I will be presenting this paper at a meeting
FOCUS ON RESEARCH AND INNOVATION IN NEUROPTIMAL®, PALM SPRINGS, CA
Someone dear to you, someone you deeply care about, has fallen through the cracks in the mental health system. The medical system has not been able to interrupt a downward spiral in the person’s life. If you are interested in how one person in a family might respond differently in a crisis, you may be interested in this story of how an older sister learns to manage self using family systems theory and NeurOptimal. (www.zengar.com) It is a story of learning to be more aware and objective about mental illness and how thoughtful relationships changing, throughout the family, can make a tremendous difference in enabling better functioning (for everyone, not just the symptomatic one). Overall it is a story of how one begins to redirect anxiety in a system.
It was April of 2006, a year after my uncle Jimmy had died at 93. Jimmy was a wealthy and influential family leader. My youngest brother, Drew, had worked for Jimmy for many years. He harbored a vague hope that Jimmy would leave him money to relieve severe financial and emotional pressures. When this did not happen, Drew began to imagine ways out of his problems. He started to play golf in the parking lot at work and announced that he was Arnold Palmer’s caddy. People get fearful when others behave in bizarre ways.
Family members called me since this kind of event had happened before. I lived eight hours away. As I thought about a plan that might work to manage the spreading fears, I began to review the memories of emotional storms in the past and how my family had coped over the generations. The first memory was of my father’s challenges and how the inability to cope with his problems led to my mother’s increasing use of alcohol.
After WW II both he and my mother drank as a way to manage the memories of the war and the suffering. One hot August night in 1952 in Florida, my parents were arrested and I (age ten), along with my two younger brothers Butch and Drew (ages almost two and eight) were placed in an orphanage for three days. As soon as my maternal grandparents could, they came to Florida and adopted the three of us.
Perhaps as you read this you will keep in mind that this is not just one person’s family story. This story is similar to the stories of many people whose parents were negatively influenced by war or other traumatic events. Few families are able to manage the transmission of intense anxiety from one generation to the next that comes with the loss of both parents from PTSD or other symptoms. There has been increasing interest and research on the transmission of these kinds of problems from one generation to the next since the Vietnam War. (See references at the end of this article)
But let’s return to the lessons learned in this story. My maternal grandparents were well off financially but intellectually didn’t have the first idea about how to talk about the downward spiral of my parents. They did what most people do reflexively. They refused to allow our parents to see us. They supported my mother financially, asking only that she not try to see her children. She then moved to the West Coast. My father was allowed infrequent visits while he tried to recover his functioning in the middle of his family in a nearby city. At times he worked for his younger brother, Jimmy. His functioning was spotty until his death in 1967 at a state hospital.
On the surface, during these early years, all of us functioned without major problems. Then, as my maternal grandmother approached her own death, perhaps not shockingly my two brothers were both diagnosed as manic-depressive. At that time I was married with two young children. One year later, in 1974, I was divorced and the older of my two brothers, Butch, was hospitalized. It was one year after our maternal grandmother had died and three days before our mother died.
It was the first time I had seen someone who really believed he was Christ. Butch was admitted to the nearby hospital and promptly escaped. The doctors told me he was a “danger to himself and others” and I must find him and bring him back. Being a good oldest sister I did just that.
Someday I would like to make a movie about this event. It was ludicrous. The serious sister (me) tries to return her brother to the hospital, but ends up chasing him around airports and was seen as a stalker by the local police. I would call the movie Seriously Crazy, as the more crazy some get, the more serious everyone else becomes.
The closeness of the family deaths and my brother’s hospitalization, and my inability to manage the situation, really got my attention. I was ignorant. I realized that it was not just my brother who had a problem. It was all of us. Clearly we were all connected or disconnected and fear ran the show. People were tied to one another and anxiety was flowing through the group and no one knew what to do or really what the essential problem was. I could only try to manage the incredible stress and changes in the family until I could learn more.
Having only two years of college and no real career path at the time, I choose to work at a psychiatric hospital to understand what could be going on that leads to such problems. Eventually I met Dr. Murray Bowen, learned about his Family Systems Theory and later became involved in biofeedback and neurofeedback.
Over the following thirty plus years since 1976, I saw that when a family has a crisis, people get fearful and mad, demanding that the other behave their way. The result is that the downward spiral intensifies. The frustration and blaming increases until people cut off from one another and all become more isolated and symptomatic.
Anything one person can do to redirect the anxiety away from the person “with the problem” is useful. To do this requires that one person enter into relationship with the person who is symptomatic and those surrounding him or her. Of course to do this one has to be prepared to manage a great deal of frustrated and chaotic energy. One has to be willing to be blamed and accept the criticism with a smile about how they’re handling the situation. None of us is perfect and there is little use in defending self. There will be no love and approval for taking a position for self in an anxious family.
Preparing and recovering from relationship disruptions and preparing to mange self with anxious others is how NeurOptimal has been useful to family, my clients and me. As a result of my family’s effort with my brother Drew (more on that in a minute), eleven people in my extended family have also used neurofeedback and my godson, Dominic Eitt, has even become a trainer.
Now back to 2006 and the effort that many people in the family were able to make in being more thoughtful about relating well to my brother Drew and his wife Margie.
My initial idea was to use my cousin’s farm in Fredericksburg as a central meeting place. It was two hours away from Drew and six hours from me. We could meet once a month and have fun and talk about family issues and all of us could do the training with NeurOptimal. My cousin Liz and her husband Mark generously agreed to my inviting my brother and his wife to her farm (the Zen Farm) every month in order to continue to talk about life’s little problems. Liz is also a polarity therapist and has a studio on the farm and is my closest extended family member. She had also studied Bowen theory and we had made many trips to get to know people in our extended family. Other family members were willing to donate money to the effort to enable Drew and Margie to begin again. With this family support I was ready to approach Drew and Margie with a deal.
I went to Williamsburg where Drew was living in a very chaotic house with an eviction notice on the door. Drew told me “the love boat was sinking.” He said that everything he had tried to do for his wife and family had turned to nothing, he had lost his job and the sheriff was coming to evict them. Drew was ready to make a deal.
I had talked with various members family members about how they could lend Drew a hand if Drew and his wife were willing to take some difficult steps. I offered him a 50-50 deal. “I need you to do some difficult things and in return I will do some difficult things that might just be useful to you.”
The deal involved moving out of their house, putting their things in storage and arranging for Drew to have his teeth fixed, which were in bad shape. My brother Butch and I arranged for Drew and his wife to buy a trailer and move in. We were able to offer them limited financial support for six months while they applied for disability payments. I would return each month and they were asked to travel to our cousins Liz’s farm and spend the night. Liz is the same age as Drew and they were close as youngsters so he and Margie agreed to the deal.
Yes, there was tension in the air and a lot of issues had to be put on the table and clarified. The main issue for me was how to be a more separate self and yet stay connected in order to lend a hand to my brother and his wife, Margie. This was not an easy time. From May to August 2006 we met at the Zen Farm and a bit of progress was made. However the drugs he was on had side effects. Drew began to develop more Parkinson’s like symptoms.
During these four months that we were meeting at the Farm, Drew made three trips to the emergency room and had three short-term hospitalizations. His condition continued to deteriorate until finally he was unable to eat or bathe. His wife could no longer take care of him and a family member arranged for him to be hospitalized in the same state hospital in which his father had died.
During his six weeks in the state hospital, my brother’s Parkinson’s like symptoms increased and he lost over thirty pounds. When they put him on a suicide prevention watch I talked to his wife about asking the director to release him into an after care program designed by his family.
The letter stated a few of the reasons he was not doing well at the hospital including: 1) his fear of being in the same hospital where his father had died, and 2) his reaction to antipsychotic medication. We described the treatment program that our family was willing to implement.
The Director agreed to release him and he came back to the Zen Farm for an after care program. I knew that Drew could die. He was not stable. But I thought it was a better family story that he die at the Zen Farm than in the state hospital. Despite the decision, I was nervous and did a lot of NeurOptimal training.
I stayed with him at Liz and Mark’s farm for a week. People in the community were also invited to stay with Drew because he required 24-hour care. Drew was also asked to see a local physician and a local therapist. After the first week he was to return to his home for a few days and then come back to the Farm for another week. This was to be followed by monthly meetings with dinner and an overnight stay.
The goals were for each of us were to:
1) Diminish our fears in relating to my brother;
2) Put no direct demands on Drew to function in any particular way, other than to take or be given a daily shower;
3) Provide good food, (which by the way he never refused);
4) Maintain a focus on not knowing what my brother should be doing but only what we observed him do;
5) Write down what seemed to work in having more positive interactions and to put any ideas, observations or questions in a journal, which was available for all to see; and
6) Do neurofeedback training each day.
After Drew’s first neurofeedback session, which lasted about three minutes, my brother stopped shaking. I was amazed and decided to buy a video camera to tape the interactions and summaries of these family gatherings.
The meetings still continue several times a year. The intense symptoms in my brother have not returned. His wife has had more physical symptoms but overall the two of them have adjusted well in their new community. The family has increased their contact with Drew and he has enjoyed being with them.
Part of what I learned and what people can see in the videotapes, is the usefulness of humor and paradox in breaking up old patterns. There were difficult conversations which were needed, and after any intense conversations, all would relax using NeurOptimal.
Changes in Extended Family: Many people in the extended family were able to visit and support my bother. This was a major change in family patterns. Five family members offered money to help support him until he qualified for the disability payments. People who had been afraid of him when he was in a manic episode began to have confidence in Drew and be in better contact with him. It is interesting that the families who made contact with Drew have had fewer symptoms than those families who have avoided making contact with him.
There is no doubt that the years of my being in better contact with people in my family helped create an environment in which such relationship changes could occur. I am grateful for all the people who lent a hand in this family crisis. There have been no further hospitalizations and there is documented improvement in my brother’s cognitive and affective functioning.
Observations and Operating Principles:
- Being with family members who are able to manage self, and to reduce the blaming of others, allows people who are suffering to increase their functioning.
- Activating the relationship system around the person can offer more resources to the person. People can be critical but will often settle down and be willing to participate.
- One has to be able to manage the initial upset in those you contact with your view of the story, because your view probably does not fit with how they have seen the problems.
- By defining what one will or will not do, others can consider their own participation without as much pressure.
- Using NeurOptimal provides an opportunity for the brain to increase its resilience during challenging times.
- Finding ways to break up relationship patterns without controlling others, often requires the ability to think paradoxically and to use psychological reversals.
- Increasing one’s ability to remain positive, even if people are negative towards you.
- Continuing to see the big picture while understanding and accepting one’s part in any family problems.
Implications for Society:
Currently the focus in the helping and therapeutic professions is on treating individuals who have symptoms, blinding the family itself from understanding how to see what constitutes and promotes effective change in the family as a whole. Does diagnosing people work or does it simply add to the problems?
Diagnosing an individual and then turning the situation over to professionals suggests that families cannot participate and adapt to the illness of a family member. When mental illness or other serious symptoms appear, often family members feel helpless. People have a hard time understanding how the development of symptoms in one person may be an instinctive way for the family as whole to survive.
If family members understand a systems way of seeing symptoms, cause and effect thinking is put aside. Those who are able and willing can move towards the person with symptoms, in a disciplined way. When this change happens, more people in the family absorb the overall anxiety and that anxiety is not left to reside in one person with symptoms, the “identified patient”.
As long as people are reacting as they were emotionally programmed that “the problem is in the weak person”, there is less opportunity for the whole group to pull up its’ functioning. Thinking about others as problems, and self as having no part in the problems, leads to further isolation, and increases the family’s blindness to the reality of the way it is acting as a group. We are mostly blind to the function of putting the blame on the weaker ones.
Blame functions to promote the overall survival of a few well-functioning people but increases the blindness and the suffering of the weaker ones. The long-term problem is that an “other focus” impacts the way we see problems in every aspect of our life as family members and in our communities.
If this one case study has implications for further research, then future pilot programs would be designed that include family members participating in understanding “systems” and the individuals would use NeurOptimal training to focus more on strengthening self. This would be a new paradigm for family members and a major shift in how mental illness is understood.
New knowledge spreads slowly, but if these ideas are useful then time alone is the biggest factor in changing our current focus on diagnosing and treating one person rather than offering training for the family as a whole.
There are still many questions about how aware people are of the nature of their interactions with others. The brain itself has a great many blind spots and deeply ingrained emotional responses. But it is possible for families to acquire a deeper understanding of the family as a unit and, at the same time, increase their potential for mind-body integration, strengthening their ability to cope and adapt.
Since 2006, my family’s efforts with my brother and his wife has provided a platform for others to begin such programs. One is now in central Vermont, Hanna’s House and the other is taking place in Fredericksburg, Virginia at the Zen Farm. Many other families are now participating in a version of the program begun for Drew and Margie and their family. zenfarm.com/Zen_Farm/Zen_Farm.html
1) Murray Bowen, Family Therapy in Clinical Practice, 1977
2) Jordan, B. K., Marmar, C. B., Fairbank, J. A., Schlenger, W. E., Kulka, R. A., Hough, R. L., et al. (1992). Problems in families of male Vietnam veterans with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 60, 916-926.
3) Cosgrove, L., Brady, M. E., & Peck, P. (1995). PTSD and the family: Secondary traumatization. In D. K. Rhoades, M. R. Leaveck, & J. C. Hudson (Eds.), The legacy of Vietnam veterans and their families: Survivors of war: catalysts for change (pp. 38-49). Washington: Agent Orange Class Assistance Program.
4) Harkness, L. (1993). Transgenerational transmission of war-related trauma. In J. P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes (pp. 635-643). New York: Plenum Press.
5) Parsons, J., Kehle, T. J., & Owen, S. V. (1990). Incidence of behavior problems among children of Vietnam War veterans. School Psychology International, 11, 253-259.
6) Rosenheck, R., & Fontana, A. (1998). Transgenerational effects of abusive violence on the children of Vietnam combat veterans. Journal of Traumatic Stress, 11, 731-742.
7) Dansby, V. S., & Marinelli, R. P. (1999). Adolescent children of Vietnam combat veteran fathers: A population at risk. Journal of Adolescence, 22, 329-340.
8) Kellerman, N. (2001). Psychopathology in children of Holocaust survivors: A review of the research literature. Israel Journal of Psychiatry and Related Sciences, 38, 36-46.
9) Ancharoff, M. R., Munroe, J. F., & Fisher, L. M. (1998). The legacy of combat trauma: Clinical implications of intergenerational transmission. In Y. Danieli (Ed.), International handbook of multigenerational legacies of trauma (pp. 257-275). New York: Plenum Press.
10) Harkness, L. (1991). The effect of combat-related PTSD on children. National Center for PTSD Clinical Quarterly, 2(1).
I am so impressed by this story. Thank you for sharing it. I too am the eldest daughter of my family, and I also have a brother who was labelled as “the identified patient” years ago. I have studied Bowen’s FST for about 5 years and it has made a tremendous difference in our family. In my case, my focus has been on using the theory in a less structured way than the plan you implemented at Zen farm, but it’s still amazing how the theory can work so dramatically. (I have had personal success using a biofeedback product called the Stress Eraser which focuses on helping the user to become more conscious of breathing patterns.) It is definitely encouraging to hear how others have used FST to help themselves and their families. Thank you!
Your ability to walk alongside your brothers is compelling and encouraging. Here’s an article in the 2/28/2012 issue of the Wall Street Journal that may relate, at a “biological/cellular” level, to the story you tell in this blog. There are some interesting graphs that don’t show up in the copied article below but that you can see if you go to the article in the WSJ.
IN THE LAB
FEBRUARY 28, 2012
The Genetic Ripple Effect of Hardship
By SHIRLEY S. WANG
Our experiences in life don’t just affect how we learn and behave, they can also mark our genes and influence our children, a growing body of research suggests.
Stressful events and drug use appear to alter how and when genes are turned off and on. Some environmental influences create such long-lasting and significant biological changes that they can be passed on to affect the health of the next generation, studies have shown. They don’t appear to alter the genes themselves.
When parents are stressed out, even their kids’ DNA is affected. A study found that adolescents had different DNA patterns depending on the degree of their parents’ stress when the kids were in preschool. Shirley Wang has details on Lunch Break.
Not all of our roughly 20,000 genes—which contain the information that tells the body’s cells what to do—are called on to be active, or expressed, at any one time. In a phenomenon known as epigenetics, environmental influences alter whether particular genes are activated. For example, one way that smoking appears to increase the risk of cancer is by deactivating a specific tumor-suppression gene.
Increasingly, scientists are looking for epigenetic changes to help explain how factors like poor parenting and stress in early life degrade physical and mental health later on.
“We want to know how experiences really influence the brain,” says Marilyn Essex, a professor of psychiatry at the University of Wisconsin’s school of medicine and public health in Madison. “What are some of the underlying biological mechanisms that can help us understand how we get from the early stress to the later health outcomes?”
Scientists say epigenetic signatures might someday be used to predict people’s risk of developing disease. Such patterns also might aid clinicians in diagnosing certain conditions, including psychiatric disorders, earlier or more accurately than by relying on observable symptoms alone.
In a recent study, Dr. Essex and her colleagues examined epigenetic markers on the DNA of 109 teenagers who had been observed since birth. DNA was collected from cheek swabs and analyzed for the presence of a group of chemicals known as the methyl group. When attached to DNA in a process called methylation, these substances appear to suppress the action of a gene. Increased methylation of DNA is associated with a variety of negative outcomes, some studies show.
In the study, teens whose mothers reported significant stress during pregnancy, such as depression or marital conflict, had substantially more methylation than teens whose mothers reported low stress. This suggests mothers’ stress might affect their children even into their teen years, says Dr. Essex. The work was published in September in the journal Child Development.
Just because negative life events appear to make a biological imprint doesn’t mean children are condemned to disease, cautions Michael Kobor, a co-author of the study and a professor of medical genetics at the University of British Columbia in Vancouver. Rather, the researchers say, some stress might aid development, and understanding the process could help doctors and parents find ways to intervene early or adjust the child’s environment.
In a study, teens whose mothers reported significant stress during pregnancy, such as depression or marital conflict, had substantially more methylation than teens whose mothers reported low stress.
They plan to continue to examine epigenetic markers in these children to see if future changes in methylation are related to their later mental or physical health problems.
Researchers including Barry Lester, a professor of psychiatry and pediatrics at Brown University in Providence, R.I., are trying to understand why babies born to mothers who endured traumatic events often had low birth weights and later developed heart disease, obesity and other ailments.
The scientists have found epigenetic changes that can affect the metabolism of a fetus, suggesting that a baby can be physically reprogrammed to deal with being born into poverty, says Dr. Lester. But if that child isn’t born into an impoverished environment, it can’t handle the enriched surroundings well, contributing to eventual disease, he says.
This discovery led scientists to wonder if behavior might be affected by a similar process. Indeed, studies show low-birth-weight babies are more likely to be depressed or suffer other psychiatric disorders.
“The idea is that something that goes on in-utero to trigger some kind of epigenetic process could actually change the baby’s behavior and ultimately lead to something like psychopathology,” says Dr. Lester.
Parental care also appears to affect biological changes in offspring. Michael Meaney, a professor of psychiatry, neurology and neurosurgery at McGill University in Montreal, and his team have conducted an extensive series of studies on this topic in rats and humans. In one, they demonstrated that rat mothers’ grooming behavior, such as licking their pups, changed how the pups reacted biologically to stress.
In humans, they have examined samples of tissue from 36 brains—12 from suicide victims who were abused as children, 12 from non-abused suicide victims and 12 from people who died of other causes—for marks of epigenetic variation. They found distinctive patterns depending on whether the person had been abused or not.
“These very social psychological forces actually affected the biology of the brain,” says Dr. Meaney. The study was published in 2009 in Nature Neuroscience. They are now looking to see if small differences can lead to epigenetic changes. Their hypothesis is yes, says Dr. Meaney.
Scientists are finding that epigenetic effects also appear to be transmitted across generations, at least in animals. Eric Nestler, a molecular biologist and neuroscience professor at Mount Sinai School of Medicine in New York, took male mice and stressed them out, then bred them with normal females. After the pups grew up, they showed sharp increases in anxiety and depression. “I couldn’t believe it,” he says.
In another study, published last year in Biological Psychiatry, female mice were impregnated by in vitro fertilization. The offspring of the females that had procreated normally with stressed males were impaired, but the pups that resulted from IVF were “essentially normal,” says Dr. Nestler.
The most likely reason for the finding is that the females somehow sensed they were mating with “losers” and altered their maternal care, says Dr. Nestler. Work by other researchers has shown a variety of animals can detect inferior mates and accord fewer resources to the offspring.
Most epigenetic changes aren’t stable and can be rapidly reversed, says Dr. Nestler. But some persist and can modify how creatures respond to events later in life. For instance, stress predicts stable epigenetic changes that make animals more vulnerable to cocaine addiction.
Stress “dials up or down vulnerability” to cocaine, says Dr. Nestler.
Write to Shirley S. Wang at firstname.lastname@example.org
A fantastic article. Thanks so much for sending. Also thanks to both you and Mary you for putting in your ideas. The feedback makes this blog more like a conversation which I appreciate.