Sunday, December 2, 2012

Bipolar Anger & Toxic Shame?

Fighting the SYSTEM "Out There," or a SYSTEM Within?
She was "acting out," angry at the SYSTEM!

'The system's F..... Man! I been waiting for an hour and these jerks just keep messing me around.

Later: I watched her storm out of the office area towards her waiting children, yelling abuse towards the SYSTEM once again.

'Your all a pack of F.....g B......'s, and you can all rot in F.....g hell.'

Many sat around me cringed as her tirade towards the office staff continued. Something about her social security benefit's being reduced unfairly, in her eyes.
'Wow! She's really pissed off, at them, eh?' Said a person sat behind me. 'She's sure crazy now, man!' Said another.

It seemed so patently obvious that she was angry because her benefit payments had been reduced, and the office staff were to blame, they were the F.....g System. Simple cause and effect thinking? Plain commonsense? Right?

Yet was her "acting out," stimulated by a reaction towards the world "out there," in our everyday cause and effect reasoning? Or was she fighting a system within, in an effort to control her own, deeper feelings of shame-humiliation? Is our mind's "objective" sense of the world "out there," really a true reflection of the reality of our nature, and our internal motivation? It is said by many psychologists, that the best emotional antidote for feelings of shame, is the emotional energy of anger-rage. Was the need of an antidote to feelings of shame and humiliation, the real cause of an angry lady, unconsciously "acting out?" Blaming (anger-rage) the staff in the office for a deeper sense of shame, she could not afford to consciously acknowledge? Consider an explanation of "unconscious" shame reactions;

Anger--Rage & Unconscious Shame Reactions?

Stigma, just like rank and status is entwined in a compass of shame which binds us all together. Shame is the emotional force which shapes our civil society, our civilization. Shame is the emotional glue which keeps us together in structures of social order, underpinning our hierarchical orders of rank and status. Some think that shame and our unconscious reactions to this innate affect, is the emotional compass around which society functions.
At the North end of the Compass is Withdrawal. At the East end of the Compass is Attack Self. At the South end of the compass is Avoidance. And at the West end of the compass is the Attack Others pole.

"The Compass of Shame by Harold Grossman, MD, FRCP(C)

In the 1960's, Dr. Sylvan Tompkins investigated, through the use of video tape analysis, the primary instinctual affects (emotions of the moment) of infants. He described nine innate primary affects which he said were truly constitutional rather than learned responses. Two are positive: Joy and Excitement. One is neutral: Startle. The negative six affects that one can observe are: Fear, Disgust (tongue out), Dissmell (lifting away of the nose), Rage, Despair, and most importantly, Shame (eyes averted, head down). Shame is supposed to be a protective response to keep us connected to the group rather than wondering off dangerously by ourselves.

It has been given to us to help us survive and to eliminate it would not be safe.
When confronted with shame in our adult years, those of us with good self esteem and a background of being loved and accepted, process the experience differently then those who do not have these inner resources. The most mature of us begin an inner search of memories for times when we felt truly accepted and loved, and are able to recover our equilibrium and even learn something more about ourselves and about the part that was exposed.

Those of us that cannot digest the shame in this way respond in one of four different defensive directions,a concept organized by Dr D.L. Nathanson, he calls “The Compass of Shame”. Each pole represents a scripted set of things to say to oneself and ways of behaving towards others.

At the North end of the Compass is “Withdrawal”. It is hiding from others and living in fear of exposure of what we perceive as a defect or weakness. It leads to isolation and gradual absorption into a darker insulated world. It would tend to defeat our human need to belong, for sake of survival.

At the East end of the Compass is “Attack Self”.
With this set of behaviors we diminish ourselves in the presence of others. In a sense it is “heading off at the pass” the fear of rejection. Unlike Withdrawal, we can stay connected, as it is not hard in this competitive world to find a person who wants to feel like a winner by connecting to a loser. In its safety it just worsens the pain and degrades the soul. There is a danger in living at the North and East poles. Because the feelings are not processed, they can build up inside and can lead to explosions or extreme violence (a notable example was the story of the murderous teens in the shootings at Columbine).

At the South end is the opposite of “Withdrawal”, what Dr. Nathanson calls “Avoidance”.
The goal of this strategy is to hide the feelings of shame entirely from consciousness, if possible. The use of alcohol and other illicit drugs leading to addiction is a way of avoiding the feelings. It is said that shame is dissolved in alcohol, melted by narcotics and boiled by cocaine and amphetamines.

Another strategy used at this pole of Avoidance is to call attention to oneself in ways meant to distract others by “showing off” or being an exhibitionist. It is also at the core of a theory about the development of Narcissistic Personality Disorders, whose self aggrandizement is seen as an avoidance of shame to the point of complete unawareness. Like the East pole, people remain connected with others, although in a way that is devoid of true intimacy (i.e. the sharing of vulnerabilities). It creates a hollow, false sense of self and, like the addiction strategy, seems never to be enough to satisfy the underlying need.

At the West end is the “Attack Others” pole. Simply put, this strategy refers to the bully who metes out their own inner sense of shame on another. It is these people who prey on the vulnerable, leading to damage that scares people, often for the rest of their lives. Even the most stringent of rules to contain their behaviors does not solve the problem that promotes these actions. Until the matters of shame are addressed, these people remain a risk to those in their sights.

At all points in this “compass of shame” there is significant damage to the individual and to others around them. Humility can be a path leading away from the poles of this compass and bringing us to healthier ways of living and relating. We can move from shame to humility when we allow ourselves to feel accepted and loved with all our flaws, all our vulnerabilities and failures. Humility can enable us to preserve our attachment to relationships and groups that mean safety and security to us. By striving for humility, we can make the choice to be autonomous and authentic, without diminishing ourselves or destroying the possibility of relationship in our interpersonal worlds." And we learn about shame very early in life, as John Bradshaw points out below.

Shame is the emotional force which drives unconscious reactivity and shapes human groups from the average family up to nations and international relations. Its affects were represented in Harold Grossman's essay above, with observational descriptions. Yet such surface observations and descriptions leave out the neurobiology of the brain and nervous systems, particularly the autonomic nervous system, and their whole body/brain, unconscious role in our blaming and shaming, reactions and counteractions.

The Human Face - The Dashboard of Emotion?
Some suggest that these unconscious and autonomic reactions of anger-rage and shame-humiliation, are spoken of as metaphor in Shakespeare's "the slings (rage) and arrows (shame) of outrageous fortune?" It can be fun to watch politicians debate their party agenda, and with this compass of shame in mind, and notice how we rationalize an unconscious motivation. Sylvan Tomkins believed that the primary "affects" he described, are most visible on the human face, which he called "the dashboard of emotion." Although Grossman is correct in his statement, "Shame is supposed to be a protective response to keep us connected to the group rather than wondering off dangerously by ourselves."

Shame, as a survival response, has been adapted for the "social politics," of our rank and status hierarchies, in civil society. Many of us know the superior look of contempt from a higher ranking authority figure in our life. Is it an instinctive aspect of our nature, designed to affect that down-spiral feeling of shame, many us know well from less than optimal, childhood experience? The emotional trauma of childhood, is only now, beginning to be understand, in its life-defining consequences, with the question of nervous system sensitivity, changing our view of trauma from an external observation of "event related" impact, to the internal dynamics of brain-nervous system function.

The Human Face - The Dashboard of Emotion?

* * *

From Sylvan Tomkins observations of the these primary affect/emotions and his nomination of the face as the dashboard of human emotions, consider Stephen Porges recent discovery of a third branch to our autonomic nervous system, whereby the nerves and muscles of the head and face, regulate the tone of the heart, and our unique human interactions of "social engagement." Professor Porges has called his discovery, "the Face-Heart, connection."

Discovering a Paradigm Shift in Mental Health?
Prof, Stephen Porges - "The Polyvagal Theory"

Understanding the Face-Heart connection, and hidden vitality affects, in human health?

The paradigm shifting discovery of a “polyvagal” control of the heart, explains just how, those of us suffering from unresolved trauma experience, become locked out of the social system of group survival, in our inability to self-regulate unconscious survival reflexes,
ie, freeze/flight/fight?

The theory shows just how “unconscious, spontaneous, social reflexes,” are inhibited in those of us struggling to cope with unresolved traumatic experience, so often diagnosed as a mental illness. In a computer analogy, its like having two distinctly different operating systems, (1) survival, (2) social. If our unconscious spontaneous social reflex functioning is “turned off,” by unresolved trauma experience, we cannot form the kind of healthy human relationships, so vital for our physical/emotional/mental health.

* * *

Consider the Affect of Shame on Families & Society, 
Unconsciously Handed Down to each New Generation?

My Name Is Toxic Shame

I was there at your conception
In the epinephrine of your mother’s shame
You felt me in the fluid of your mother’s womb
I came upon you before you could speak
Before you understood
Before you had any way of knowing
I came upon you when you were learning to walk
When you were unprotected and exposed
When you were vulnerable and needy
Before you had any boundaries

I came upon you when you were magical
Before you could know I was there
I severed your soul
I pierced you to the core
I brought you feelings of being flawed and defective
I brought you feelings of distrust, ugliness, stupidity, doubt
worthlessness, inferiority, and unworthiness
I made you feel different
I told you there was something wrong with you
I soiled your Godlikeness

I existed before conscience
Before guilt
Before morality
I am the master emotion
I am the internal voice that whispers words of condemnation
I am the internal shudder that courses through you without any
mental preparation

I live in secrecy
In the deep moist banks of darkness
depression and despair
Always I sneak up on you I catch you off guard
I come through the back door
Uninvited unwanted
The first to arrive
I was there at the beginning of time
With Father Adam, Mother Eve
Brother Cain
I was at the Tower of Babel the Slaughter of the Innocents

I come from “shameless” caretakers, abandonment, ridicule,
abuse, neglect – perfectionistic systems
I am empowered by the shocking intensity of a parent’s rage
The cruel remarks of siblings
The jeering humiliation of other children
The awkward reflection in the mirrors
The touch that feels icky and frightening
The slap, the pinch, the jerk that ruptures trust
I am intensified by
A racist, sexist culture
The righteous condemnation of religious bigots
The fears and pressures of schooling
The hypocrisy of politicians
The multigenerational shame of dysfunctional
family systems

I can transform a woman person, a Jewish person, a black
person, a gay person, an oriental person, a precious child into
A bitch, a kike, a nigger, a bull dyke, a faggot, a chink, a selfish
little bastard
I bring pain that is chronic
A pain that will not go away
I am the hunter that stalks you night and day
Every day everywhere
I have no boundaries
You try to hide from me
But you cannot
Because I live inside of you
I make you feel hopeless
Like there is no way out

My pain is so unbearable that you must pass me on to others
through control, perfectionism, contempt, criticism, blame,
envy, judgment, power, and rage
My pain is so intense
You must cover me up with addictions, rigid roles, reenactment,
and unconscious ego defenses.
My pain is so intense
That you must numb out and no longer feel me.
I convinced you that I am gone – that I do not exist -
you experience absence and emptiness.

I am the core of co-dependency
I am spiritual bankruptcy
The logic of absurdity
The repetition compulsion
I am crime, violence, incest, rape
I am the voracious hole that fuels all addictions
I am instability and lust
I am Ahaverus the Wandering Jew, Wagner’s Flying Dutchman,
Dostoyevski’s underground man, Kierkegaard’s seducer,
Goethe’s Faust
I twist who you are into what you do and have
I murder your soul and you pass me on for generations
MY NAME IS TOXIC SHAME” _Leo Booth/John Bradshaw.

* * *

Toxic Shame & Emotional Trauma in Childhood Development?

In 2013 the DSM-5 is due for release, along with a proposed new definition of childhood trauma, in order to further clarify the issue of post traumatic stress disorders. Please read a recent paper for this proposal;

Understanding Interpersonal Trauma in Children:
Why We Need a Developmentally Appropriate Trauma Diagnosis

"Childhood exposure to victimization is prevalent and has been shown to contribute to significant immediate and long-term psychological distress and functional impairment. Children exposed to interpersonal victimization often meet criteria for psychiatric disorders other than posttraumatic stress disorder (PTSD).

Therefore, this article summarizes research that suggests directions for broadening current diagnostic conceptualizations for victimized children, focusing on findings regarding victimization, the prevalence of a variety of psychiatric symptoms related to affect and behavior dysregulation, disturbances of consciousness and cognition, alterations in attribution and schema, and interpersonal impairment. A wide range of symptoms is common in victimized children.

As a result, in the current psychiatric nosology, multiple comorbid diagnoses are necessary—but not necessarily accurate—to describe many victimized children, potentially leading to both undertreatment and overtreatment. Related findings regarding biological correlates of childhood victimization and the treatment outcome literature are also reviewed. Recommendations for future research aimed at enhancing diagnosis and treatment of victimized children are provided." From: The Trauma Center

As it states at the top of this blog, I firmly believe that bipolar disorder involves the body and the nervous system, as much as it does the brain, particularly the bi-phasic activity of the autonomic nervous system. Perhaps the very root of our ubiquitous tendency to blame and shame, "the slings and arrows of outrageous fortune?" What do YOU think?

Discovering a Paradigm Shift in Mental Health?
Bipolar Anger