Friday, December 7, 2012

Mental Illness & The Face - - Heart Connection?

So What is the Face -- Heart Connection?
The Facial Reactions of our Primary Emotions, which Cannot tell a Lie?
And What is the Connection to Mental Illness?

Safety! & "Autonomic-Unconscious" Nervous Reactions.

Safety, as an inner sensation, not a mind-based concept. Its that feeling of inner-security the late, great, John Bowlby and developmental psychologist Mary Ainsworth called our "secure-base," and our fundamental need of attachment to others, for healthy physical and emotional/mental, functioning. Consider;

"Attachment theory describes the dynamics of long-term relationships between humans. Its most important tenet is that an infant needs to develop a relationship with at least one primary caregiver for social and emotional development to occur normally. Attachment theory explains how much the parents relationship with the child influences development.

Attachment theory is an interdisciplinary study encompassing the fields of psychological, evolutionary, and ethological theory. Immediately after World War II, homeless and orphaned children presented many difficulties, and psychiatrist and psychoanalyst John Bowlby was asked by the UN to write a pamphlet on the issue which he entitled maternal deprivation. Attachment theory grew out of his subsequent work on the issues raised.

Research by developmental psychologist Mary Ainsworth in the 1960s and 70s reinforced the basic concepts, introduced the concept of the "secure base" and developed a theory of a number of attachment patterns in infants: secure attachment, avoidant attachment and anxious attachment. A fourth pattern, disorganized attachment, was identified later." See: Attachment theory

Feeling safe within, having a secure-base, is now increasingly understood, as being as vital to our physical, emotional and mental health, as oxygen is for our ongoing survival. All the research and fearless thinking of the 1950's, has been recently updated by a surge in high tech neuroscience research from the 1990's on. Feeling unsafe within, not having a secure-base, "autonomically" triggers our ancient freeze/flight/fight defenses, through a process professor Stephen Porges calls "neuroception?"

Prince Siddhartha - The Buddha
When we don't feel safe within, when we have no secure-sense-of self, the resulting muscular tension, is written all over our face, as the examples of primary affect/emotions above, clearly show. Hence my reference to the Buddha's serene face in my previous post, and its remarkable absence of muscular tension.

Did this Prince of Sense-Ability understand an inner reality, for which modern science is only now unveiling "empirical evidence?" Does Stephen Porges "The Polyvagal Theory" provide us with the scientific proof of ancient wisdom's about the mind-body connection? See Mental Illness - Psychological & Physiological? and Discovering a Paradigm Shift in Mental Health?

Are we entering a period of healing a mind-body split within Western medicine, which is contributing to our burgeoning problems with mental health issues? In presuming a diseased brain process, are we producing more chronic mental health problems, by medicating natural, nervous system reactions? Such as a much misunderstood, and thus thwarted, natural response to trauma, which can become a serious mental illness?

Have we become so lost in a mind-based sense-of-ourselves, that we fail to notice and register the communication which is written all over our faces? Silvan Tomkins, the father of "affect theory," suggested that the human face, is the dashboard of our unique emotions, and now "The Polyvagal Theory" is showing us just why this is so. Showing just how facial expressions and emotion, helped evolve that "higher faculty" of intellect, and the frontal-lobes, we are so very proud of. Consider more from that decade of fearless thinking, the 1950's, which some suggest was a natural reaction to the carnage and loss of two world wars. Please consider;

"In psychology, affect is an emotion or subjectively experienced feeling. Affect theory attempts to organize affects into discrete categories and connect each one with its typical response. So, for example, the affect of joy is observed through the display of smiling. These affects can be identified through immediate facial reactions that people have to a stimulus, typically well before they could process any real response to the stimulus.

Affect theory is attributed to Silvan Tomkins and is introduced in the first two volumes of his book Affect, Imagery, Consciousness. The word affect, as used in Tomkins theory, specifically refers to the "biological portion of emotion," that is, to "hard-wired, preprogrammed, genetically transmitted mechanisms that exist in each of us" which, when triggered, precipitates a "known pattern of biological events," although it is also acknowledged that, in adults, the affective experience is a result of both the innate mechanism and a "complex matrix of nested and interacting ideo-affective formations." From Wikipedia, the free encyclopedia

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The Genetic & Generational Transmission of Mental Illness?

The Expression of Negative Affect/Emotion
He comes in wearing the same face every week. It triggers me sometimes, times when I'm fatigued, too low in energy to remain conscious of the unconscious, transmission of affect/emotion. Its the same default, kinda face from my family of origin too, the face of innate negative emotions? We share similar histories, of highly neurotic families, in a traditional Western style of existential angst and the same "affective disorder," also known as bipolar.

"Anger/Rage - frowning, a clenched jaw, a red face. Disgust - the lower lip raised and protruded, head forward and down. Dissmell (reaction to bad smell) - upper lip raised, head pulled back. Distress/Anguish - crying, rhythmic sobbing, arched eyebrows, mouth lowered. Fear/Terror - a frozen stare, a pale face, coldness, sweat, erect hair. Shame/Humiliation - eyes lowered, the head down and averted, blushing.

Inter-personal extension of affect theory
Affect theory has been incorporated into couples therapy. Two characteristics of affects have powerful implications for intimate relationships:
a). According to Tomkins, a central characteristic of affects is affective resonance, which refers to a person's tendency to resonate and experience the same affect in response to viewing a display of that affect by another person. Affective resonance is considered to be the original basis for all human communication (before there were words, there was a smile and a nod).

b). Also according to Tomkins, affects provide a sense of urgency to the less powerful drives. Thus, affects are powerful sources of motivation. In Tomkin's words, affects make good things better and bad things worse. This nonverbal mode of conveying feelings and influence is held to play a central role in intimate relationships.

The Emotional Safety model of couples therapy seeks to identify the affective messages that occur within the couple's emotional relationship (the partners' feelings about themselves, each other and their relationship), most importantly, messages regarding (a) the security of the attachment and (b) how each individual is valued." From Wikipedia, the free encyclopedia

     'My father could be violent at times, so full of explosive rage,' he said last week.
     'Mine too,' I'd replied and we discussed the generational nature of such families and
     their emotional style of coping with life's stress.

In 1950's, in other fearless thinking about families and the human condition, notions of a "double-bind," emotional issue in mental illness were formulated, along within a theory of the generational transmission of emotionality, which produced mental health issues in sensitive members of a family tree. Consider Bowen family theory;

"Multigenerational Transmission Process:
The concept of the multigenerational transmission process describes how small differences in the levels of differentiation between parents and their offspring lead over many generations to marked differences in differentiation among the members of a multigenerational family. The information creating these differences is transmitted across generations through relationships. The transmission occurs on several interconnected levels ranging from the conscious teaching and learning of information to the automatic and unconscious programming of emotional reactions and behaviors. Relationally and genetically transmitted information interact to shape an individual's "self."

We both grew up in the same country, my friend wearing his weekly face, and I, both raised in the UK during the 1950's. Both of us remember the harshness of corporal punishment at school, a British way of life struggling to leave the Victorian era behind. "Spare the rod, and spoil the child. - Children should be seen and not heard." And my favorite example of transmitting innate Shame/Humiliation, when a child asked what they'd done wrong. "Your breathing, aren't you!" Delivered face-to-face, with all the rest of those powerful, 'affective resonances" of negative affect/emotion.

In trying to resolve the impact of such negative experiences in childhood, the excitement of a new approach to life, has triggered the manic phase of my bipolar constitution. Like my friend, I have not been able to cope with the "joy" aspects of life, and the affect/emotion we label "elation." Yet elation, as source of "metabolic fuel," which is vital for the postnatal maturing of our brain-nervous systems, also shows a striking similarity to mania in adults? Please consider;

"Affect dysregulation is also a hallmark of Bipolar Disorders that involve manic episodes. Manic depressive illnesses are currently understood to represent dysregulatory states. The developmental psycho-pathological precursor of a major disorder of under-regulation can be demonstrated in the practicing period histories of infants of manic depressive parents.

"Noting the commonalities between elation as a basic practicing period mood in infants and manic symptomology in adults, Poa (1971) observes. 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."
Excerpts from "Affect Dysregulation & Disorders of The Self," by Allan N Schore.

Also consider an older post on this blog;

Its not easy to accept the notion of muscular tensions as the primary source of  mental anguish? The powerful, unconscious stimulation of approach & avoidance behaviors, in our "unconscious" muscular postures.

Understanding that such approach & avoidance responses apply just as much to our internal enviroment as our external circumstances, allows better awareness of this primary stimulation of "postural attitudes" to life, and their multigenerational transmission Take the thought of an unconscious, evolved nature a step further and insensitive responses to traumatized people, come into view, as the unconscious behavior of nature "acting-out?"

Try relaxing the muscles of your face, your tongue, the tensions of the jaw & around the eyes & be aware of spontaneous shifts in the depth of breathe. As the your focus turns to awareness of body sensations, the grip of intense dissociation eases within the mind & as the muscular system relaxes the minds activity follows?

This is how I now manage the excitement phase of coming up & out of myself & away from the fearful traumatized withdrawal, which some doctors call mania, paranoia or many other symptoms of mental illness. Consider Peter Levine's statements about posture, from my previous post;

"Our Postural Attitudes?
These bodily reactions are not metaphor’s, they are literal postures that inform our emotional experience. For example, tightness in the neck, shoulders and chest and knots in the gut or throat are central to states of fear. Helplessness is signaled by a literal collapsing of the chest and shoulders, along with a folding at the diaphragm and weakness in the knees and legs.

All these “postural attitudes” represent action potentials. If they are allowed to complete their meaningful course of action, then all is well, if not, they live on in the theatre of the body. Trauma is the great masquerader and participant in many maladies and “dis-eases” that afflict sufferers. It can perhaps be conjectured that unresolved trauma is responsible for a majority of the illnesses of modern mankind." Excerpt from: Mental Illness - Psychological & Physiological?

* * *

The Face & Positive and Negative, Unconscious Feedback?
This was my first attempt to write about, unconscious, Affect-Emotion?

Flowers remind us of "essence,"
What is the essence of a heart-felt smile? 
‘Why do you read this book so much?’ Sasi asks me.

‘Because it’s very good - fantastic food for thought.'

‘I like the smiling mother and baby on the cover,’ She tells me, ‘but the title, “Affect Regulation and the Origin of the Self - The Neurobiology of Emotional Development,” by Allan N Schore,’ she adds, shaking her head and wrinkling her nose.

‘It’s about how you maintain your organism, darling.’

Really!’ Raised eyebrows and a twinkle in her eye, underline her very playful nature and why I am so besotted with her.

‘No sweetheart, your organism, not your orgasm,’ I say, laughing.


‘Perhaps those smiling faces remind me of you darling’ I tell her.

Sasi beams now, one of those effortless and orgasmic smiles that affects me, into sensations of pure joy. Although, not without hooking you up to some sophisticated virtual machine, could I really convey the wonder of Sasiprapha's smile, and how it "unconsciously" affects other people. How do I give you a sense of its essence, the pure innate joy that is so often free from adult simulation or muscular constriction. She smiles with all the innocence of a happy and delighted three year old, and it feels like a whole body reaction from deep within her, not just the passing comment of facial expression, that many adult smiles often are. "Sasiprapha, is a force of nature," as some have commented, her effervescent vitality is so contagious, infecting-affecting, all who come within sensory range of her.

‘How do they remind you of me?’ She asks, smiling and fishing for more compliments.

‘Because a smile is like magic darling, just like you; the smile of innate joy is a vitality affect for both the giver and receiver,’ I tell her, and Sasi indicates confusion with a shake of her head and squinting of her eyes, as if to say ‘What?

‘Well, when you smile, facial muscle actions and nerves, send signals to neurons in your brain simultaneously changing the flow and temperature of blood through your head, and your nervous system gets an active chemical surge with all sorts of hormones released making you feel good - it’s what’s called a vitality-affect and that’s why smiling is orgasmic.’

‘Because it’s magic, sounded better,’ Sasi tells me with a mimicked yawn, causing me to hold the book up and explain that the smiling gaze of a loving mother is vital to the positive maturation of her young baby’s brain and nervous system, which goes through its most important postnatal growth and maturing process in the first three years of life. Positive, affective states, such as the affect/emotion of elation, which a mother's smiling face evokes, are vital to the growth of neural networks in the brain and autonomic nervous system reactivity, which will unconsciously guide her offspring through the experience of life.

‘It’s about the feedback fired neurons in your brain, darling’

Feedback fired neurons! - Sounds like a Chinese noodle dish,’ Sasi exclaims, hands held up to her face as she makes slant eyes at me.

‘Oor you wan feedback fired neurons, wid you sweet an sour pork?’

‘Its as good as chicken soup for the soul,’ I tell her with a shrug of the shoulders.

As the new field of ‘affective neuroscience’ explains, early affect experiences, such as the triggering of innate joy, which is the initial neuronal spark to the emotion we call elation, become imprinted in neural networks and nerves, setting up patterns of sensation expectation that will generally last a lifetime. Science now understands that postnatal brain growth and maturation is experience dependent, setting up patterns of unconsciously expected sensation experiences, which become an unconscious, "autonomic self-fulfillment."

Huh!’ Says Sasi.

Excerpt from: When Sasiprapha Smiles - And from the book quoted above;

"Facial actions in emotional expression, regulates blood supply to the brain for oxidative metabolism (P,150)

The development of internal representations of external objects - such as faces - that consistently provide stimulating responses to the infant. The elements which mediate this function are found in a "neural network or connection matrix," and the creation of the architecture of this network depends on pulses of electrochemical energy through the infants brain "at critical developmental junctures" (Page, 185)

As these pulses flow through the brain, synaptic connections are established and strengthened and the firing rates of groups of neurons are set. The result is that certain kinetic pathways are established, making it more likely that these patterns will guide future energy flows (P,185)." Excerpts from "Affect Regulation & The Origin of the Self."

Please consider;

"One’s posture and facial muscles signal emotional states, not only to others, but to oneself as well. We must be able to “resonate” with the sensations and emotions of others through non-verbal postures and expressed emotions, such “postural resonance“ bypasses the conscious mind. (see The Physiological Foundations of Mental Anguish?

Our perceptions of the motor acts and emotive reactions of others, appear to be united by a mirror mechanism that permits our brain to immediately understand what we are seeing, feeling or imagining others to be doing, as it triggers the same neural structures - that are responsible for our own actions and emotions.

The posture, gestures and facial expressions of people tell the untold tale of what did and did not happen when threatened and overwhelmed. Habitual postures tell us what paths need to be retraced and resolved. The traumatized body/mind was poised in readiness but failed to execute its coarse of action, it was blocked. Addressing a clients “body speak” first and then gradually enlisting emotion, perception and cognition is essential. Cannon’s “fight/flight” could be updated to “the A and three F’s: Arrest (increased vigilance, scanning) Flight, Flight and Fold (collapse into helplessness).

Trauma occurs when we are intensely frightened and are either physically restrained or perceive that we are trapped. We freeze in paralysis and or collapse in overwhelming helplessness.

While traumatized humans don’t actually remain physically paralyzed, they do get lost in a kind of anxious fog, a chronic partial shutdown, dissociation, lingering depression and numbness, a kind of “functional freeze.” (self sustaining feedback loops of emotion/thought and muscle contraction)

Modern culture tends to judge immobilization and dissociation in the face of overwhelming threat as a weakness. Beneath this castigating judgment lies a pervasive fear of feeling trapped and helpless. (mirror reaction - postural resonance) (the freeze reaction causes self-blame and self-hatred - the “fight” response turned on the self)"
Excerpts from "In an Unspoken Voice."

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From the fearless thinking of the 1950's to 2010 and;
The author of the Face -- Heart Connection:

Professor Stephen Porges, PhD.
The Polyvagal Theory provides a plausible neurobiologically-based model to understand socio-emotional and communication disorders. Moreover, the model provides a strategy to assess and to intervene. The theory assumes that difficulties in looking, listening and exhibiting other prosocial behaviors may be a product of a functional and not a structural brain abnormality. Based on the Polyvagal Theory, we have developed an intervention designed to improve social behavior and communications skills.

Organizing principles. Depending on the training of the therapist selected to deal with a child's behavioral problem, the parent will receive not only a preference for treatment but also a biased interpretation of cause. These different views depend on the experiences, professional training, and expectations of the therapist. In addition, parents, practitioners, and scientists often view the same behavioral problem from different perspectives. Often we have different vocabularies, assume different causes, and look to different treatments for remediation. In fact, the discipline within science or the training orientation within a profession will also bias our views. Professional training promotes an acceptance of a model to explain behavioral disorders that may be theoretically in conflict or difficult to translate into the constructs and vocabulary of another profession. Thus, even independent of clinical and financial resources, parents experience difficulties in selecting the most appropriate treatments for their child. Similarly, from a scientific perspective it is difficult to integrate knowledge gained from parental reports and clinical observations into an efficient and effective scientifically-based intervention strategy.

What is missing? We lack an organizing strategy focused on principles that transcend professional disciplines. Without appropriate organizing principles, we are unable to interpret the abundance of clinical and neurobiological information into meaningful patterns. Organizing principles provide approaches to make sense out of complex and often conflicting information. Unfortunately, organizing principles employed in one discipline (e.g., the structure of personality in Psychoanalysis) may be incompatible with the theoretical constructs of another discipline (e.g., the ontogeny of the brain in Neuroscience). Clinicians, parents, and neuroscientists use different vocabularies to describe pathology and unique behavior. These profession-dependent lexicons limit our ability to communicate, to diagnose, and to treat children with developmental disorders.

However, some constructs transcend discipline. Specific constructs can be identified and demonstrated to be useful in furthering our understanding of normal and of atypical development. This proposal focuses on two organizing principles, based on the biological processes of evolution and dissolution (i.e., evolution in reverse). These principles help us understand the etiology of socio-emotional and communication disorders. When appropriately applied to research, these principles foster the development of three clinically relevant products:

1. A better understanding of the neurophysiological mechanisms underlying normal and dysfunctional development.
2. The development of more reliable neurophysiologically-based assessments.
3. The application of neurophysiologically-based intervention strategies consistent with our understanding of the mechanisms causing the disorder.

Polyvagal Theory: Three phylogenetic systems of affective regulation. The Polyvagal Theory was developed to relate the evolutionary shift in the neural regulation of the autonomic nervous system to the range and regulation of emotion expressed and experienced by humans. The theory proposes that physiological state limits the range of behavior and psychological experience. The Polyvagal Theory emphasizes the joint evolution of the facial expression of emotional state (including looking and listening) and the specialized neural regulation of our viscera (e.g., heart and gut) to regulate behavioral states. The Polyvagal Theory proposes that the evolution of the autonomic nervous system provides an organizing principle to interpret the adaptive significance of affective processes. The Polyvagal Theory links the evolution of the autonomic nervous system to affective experience, emotional expression, facial gestures, vocal communication and contingent social behavior. Thus, the Theory provides a plausible explanation of socio-emotional and communication disorders, a foundation for assessment, and an intervention strategy.

The term Polyvagal is used to emphasize the neurophysiological and neuroanatomical distinction between two branches of the vagus nerve. The vagus, a primary component of the autonomic nervous system, exits the brainstem and has branches that regulate structures in the head (e.g., larynx) and in several visceral organs (e.g., heart, gut). The Theory proposes that the different branches are related to unique adaptive behavioral strategies. The Theory articulates three documented phylogenetic stages in the development of our autonomic nervous system. These stages reflect the emergence of three distinct subsystems, which are phylogenetically ordered and behaviorally linked to communication (e.g., facial expression, vocalization, listening), mobilization (e.g., fight-flight behaviors), and immobilization (e.g., behavioral shutdown, fainting). The most phylogenetically recent component, the communication system, is dependent upon the functioning of the "new" mammalian vagus. The mobilization system is dependent upon the functioning of the sympathetic nervous system. The most phylogenetically primitive component, the immobilization system, is dependent upon the unmyelinated vagus, which is shared with most vertebrates.

Parts of several cranial nerves (i.e., trigeminal (V), Facial (VII), Glossopharyngeal (IX), Vagus (X) and Accessory (XI)) evolved to regulate the structures that emerged from the ancient gill arches of primitive jawless fish. The phylogenetic development of vertebrates, which is paralleled in our own embryology, illustrates transitions of the ancient gill or branchial arches into the structures of our face. These structures provide or modulate our direct contact with the world via looking through our eyes (i.e., controlling eyelids), listening to human voice through our ears (i.e., tensing the middle ear muscles), and breathing and ingestion through our mouth. The branches of the cranial nerves regulate the muscles associated with structures that emerged from the ancient arches and evolved together. Collectively, the branches of these cranial nerves are known as "special visceral efferent" pathways. Special visceral pathways are involved in controlling the voluntary social behaviors described above. Moreover, the source nuclei of these pathways located in our brainstem are neuroanatomically linked with structures that regulate ingestion (e.g., sucking, swallowing, salivation) and inhibit our cardiovascular system to calm us and to foster self-soothing behavioral strategies. Note that these systems are related to symptoms experienced by many challenged children including difficulties in listening, poor eye gaze, highly selective food biases and difficulties in regulating behavioral states (e.g., temper tantrums).

During evolution, as part of the special visceral efferent system, nerves evolved that regulate the muscles of the middle ear and the eyelids. With appropriate neural regulation, the muscles that control the bones in the middle ear and the eyelids produce a "looking and listening" behavior characterized by a lifting of the eyelids and a tensing of middle ear muscles. The tensing of the middle ear muscles actively attenuates the transmission of sound energy associated with low frequency background noise and functionally amplifies the higher frequencies associated with human voice. Neural regulation of these muscles controls the quality and quantity of acoustic and visual stimulation. Thus, this phylogenetically "new" system, via the central regulation of the special visceral efferents, enables us to select human voice from the complex acoustic environment, usually in parallel with direct visual eye contact with the person to whom we are listening.

The Polyvagal Theory proposes that the evolution of the mammalian autonomic nervous system provides the neurophysiological substrate for the emotional experiences and affective processes that are a major component of social behavior. In this context, the evolution of the nervous system determines the range of emotional expression, quality of communication, and the ability to regulate bodily and behavioral state.

Voluntary (i.e., cortical) control of the special visceral efferents, via neural pathways from the frontal cortex to the brainstem, is available when the environment is perceived as "safe." However, when the environment is not perceived as "safe," the nervous system will function adaptively to facilitate fight-flight behaviors. Fear, stress, and illness result in a retraction of this voluntary "social engagement system," resulting in an individual with compromised social abilities. Depressing this neural system has several behavioral consequences including flat affect, aprosody, difficulty in phoneme recognition, articulation problems, auditory hypersensitivity, and behavioral state regulation issues. Although these symptoms are nonspecific regarding differential psychiatric or behavioral diagnosis, they are shared by many children with developmental disorders." From: A neurobiological model of socio-emotional and communication disorders

Of coarse the paradox of our complex, evolved, human nature, is our instinctual need for quick, easily identified with, answers to complex questions? Hence to get the message across, the complex language of neuroscience and "The Polyvagal Theory," has been reduced to the simpler metaphor of;

The Face -- Heart Connection.

Mental Illness - Psychological & Physiological?
Discovering a Paradigm Shift in Mental Health?
Bipolar Anger & Toxic Shame
Bipolar Anger