Friday, January 27, 2012

Mental Disorder & The Felt Sense of Self?

From Felt-Sense to Felt-Self:
Neuroaffective Touch and the Relational Matrix. _Aline LaPierre, Psy.D.
As a long term sufferer of an affective disorder (Bipolar Disorder 1) as its subjectively categorized in the DSM 1V, a more primary communication with others has helped me stabilize cyclic energies & discover a lost, felt sense of self.

Merging a subjective, cognitive sense of self with a felt sense of self is helping me find an increasing sense of wholeness and well being?

Now living in a culture where interpersonal communication is based more on emotional connection via gesture, facial expression and voice intonation, than sophisticated dialogue, I'm daily invited to feel more than think? Involved in a relationship with no shared language, we are forced to communicate via our primary sources of inter-personal contact. Look's and touch are our means of reaching common understanding, as we discover the surprising depth of connection and communication involved in our mutual gaze and eye contact?

The flashing language of our eyes seems to speak more than a hundred words can say, and my troubled soul is finding its way home again? "Don't you miss the more sophisticated conversation from back home," a fellow expat asked me recently. "Sometimes, but I really needed to discover just how much I avoided myself in all that clever dialogue," I replied. Squinting eyes signaled his perplexed response, with no real need to say, "what do you mean?"

Before I came to Thailand I had read as much of the latest knowledge on the neurological underpinnings of our subjective experience, as I could get my hands on. It was a self education quest fueled by the failure of subjective analysis, to find better self interpretation and self regulation of mood. Forced into a primary form of inter-personal communication, new knowledge has found an experiential integration beneath my minds subjective awareness. Newly acquired knowledge about my brain and nervous system took on real depth and meaning through the primacy of body language.

During training to become a therapist in Sydney Australia, I remember well the topic of touch in the client - therapist relationship. Touch, like in the classroom has become increasingly taboo in a first world culture that sanctify's the power of cognition over the felt sense of being. Touching client's is strongly discouraged in many therapies that favor rational interpretation and fear the possible consequences of litigious accusation. Losing touch with one another also seems to be a particular malaise of our techno driven modernity, which coincides with an explosion in mental health problems? Our we loosing our grounded sense of self to a highly subjective mind?

For many years now, I have held the view that my experience of bipolar disorder, is a deep need to redress a developmental issue in my maturing process. Some suggest an emotional re-enactment of a missing experience during childhood, a missing need. That classic mania is a spontaneous, unconscious attempt to correct a thwarted emotional development. More scientific explanations of this view is what I searched for in the language of neurobiology and its research into the human condition. Here is an example;

"Noting the commonalities between elation as a basic practicing period mood in infants and manic symptomology in adults. Elation as a basic mood is characterized by an experience of exaggerated omnipotence which corresponds to the child's increasing awareness of his muscular and intellectual powers. The similarity between the two is striking.

Manic disorder has also been described in terms of a chronic elevation of the early practicing affect of interest-excitement; this causes a "rushing" of intellectual activity and a driving of the body at uncontrollable and potentially dangerous speeds." (Schore, 1994).

Since 2007, when I first began to explore my experience of manic depression by allowing it to unfold rather than suppressing it, this link between the need for elation in infancy and manic euphoria in adult life has rang true for me. It speaks to a constricted childhood experience, when I "held myself in," to avoid disturbing my father's unpredictable and rather volcanic rage.

My first experience of mania is captured perfectly in "a basic mood is characterized by an experience of exaggerated omnipotence which corresponds to the child's increasing awareness of his muscular and intellectual powers." I describe the muscular release of habitual tension and its affect on my sensory perception, leading to mania (here) In this post I would like to share more of a reading education that is bringing me an ongoing vindication of my views of an emotional need rather than medical illness, in classic manic depression.

From the paper; From Felt-Sense to Felt-Self: Neuroaffective Touch and the Relational Matrix. _Aline LaPierre, Psy.D.
"As a result of the current interdisciplinary rapprochement, a new-found interest in the use of touch in clinical treatment is challenging the classical view that physical contact is an intrusive and detrimental violation of neutrality. Basic research conducted by Tiffany Field (1995), director of the Touch Research Institutes at the University Of Miami School Of Medicine, shows that touch is at the foundation of relational experience and, in parallel to facial play and dyadic gaze, is a fundamental mode of interaction in the infant–caregiver relationship.

There is now widespread evidence that the basic nonverbal mechanisms of the infant–caregiver relationship are activated in the patient–therapist transference–counter-transference relationship. This principle has been incorporated into somatically–oriented clinical contexts, and so touch as a therapeutic intervention is emerging as a valuable tool to address breaches in the development of the relational matrix which cannot be reached by verbal means alone.

When we consider the somatic experiences of the preverbal infant for whom language links are yet unformed, or the neuronal and biochemical infraverbal processes that underlie verbal thought throughout the lifespan, we realize that tending to the inner life of the body—to the lifelong relationship between bodily experience and mental states—is experiential territory only beginning to find its rightful status in our treatment approaches which have privileged reason over affect and somatic states (Harris, 1998)."

As I've described in my account of a shift into altered perception, what took place was fundamentally a somatic experience. "Then it began, a new sensation, a feeling at the top of my head which flowed down slowly, down through my face, into my shoulders and down through my chest, down into my pelvic area. I sat with a sense of "what is it” wonder, although more felt than in any thinking sense.

A sense of wonder that was similar to the out of body experience when I was fourteen, except this slowly descending calm was the polar opposite of the sudden sharp elevation, when I'd seemly left my body. It felt like I'd been sitting in a bath of water that was over my head and someone had pulled the plug. I sat there as calm descended slowly from head to toe, as if a mind numbing tension were being drained out of me, like waste water flowing down and out through my toes."

What I believe led me into mania over the following 24 hours, was inexperience in managing the energies contained in my new sensory experience. And a life long need to nurture myself by the use of relational fantasy, led to an amplification of natural senses into delusion via vivid imagination. Enter the professional psychiatrist with his knowledge of medical intervention, for disruptions to a sense of normality.

In a preference for cognitive interpretation and the proven sedative effects of psychotropic medication, my psychiatrist doctor determines a medical illness. His training ranks him above other professions that explore the somatic nature of human experience and he views notions of energy release and balance as nonobjective, unscientific and in a practical sense counterproductive. Yet continuing research into the electro-chemical mechanisms of our body/brain speak increasingly in terms of shifts in metabolic energy states.

"The core of the self lies in patterns of affect regulation that integrate a sense of self across state transitions, thereby allowing a continuity of inner experience." (Schore, 1994).

Consider your reaction to a sudden and very loud noise close by, every human being has a startle response to this phenomena. A sudden freeze followed by a hyper-vigilant scan that seeks the source of possible threat. We all know what this looks like externally and describe it in those terms, yet internally there is an instant shift the energy state of the body/brain. What we are consciously aware of is an action response, yet beneath awareness electro-chemical reactions take place as a sudden shift in metabolic energy stimulates the action response.

Learning to get back in touch with my felt sense of self, after a life time of avoidance by using intellectualism has brought a more balanced and complete sense of self in an ongoing reunion of thought/felt sense in immediate experience. Like in the movie "sliding doors," fate is a matter of chance and circumstance and who knows how my life would have unfolded if I'd seen a somatic therapist and not a psychiatrist in 1980. Consider;

"Somatic Psychology has evolved to address the perceptual experience of the sensory channels to prepare patients to self-regulate their own physiological activation. Somatic techniques guide a patient’s attention inward to the interoceptive sensations—body heat, involuntary and voluntary muscular contractions, organ vibrations, skin sensitivity—to bring awareness to these invisible, usually unconscious, hard to perceive internal activities.

As a patient learns to increase conscious receptivity to internal visceral-affective experiences, a somatically-trained psychotherapist often uses touch and/or movement to guide,
stabilize, or stimulate impulses. The intent is to help a patient engage in a sensory dialogue that nurtures neurological deficits, encourages new neurological connections, elicits dormant impulses, stabilizes hyperactivation, and releases dysfunctional patterns in order to organize and facilitate neural interconnectivity and employ the body’s regulatory mechanisms in new ways."

Touch and the Relational Matrix:

"Lyons-Ruth (1999), Co- Director of Academic Training in Child Psychology at Cambridge Hospital and a leading attachment theorist, concludes that developmental change is based on unconscious, implicit representation rather than on symbolized meaning. She argues that “procedural systems of relational knowing develop in parallel with symbolic systems, as separate systems with separate governing principles”

Touch requires a specific focus of intention and attention and this in-depth, therapeutic and psychologically significant touch could be referred to as neuroaffective touch. Informed by current neurobiological, emotional, and developmental theories, a psychotherapist using neuroaffective touch focuses on tracking signals in the different physiological systems (skeletal, ligamentous, muscular, visceral, endocrine, nervous, fluid, and fascial) as they operate to keep the soma–psyche in dynamic balance."

Psychiatrist's view our sense of self through the minds cognition, its symbolized meanings (word thoughts), while a somatic therapist is interested in the implicit sense of self and its sensory experience within the body. Perhaps if I had seen a therapist more interested in my heightened sensory experience during my initial shift into a new sense of awareness, I might have discovered a growing balance of thought/felt experience much sooner? I might have learned to regulate my emotional energies much better a long time ago?

In a recent email reply to someone asking advice about a loved one going through psychosis, I suggested limiting verbal communication and calming by a compassionate acceptance and presence that uses appropriate proximity and the non verbal contact of eyes, gesture and touch. It is a very common experience of people in these crisis periods being made even more agitated by the dispassionate question and answer regime that greets them in formal medical settings. What is being acted out in psychosis are the primary, unconscious energies of our being, rational questions evoke a frustrated sense of being completely miss-understood.

Grounding exercises through mindful awareness, are now a common practice in many therapies treating mental health disorders. We all have a sense of that split between mind and body that can feel a bit like two separate people at times. As Ruth Lyons points out, “procedural systems of relational knowing develop in parallel with symbolic systems, as separate systems with separate governing principles.” Is it the loss of a felt sense of self through the experience of trauma that leads us into the imbalance of mental/emotional disorder?