DID YOU SEE…?: Bruce Perry on how stress works

Starting from my own personal experience and extending into my professional practice as a psychotherapist, I’ve long been aware that managing stress is a crucial part of health and well-being, every bit as important as diet, exercise, sleep, and touch. But I’ve never known the scientific particulars of how stress works on the body, especially the brain, for better and for worse, until reading an article published in the latest issue of The Sun, an excellent literary magazine published in North Carolina that doesn’t accept advertising and is completely supported by its readers — the magazine equivalent of National Public Radio, without the big federal grants. Each issue contains a lengthy Q-and-A interview with someone who’s an authority on some important political, social, spiritual, or medical concern. The November 2016 issue presents an interview conducted by Jeanne Supin with Bruce Perry, a North Dakota-born Houston-based psychiatrist and researcher who has co-authored two books, The Boy Who Was Raised as a Dog and Born for Love: Why Empathy Is Essential — and Endangered. In this conversation, titled “The Long Shadow: Bruce Perry on the Lingering Effects of Childhood Trauma,” Perry gives the simplest, most thorough explanation I’ve ever read of how stress interacts with the human body.

The interview is long and interesting and worth seeking out in full. I’d like to share here a significant chunk specifically talking about stress. Here’s the gist of what he has to say.

On the harmful impact of chronic stress: “When you are overstressed, you no longer have efficient access to your higher brain functions. By the time you’re in a state of alarm, significant parts of your cortex – the highest-functioning part of your brain – have shut down entirely. This is adaptive if you’re confronted by a predator, because you don’t want to waste time thinking about how to respond: you want to fight or run away. But to do your best reasoning, you need access to that sophisticated part of your brain. To learn and plan, you need to be in a relatively calm state.”

On the healthy aspect of stress: “Resilience comes from stress. It’s important that parents, teachers, and coaches not be afraid of it. Exploring, getting dirty, and falling down help you build resilience and tolerate novelty and discomfort.”

To put those passages in context, read on, and let me know what you think.

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Supin: Can you explain how our stress-response systems work?

Perry: All input – feelings of hunger or thirst, loud noises, the sound of someone’s voice, some information we learn – first enters the lower, more primitive part of our brains, which determines if this input is familiar or unfamiliar. If the input is familiar, it then travels to a higher, more evolved part of our brain, where we decide based on memory whether it’s good, bad, or neutral. If the input is unfamiliar, the brain’s default conclusion is This can’t be good. Any novelty – even desirable novelty, like learning something new – activates our stress-response system.

Some stress is actually good for us – for example, the stress related to meeting a new person or traveling to a new place. Predictable, controllable, and moderate activation of the stress-response system has been shown to build our capacity to manage challenges. When a child has the opportunity to challenge herself in the presence of supportive adults, it builds resilience. It’s the dose, the pattern, and the controllability that determine whether the stress is adaptive or harmful.

Let’s say you’re a six-year-old boy, and up until now your life has been OK. Mom and Dad split up, and there was some conflict around the divorce, but nothing too horrible. Then all of a sudden Mom has a new boyfriend in the house. That’s novel, so it generates moderate stress. At dinner he raises his voice at you; that’s unpredictable. He soon starts barking orders at you more frequently. He yells at your mom. He hits you, or he hits your mom. Your stress-response system doesn’t have time to return to baseline before another source of stress arrives. You start having anticipatory anxiety about what will happen next. Your baseline level of stress increases; things that would not have bothered you much before now bother you a lot. A harsh tone of voice that may have been mildly upsetting is now overwhelming. If the boyfriend’s behavior continues, your stress-response system may start to register any angry tone of voice as threatening. You’ve become what we call “sensitized.”

Conventional wisdom might suggest that the boy would get used to the angry, violent behavior and be less affected by it over time, but you’re saying the opposite is true.

Exactly. The more our stress-response system is activated in uncontrollable ways, the less able we are to handle even small amounts of stress.

When you are overstressed, you no longer have efficient access to your higher brain functions. By the time you’re in a state of alarm, significant parts of your cortex – the highest-functioning part of your brain – have shut down entirely. This is adaptive if you’re confronted by a predator, because you don’t want to waste time thinking about how to respond: you want to fight or run away. But to do your best reasoning, you need access to that sophisticated part of your brain. To learn and plan, you need to be in a relatively calm state.

Let’s go back to the six-year-old boy in your example. What happens to him at school?

The brain is good at generalizing from one kind of experience to another. Most of the time this ability is a gift, but this boy may generalize that all male authority figures who raise their voices are terrifying. This starts a vicious cycle: The boy arrives at school already on heightened alert due to his home situation, and he can’t pay attention. The teacher gets frustrated and raises his voice. The child is now even more on red alert. It’s impossible for him to concentrate. The rational parts of his brain shut down. Instead he has access only to the parts that process information valuable in threatening situations. He’s attuned to the teacher’s tone of voice, to whom the teacher is smiling at. He’s learning to read nonverbal cues. The calm child will learn the state capitals; the sensitized child will learn who is the teacher’s pet.

Can he recover from that?

Yes, opportunities for controlled, moderate doses of stress can shift these systems back toward well-regulated functioning. The key is that a moderate challenge for a typical child may be a huge challenge for a sensitized child.

The achievement gap in schools has a lot to do with the child’s home and community life if the family is concerned about not having money for food or rent or a doctor’s visit, that creates a pervasive sense of anxiety and unpredictability. The longer the child is in that environment, the worse the vicious cycle at school becomes. Eventually the kid says to himself, “There’s something wrong with me. I’m stupid.” And he drops out as soon as he can.

What about the character-building benefits of facing down adversity, of “rising to the challenge”? Is that ever applicable in these situations?

If you start from a healthy place, adversity can be character building. But if you grow up amid constant adversity, you are less likely to have the flexible and capable stress-response systems you need to face down adversity. Certainly many children do grow up with remarkable gifts and strengths despite their challenges, but when this happens, it’s often because there were people in the child’s environment who helped create a safe, predictable space for the child at least part of the time.

Are there instances in which well-intentioned parents protect their children from stress too much?

Yes, I’ve seen upper-middle-class children develop anxiety disorders because they had never been given the opportunity to explore the world. They’d been told only, “Don’t do this, don’t do that, don’t get dirty.” By the time these children went to preschool, they hadn’t learned to tolerate even slight discomforts. They became overwhelmed by the novelty of preschool and had meltdowns.

Resilience comes from stress. It’s important that parents, teachers, and coaches not be afraid of it. Exploring, getting dirty, and falling down help you build resilience and tolerate novelty and discomfort.

How might we apply this to whole communities?

First we have to understand that feeling connected to other people is one of our most fundamental needs. We feel safer when we are with kind and familiar people. Tension can arise from being part of a marginalized minority, whether you define that minority status by economics, race, ethnicity, religion, gender identity, sexual preference, or whatever. The marginalized group has a much higher level of baseline stress. It’s not a specific traumatic event; it’s a continuous sense of disconnection.

Our brain is constantly monitoring our environment to gauge whether or not we belong someplace. If we frequently get feedback that we don’t belong – or, worse, overt threats – then our body’s systems stay in a constant state of arousal. This increases the risk for diabetes and hypertension and makes learning, reflection, planning, and creative problem-solving harder. Over time it will actually change the physiology of your brain.

For example, for someone who already feels marginalized and is hypervigilant, even a relatively benign interaction, such as a police officer asking for your license, can trigger a volatile reaction. This is true for both the person being stopped and for the cop who’s doing the stopping. They both can be sensitized. People in law enforcement should know the principles of stress and trauma. It’s the key to understanding why some of their policies and behaviors have a destructive effect.

 

DID YOU SEE…: New York Times on workday stress reduction

Phyllis Korkki’s Applied Science column in today’s Sunday New York Times offers good sensible advice about using conscious breathing, posture, and body awareness tools to reduce stress and anxiety on the job. These are simple mechanisms that we all know about but it’s easy to forget them.

Seeking some assistance in dealing with mounting stress, Korkki says, “My first stop was Belisa Vranich, a clinical psychologist who teaches — or rather reteaches — people how to breathe. Dimly I sensed that the way I was inhaling and exhaling was out of whack, and she confirmed it by giving me some tests. First off, like most people, I was a ‘vertical’ breather, meaning my shoulders moved upward when I inhaled. Second, I was breathing from my upper chest, where the lungs don’t have much presence.

“In her Manhattan studio, Dr. Vranich taught me the right way to breathe: horizontally and from the middle of the body, where the diaphragm is. You should expand your belly while inhaling through your nose, she said, and squeeze your belly inward while exhaling.l way to breathe — the way children and animals do it, Dr. Vranich said. It’s when society begins to exert its merciless pressure on us that we start doing things the wrong way.

stress reduction illo by michael waraska                                  illustration by Michael Waraska

“When we are under stress at work, we tend to brace and compress ourselves, and our field of vision becomes narrow, Dr. Vranich said in a recent interview. This causes us to breathe more quickly and shallowly. The brain needs oxygen to function, of course, and breathing this way reduces the supply, causing muddled thinking. Also, the digestive system doesn’t receive the movement and massage it needs from the diaphragm, and that can lead to problems like bloating and acid reflux, she said. Stress can send people into fight-or-flight mode, which can lead them to brace their bellies to appear strong. This is exactly the stance that interferes with calm, alert thinking.”
Paying attention to these body cues and shifting your response to them is good practice. Check out the whole article online here and let me know what you think.

Quote of the day: MINDSET

MINDSET

My research started out looking at how people cope with failure and setbacks, especially students who were asked to solve challenging problems. Some students acted as though a failure was a catastrophe, while others actually relished the challenge. I was particularly interested in the latter group. I vowed that I’d figure out what their secret was and try to bottle it. It comes down to whether you focus on growing your abilities, as opposed to proving and validating them all the time. When you’re in what I call a fixed mindset, your goal in life is to prove you’re a smart, competent, worthwhile person and avoid doing things that could undermine that image of yourself. In the growth mindset, you believe these abilities and talents can always be developed, so you’re not on the spot every second to prove yourself, and you can focus on developing those abilities through taking on challenges and seeing them through. You can be more resilient from setbacks because they don’t define who you are. In other words, the fixed mindset is the idea that you have a fixed amount of intelligence, ability, or talent, and the growth mindset is the idea that you can always develop these abilities and talents. Of course, people differ in their abilities, but the underlying premise that separates people is the degree to which they believe they can develop their talents and capacities further.

–Carol Dweck, interviewed in Psychotherapy Networker

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QUOTE OF THE DAY: Sue Johnson on passion and female desire

PASSION

Passion is attachment longing—the longing for emotional connection twined with attunement and erotic exploration and play. Passion is about so much more than responding to novel stimuli or ramped-up lust. In the dance of sex, passion can be constantly renewed, not simply by finding more exotic sexual positions (although who can resist being intrigued by the positions in the new Joy of Sex, such as Wailing Monkey Climbing Tree) but by changing the level of our engagement in the moment and with our lover. If we really understand love, we can also understand how to shape lasting passion.

In today’s world, we’re surrounded by impersonal sex—to the point where young men are routinely seeking help because, having conditioned their brains every day since the age of 12 to respond to porn sex images, they can’t get an erection with their girlfriends. We’re also regularly told that sex in long-term relationships is almost always “vanilla,” bland. To be spicy at all, it just has to be ramped up with constant novel stimuli, new lovers, rougher sex, new toys. So let’s look at the difference between impersonal—what I call avoidantly attached sex—and sex that’s infused with emotion and attachment.

This focus on emotional safety may be a particularly crucial defining element in sex for women. If you expose men and women lying in brain-scan machines to explicit or subliminal sexy pictures, everybody’s brain lights up. But only in women does the cortex—the judgement/control center of the brain—light up. Women’s brains naturally pair up desire and safety concerns. Makes sense! Sexual intercourse is literally much riskier for women. So women most often need to check out the relationship context—to talk as part of foreplay before allowing themselves to descend into conscious, active desire. Women, in particular, may be physically aroused (their body registers a cue as sexually relevant) but may not necessarily translate this into explicit desire—wanting to have sex.

All the new evidence is that women are more sensitive to relational context—safety!—and so for them, desire often follows arousal, versus the classic model of sexuality, where desire comes first. Desire is in response to interactions with their partner. Note: this means that a woman can be totally healthy and normal and never experience spontaneous sexual desire. This research helps me explain to a husband that the fact his wife doesn’t come on to him or instantly respond to any sexual signal isn’t a sign that she doesn’t desire him—and that the emotional context he creates is key in moving her into a sexual space. The way he demands sex actually activates her sexual brakes—pushes her out of sexual and into safety/survival mode. He needs to get curious about what context cues activate her sexual accelerator.

Bonding science says that a loving relationship also offers us a secure base to go out from. What this says to me is that great sex is a “safe adventure.” Thousands of studies show that safe emotional connection fosters curiosity and confident exploration. Think of a zip line: the freedom, the exhilaration you feel comes precisely from knowing you’re on a line and you’re held. Would you be screaming, “Weeeeee!” if you weren’t sure that the line would hold?

Hundreds of attachment studies show that safe emotional connection is the opposite of deadening, in or out of bed. Security increases risk-taking and spontaneity. A secure base allows us to play, to learn, to explore each other’s bodies and minds. Thrilling sex is about being secure enough to surrender to the moment—to let go and see what happens.

–Susan Johnson, author of Hold Me Tight

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THE PARADOX OF PORN: Joe Kort on straight vs. gay approaches to porn

Recently, my partner Andy and I shared a barbecue dinner with three straight women in their 40s of various marital statuses — one married and cohabiting, one married but living apart for work reasons, the other not married but cohabiting. It was a wide-ranging adult conversation, and I got up the nerve to pose a question I’d never dared to ask a group of women: how much time do you spend looking at porn? The woman in the long-distance relationship admitted that she sometimes looks at porn when she’s horny (she wouldn’t reveal what she looks at — we weren’t that friendly). The others said they virtually never look at porn, though one said her first exposure to porn came from accompanying friends to a gay bar. They all agreed that their men probably look at porn almost every day.

This conversation confirmed the basic thesis of gay sex therapist Joe Kort‘s recent article in the Huffington Post, “Porn Is Not a Public Health Crisis for Gay Men: Then Why Is It for Straight People?” Kort asserts that men tend to view porn matter-of-factly, as a ready source of healthy sexual stimulation. In relationships between two men, it’s assumed that both partners look at porn on a regular basis and it’s not a problem, whereas in relationships between men and women there is often tension about the men’s porn-watching, which is seen as tantamount to infidelity. It’s a very interesting and complicated topic, which Kort covers with considerable nuance.

Porn typing on the white keyboard. Online porn concept

He says, among other things, “The real public health crisis is a lack of sexual education. A step in the right direction could be having a conversation about gay men and lesbians who watch porn and are not in crisis over it. It would be better if all children in schools could receive a proper sex education that included balanced representation of porn and all the ways that exist to be sexual that are not primarily and only heterosexual. There is no sex education in schools for gay boys, and so they have to turn to porn to get it. Discovering gay pornography is almost a rite of passage for young gay men. For sexually fluid men, or sexually repressed men, watching porn can begin to connect them to who they really are sexually.

“Sex is messy, politically incorrect, taboo on so many levels. Porn is not what we would do in real life. Just like in watching movies, it is fantasy. Straight people need to learn what porn means to men. Men objectify more than women, who are more relational. And it is a scare tactic to say that watching porn leads to infidelity, as some have said. In fact, it is often way of not engaging in infidelity, an outlet that allows them to vicariously enjoy an act that they cannot do, like watching football—they can’t play it but boy to they enjoy watching it. Some may say, ‘see what porn did to you?’ but my belief is that they are discovering something already alive within them, and can begin to move toward more authentic sexuality.”

Check out the whole article online here and let me know what you think.

SEXUAL HEALTH: sex therapy for wounded veterans

In an article by Joseph Jaafari posted online May 12, The Atlantic covered creative therapies that are teaching veterans with genital injuries alternative ways to be intimate. “While all Veterans Affairs hospitals offer Occupational Therapy, which includes sexual therapy, the VA Long Beach Healthcare System in southern California and Walter Reed Medical Center in Bethesda, Maryland, are unique in that they have introduced courses and counseling focused on this issue. The programs offer guidance as veterans recover from genital wounds, and are part of an increasing effort by the military to both address these injuries and protect soldiers from them in the future.”

The article focuses on the treatment of a former U.S. Marine Corps staff sergeant named Timothy Brown. “Post-recovery, Brown has taken a different approach to sex than he had before—shifting the emphasis from his personal satisfaction to insuring that his partner enjoys the experience. ‘I went from being self-centered to trying to encompass everything for the both of us,’ he says. ‘Simple things like feeling [his partner’s] body, feeling their muscles when you hit the right spot.’ While he developed this outlook on his own, he notes that the program enabled him to feel more secure in his sexual life.”

Army Spec. Chris Smith, a soldier from the 10th Mountain Division stationed at Fort Drum, sits in The Different Drummer Internet Cafe in Watertown, New York April 16, 2008. The Different Drummer is a place where soldiers both active and discharged can go for support, counciling or just to socialize. Soldiers of the 10th Mountain Division are among those who've spent most time in Iraq and Afghanistan, making its base at Fort Drum a "canary in a coal mine" for a looming crisis of post-traumatic stress disorder.  Picture taken on April 16, 2008.     To match feature USA-MILITARY/ and USA-MILITARY/MARRIAGE         REUTERS/Mark Dye          (UNITED STATES) - RTR208HV

Army Spec. Chris Smith, a soldier from the 10th Mountain Division stationed at Fort Drum, sits in The Different Drummer Internet Cafe in Watertown, New York April 16, 2008. The Different Drummer is a place where soldiers both active and discharged can go for support, counseling or just to socialize. Soldiers of the 10th Mountain Division are among those who’ve spent most time in Iraq and Afghanistan, making its base at Fort Drum a “canary in a coal mine” for a looming crisis of post-traumatic stress disorder. Picture taken on April 16, 2008. Photo by Mark Dye

The article notes that “Brown’s approach is exactly what occupational therapists at Walter Reed have tried to teach other injured soldiers. Within the hospital there is a sexual health and intimacy service that focuses on education and therapy. According to Brown, therapy sessions were de facto sex classes that included sex toys aimed at stimulating different parts of the body. Officials at Walter Reed wouldn’t comment on what products were used during the sessions. In addition to funding classes like this one, the Department of Defense spent more than $84 million on erectile dysfunction drugs in 2014.”

Check out the whole story online here and let me know what you think.

DID YOU SEE: gay critique of mainstream tantra classes

Tantra is an ancient spiritual practice that seeks to channel divine energy through human experience. In our time, the word “tantra” is tossed around very lightly, and its meaning shifts wildly depending on the context. In its classic definition, tantra is a school of meditation that envisions universal consciousness as an intricate erotic dance between Shiva and Shakti, form and flow. In the West, the sexual metaphor has gotten literalized so that the most familiar manifestations of tantra are tantric sex and tantric massage, which invite participants to experience sex as energy. People are often drawn to study tantra by the invitation to deepen the connection between sexuality and spiritual practice that other religious traditions tend to keep strictly apart. There are many different ways to study tantra in schools, classes, and workshops, and like any educational process the quality of teachers and teachings can vary wildly. The original tantric teachings rely super-specifically on the dance of male and female energies, which complicates matters for queer people undertaking the study of tantra, as Lisa Luxx discusses in great detail in her article “Why is Gay Tantra So Taboo?” which appears on Ruby Warrington’s website The Numinous (subtitled “material girl, mystical world”). Her description of attending a tantra training and being pressured into ridiculously literal-minded tantric exercises that reinforce hoary old gender-role stereotypes matches my own experience when I first started exploring the world of tantra in the early 1990s, when most tantra workshops derived from the teachings of Margot Anand (best-known for her book The Art of Sexual Ecstasy).

concha on behance
credit: Concha on Behance

Luckily, there are tantra teachers that speak to the experience of queer people. The Body Electric School, founded in 1984 by Joseph Kramer, incorporated tantric and Taoist teachings into a series of workshops starting with “Celebrating the Body Erotic” that taught erotic massage as a healing practice combining breath and touch to connect the dots between the physical, the erotic, the emotional, and the spiritual. While the Body Electric School originally emerged from and spoke to the population of gay men struggling to preserve sexual health and vitality in the midst of the AIDS crisis, it expanded its offerings to include trainings for men, women, and those who decline the gender binary. Other trainings have evolved that address tantra specifically from a queer female perspective, such as Barbara Carrellas’s Urban Tantra program. One of the coolest things about Lisa Luxx’s article is that the comments thread provides information and links to other tantric explorations for women all over the world that transcend simplistic gender stereotypes.  Check it out and let me know what you think.