Trauma, Brain and Relationship Helping Children Heal
From NEURONS TO NEIGHBORHOODS
Second Annual Conference
Interview with Jane Weatly-Crosbie, MSW, LCSW
MS. JANE WEATLY-CROSBIE, FOR REFERNCE CAN YOU GIVE US YOUR NAME, PROFESSION, AND SPECIALTY?
My name is Jane Weatly-Crosbie. I'm in private practice as a psychotherapist in Santa Monica, and have been doing this work for about 30 years. I have a lot of clients and specialize in the area of attachment trauma, or early developmental trauma, meaning people who have had some sort of abuse or neglect in their early life situations and this has created changes in their actual brain structure. A lot of the ripples in the stream of the effects of that come into how it affects their relationships with other people, their capacity to relate, their capacity to regulate themselves, and their capacity to handle their own affect storms.
WITH THIS NEW MATERIAL THAT WE'RE HEARING ABOUT TODAY IN PSYCHO NEUROBIOLOGY, HOW HAS IT EFFUSED YOUR WORK, AND WHAT DO YOU THINK ABOUT IT?
I am especially interested in the links, the linkages between the neurobiology and somatization, which is another area of my interest and expertise. For a long time, the psychosomatic illnesses have been sort of like a stepchild in the medical system. They don't really get adequate care, because the medical ways of operating are very much to attend to the structural problems, whereas these issues are more predominantly functional problems in health issues. They're actual changes in the body, but usually the degree of measurable effect is very subtle, so that our tests don't really reflect adequately what's going on. Now that neuroscience has been in this particular area doing some exploration, we're beginning to understand what the problem is.
The person whose theory I think is very sound, is a neurologist named Bob Scare. He works with the idea that these psychosomatic illnesses are the reflection of bipolar cycling in the autonomic nervous system, in disregulations of the autonomic nervous system. Sometimes the person is in a highly aroused state with heightened heartbeat and high blood pressure. Sometimes the person is in the parasympathetic end of the autonomic nervous system and the diseases that are related to that. It's much more difficult to determine exactly what's going on in a situation like that, because of the complexity of the changes and the swings. What I like about this study is it helps me in working with patients to really help them discover what is hard wired about their situations and what they can adapt. There really are changes that can be permanent in the brain with regard to a person's capacity to regulate him- or herself; the capacity to just deal with affect, feelings that are coming up. And those intense affects directly affect the body.
NEUROBIOLOGY HAS HELPED YOU IDENTIFY WHAT'S GOING ON WITH THE PATIENT, RIGHT? AND IT AFFECTS SELF-REGULATION? THAT HELPS HOW YOU TREAT THEM?
When a patient presents a problem, for example, a common one is irritable bowel syndrome. They're coming into the office and they're suffering from abdominal cramping and their whole world perspective just kind of narrows down to this very central pain that's just dominating everything, I do a couple of different things to work with them. I work with the body. I invite them to come with me into attending to the sensations. This is a real challenge for people who have physical pain, because they've dissociated from their bodies, because it's too much. So that's one way I help them, by just kind of teaching them to hang out in the sensational realm.
The other thing that I do is I help them understand that this isn't all their fault. You know, I think a lot of times when people are sick, they think, "what's wrong with me" and "it's all my fault." In this sense, I'm helping them see that these structural changes in the brain happened when he/she was a tiny child, and those structural changes directly impacted their own autonomic nervous system and reduced their capacity to deal with normal stressors that other people can deal with more easily because their structure is different. For example, there's a part in the brain called the cingulet, and that part of the brain has a lot of opiate receptors, which means that the natural body's pain killers are located there. Well, in a person with IBS, who often has pain, though that particular cingulet, the cingulet does not function property. It does not have the normal inhibiting functions.
HOW DOES THIS RELATE TO CHILDHOOD TRAUMA?
In the childhood experience, when a young child is in relation to the parent, the attachment bond between the parent and the child is really the carrier of all development. The regulation that a mother provides, the soothing that the mother gives to the baby, the calming of the baby's nervous system, if she can do that well, the baby's nervous system will learn how to regulate itself. If she cannot do that, if she herself is all unregulated, if she is sick, if she is in marital discord, if she's depressed, she cannot attend adequately to her baby to where the baby feels like there's somebody there watching out for him or her. Then the baby goes into these heightened states of hyper-arousal and disregulation. The body, the template of that, is being set for later somatization problems.
I use awareness of neurobiology to educate people as to what's going on in their situations of chronic ill health. Some of them haven't understood that this was really a product of very early misattunements in their relationships with their primary caregivers. That their own capacity to regulate their feeling states and their bodily states never fully developed and that has produced this ongoing state of chronic ill health. I work with trying to help them minister to the pain and reduce the pain. I also work with them to help them find meaning in what this experience could be for them. It's something I understand as a meaning in the person's sort of growing toward wholeness. The symptom itself can help them fill in or fill out certain aspects of the personality that haven't been developed, that are somehow brought into the forefront by this illness. For example, people who are spending a lot of time racing around, an illness really slows you down, and that can definitely be a way of finding some meaning in this sort of otherwise depressing and difficult experience of having chronic illness.
HAS THIS NEW NEUROBIOLOGICAL RESEARCH MADE IT MORE EFFECTIVE FOR YOU IN YOUR ESTIMATION?
I believe it has, because I have explanations now that I didn't have before. I can help people determine which things might be hard wired, as opposed to which things they can continue to adapt further. Some people are just adapting and adapting and adapting. When in fact these early memories from child abuse, for example, are indelibly imprinted in a young child's brain, they set off fear responses like flashbacks and then there's a whole cascade of bodily symptoms that often follow. When a person has some reassurance that this present situation is linked with that past, it just kind of puts things in perspective and makes things make sense in a way that it didn't before.
THAT'S GREAT. THANK YOU FOR THE INTERVIEW MS. WEATLY-CROSBIE.
(END OF INTERVIEW)
Stan Tatkin, Psy.D. - Psychotherapist
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