I’ve recently read a series of articles and quotes that spoke to me and emphasized the direction I want to keep taking with this blog. It has to do with the remarkably unrecognized role that trauma plays in our culture. Trauma influences the way we understand chronic illness, whether physical, emotional or mental. It therefore also affects how we approach treatment.
I’d like to share a few of these quotes and links with you as I find my way with this topic, which feels difficult to describe because I’m talking about things we have come to see as normal in our culture.
I was recently reminded of the work of Alice Miller in a conversation with David. She is a Polish-born Jewish psychologist who survived the holocaust. She explored the role of childhood trauma that occurs through culturally condoned parenting behaviors. In her many books she described the role of this “Poisonous Pedagogy” in the roots of illness and violence (see more on her posthumous website). Here is a citation from David’s Master’s thesis in his training as a child and family therapist:
“Alice Miller (1984) in her book, “For Your Own Good” writes about poisonous pedagogy and guides to child rearing from the last two centuries that have been the breeding grounds of hatred and violence. She details how our cultural child-rearing techniques are abusive and how they are universally practiced and perceived as normal by our society. “How can they (children) know that their will was broken since they were never allowed to express it? Yet something one is not aware of can still make one ill.” 
We – as a culture, as a nation, as a society – are showing the effects of our own unrecognized trauma. Our parents, grandparents and great grandparents have lived during times of tremendous sources of pain, loss and horror. We, as a collective, have only just come through the Civil War, Slavery, the Genocide of Native Americans and Jews, two World Wars, The Great Depression and The Great Recession, Vietnam, 9/11 and now contemporary wars, etc… And these are just a few of the Big Ones.
The most precious thing a nation has is its future generation, yet because of our cultural burden of trauma we have developed blind spots. We’ve normalized what is in essence a lack of support for women and families in pregnancy, childbirth and the raising of their children. This normalization has made it difficult for mothers and fathers to bond with their babies and for children to feel connected and secure.
“Authentic connection – intimacy – is our natural state as human beings, the state we begin life in, the state we function best in, the condition we most crave, despite our wounds and defenses. 
Passing Trauma through the Generations
“The thing I’ve gained from the work I do is that stress is a big suppressor of maternal behavior,” she says. “We see it in the animal studies, and it’s true in humans.
Hurley adds that we are learning that the effects of stress and trauma also perpetuate across the generations:
“In a study led by Champagne … they found that inattentive mothering in rodents causes methylation of the genes for estrogen receptors in the brain. When those babies grow up, the resulting decrease of estrogen receptors makes them less attentive to their babies. And so the beat goes on.
We know there are similar epigenetic effects of prenatal stress in women, and that these effects carry forward through multiple generations. [4, 5]
Parents today, as well as their parents and generations of parents before them, have been caught between recommendations made by experts, who are supposed to know more than we do, and deep parenting impulses to console and respond to their children’s signals. Sleep training is one example of expert recommendations that have fostered this kind of profound internal conflict (see a history on this recommendation here and here).
Letting babies “cry it out” is not only stressful for them but associated with despair and giving up rather than the learning of a new behavior. The quote below comes from a blog describing a series of studies conducted by a leading psychiatrist and psychologist in the field of attachment and child development named John Bowlby (read more on wikipedia). The findings are distressing and they are painful to acknowledge. I see these feelings as a sign of health.
Researchers found that during CIO [crying it out], young children went through four predictable phases. The first phase, labeled “protest”, consisted of loud crying and extreme restlessness. The second phase, labeled “despair”, consisted of monotonous crying, inactivity, and steady withdrawal. The third phase, labeled “detachment”, consisted of a renewed interest in surroundings, albeit a remote, distant kind of interest. They concluded that while leaving babies to cry it out can lead to the eventual dissipation of those cries, it occurred due to the gradual development of apathy in the child. 
Another blogger writes about a 2012 study (here’s the abstract), which found that while mothers’ levels of cortisol decrease as babies learn to become quiet during sleep training, babies’ cortisol levels do not. 
Apathy and detachment are trauma responses. They represent the last ditch attempts to cope with an experience that is overwhelming and inescapable: through the unconscious nervous system response known as freeze. I describe how the initiation of the freeze response may affect risk for chronic illness in more detail in The Chronic Illness Model and Trauma is like a Dandelion. See some good reviews here and here on why following our hearts and guts to respond to our childrens’ signals, rather than letting them cry it out, is important.
The underlying patterns of trauma in our culture affect the way we approach and treat physical, emotional and mental health.
Presence and connection are healing, but it takes time, courage, and personal work on our own attachment and traumatic experiences to listen to the often difficult experiences that people with illnesses and addictions and depression have been through. Doctors are wounded healers. We are drawn to helping others even at the expense of years of difficult, intensive training. Like parents, doctors are torn. They are caught between the reasons they went into medicine – the desire to connect and make a difference – and a traumatized, depersonalized high-pressure system increasingly focused on the financial bottom line.
We’ve been seeing epidemic increases in type 1 diabetes, type 2 diabetes, heart disease, autism, inflammatory bowel disease, chronic fatigue, depression and other serious illnesses in recent decades. Many factors are seen as contributing to these rises, from changes in eating habits, exposures to toxins and the loss of the extended family, to the onset of hospital birthing, bottle feeding, and cesarean deliveries. While these factors are likely additive and important, I suspect that unrecognized trauma is the critical factor influencing susceptibility.
I come back to Rachel Remen, a pediatrician who grew up with inflammatory bowel disease and experienced both sides of divide: as a doctor as well as a patient with a life-threatening illness. She became a counselor, and a champion of the Art, and not simply the Science, of healing. This is part of why she became such a role model for me. I will close with this quote because it inspires me. It gives me hope that we will keep looking for the truth, because we recognize truth from the inside and it serves as our guide to what is truly healing. It is entitled “In the Service of Life.” 
There is distance between ourselves and whatever or whomever we are fixing. Fixing is a form of judgment. All judgment creates distance, a disconnection, an experience of difference. In fixing there is an inequality of expertise that can easily become a moral distance. We cannot serve at a distance. We can only serve that to which we are profoundly connected, that which we are willing to touch. This is Mother Teresa’s basic message. We serve life not because it is broken but because it is holy.
1. Ridinger, D. N. (2001). Enhancing a Child’s Inner Strength: A Systems Approach. Contemplative Psychology. Master’s Paper, Boulder, Naropa University, p. 6. citing Miller, A. (1984). For your own good. Toronto, Collins Publishers.
2. David told me about this quote by Terrence Real, author of I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression. The quote comes from Real’s article The Awful Truth, (2002). Psychotherapy Networker Magazine, November. Here’s a version of the article online, and here is how David used it, in context on his website.
3. Hurley, D. (2013). Grandma’s experiences leave a mark on your genes: Your ancestors’ lousy childhoods or excellent adventures might change your personality, bequeathing anxiety or resilience by altering the epigenetic expressions of genes in the brain. Discover. May.
4. Francis, R. C. (2012). Epigenetics: how environment shapes our genes. New York, W. W. Norton & Company.
5. Nathanielsz, P. (1999). Life in the Womb: the origin of health and disease. Ithaca, NY, Promethean.
6. The writer of this blog post refers to Bowlby but does not cite a reference directly. See a wikipedia article on James Robertson, a psychiatric social worker and colleague of Bowlby’s who describes the same perspective of seeing protest, despair and detachment in hospitalized children separated from their mothers.
7. Middlemiss W., et al. (2012). “Asynchrony of mother-infant hypothalamic-pituitary-adrenal axis activity following extinction of infant crying responses induced during the transition to sleep.” Early Hum Dev 88(4): 227-232; A letter submitted to the editor criticized the broad conclusions being made from this study. Middlemiss et al responded that their study is early in the field and small, not conclusive but still offering early insights into dissociation between behavior (babies that stop crying) and physiology (continued elevations in cortisol). I also found two blog posts of interest, one citing problems with the study, and another describing areas of validity.
8. Rachel Naomi Remen, Noetic Sciences Review, Spring 1996