Author Archive: ACE Aware

Book review ‘The Myth of Normal – Trauma, Illness & Healing in a Toxic Culture’ door Gabor Maté en Daniel Maté, Part 1

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And then it arrived, early October: the long-expected new book by Gabor Maté and his co-author, son Daniel Maté: The Myth of Normal – Trauma, Illness & Healing in a Toxic Culture – what a treat! It is a great tome of 500 pages (excluding notes with references and the index) and provided with 22 recommendations by big names in the field, such as of course Bessel van der Kolk, Daniel Siegel and Richard Schwartz, but also Esther Perel, V (formerly Eve Ensler) and Marianne Williamson.
No tables, no graphs, no colourful images to distract the reader from the content – just two paintings printed in black-and-white (made by Rae Maté, Gabor’s wife), beautiful chapter opening quotes from wise people all over the world, and words, words, words, captivating strains of sentences, endless fascinating overviews and winding roads around the central theme of the book that is phrased as follows:

“I will make the case that much of what passes for normal in our society is neither healthy nor natural, and that to meet modern society’s criteria for normality is, in many ways, to conform to requirements that are profoundly abnormal in regard to our Nature-given needs – which is to say, unhealthy and harmful on the physiological, mental, and even spiritual levels.
If we could begin to see much illness itself not as a cruel twist of fate or some nefarious mystery but rather as an expected and therefore normal consequence of abnormal, unnatural circumstances, it would have revolutionary implications for how we approach everything health related (p.7, 8; author’s italics).”

Quite an assignment to take on, dealing with ‘everything health related’, and the thickness of the book is therefore no miracle. We are halfway through now, but took a curious peak at the acknowledgments in the back to see what the authors had to say about the journey undertaken. After many names, Gabor lastly thanks Rae with his well-known self-reflective self-mockery, explaining how her “much-needed critique and the most honest feedback [were], not always graciously received but eventually almost always, heeded” (p. 500). Daniel speaks frankly, too: “It’s been the opportunity of my lifetime to finally get to put words in your [Dad’s] mouth, and a true joy besides. Proud of you, Pop” (p. 502). He calls the book Gabor’s “magnum-est opus yet”. There is a lot of loving honesty and recognition in both their words, by which they implicitly illustrate the processes they have gone through over the years, processes deeply related to healing within the culture of their own family, families being those very basic units of the collective cultures we all live in.

We can wholeheartedly recommend reading the whole book (Dutch translation expected to be available early December 2022), but for those who won’t, we will try to give a fairly thorough overview of a seminal work that is already a bestseller. This blog will cover Part I, the first seven chapters.

The book has five parts: Our Interconnected Nature; The Distortion of Human Development; Rethinking Abnormal: Afflictions as Adaptations; The Toxicities of Our Cultures; and Pathways to Wholeness, fairly evenly split into 33 chapters dealing with aspects of these themes. In the introduction, Gabor discusses “Why Normal is a Myth”. As he does in many of his lectures and presentations, he emphasises again how the mind cannot be separated from the body, and the individual not from the environment, because it hugely impacts our social-emotional lives and thus either supports or undermines our health and wellbeing. With stress and inequality being so ubiquitous, they are easily misunderstood as being normal, or worse… we do not even recognise them, because, like fish, we cannot be aware of the water we swim in. He describes this state of affairs as a “toxic culture”, defined as “the entire context of social structures, belief systems, assumptions, and values that surround us and necessarily pervade every aspect of our lives” (p. 3), with most people in effect being “acculturated” to the many stressors present. The pathology resulting from this arises from “a web of circumstances, relationships, events, and experiences” (p. 9). How all of these play out in daily life, has a lot to do with the extent to which our basic, “nonnegiotable human needs” are satisfied. If unmet, they lead us into a state of survival that fragments our experience of self and the world around us. It also disconnects us from our body, because truly feeling the pain of unmet needs is often unbearable. Healing, therefore, is about wholeness, feeling your body again, undoing the fragmentation and (re)turning to a deep understanding of the interconnectedness of life’s many aspects.

Chapter 1 lays out a basic picture of what trauma is and does. In Greek, it means ‘wound’ and the wounds that trauma causes, the unsafety we experience, dysregulates our stress regulation system, and undermines immunity. It causes us to fall into very primary survival behaviours that restrict our ability for rational thinking and considered action and keeps us strongly tied to the past and the fear it : “Trauma is not what happens to you but what happens inside you” (p. 20), to use Gabor’s shorthand definition. And because all societal layers and institutions are built from people who have their own life history that often carries trauma within it, trauma is very pervasive. It often subconsciously shapes our personal and professional practices and routines. Once we have learned the world to be a scary place, our approach of her will unfold accordingly.

Chapter 2 discusses the mindbody-unity, that is very concisely summarised in the term “psychoneuroimmunoendocrinology”, a word focussing “on the unity between all our constituent parts: mind, brain, nervous and immune systems, and the hormonal apparatus” (p. 45). In this context, many of our readers may be familiar with the HPA-axis, the pathway from the hippocampus, to the pituitary and then the adrenal glands to activate the body when danger is signalled. These danger signals have a lot to do with our social context and humans are thus often called biopsychosocial creatures: the biological organism is influenced by psychological and social events.
This also means we highly influence those most near to us: we “are affected by all, and affect all”, also called interpersonal (neuro)biology, all that happens to the organism within the relationship, as explained in Chapter 3.

Chapter 4 deals with the by now anachronistic idea that most of who and how we are is determined by genes. Of course, we do have a genetic potential, but how that potential expresses itself, is based on experience. The field that occupies itself with this topic is epigenetics. Many genes even need environmental input, or they will not function at all. The chapter also deals with telomeres, “miniature DNA structures at the end of chromosomes”; the length is influenced by the context and a shorter length due to adversity has a negative influence on longevity (p. 59, 65).

Chapter 5 speaks about the many devastating effects of chronic inflammation and the resulting increase of autoimmune diseases. When there is early childhood trauma, chances increase of inflammation in adulthood. This can happen through the mechanism of suppressing emotions and thus increasing stress in the body; this wears out the immune system, creating an allostatic load. By clearing up these mechanisms, and the role of interpersonal stress in them, we can get a much better idea of the direction we might choose for diagnosing and healing. This, however, constitutes a true paradigm shift that will probably face much resistance, seeing the disruptive character for the medical status quo.

Chapter 6 discusses disease as a process in which often “martial metaphors” are used (p. 87), an external enemy that has to be killed or conquered. But… “[w] if we saw illness as an imbalance in the entire organism, not just as [molecular and cellular] pathology” (p. 89), or put differently, would take a biopsychosocial approach and would see illness as a systemic issue? It can then be seen as an alarm, a cry for help to heal the system as a whole.

Chapter 7 deals with one of Gabor’s favourite topics: the tension between attachment and authenticity. Children need the proximity and physical and emotional care of their primary attachment figures, because without it, they cannot survive. Another core need is authenticity, “being true to oneself, and the capacity to shape one’s own life from a deep knowledge of that self” (p. 106). If attachment is threatened by authenticity (‘If I am myself, my parents will not love me anymore; I have to earn their love’), children will usually compromise on their authenticity. Their character will adjust to the family system’s expectations and where needed they will suppress unwanted emotions. What looks like a character trait, may well be a coping strategy – with all kinds of health consequences related to it.

In the next blog, we will speak on Part II, The Distortion of Human Development.

Collective Trauma Summit 2022 – a treasure trove!

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Last week, it was the week of the Collective Trauma Summit again, an online conference with a huge number of lectures that you can listen to without cost if you keep up with the daily uploads. After two days, they disappear behind a paywall. With a relatively very cheap upgrade you get access to all the lectures, to transcripts, videos and other contributions in the field of trauma healing, but also mindfulness, relaxation, integration, music, and poetry. What a treasure trove of information this conference is each year – impressive.

The host of the event is Thomas Hübl and this year he also had a little thread of his own, called ‘Daily Insights’, each day of the conference a short reflection of about ten minutes in which he discussed a specific theme around trauma. I took an endless amount of notes, so that I can both read and enjoy his wisdom again myself and hand down his valuable insights during upcoming trainings organised by ACE Aware NL.

In a few of the lectures, Thomas brought up an interesting issue. We often say: ‘Ah, well, that’s just how life is’, when we notice certain processes. Thomas pointed out that we do not say that when we see something beautiful, like a mother cherishing her baby or a loving interaction between two people. We say it when we see things that we dislike, that we do not want to be a part of. In speaking about things we dislike with such wordings, however, we implicitly and often unconsciously show an acceptance of pain and suffering. By downplaying them as if they were something normal that is inevitably part of life, we distance ourselves from them. In a certain way, we break the connection between ourselves and the suffering of the other. We no longer see ourselves as part of it, although we all live in that same world where pain is ubiquitous. Thomas regularly emphasised the connection between the individual, the ancestral and the collective in relation to trauma. By becoming aware of the links between these layers, we can look for ways to change sociocultural processes, because the individual is an expression of the whole and of the history of the collective.

What we need for the connection and the change, is an awareness of the impact of human physiology, said Stephen Porges in his fascinating conversation with Thomas. We can look at an event, a stimulus, as the driver for a response, but that is a very behaviouristic approach. The point is, according to Stephen, that in between the stimulus or trigger on the one hand and the response or reaction on the other, there is our body with its physiology. That physiology has a history, like families (ancestral) and communities (collective) do. If that history carries trauma, the response to a trigger can be that someone either shuts down or becomes overstimulated. It is, therefore, not simply about behaviour resulting from an event; it is about the experiences (whether safe or unsafe) a person has gained with similar events. Their imprint on the body has built a certain kind of physiological response. That response influences what the subsequent reaction or behaviour will look like. Thus, not the event is the determining factor for what follows, but the physiology in between.

Together, they brought up crucially important topics and although not all was new to me, it was brought in such a beautiful way that it did bring a lot of new insights. The wisdom deserves to be shared here with a couple of quotes.
“Our nervous system does not care whether there is a physical or a psychological threat.”
Regarding illness: “The body screams at us, but western society says: ‘Don’t listen; keep moving, keep working’, but there is a great price to be paid for this in the form of illness.”
“Trauma should be seen as physical injury: the nervous system was impacted by a threat to life.”
“Polyvagal theory is the science of safety, understanding the innate need and quest to feel safe.”
“Education should focus on a basis of sociality, coregulation, friendship and trust, not primarily on cognition.”
“Everything that enables us to function as thriving humans, requires our bodies to not be in a state of threat.”

The basic tenet in the whole conversation was that evolution prepared us for sociality and coregulation, of a life setting in which we take care of one another. Our big brains need a lot of oxygen, so we have to remain coregulated and support one another in bringing our stress down. If not, the oxygenation of our brain is in trouble and this seriously impairs our functioning. We all know this: in fear, we have a truly hard time thinking straight and taking important decisions about the future. We are then in the here and now, merely trying to survive. The human blueprint, the model for coregulation, is the mother-baby-relationship, said Stephen Porges. If they are closely attached, they look into each other’s eyes and develop a deep familiarity, which, in the brain and nervous system, is translated as safety – crucially important for problem-solving creativity.

Well, the conference was riddled with much more of this kind of beautiful knowledge, although the conversation between Thomas Hübl and Stephen Porges was truly an exceptional one. If you want to have another go at it… an encore of a few days was announced this weekend. Find more information, also about registration and upgrades here: https://collectivetraumasummit.com/ You have a couple of precious hours left to register and watch.
And if you happen to be too late for this year’s edition… keep an eye out for next year!

Powerful inspiration, beautiful cooperation, and courageous steps

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Thursday 29 September was an intensive day with beautiful, inspiring conversations and encounters!

The day started with the first team meeting with colleagues from the IkiBuntu Foundation, with whom ACE Aware NL will collaborate intensively in the coming period.
I met one of the founders, Ilona Schra, during my fieldwork for the master Medical Anthropology & Sociology. We were together at the same meeting about a research project on the concept of Positive Health, where she was present as a student for the master Healthy Aging. We started talking, met a number of times afterwards and turned out to have a lot in common in terms of views on health and what it takes to lay a solid foundation for it through fulfilling the basic needs of children. She and her fellow student Wout Peters subsequently set up the IkiBuntu Foundation, whose six pillars are a supportive network, nourishing food, natural exercise, consciously relaxing, living a meaningful life and waking up well-rested. The name comes from the merging of two beautiful concepts, namely the Japanese ‘ikigai’ and the African ‘ubuntu’.

Ikigai is about meaning. What do you get out of bed for? What drives you? What things are worth living for? Four elements come together in it: what you love (passion), what the world needs (mission), what you can be paid for (profession) and what you are good at (vocation). If they all come together in what you do, then you have found your ikigai!

Ubuntu is a concept that roughly translated means ‘I am because we are’ and is broadly about humanity, about service to the community of which you are a part. You can define this community small and large (your family, your neighbourhood, your work environment – ​​the world!), but the core is that as a person you are connected to humanity as a whole. It is about not feeling threatened by others, but being confidently aware of your own value for the whole, making your unique contribution to that whole and feeling that with the suffering of a part of humanity, humanity as a whole gets damaged and needs healing.

Both concepts, brought together in IkiBuntu, fit in beautifully with the seven pillars of ACE Aware NL: connection, compassion, courage, curiosity, confidence, kindness and resilience. These concepts are both a precondition for and a result of positive life experiences. How do we get there?
The formation of our world view starts very early, much earlier than often thought. When you are exposed to a lot of stress hormones in your mother’s womb, because she is having a hard time and has to endure a lot of adversity, then you, as an unborn baby, already get the sense that the world is a threatening place. Your mother’s stress hormones, reaching you directly via the umbilical cord and influencing your rapid development in the womb, make you establish a stress regulation system that is on alert from the start.

If the living conditions after your birth do indeed turn out to be stressful and worrisome, that early imprint is confirmed again and again; it then becomes deeply ingrained. Your worldview is intensely coloured by traumatic early experiences and probably influences your behavioural patterns as well. Under difficult circumstances this is ‘adaptive’, helping and supporting. However, it often later becomes ‘maladaptive’, hindering and undermining. It takes a toll on your entire organism, on the constant feedback between all your organ systems. That has an impact on the beliefs with which you go through life. Those convictions are not a conscious choice, but a ‘default setting’, a basic attitude that is based on your very earliest experiences. This can lead to beliefs such as ‘I’m not good enough’, ‘I can’t do this’, ‘I can’t count on anyone when it comes down to it’. Such thoughts make it difficult to reveal your spontaneous personality and your radiant authenticity. They are trauma reactions to what you had to deal with at the beginning of your development and which left you feeling overwhelmed because of the lack of support.

These kinds of beliefs and the behaviour that can result from them in the form of aggression, defenses, reticence, unhealthy lifestyles, addictions and even crime, therefore have a neurophysiological basis: your brain and your other organs are constantly in survival mode from a deep sense of insecurity. In that mode it is very complicated and almost impossible to focus on things like logical thinking, developing more patience and changing unhealthy behaviours. Your only goal is: to survive, to keep yourself upright, with everything you think is necessary for that and what helps you with it.

That is why it is important that everyone who cares for others, in whatever environment, is aware of these developmental processes. Knowledge about this helps enormously to interpret certain behaviours in a correct way. Why is your child ‘suddenly’ hot-tempered? Why are you jumping out of your skin? Why is your colleague being so snappy? What is the reason the doctor does not listen to you? Where does your customer’s aggression come from? Being aware of possible underlying stressors and then responding appropriately to the other person is the core of what we call a trauma-sensitive approach. You take into account that the other person’s stress system is overloaded by adverse experiences. That can also help explain a person’s behaviour pattern. This is often about behaviours resulting from that early imprint of lack of safety and security: fight, flight, freeze, fawn.

This is not a simple matter. That childhood was not as cheerful as we like to remember is often unconsciously present like a pink elephant in the room. Yet we do feel that there is something very great and essential that burdens and hinders us or the other. The emotions that accompany this are often suppressed for all sorts of reasons. They remain unspoken, with all the consequences that this has for the immune system that does feel that stress, even if it is not made explicit. Many people get stuck in healthcare and in therapies due to the lack of attention and recognition for the early childhood trauma they have gone through. They carry that with them and it has (had) an impact on their neurophysiology and stress regulation.

The effects of suppressed emotions… that is the core of what the Emovere Foundation focuses on. After the great team meeting, I took the train to Ede last Wednesday, where in the afternoon and evening Emovere’s fourth friends meeting took place. The plenary sessions, the documentary about the road that Michelle Kraaij took to recovery, the workshops that were given in two rounds… they all had one vision in common: it is important to view pain complaints as signals from the body and to look for the underlying emotions.

It is essential that we recognise that by the time that, as humans, we move into any external setting, we have already spent a crucial formative time in our family of origin. That family was our beginning, the place we depended on as babies, as children. We therefore feel a lot of loyalty to that place and the people who belong to it. That also makes it understandable that a lot of resistance can be felt against looking for the cause of current (emotional and physical) pain in that place and those people. That old, sometimes all-encompassing sadness you feel… holding open or facing the possibility that it originates in your own origin… that hurts.

It takes courage to dive deeply into that, to where it gets dark and uncomfortable, but where also lies the key to insight, wisdom and healing. The injury arose in a social environment where the interaction did not go well. For healing, it is invaluable to build an environment where compassion prevails and an understanding of how the injury can affect a person’s life in an intensely sad way. You deserve to find and gather people around you who understand that, who don’t try to fix you, but just listen to your story first.
That’s what ACE Aware NL is committed to and we think it’s great that the film ‘Resilience’, which explains all this so impressively, is the center of the lunch webinar by Alles is Gezondheid, ProScoop and the Emovere Foundation in collaboration with ACE Aware NL.

Would you like to know more about it and plan a training or presentation for your organisation? Let us know; we would love to talk to you to work out the details together!

Zomergasten (Summerguests): the body and the experiences that are not forgotten

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In the last week of August, in the run-up to the impending broadcast of ‘Zomergasten’ (‘Summer Guests’, an interview programme since 1988), there was commotion around the core figure of the three-hour conversation. Three academics had a warning for the Dutch people, which led to lively discussions on social media. In the last episode of the season, the stepping-down presenter Janine Abbring would receive as a guest the world-famous psychiatrist, scientist and author Bessel van der Kolk (1943), a man with Dutch roots who has lived in the United States since the early 1960s and has created furore as a pioneer and expert in the field of trauma. He did this, among other things, through his roles as an adviser or expert witness to international investigations and trials, such as the Truth and Reconciliation Commission in South Africa after the end of apartheid and on the road to democracy. His acclaimed book ‘The Body Keeps the Score’ (translated into Dutch as ‘Traumasporen’, trauma traces) has as its core message that the intellectual brain is sometimes so overwhelmed by events that it uses the mechanism of dissociation as a survival strategy. The emotional charge of the experiences is deeply buried so that the one who endured the events can somehow continue with life. Conscious experience of the trauma would be too painful, too unbearable. However, the body has gone through all that toxic stress, and those experiences affect stress regulation, brain development, neurophysiology and thus the immune system, resulting in a range of potential social and health problems. The body carries everything with it: the body keeps the score. This view is clearly not yet universally accepted.

The three authors of the Volkskrant article (a professor, an emeritus professor and an associate professor) stated that Van der Kolk might be given room in the program “to spread incorrect and dangerous ideas” about repressed memories (de Volkskrant, 26th August 2022). They stated that he “makes a living popularising that idea” that traumatic memories are repressed and that many therapists who believe this are talking people into believing they went through all kinds of abuse and misery. They tell their patients that the physical and psychological symptoms they report to a psychiatrist “have arisen because they were once abused but the memory of it is hidden in their subconscious mind.” This approach would lead to “fake memories of abuse”. The client does not heal, but is “talked into a made-up traumatic past”, according to the article. The academics said they feared “disastrous consequences (…) for patients and their families”.

And then it is Sunday evening, August 28, and I’m going to sit down properly. I want to hear this man, because I know his work, which is in line with that of other big names in the field, and I am curious about what he will provide the Dutch public with in terms of knowledge, considerations and visual material.
It is impressive, and when I watch the broadcast a second time, I am even more moved. Here is a true expert speaking, a man humble in all his wisdom, who, with humility and self-reflection, tells the story of elements from his field and reveals aspects of his life, and who scrutinises both himself and patterns of interaction. The still ongoing ignorance, despite the extensive research, does not go unmentioned either. Already in the first few minutes he tells that PTSD was still defined in 1980 as a very rare phenomenon. “That says something about how blind we were to the misery in the world”, he concludes. Later in the broadcast, he fears that little has been learned from Harry Harlow’s studies with monkeys in the 1950s and 1960s, based on the work on attachment by John Bowlby, who was a good friend of Van der Kolk. According to him, there is still too little attention for the suffering that many people go through and at two-thirds of the interview he wonders with some fierceness in relation to the Volkskrant article: “Who are those people who are so afraid of the reality about which I speak? Who are these people who don’t want to see how many children are being abused? Who are those people who cannot listen to what is going on in other people’s lives?”

Up to these critical questions, he has mainly been very mild and contemplative and shows film fragments that demonstrate how much the mutual relationships between people are coloured and marked by their life stories. With his first fragment, from the American television series Ted Lasso, he illustrates how important it is that people within groups and teams can tell the truth of their personal history in a safe way, in a secure setting. That history helps to explain why they sometimes behave rudely, lash out at others or build a wall around themselves, for example because their authoritarian father never allowed them to be weak. If attention is paid to this, says Van der Kolk, then people can use their idiosyncrasies for the greater whole and do not have to use them in a negative way against themselves and each other. When vulnerability becomes a virtue instead of a weakness, you can reflect on your own behaviour and learn to behave differently where necessary. However, you need the support of your social environment for that, because loneliness, he later says, is the most important aspect of trauma: “We are members of tribes, we belong together. We have to belong to someone, we have to have a home, especially as children, and if children do not find that protection at home with their parents, then they are alone in the world and then they have to find some kind of adaptation. A child usually says, “This is happening because I’m a bad person.” What arises is a lifelong sense of ‘there’s something wrong with me, or they would never have done this to me’. Not being seen is the most difficult thing for a child. The feeling that everyone is acting as if nothing is wrong, that the interests of the adults are more important than what happens to the child, that those adults cannot find the courage to bring things up: that is the real trauma. The child has no choice, no other reality, no other possibilities and therefore blames themselves for bad events. That leads to deep loneliness: ‘I am different, I don’t belong here, I can’t be here, I am a bad person, I deserve what happens to me.’ Such a belief becomes a major problem as you get older. Such trauma carries on for generations.”

He uses all kinds of fragments to show and explain how traumatic experiences become fixed in the body, how they keep coming back via different sensory perceptions, associated with deep emotions. People get stuck in that event as if it were happening today, instead of the event being experienced as something from the past that no longer poses any danger. That is why, he says, talking alone is often not enough, and sometimes it is just impossible because it triggers too much pain. That is why he has done more experimental research than anyone else into all kinds of body-oriented therapies and why he has also been cautiously enthusiastic about the results that can be achieved with psychedelics for some time now: “Under the influence of them, people can sometimes finally find words for themselves and their story and above all, they experience compassion for what they have experienced. Humans are meaning-making creatures; as a therapist you don’t have to put anything into them. Listening attentively and not judging is enough. When there are people who offer you a safe setting for your story, psychedelics can be extremely helpful. You then see other dimensions of your own life and of yourself.” In line with that, at another moment: “People usually do not want to remember bad things at all and that is why it is very difficult to talk people into things. By really feeling in your body what things have done to you and are doing now, you can learn to see and do things differently. You can learn to let go of the role and the beliefs you grew up with. If you cannot tell your own truth, it all gets stuck in your body and your heart will break. Then you will break other people’s hearts with your anger and bitterness. Connection is indispensable for us as humans.”

There is so much more worth mentioning. We therefore sincerely recommend watching the replay of the broadcast, so that everyone can decide for themselves about Bessel van der Kolk’s vision: is it ‘dangerous’ or urgently needed? You can watch (in Dutch) for a few more weeks via this link.

At least one question has remained unanswered: what would Van der Kolk, led by Ted Lasso, have thrown into the barrel as a sacrifice to exorcise the evil spirits…?! 😉

 

 

The lived experience, Episode 6 – This week: Anja and Peter (Part 3, final)

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The lost connection with ourselves (trauma) can be very difficult to find back. Who am I really? What do I actually want? You may have developed a great sensitivity to what others think and want, but what about you…? Can you tap into your own wisdom? Can you find the courage? Do you experience buffering protection, ‘holding space’, a non-judgmental presence of someone to whom you can show your emotions, after which you can come up with your own solutions?
Does David dare to do this? Peter notes that regularly, he seems to see rejection in David’s eyes. Anja also indicates that she often does not feel the connection. They are disappointed that they get so little appreciation from Z even though they try so hard. They look for appreciation for who they are and what they do. The whole situation has a negative impact on their self-esteem, on their relationship, on their health.

The question is… where did that start, that lack of appreciation? The origin of this probably lies in what they just made visible with the layings: in the parental family they were not really allowed to be who they were. There was a lot of criticism and their self-expression was limited. Not being valued as a child has left a wound for both of them. That wound deserves healing, just as the wounds of their parents deserved healing. However, David cannot realize this for them, just as they could not do it for their parents. He is not his sparkling self, but they, too, are currently not themselves, as they have explicitly stated. A child cannot retroactively restore your own childhood. This requires different steps. A first could be that you yourself appreciate how you have done your best. You committed yourself with everything you had; what you gave, was all there was. Old pain often lives right under the surface. Sometimes it only takes a little to touch it. If David disagrees with Anja, she feels irritation and tries to justify herself, as she did to her parents. When David is displeased and screams, Peter gets a knot in his stomach and shuts down, just like he did when his dad would explode. We investigate which feeling goes with that behaviour. After mentioning some things that involve more labels and judgments, he gets to the crux: “Sadness, emptiness, loneliness.”

I explain how immature the human brain is at birth and how quickly it forms under the influence of social experiences. I tell them that especially a feeling of insecurity results in the development of a number of ‘highways’ that bring you smoothly and adequately into a survival mode, but that make it difficult to react in a balanced way and consider things carefully. The most primitive part of your brain yells ‘Alarm!’ and so that is how you react: with defense mechanisms. The more the brain is ‘marinated’ in oxytocin in early life, the more finely branched the neurological network develops and the richer your behavioural pattern. The more the emotions that arise from fear and insecurity and loneliness are depressed (depression!), the greater the chance that they will lead to damage: damage to your social functioning, to your mental well-being, to your health.

Anja says that indeed she still often feels that she has to defend herself against her parents and we discuss whether there is a question of ‘should’. Could she learn to see the way her parents try to enforce that responsibility as their way of being heard…? We conclude that there is a lot of mirroring going on between parents and children: Anja once wanted to be heard by her mother and felt unheard, probably because her mother was trying to be heard by Anja, whose job it was not and now we have a whole generation. The result: misunderstanding and miscommunication and disruption of the relationship in several directions… very sad. And yet it is important to remember that every pattern of behaviour we develop was once functional, even if it gets hopelessly in the way later on. By looking at things this way, we can develop compassion and learn to see what caused it. Then it is no longer about ‘What is wrong with you?’, but about ‘What happened to you?’, not about ‘What is your problem?’, but about ‘What is your story?’. It takes time and attention to develop this approach, but it has the potential to change everything for the better.

They tell about a health care professional who advised them not to be too hard on themselves and that they are doing just fine, but it doesn’t feel that way at all. “Recently David said: ‘I wish I wasn’t there, that I was dead’… and I’m very sorry that he feels that way…” Anja is in tears at this intense revelation. I ask if one of them recognises that feeling. Peter says: “Yes, I have been there, that feeling of… if I wasn’t there anymore, I didn’t have to do so much and I didn’t have to think all the time…”
I return to an earlier topic and ask if it is not time to tell David about the difficult IVF process, because I would not be surprised if some of his statements have to do with it. They wonder if that is not too hard for him, to which I wonder if it might still be too hard and too sad for themselves. They see how sweet and gentle he is towards babies. Having to tell him that he will never get a sibling… and then face it again… that is no small feat. Still, they want to consider it, discussing this heavy theme with him in a mature way: “He heard us talk, of course, so he may know more than we think…”

In any case, they feel that something has to change. They both find that nowadays they say too often that they do not like what he is doing, and they realise that David may translate that as “I am not lovable,” a message they do not want to give at all. I share their concern about that and say he is authentic when he says all those heavy and difficult things. The brave step they can take is to ask themselves: “What triggers me in what he says? Why is this so difficult for me?” And also: if he feels that way, can they offer holding space for that? Can they sit in the dark with him? And how long can they sit in the dark themselves? It is difficult for them to take good care of him when their own energy is so lacking. I give the example of the oxygen mask in an airplane: parents always have to put it on themselves before they help their child. This resonates and that is beautiful; some one-liners can quickly bring you back to the core at the craziest moments, without very theoretical considerations. With the help of those, they can support each other change ingrained habits.

Whatever the next steps will be… everything starts with awareness, with understanding one’s own and others’ patterns of behaviour and reaction. There is no mirror as sharp and confrontational as a child for the parents and the discontent of David is not unknown to Anja and Peter: there are many dimensions in their lives that they would like to see differently and that deserve attention. If they are constantly stressed about the things that are not going well, their whole system gets disrupted and it becomes almost impossible for them to be present for David as a co-regulating adult. They can try to get into David’s skin when things get rough: if they were in his shoes, what would they need? And perhaps they have already started doing that (after all, they approached me!) and all three have yet to kick the high adrenaline levels of the past period. The alertness of adrenaline gives the feeling that you are ‘alive’, that life is exciting, but adrenaline is also extremely addictive. When there is more calmness and time for reflection and contemplation, it almost feels more threatening than the constant stress.

Anja has meanwhile prepared a delicious lunch and we eat together after a final draw of two beautiful psychological cards that are very suitable for both. They reminisce how they got to know each other and how exciting that was, how they sent endless emails and how they were head over heels for each other.

We have talked for a long time and I have seen a lot of love and also a lot of pain and sorrow. There is much willingness in both to give and do good, to learn and to try, and at the same time there is such a high need to receive and be comforted. That makes sense, because as humans we crave meaningful connection, closeness and nurturing. I sincerely hope that we have been able to make a small start in figuring out where needs have been left unmet and can still be satisfied. We have untangled the knot to some extent and now it’s up to them to study the threads more closely.
When Anja has taken me to the train, I walk to the platform, fully absorbed in my thoughts. I am tired and grateful, sad for their old pain and hopeful for their open vulnerability.