Harmonious Momentum

In three words I can sum up everything I’ve learned about life: it goes on. — Robert Frost

When discussing the fundamental differences between adaptive and maladaptive behavior, it’s necessary to understand that maladaptive behavior typically emerges as an adaptive response to undesirable stimuli. A behavior or thought process is often considered maladaptive retrospectively, after a period of negative psychosocial consequences have been assessed and significant impairment in functioning has occurred. However, I would submit that every behavioral response is adaptive during the initial stages of trauma and less-than-optimum cognition may have been useful at one time. The brain’s reaction to trauma depends on a variety of genetic and environmental circumstances, but general responses to trauma often involve an inability to emotionally shift past the primary event. “Neurons that fire together wire together” is a neuroscience axiom that emphasizes the impact traumatic events can have on memory. As such, memory influences emotion, and the ability to reconcile an event may vary based on the type of trauma, the intensity of the trauma, and the sensitivity of the individual.

The psychologist Francine Shapiro refers to the concept of adaptive resolution as a functional integration of trauma processing when describing EMDR intervention.* Although she does not claim to reveal the neurological mechanisms involved with dysfunctional memory storage, she does refer to a static-state phenomenon where the brain indefinitely recycles a disturbing event when triggered by various environmental cues.¹ For the sake of conceptualization, I would say that reconditioning the limbic system is another way of thinking about trauma reconciliation. From a localization perspective in neuroscience, the amygdala is considered the brain’s hotspot for emotional reactivity and the hippocampus works primarily as a memory storage component. However, what’s not often mentioned is the limbic system’s role in determining things worth ignoring, since this job is usually outsourced to the brain’s cortical regions. The amygdala, for example, also plays a role in identifying when we should relax instead of being paralyzed with fear. In other words, if all systems in our limbic apparatus are running smoothly, hypervigilance should be countered by due diligence. Problems arise when a significantly disturbing event overrides the regulatory responses of neuroanatomical correlates so that a checks-without-balances effect takes place.

Victims of trauma have described the experience of grief as “a desire to stop time,” while witnessing horrific events or enduring physical abuse has been know to induce a sensation of “everything slowing down.” It should be obvious that the brain is protecting itself by adaptively switching off select regions of activity to focus attention on primary concerns for purposes of securing safety and allowing space for comprehensive introspection. Unfortunately, this well-intended adaptive response can overstay its welcome, and what was once useful can outlive its usefulness … hence becoming maladaptive. Of course, something clearly was moving too quickly or too abruptly for processing during the traumatic event, so it’s only natural for the victim to respond to incoming stimuli with subsequent trepidation. Unfortunately, the world and everything in it continues to move like a whitewater rapid steeped in indifference (this is why the rejoinder “get over it” is considered a tasteless and ineffectual form of motivation).

Incorporating a useful analogy at this point may demonstrate how the body and brain can unintentionally act against its own self-interest. For example, in cases of arthritis and encephalitis, the physiological response to antigens is inflammation. Inflammation alerts the body that a problem exists and ensures limited movement on behalf of the host, but long-term inflammation with arthritis can cause worse problems such as further tissue damage and chronic pain. In addition, seizures, coma, or death can result when the inflammatory response to encephalitis runs rampant. Similarly, behaviors and thought processes that initially serve to safeguard well-being can invariably implode when their expiration date is not realized.

The body is a dynamic system, and the mind is what the brain does. With maladies such as PTSD, depression, or substance abuse, the person suffering may refuse to move, can’t move, or (more often) doesn’t know how to move. Facilitating mental vitality to offset stagnancy is the key to uprooting negative experiences, because the byproduct of persistent engagement leads to improved daily functioning and eventual acceptance via psychologically congruent processing. Incremental change based on subtle realizations can, in turn, reverse engineer the cognitive constipation of traumatization when maladaptive responses that were originally meant to be adaptive are adaptively reconfigured.

In two words I can sum up everything I’ve learned about recovering from unfortunate life events: keep moving.

1. Shaprio, F. (2001). Eye Movement Desensitization and Reprocessing. Second Edition. New York: The Guilford Press

*non-specific effects notwithstanding

Image by Lori Anne Parker-Danley. Thicket, 2015. Gauche and oil pastel on paper, 15 x 22 in.

Salubrious Byproducts

We can only see a short distance ahead, but we can see plenty there that needs to be done. Alan Turing

Some of the best ideas are simple but counterintuitive. Charles Darwin’s theory of natural selection established how complexity could emerge from simplicity and overturned previous assumptions regarding trickle-down causality. Likewise, the polymath Alan Turing demonstrated a computational approach for constructing basic algorithms that revolutionized computer science and the future of artificial intelligence. Even the most elegant architecture in the world began with rudimentary drafts developed over time while being constructed incrementally. Progress requires the application of consistency when sculpting desired outcomes.

In therapy, progress often takes a sawtooth form and therapeutic insights that encourage change can also cause behavioral or emotional relapse when conditioned responses are fully exposed. The instant gratification of impulsive living often prevails when the banality of slow improvement loses its magnetism. Sometimes the task of reverse engineering cognition and behavior is overwhelming, frustrating, and seemingly futile. This is when the emergency axe of tenacity shatters the glass of intransigence to reveal the Byproduct Theory of Engagement.*

Like many counterintuitive ideas, the Byproduct Theory of Engagement (BYTE) maintains that desirable outcomes are simply byproducts based on the cumulative effects of engagement rather than the inevitable default positions of therapeutic processing. BYTE demands attentive persistence and the ability to remain relatively unaffected by emotional setbacks while trusting the power of process. For example, many people wait until they experience a psychological epiphany before committing to a routine schedule, making a change, or pursuing activities they value. If fear is affecting their ability to function, a reduction of apprehension is often achieved by engaging in at least one challenging activity on a daily basis. The more the person distracts themselves by focusing on a project, the greater their sense of self-efficacy. For example, I often suggest productive sublimation as a way to create value with emotions rather than succumbing to preemptive despair. Granted, many of my former clients could do nothing that demanded motivation until their symptoms were attenuated with the proper psychiatric medication, but the primary efficacy of BYTE revealed itself with treatment-resistant clients who had already “tried everything.” As with physical exercise, the commitment to routine is usually solidified after the momentum of routine has already been established. Most people believe they would be more determined in life if previous outcomes had been favorable, or if their current disposition was inspired by enticing incentives. However, to paraphrase the author Joyce Carol Oates, one does not wait for the mood to write; you write to get into the mood. What initially may seem contradictory is often the ironic inversion of reasoning necessary for moving forward.

Acceptance and Commitment Therapy (ACT) is an established form of clinical behavior analysis that focuses on recognizing negative emotions when confronted with unfavorable stimuli while engaging in alternative behavioral responses. Similar to the Byproduct Theory of Engagement, a commitment to manifesting change through activity remains a significant component of ACT. However, values generally precede action in ACT; whereas values are considered a process of ongoing discovery in BYTE, and auspicious outcomes are the “side-effects” of being occupied.

J. B. S. Haldane, a British biologist and geneticist, who was one of the founding fathers of the modern evolutionary synthesis, understood the implications of time and variation in biology via mathematical models. Population genetics was built on calculating changes in gene frequency over time and the “byproducts” (phenotypes) of this development are seen all around us.

Consistent environmental pressures, variation, and replication are responsible for the diversity of life in the same way that gradual erosion carves the scenic views of oceanic landscapes. Dedication to process is best achieved by immersion in process, and unbounded processes make all experience possible.

*Developed via fortuitous thought experiments in a community mental health setting.

Serviceable Despondency

Depression is a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the selfto the mediating intellectas to verge close to being beyond description. William Styron

Behavioral norms and stereotypes often stigmatize or prematurely dismiss complex maladies such as depression. For example, mentioning depression in certain company can imply failure. The depressed individual may also be perceived as experiencing a lack of motivation, or possessing the inability to obtain a proper perspective on life’s vicissitudes. However, it’s the colloquial descriptions of depression (e.g., “having the blues”) that should not be confused with clinical depression, and clinical depression is not generally alleviated by blaming the victim.

Exploring the idea of there being an evolutionary advantage to depression could explain how, in some cases, the process of contemplative brooding can result in adaptive resolution. According to some speculations promulgated by evolutionary psychologists, the genetic proclivity for an individual to succumb to depression may indicate a type of (counterintuitive) selective advantage—theoretically described as the analytical rumination hypothesis (ARH). Keep in mind that most justification for the ARH model is based on the statistical prevalence of depression (Scientific American states that 30 to 50 percent of people have met current psychiatric criteria for Major Depressive Disorder at sometime during their lives). Perhaps depression can be seen as an ipso facto opportunity for the brain to adapt to misfortune, but not in a way that benefits the species as an overall evolutionary adaptation. After all, depression is a costly defense mechanism with disabling effects on one’s ability to function and survivenot to mention the potential consequences of suicidal behavior or substance abuse. Even if a protective impetus is initiated by the symptomatic nature of depression as an adaptive response (i.e., psychosocial “hibernation”), it would not be as adaptively useful as one’s ability to overcome depression. Since the empirical evidence for the efficacy of cognitive behavior therapy in treating depression is good, this suggests that neurological plasticity via salutogenic priming plays a significant role in reversing the pernicious effects of this disorder. In other words, the learned therapeutic skills one employs to battle depression may increase the likelihood of recognizing it’s emergence in the future. This reflective capacity may also reduce the potential of being victimized by severe depression later on if the experience of adaptively processing negative thought patterns is committed to episodic memory.

It should be noted that the causes of depression are as debated as the prescribed treatments. Furthermore, a combination of biological and environmental factors for depression are often equally involved in unquantifiable ratios. In fact, recent studies have shown that serotonin levels have less to do with depression’s actual effects as does the reduction in neurogenesis, changes in neuronal connections, relentless stress, long-term anxiety, and psychological disillusionment.

The phenomenology of depression has been the topic of many poems, books, paintings, musical compositions, and artistic endeavors. Michael Foucault, Ernest Hemingway, Ludwig Wittgenstein, and Sylvia Plath are just a few of the notable figures who have suffered from disillusion-based depression (sometimes described as intellectual depression). William Styron’s Darkness Visible: A Memoir of Madness is filled with caliginous metaphorical allusions attempting to describe the visceral experience of Major Depressive Disorder. Similarly, the British biologist Lewis Wolpert vividly recounts his bout with depression in a partly autobiographical and scientifically informative investigation entitled Malignant Sadness: The Anatomy of Depression.

Counteracting the effects of depression requires a comprehensive therapeutic approach with additional pharmacological intervention when necessary. The important thing to remember is that depression is a complicated abnormality and no two individuals will necessarily respond to treatment in predictable ways. The more we learn about depression, the more we may discover the brain’s capacity for developing resilience in the wake of adversity.

(This article originally appeared as Depression: A Silver Lining? in the NPI newsletter, Summer edition, 2012).

Reversing Rigidity

Neither separateness nor union is the goal of the therapeutic process, but rather the exhortation of the endless and often painful undulation between them. — Walter Kempler

Many philosophical, political, and ethical topics are conveniently bifurcated, buffered, or dismissed simply because of the psychological implications involved when addressing the fact that most situations in life require a willingness to challenge comforting intuitions, biased assumptions, and developmentally imbedded preconceptions.

Walter Kempler, the American psychiatrist who worked closely with Fritz Perls (founder of Gestalt therapy), noticed an indispensable continuity within experiential and existential modes of ontological awareness that was pivotal to the outcomes of long-term emotional equanimity. Kempler focused on the importance of accepting disappointment, challenging intuitions, confronting obscurity, and developing a capacity for compromise and resilience in the face of uncertainty. From an existentialist viewpoint, an inability to cope with impermanence predominates when a denial of change persists. Likewise, experience sculpts perception and the type of experience often measures an individual’s ability to emotionally process and reflect on life events in a healthy, congruous manner. Ideally, a regulatory flexibility should occur that enables one to adapt to change while realistically assessing and differentiating actual threats to survival from situational inconveniences. “Oriented to an exploration of the resistances to experience” was Kempler’s philosophical position, and realistic compromise is the necessary ingredient to facilitate life transitions.

Similarly, a parallel analogy of this conceptual framework can be demonstrated in modern theoretical physics. For centuries cosmologists adhered to an Aristotelian model in which distinct realms of existence were defined by the idea that the earth was the orbital center for all celestial bodies. In the seventeenth century, this antiquated model of astronomy (otherwise known as the geocentric model) was replaced by a less rigid cosmological system known as the Newtonian model. Eventually, as the scientific community learned about general relativity, the expansion of the universe, and the counterintuitiveness of quantum mechanics, a very open-structured system known as the relational model acquired preeminence. The relational model, simply put, describes how the principle of perpetual fluctuation in the cosmos dictates that no point is any more significant than any other point in a spectrum of physical “relationships.” No longer are we saddled with a static hierarchy of definitive boundaries. The universe is unconstrained by stationary layers and the random particle relationships result in an infinite recombination during the interchangeable dance of mass and energy.

So what does this have to do with psychotherapy? An acknowledgment of the human need for safety, comfort, and security cannot be dismissed; however, in a world where change is inevitable, the ability to acquiesce to shifting parameters in the social landscape becomes a vital coping skill. Life is ephemeral and relationships between family members, friends, lovers, co-workers, and strangers involve complicated forms of exchange that require malleability, openness, and the willingness to reduce unrealistic expectations while relinquishing the desire for control. Humans encounter a plethora of goals, drives, beliefs, and ideas on the platform of daily interaction; more importantly, navigating this myriad of experiential diversity requires a mindset capable of eschewing simplistic black and white thinking. However, this does not mean that all positions or beliefs are relative. Clearly, many inquiries do have right and wrong answers based on objective methodologies that produce reliable and verifiable results, but our approach should include the realization that relationships and communication are based on process rather than destination (for example, field theory strategy in Gestalt therapy recognizes structures and relationships as dynamic rather than fixed).

Being “okay with the gray” is another way to think about reducing the black and white hues of cognition to enhance emotional and behavioral regulation, improve interpersonal effectiveness, and increase our level of distress tolerance when dealing with life’s acute or chronic adjustments. No matter how much impassioned momentum or emotional dividends we have acquired from certainty, reversing rigidity is a developmental process worth experiencing.