psychotherapy – Becoming Human

The neuroscience of fear

Continuing my interest in the neuroscience of emotion, I recently finished reading neuroscientist Joseph LeDoux’s book “The Emotional Brain”(*). This is a quick review and synopsis, in particular of those points relevant to psychotherapy.

LeDoux is one of the best known figures in the field, alongside Antonio Damasio, whose work I have also delved into, but found rather indigestible. Although I found Ledoux more readable than Damasio, I have two major gripes with the book. The main one is the title: there is not a lot in the book about emotions in general; Ledoux rapidly zeroes in on the single emotion of fear, which is his area of specialism. On this subject he is relatively enlightening, but it wasn’t what I expected or hoped for. In addition, some of the statements he does make about emotions in general, even if they may apply to fear are not obviously true of all emotions.

Additionally, the blurb suggests a book which is highly readable, but I did not find this to be really the case. It’s fairly readable, but has a tendency, especially in the later chapters, to get lost in detail. I would say it is not ideally pitched to the non-specialist reader (though likely at the same time to be oversimplified for a specialist), and does not belong to the best in science writing. Having been written in 1998, it is of course also somewhat dated by now, though I have not come across anything more recent.

LeDoux argues convincingly – but it is not very surprising – that there is no single “emotional system” in the brain, but we have to look at each emotion separately. As i said, he focuses on fear, which presumably is one of the easier emotions to study because it has a much longer evolutionary history than some of the “higher” emotions like love and joy which seem more particularly to relate to human experience. It is quite hard to read any conclusions across from fear to these other emotions.

LeDoux argues that we typically have little reliable insight into the factors which trigger our emotions, but a great tendency to make up stories about them and to believe in these stories. Indeed, we are unreliable in our reports of our emotional states as such. Emotions, unlike cognition, are intrinsically linked to the body and prompt bodily response; they evolved as “behavioral and physiological specializations” (p.40). The characteristic “feel” of emotions reflect their different physiological signatures.

Emotions operate below the level of consciousness. This is illustrated by the phenomenon of “emotional priming” whereby the response to an explicit stimulus is influenced by a preceding stimulus the duration of which is too short for it to be captured in conscious memory (p.59). Mere exposure is sufficient; there is no need for any logical connection between the two stimuli.

The study of fear has, of course, a particular relevance to psychotherapy and some of LeDoux’s arguments bear consideration in this context, as he himself notes, though does little to develop. LeDoux argues that fear, and comparable emotions, are registered in the amygdala from where they govern programmed physiological reactions; at the same time there is a feedback loop to cognition which passes via the hippocampus. This latter circuit is obviously much more developed in humans than in lower mammals, but in all species it is notably asymmetric: the hippocampus, which is where new memories are created, has the equivalent of a broadband connection to the medial prefrontal cortex, but the available bandwidth is much less in the opposite direction. This, LeDoux argues, makes it difficult to reprogram the association made in the hippocampus between certain remembered events and the fear response. This sounds plausible, and may reflect experimental observations on the persistence of conditioned fear responses in rodents as well as the observed difficulties of therapy, but it is no more than suggestive of the conclusion which LeDoux draws.

Fear conditioning is the process which “turns meaningless stimuli into warning signs” (p.141). Some stimuli are preprogrammed: “laboratory-bred rats who have never seen a cat will freeze if they encounter one” (p.143). But most, of course, are learned. The simultaneous presence of two stimuli of which only one, the “unconditioned stimulus” (US) is intrinsically unpleasant is sufficient to form a link between them, on the basis of which the second or conditioned stimulus (CS) is subsequently sufficient to evoke the fear response, regardless of its intrinsic link to the US. This link is highly persistent and may indeed be impossible to forget completely even if, subsequently, no link between the stimuli is observed for a protracted period. The best that can be done is to extinguish it by presenting the CS repeatedly in the absence of the US, but there is always the risk of recurrence if relevant circumstances, such as re-exposure to the unconditioned stimulus, or simply a high level of ambient unrelated stress, arise. A CS may be almost anything: a place, a gesture, an expression, a tone of voice… Of course, the atomicity of these candidate stimuli is hard to determine : is being in exactly the same place necessary to evoke the conditioned response, or is it sufficient that a place bear some resemblance and, if so, in what respects?

In stressful situations, memory formation by the hippocampus is impaired. This would imply that traumatic events might not leave a memory trace, but still result in fear conditioning. In such cases, there may be no way to “reverse-engineer” the event out of the conditioned reaction. This has the clear implication that going after memories of traumatic events may be a fruitless strategy, and that resolution of trauma might happen without those underlying events ever being recalled, even if they occurred past the stage of childhood amnesia. However, the stress hormone cortisol has the opposite effect on the amygdala. Thus it is “completely possible that one might have poor conscious memory of a traumatic experience, but at the same time form very powerful implicit, unconscious emotional memories” (p.245). At the same time, recreating the emotional state conditioned does facilitate recall of explicit memories (p.212).

LeDoux’s analysis of conditioning and memory therefore sheds some light on problems encountered in therapy and on effective therapeutic strategies. I learnt something from this book, but I suspect that a general book on recent contributions of neuroscience to psychotherapy might have gotten me more rapidly to my goal.

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(*) References are to the 1999 paperback edition published by Orion books.

Five Rhythms

I have been dancing the movement practice called “Five Rhythms” on and off for a couple of years now, and am presently in the middle of a series of workshops which are subbranded “Heartbeat”. As far as I can gather from the founder’s website, which is not however very clear on this, this is intended to be the second of five “levels” in the Five Rhythms practice (the subsequent ones are “Cycles”, “Mirrors” and “the Silver Desert” respectively – the site is in Java so there are no hyperlinks to individual pages but look under “The Dancing Path” and “Becoming a Teacher”). (Roth also calls these the “first five levels”; afterwards there is still “Embodiment” and “Expression”). Our teacher says that Heartbeat is “the name for the emotional work in Five Rhythms dance”.

Whilst there is a lot of wisdom in some of what Roth says and has transmitted to other teachers, it is time for a working hypothesis of my own in relation to what this practice is and is not, the claims it makes and the place it might occupy in ones personal development practice portfolio.

I dance Five Rhythms and will probably go on doing so basically because I find it a very good integrative practice, as well as an enjoyable way to practice embodiment and embodied meditation. The wisdom of the body is there to be discovered in the practice. Five Rhythms is very popular in the tantra community for this reason.

However, whilst it does not appear to eschew portraying itself as such, which I find very regrettable, Five Rhythms is not a transformative or complete practice, and certainly not a rapid and/or deep one. In my opinion Roth, like so many others, has succumbed to commercial temptation and erected her system into a clumsy systematic “theology” of branded personal growth which is as unconvincing as it is inoperative and unnecessary. Just as access to the Godhead is mediated through layers of priesthood in the folk practice of the church (not in its mystical tradition), so layers of practice are interpolated between the practitioner and his or her full embodied expression in Roth’s schema, and the more there are, the more profitable it is. This is not a new strategy. It has been the strategy of religion through the ages.

I am not of course saying that there is no role for trajectories in such practices at all. But all they are is practices. They are not paths. Roth loses sight of this by pushing her initially perfectly valid observations and frameworks into overarching metaphors which are presented as a kind of key to unlock the secrets of the heart and of being human, but which are no such thing.

As any theory which is helpful enough in terms of what it is designed to explain, its reckless extension by analogy produces only increasing distorsion. Roth’s pentateuchal fetishism in these successive layers of practice reaches levels which evoke the spirit of Pythagorean mysticism. What is to be discovered is no longer innate but increasingly arcane. This strikes me as a dance of the mind, fully disconnected from reality, ungrounded and hopeless.

Let me illustrate. A (supposedly positive) review of Roth’s autobiographical handbook Sweat your Prayers on amazon.de states that as a result of movement work with Fritz Perls (the founder of Gestalt therapy), Roth “came to isolate five rhythms related to five archetypes or states of being“. Now, the description of these as “rhythms” is itself strange, as they of course are not; they are something more like “musical moods”. That there are exactly five such “moods” (flowing, staccato, chaos, lyrical and stillness) is hardly a taxonomy which exists naturally and objectively. Rather there is an infinitive variety of musical moods, which fade indistinctly into each other. Thus Roth has at the outset chosen what can only be reasonably considered a metaphor, and goes on to overapply this metaphor to everything that comes within her sight.

The same source goes on to say that “Roth claims that even terminally inhibited people can learn to enter these rhythms and sense how it feels to inhabit ‘mother, mistress, madonna, father, son and holy spirit.’ The three feminine archetypes follow a flowing rhythm, according to Roth, while the energy of the masculine archetypes corresponds to a staccato rhythm. Roth discovered that when the masculine and feminine fuse, a rhythm of fertile chaos results, as in acts of artistic creation or love. The resolution of chaos is the lightness and liberation of a lyrical rhythm, while stillness is the most profound rhythm of all.”

This is once again a fully extraordinary statement. Firstly, the identification of the Christian trinity as a trinitarian aspect of the masculine akin to the three feminine aspects embodied in the ancient European triple Goddess representation is to my knowledge unprecedented and very odd. Although there is a superficial similarity (the number three), the feminine trinity represents the three phases of the moon and of adult womanhood; the “masculine trinity” (the Christian one at least) represents no such thing. Furthermore, the Christian doctrine of the trinity as such is a late innovation which in no way can be or ever was designed to supplant the cult of the triple goddess. The subjugation of female by male deities had been complete millennia earlier. Thus the two have nothing whatsoever to do with each other.

The inherent counter-intuitive and speculative nature of the “discovery” of the fusion of masculine and feminine into “chaos” and the rest of the ontogenesis of the Rothian pentateuch (which looks like a discovery of three additional genders) I leave as an exercise to the reader…

In the workshops we have been invited to experience more exotic combinations of the “rhythms”. The “five” emotions (which is Roth’s own and certainly not a canonical list) of fear, anger, sadness, joy and compassion are paired with each of the “rhythms” in a way which is not really obvious, nor consistent with the characterization in Roth’s own book Maps to Ecstasy of some of these rhythms as “masculine” and others “feminine”, and the proposition of a fivefold classification of character (with no theoretical or experimental basis at all) corresponding to each of the five “rhythms”. In my view this is absolutely no reasonable basis for a scientific psychotherapy. It is basically, as another reviewer on Amazon characterized it, “cumbersome and tiresome psychobabble”.

We are then invited to experience one rhythm within another, the rhythm with and without the corresponding emotion, lightness within each of them … an utterly confusing attempt at embodied “visualizations” which sollicited the head far too much for a technique supposed to be centered in the body.

The workshops have primarily involved actual dance, but there have also been some exercises, mostly with no particular power to them compared to what I have found in pretty well every tantra workshop I have attended. I have found that in Five Rhythms it is very easy to avoid contact with the other dancers and this is what most people in fact do – contact is only fleeting and never to the point of discomfort which might prompt psychosomatic response. I see no real reason why the practice, relying as I said on “embodied visualizations”, should reorganize the psychic armoring. In my view this is a secondary phenomenon in the workshops which mainly draws on experiences outside of them. When a psychosomatic response does occur, it is not built upon to the benefit of the group – the workshop leader does nothing with it, certainly at group level.

This is why I characterize the practice as “integrative”. The best experiences I have had dancing Five Rhythms have been when I entered the room with a quantity of open psychic material, as a result of life events or of other workshops. I have felt it has an ability to “sew me back together”. But not to rip me apart. Of course to some degree it might if the very fact of engaging in such a practice is challenging for the practitioner. But this strikes me as a relatively low bar to clear. Most people will be well able to engage in the practice without troubling their resistances.

In short, I still like the practice notwithstanding its quasi-metaphysical psychobabble and I have certainly also drawn benefit from it, some of which I will hopefully describe in future posts. However, I think it would be far purer and more useful in a form freed from the oppression of the omnipresent pentateuchal metaphysic, and less comfortably solipsistic. There is a place, undeniably, for gentle approaches which are accessible to a wider audience, and for restorative methods, not only the deconstruction of defenses; but these approaches should be honest about what they can and cannot achieve.

Reich’s economic model of psychosomatics (4 – a reappraisal)

In my previous articles on the development of Reich’s thinking*, I have explained how his inquiry into Freud’s libido theory eventually led to his positing an equation between somatic and psychic states, an identity which I believe has been very therapeutically fruitful.

Reich of course went on to engage in work of a much more (some would no doubt say “even more”) speculative character, in which he sought to identify the energy present in orgasm with other energies physically present in the cosmos. From our modern perspective, this effort seems very strange, and to many of Reich’s admirers it is no doubt an embarrassment.

Bernd Laska’s biography helps us somewhat to see the chain of reasoning from Reich’s own perspective, and thus more sympathetically, but it remains evident that Reich in his later period wandered far from scientific method and truth, and one cannot help asking what these later developments imply for the scientific validity of his earlier orgasm theory.

And it seems to me that there is indeed a major flaw embedded in the earlier theory, which does not undermine its therapeutic validity but did lead both to the raft of later speculations and to a certain alienation from authentic sexual experience.

Reich’s error seems to me simple: he confused correlation with causation. Continue reading “Reich’s economic model of psychosomatics (4 – a reappraisal)”

Reich’s economic model of psychosomatics (2 – the biological core)

Following his discovery of the link between sexual repression and character, Reich inquired into the nature of the mechanism underlying this link. His starting point was the observation that there existed, even if they were hard to codify, characteristic postures and facial expressions which allowed the most unlearned observer to decipher the character disposition of his interlocutor. Reich hypothesized that these resulted from, in the main, hypertonicity of certain functional muscle groups. Almost all muscles display in equilibrium or at rest a natural level of contraction called tonus. When this equilibrium is disturbed by a constant perception of threat, muscles become pathologically hypertonic. The attitude habitually assumed, be it of aggression, mistrust, helplessness etc, then becomes anchored in the muscular economy with attendent effects (though Reich does not discuss this) on skeletal development as well. Reich contends that the somatic and psychic expression of neurosis are functionally identical and mutually reinforcing. The somatic expression he calls the “biological core” of the neurosis. It is similarly this pattern of muscular spasticity which disrupts the orgastic response.

Reich goes on to make his central conjecture, laid out in Function of the Orgasm, that the natural orgasm serves a purpose of discharging vital energy and thereby regulating the energy economy of the body; this is thus a direct somatic parallel to Freud’s libido theory. Disturbances of the orgastic function compel the organism to regulate its energy economy otherwise, whether by reduced energy production (lethargy) or by other, imperfect mechanisms such as compulsive behaviors which only kick in when the tension has reached an unbearable level and then only partly resolve it.

The hypothesis of the “functional identity” of the neurosis and its somatic expression allows Reich to complement then-existing psychoanalytic techniques with a body-oriented approach and, he claims, achieve more consistent results, more rapidly, as well as penetrate some types of neurosis which were less amenable to traditional methods. His espoused technique advocates alternating opportunistically between addressing psychic and somatic blockages. This he called “vegetotherapy” in an allusion to its effects on the vegetative, or what we would now call the autonomic (i.e. involuntary) nervous system. How he did this in practice seems to be less well documented, perhaps because his discovery of the biological core of psychic neuroses leads him into more speculative areas of inquiry and the period of his interest in psychosomatic therapy is as a result relatively condensed, leaving methodology to be developed by others.

This new period in Reich’s life is underscored by a realization that sexual repression has not only somatic effects with psychic correlates – neuroses – but also that these primary somatic effects have in the long term direct secondary chronic effects at the somatic level in the form of illnesses such as cancer, dementia and rheumatic arthritis. This takes the hygienic challenge a long way from treated self-reported actual neuroses with anecdotal curiosities in turn-of-the-century Vienna to treating major plagues of contemporary civilization, both psychic and somatic.

Part 3: Reich’s legacy

Reich’s economic model of psychosomatics (1 – from Freud’s libido theory to character analysis)

Although the work of Wilhelm Reich in relation to what he called sex-economy lies at the root of many contemporary approaches to psychotherapy and personal development, it is widely misrepresented, caricaturized and misunderstood and a summary of it for the educated layman is, to my knowledge at least, difficult to come by. I am often asked to explain Reich’s thought which has very much influenced my own, and so I thought fit to attempt such a summary. In this and the next article, I propose to set out how he arrived at, and the basis for, the character-analytic approach to psychotherapy and his later vegetotherapy which aimed at directly working on what he called the “biological core” of neurosis. In a subsequent article, I would like to offer a review of his theories in the light of current knowledge, and particularly in what one would hope could be described as a somewhat more accommodating social environment than prevailed at the time of his work. (UPDATE: since I wrote this article, a very good overview of Reich’s life and work has been written by Jason Louv, see here. My own treatment is a bit more technical.)

Reich’s developments of psychotherapy all draw root in Freud’s early work. Subsequent developments of Freud’s psychoanalysis, which Reich viewed as a capitulation to social conservatism, took their work in different directions. They share, nonetheless, a substantial common bedrock, and Reich remained deeply admirative of Freud’s labors even when he disagreed with him on fundamental matters.

As is well-known, the various phases of Freud’s thought never resulted in a single synthesis and different strands within it remained in tension with each other. Freud thus never arrived at an integrated theory of psychic functioning. Reich took his lead from Freud’s libido theory of neurosis; neurosis was thus the result of a binding of sexual energy as a result of developmental factors in childhood. Freud never elucidated how this binding took place or how psychoanalysis was precisely supposed to work in order to dissolve the binding and thus resolve neurosis, but he developed different models of psychodynamics, in each case essentially of a mental nature. The blocking factors in neurosis were thus mental representations and the prescribed route to their dissolution ultimately also mental, although it proceeded from the unconscious, which for Freud could not be directly observed.

Reich’s own approach is quite at ease with Freud’s model of the three stages of consciousness, being the system unconscious, the system preconscious and the system conscious. According to this model, drives which arise in the unconscious undergo a sort of filtering process in order to arrive at the level of consciousness, during which their associations and objects change more or less radically. Thus, for example, the infantile desire to suck, if insufficiently satisfied in infancy, persists in the unconscious and is satiated, though never ultimately satisfied, through ersatz means which could involve actual sucking (thumb, lollipop), other oral actions (obesity and bulimia), fixation with oral sexuality, or other forms of clinging behavior not immediately oral in their manifestation. In order to achieve satisfaction of these ersatz or secondary drives, individuals would develop typical strategems which are in a direct line of descent from those they employed successfully in childhood – all essentially manipulative, solliciting one or other emotion on the part of the caregiver which would then elicit the desired response. Some would focus on solliciting pity, others fear, still others admiration, or benevolence through humor, or distraction, etc. Whilst Freud did not feel he had a social mission and confined himself to the therapy of those cases who presented themselves for treatment, it is easy enough to see how the learning process in early childhood coupled with certain not immediately definable characteristics of the child would lead to characteristic dispositions in adulthood, a starting-point for Reich’s work.

Reich’s interest in character was at first prompted, however, by considerations of methodology. Freud and many of his close collaborators had never taken a systematic interest in determining and assessing what worked in the therapeutic context. It was supposed that individuals needed to “cooperate” in the therapy. If they failed to do so, there was no alternative approach available. Reich realized, however, that the fact of cooperation or of failure to cooperate was endogenous to the therapeutic setting. It itself needed to be interpreted and worked through. The manifestation of resistance was evidence that one was reaching carefully repressed material. To dismiss a patient for refusal to cooperate was to admit defeat, perhaps at the moment when one was closest to achieving a breakthrough.

Reich started with a layman’s concept of personality, but soon progressed it to a developmental model in which typical frustrations of infantile libido led to a freezing of certain character responses, which were then overlaid on each other. In the therapeutic setting, the therapist would work backwards through these layers, to arrive at, and liberate, the earliest material.

Reich also noted that all patients presented with actual disturbances of “natural” genital sexuality. These disturbances were of various sorts but fundamentally there were only a limited number of variables. Decreased or absent pleasure in the genital act could be due to (i) diminished sensitivity of the genital apparatus itself, (ii) its failure to respond to conventional stimuli or at all or (iii) a failure of genital response to (sufficiently) engage adjacent muscles involved in the natural orgastic response. Persons with diminished sensitivity were often, in the male, erectively potent or, in the female, highly flirtatious, but derived little pleasure from the sexual act. Reich saw this as an instrumentalisation of sexuality in the service of a secondary drive. Persons with erectile dysfunction or vaginismus were disinterested in sexuality or conventional sexuality because it conflicted with defense mechanisms they had developed. Persons, finally, with a flat orgastic response curve (premature ejaculation in the male, muted or no orgasm in the female) encountered during the process of sexual arousal psychological obstacles which made full sexual expression impossible. This typology of genital response, Reich was able to correlate, albeit loosely, with the stages in the development of the libido posited by Freud as well as with contemporary character. Frustration prior to the oral stage led to a withdrawal of sexual interest and to schizoid character. Frustration at the oral stage led to oral fixation and a lack of autonomy, expressed as sexual passivity and a capacity for surrender but a diminished response. Frustration at the anal stage led to rigidity and inability to surrender, whilst frustration at the genital stage expressed itself as individuals with strong seductive powers and sexually active, but reporting a lack of pleasure in the sexual act and as seeking it for secondary, narcissistic purposes. In Reich’s view, the vast majority of people presented with some form of neurosis and it had both character and genital expression.

Reich’s approach felt little need for Freud’s later ego theory, but remained compatible with it. In addition to his methodological work, Reich’s greatest breakthrough was his solution of the problem of masochism, discussed at length in Character Analysis. Freud had posited a primary masochism, fruit of a biological drive he termed the death instinct (Todestrieb). For Reich this had no parallel in the animal kingdom and was unacceptable. He derived masochism as a secondary drive when the pleasure principle was frustrated by overwhelming violence to which the individual as a small child was powerless to respond. The frustrated drive first sought an outlet in sadism, turning this sadism against itself when it was further repressed. Constant juxtaposition of pleasure and punishment led to a state where they became psychically interlinked. Reich pointed out that no-one took pleasure in actual pain, only in the expectation of it. Pent-up energy which could not be channeled into pleasurable activity led to tension and anesthesia and the need for more extreme stimuli to break through to the core of the sexual drive.

Whilst Freud brokered a peace with society and seems to have viewed sublimation of sexual drives as in some degree necessary to civilization, Reich presents an uncompromising faith in the natural order reminiscent of Rousseau and Nietzsche; for him it is axiomatic that to recover the natural functioning of the human organism is the one and only path to happiness. Natural man is capable, for Reich, of the highest moral qualities and it is his sexual repression that brings evil and suffering into the world.

Part 2: The Biological Core