related difficulties later in life and the goals and interventions of therapy to resolve them.

Chapter 1

WHEN THINGS GO RIGHT

Developing Brain, Mind
and Self in Good Care

Petra Winnette

How the brain develops

People want to know the best way to bring up children and how childhood influences adulthood. Is it based on genes or does it depend on parents? Neuroscience shows us how the brain develops and how the genetic template gets activated and functioning through interaction with the outside world.

The architecture of the brain is composed of highly integrated sets of neural circuits (i.e., connections among brain cells) that are ‘wired’ under the continuous and mutual influences of both genetics and the environment of experiences, relationships, and physical conditions in which children live. Experiences ‘authorize’ genetic instructions to be carried out and shape the formation of the circuits as they are being constructed. This developmental progression depends on appropriate sensory input and stable, responsive relationships to build healthy brain architecture… If the responses are unreliable, inappropriate, or simply absent, the developing architecture of the brain may be disrupted, and later learning, behaviour, and health may be impaired. (National Scientific Council on the Developing Child 2012, p.1)

A lot of attention is paid to the question of what it means to be a well-functioning, happy and healthy adult. It includes having a meaningful life, being good at work, enjoying relationships with others and being a good parent. How do people get there? What qualities do they need to develop to be able to live that way? John Bowlby, founder of attachment theory, wrote:

During the past decade or two a number of clinicians have turned their attention to the study of individuals who, it is reasonable to believe, possess well-functioning and healthy personalities… First, these well-adapted personalities show a smoothly working balance of, on the one hand, initiative and self-reliance, and, on the other, a capacity both to seek help and to make use of help when occasion demands. Second, an examination of their development shows that they have grown up in closely knit families with parents who, it seems, never failed to provide them with support and encouragement… Whilst autonomy is evidently encouraged in such families, it is not forced. Each step follows the previous one in a series of easy stages. Though home ties may be attenuated they are never broken. (Bowlby 2005, pp.128–129)

Stages

Early development in children is strongly influenced by the quality of the bonds they form with caregivers.

The mind emerges from the activity of the brain, whose structure and function are directly shaped by interpersonal experience. (Siegel 1999, p.1)

If things go right, when a baby is born he is wanted, welcomed and cared for. Someone is there, in the ideal situation a loving mother and father. They are immediately engaged and stay that way for a long, uninterrupted time. In the beginning the mother is usually the one who does everything for us. But we also belong to a father and we belong within our extended family and society. As time passes a child learns to master different aspects of life and becomes more independent. Early interactions with parents or primary caregivers build the foundation for later developmental tasks (van der Kolk 2014).

There are stages or a sequence of when and how different parts of the brain mature and connect. This development follows a genetic programme. We can compare it with the growth of a tree. If the seed is healthy and it gets all it needs, the tree will grow. First, the trunk and root system develop. The health of the tree depends on the strength of these structures and the suitability of the environment. The tree will add another layer of bark every year. Then there will be strong, large branches, tiny branches and leaves.

The brain also develops in a hierarchic manner. It starts from bottom up, elaborating the original structures and adding new ones. The first circuits to develop are simple and later become more complex and intricately connected. Every part of development leads to new competence which builds upon previous abilities. This organic process starts at conception and continues into adulthood.

Emotional well-being and social competence provide a strong foundation for emerging cognitive abilities, and together they are the bricks and mortar that comprise the foundation of human development. (Center on the Developing Child at Harvard University 2009, p.5)

Senses and social connecting

Sensory pathways, such as hearing, vision and touch, are the neural pathways that develop first. The sense of touch, for example, is well developed at birth. Science writer Lydia Denworth in an article for Scientific American Mind magazine points out the essential role of touch at the beginning of life as a base for developing social connections (Denworth 2015).

Affective touch is a potential way in to understanding the development of the normal social brain… It is giving the brain knowledge of me and you, and the emotional quality of gentle nurturing touch is a very important feeling that underpins a lot of social interaction. (McGlone, Wessberg and Olausson 2014, p.32)

When a mother touches her new-born with love and tenderness, it gives the brain sensory and emotional information. There is me and you; you are not alone; we are connected. Touch may be soothing, calming and pleasurable. Neuroscientists discovered that even a very young baby discriminates different types of touch. They sense a tactile difference between a blanket and skin. They distinguish the emotionally rich, loving touch of mother from touching fabric. There are special nerve fibres which recognise this difference and they serve in the development of attachment between a new-born and his mother (McGlone et al. 2014). By being held and touched the infant feels the closeness of the other person and safety. Other senses, such as smell, hearing and vision, also serve to connect the infant with his mother. These early connections further the development of other brain circuits which will contribute to bonding as well. The growth of sensory pathways is followed by development of language and other higher cognitive functions. The competencies which come to life later stand on the shoulders of the earlier ones (Center on the Developing Child at Harvard University 2009). As we will see, if the first stages are impaired, later functioning will be adversely affected.

Mother Rat: Licking and touching promotes resilience and strength

Michael Meaney, researcher at McGill University, studied rat mothers and compared rat pups who were well cared for with ones who were not. He especially focused on the licking and cleaning of pups, which provides lots of sensory experiences. He divided healthy rat pups into three groups. The first group got a lot of care from the mother rat. Researchers found that pups who had a lot of licking and cleaning in the first twelve hours of life developed very well. They could better modulate their level of cortisol, one of the stress hormones, for example. They were calmer and better able to explore and learn about their environment. They developed lifelong, optimal functioning. Pups from the second group had fewer touches in their first twelve hours. As a result they had a less developed system for regulating the level of cortisol and they suffered consequences from this for the rest of their lives. They performed in a restless, hyperactive way, displayed anxiety and had a high readiness to become stressed. They were afraid to overcome obstacles and explore. The third group was separated from the mother altogether. These pups ended up being numb, unresponsive or in extreme stress (Meaney 2010).

Meaney’s experiment with rat mothers and pups showed that rats which were not touched and licked did not develop the resilience, balance and strength necessary to cope with life. This suggests that early lack of care prevented realisation of the genetic program for optimal development. Describing human development Allan Schore, from the clinical faculty of the Department of Psychiatry and Biobehavioral Sciences, UCLA, concludes that interaction between the young child and his parents (caregivers) shapes the expression of genes. This occurs because the interaction induces production of hormones which directly impact gene transcription which, in turn, directs development of neuronal connections and circuits (Schore 1997). Thus, stages of development are determined by genes but the expression of genes and the resulting rate and extent of development are significantly affected by environmental factors including social interaction. To sum it up briefly, development depends on interaction with the outside world (Center on the Developing Child at Harvard University 2009). For a more detailed picture of neurobiology and the early stages of brain development, see Jon Baylin’s window to the neurobiology of good care at the end of this chapter.

Memory: The basis for learning and understanding the world

Lovijs Perquine, Dutch psychiatrist and psychotherapist, describes memory as a huge database of information. In humans the estimated memory capacity is 100 trillion bits of information. Stacked, they would make up a tower some 100 kilometres in height. We use this information to make sense of current situations.

First we had to learn to remember what is edible. A 16 month old child will put a piece of mud pie in its mouth. A two-year old will not. Monkeys that eat a large number of different tree-fruits have a large visual memory capacity and a correspondingly large brain area… A person walks through a dark alley at night and feels goose pimples and a sensation of tension between his shoulder blades. The echo of his own footsteps is unconsciously associated with a mugging that happened ten years ago. Sensorimotor and kinesthetic stimuli and experiences, like auditory and visual stimuli, are stored in memory. Every time we detect a physical sensation, it connects with previous physical sensations and experiences gained in the past. (Perquin 2004, p.126)

Without long-term memory the interpretation of current sensory information would be impossible (Perquin 2004).

The role of memory

Memory shapes our present experience and expectations for what will happen in the future:

The purpose of memory is to predict the future. (James McGaugh, University of California, in Kaku 2015, p.113)

Our understanding of ourselves and the world is unthinkable without long-term memory. People may assume that memory is a database of events as they actually happened, a mirror of reality. But memory is a neurobiological system which does not simply record an event like a camera or tape recorder. Rather it encodes how the individual person experienced the event. Milner, Squire and Kandel conclude that the structure of the brain is unique to each individual because it was shaped by the individual experiences. The individual history is encoded in the brain and its structure (Milner, Squire and Kandel 1998). People have different experiences and encode experiences differently too. For example, several children in a family may remember the same event in the family very differently. This is because each has their own unique lenses and filters which impact how an event is recorded and later recalled.

Memory is a complex system which activates neural patterns and forms connections between them and thereby encodes our experience of the world, including our experience of ourselves. As we experience an event, memory is built to keep this experience, if it is somehow deemed significant, and reopen the recording when it might be useful or triggered by an associated event. Memory thus serves as a tool which stores experiences and uses them when responding to the outside or the inner world (Siegel 1999).

Human beings learn on many different levels and continue to learn throughout life. As with other parts of the brain, memory and its different systems and functions develop in a hierarchic manner. There are many different levels of memory. Each has its own unique role in the encoding and use of information.

The hierarchic development of memory

Implicit memory

Implicit memory is one of the brain systems which develop before birth. New-borns perceive the world. They have the capacity to remember their experience with behaviours, sensations and emotions and learn from their experience (Bauer 1996; Fivush and Hudson 1990). Learning is only possible when there is a memory system which keeps the information for later use. Infants can perceive sounds, smells, internal physical sensations and touch and react to them. Memory which records this information is called ‘implicit’. It is available at early stages of devel...

Table of contents

• Cover
• Title Page
• Contents
• Introduction
• Part I: Background
• Part II: Pesso Boyden System Psychomotor as a Therapeutic System
• Part III: PBSP Clients’ Case Studies
• Part IV: Interview with Albert Pesso, Co-Founder of PBSP
• Appendix
• References
• Subject Index
• Author Index
• Acknowledgements
• Dedication
• Copyright
• Of Related Interest