Who Cares? Relationship, Regulation, Resources: Part 2

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By: Ruth Cohn, MFT, CST, original publication – Warning: This content may be activating to some individuals.

If you missed Part 1 of this 2-part Series, or would like to read Part 1 again, find the link here.

Regulation

Neuroscience is forcing us to understand the profound and developmentally crucial impact of attachment on regulation. Regulation is the management of energy in the organism, the balance between high and low-frequency electrical activation in the brain, sympathetic and parasympathetic, stress and calm, terror, rage or nameless anxiety, and a quiet return to a hopefully comfortable baseline. A flexible and adaptive flow and a reasonable level of control over life’s inevitable vicissitudes is the great blessing of secure attachment. It is the gift of the good enough caregiver, and increasingly we are coming to understand this. Even the larger (non-trauma specializing) psychotherapy field is increasingly learning this (no disdain intended.) Regulation is profoundly necessary, and sadly, far too rare. And the mainstream is all too slowly connecting the dots, all too often failing to recognize soon enough the devastating damage to self and others of the desperate attempt to find regulation somewhere, when it has not been learned at its developmentally appropriate and timely stage. Discomfort, terror, rage, or sheer amorphous compulsivity fuels the search for a way to manage unbearable ups and downs.

Because so often the feelings and isolation are points of shame, “what is wrong with me?” How many “friends” one has, certainly in times of social media is a measure of “value,” or self-worth. So, the isolated might be even more ambivalent than usual about their needs. And interpersonal needs, being so lethal, the child of neglect keeps it carefully locked away, often even from themselves. Because they might look good on the outside, helpers and the world at large readily miss the cues or do not even imagine such an outwardly successful individual being so distraught. So, they slip through the cracks and remain invisible. They often defy recognition, even among therapists, if they even think to approach therapists. Suicide rates among medical students and physicians are disproportionally high. Where can people turn? And where can they turn if they do not even know what is wrong, or that something is “legitimately” wrong?

Help

In San Francisco, the number of deaths by fentanyl overdoses beat the number of COVID deaths in 2021. In the affluent town of San Francisco, USA, I find that to be chilling, and profoundly alarming. In another story, 6 SF Fentanyl OD deaths were apprehended, lives saved in the space of days, by passersby administering Narcan to users who most likely would have died if not for such good samaritan luck. What if those good citizens had not walked by?

I am an avid supporter of local Crisis Support and Suicide Prevention service organizations. I am so grateful to them for doing the essential crisis/emergency work that I am decidedly not good at. It is so needed and so neglected. Oy vey. Neglect upon neglect upon neglect. It is literally deadly.

It saddens me so much that some of the most powerful treatment modalities we now have for restoring regulation are not yet accessible on a larger scale. Neurofeedback is such a godsend, and yet so expensive and, for most, prohibitively so, especially to provide on a large enough scale. Where do we start? Well, you and I can start by helping the world become “neglect-informed.” It took 30 years for the Adverse Childhood Experiences (ACES) Study to hit the mainstream, but it finally has, and it does acknowledge neglect. Educate the world, support services and policy insofar as we can, so we can save lives, not to mention ease the unbearable suffering.

I was gratified to learn that our US Surgeon General, the young Vivek H. Murthy, has identified a major public health crisis in this country: loneliness! 22% of the US population self-identifies as profoundly lonely. We are coming to understand more and more of the consequence of that. This is the subject of his book, Together: The Healing Power of Human Connection in a Sometimes Lonely World. I find that gratifying and hopeful, as it joins mental health on the incipient roster of important social and political matters. Yay! 

And again, my deepest appreciation to the Trauma Research Foundation for tying political and social meaning to the epidemic of trauma. More than 40 years after the PTSD diagnosis was identified and named, the larger world is adopting the understanding and necessity of being “trauma-informed.” It is a term that people are coming to know, adhere to, and use, and I hope to do the same with neglect.

Photo by Louis Galvez on Unsplash

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