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In Part II (which was posted on November 9th, 2010), I looked at such topics as …
- The David Olds Home Visitation Program
- How trauma (like domestic violence) affects early child development
- Core concepts surrounding most home visitation programs
- A (not so successful) example of a home visitation program in Hawaii
- Matching interventions to cultural beliefs or worldviews
- Home visitation program risk factors such as domestic violence, poverty, hunger, etc.
- The parent’s role as a protective shield
- Family beliefs or patterns surrounding attachment needs and how they should be satisfied
In Part III (which was posted on November 11th, 2010), I looked at such topics as …
- How trauma can affect brain development and executive functioning
- How home visitation programs should increase reflective functioning
- How the agendas of different caregivers—parents, Head Start teachers, regular teachers, home visitation workers, etc.—often conflict
- How families may view the “gift” of outside care
- How parents may put up barriers to home visitation
- A less than successful Hawaiian home visitation program
- How therapy is often presented as “one size fits all”
- The pressure to reduce therapy to cookbook steps as a way of achieving efficiency
- The pressure to use only evidenced-based modalities
At the end of Part III, I whetted your appetite by telling you that, next up, Dr. Ippen-Ghosh provided us with some interesting historical information that might give us insight into why Maslow arranged his hierarchy of needs the way he did. Lets pick up there.
- Ippen-Ghosh tells us that all methodologies are biased because they are framed by ideologies. This agrees with the continuum that I have been using as a backdrop to this multi-part summary:
worldview <==> ideologies <==> methodologies <==> interventions
- Ippen-Ghosh presented information that suggested that Maslow hated his mother and was persecuted for being a Jew. As a result, belonging (e.g., attachment to mother or others) appears right after food and shelter whereas religion doesn’t appear at all. Ippen-Ghosh told us that, to assuage his loneliness, Maslow spent hour upon hour in libraries reading books. Maslow put self actualization at the top of his pyramid as a way of essentially normalizing (or possibly aggrandizing) his life spent alone in the company of a good book. Ippen-Ghosh gives us this bottom line: “Practices are based on our assumptions.” I would add that assumptions are derived from our Inner Working Cognitive Models. This is why early attachment relationships, which give rise to our Inner Working Cognitive Models, stay with us for life and are often manifest in the form of assumptions. Maslow did not particularly care for his mother and hated being persecuted for his religion, which gave rise to the assumptions he put into his model, that is to say, we should all look at them as low priority or no priority needs (respectively).
- Ippen-Ghosh next presented us with the following key forces that have the ability to shape our inner models, perspectives, assumptions, worldviews, etc.:
- [A]tachment
- [C]ulture
- [T]trauma
- At the vertices of an equilateral triangle Ippen-Ghosh placed attachment, culture, and trauma resulting in the ACT triangle of mutually interacting forces. Sadly, Ipeen-Ghosh pointed out that most therapists do not use this ACT triangle; they use instead a triangle with the following vertices:
- Behavior
- Feelings
- Thoughts
- Ippen-Ghosh suggested that the BFT triangle is part and parcel of a rather popular model but, in an attempt to be politically delicate, never mentions it by name. It is, of course, the cognitive-behavioral model. Simply put, the BFT triangle (and the behaviorist worldview that holds it) is a non-connectionist worldview, that is to say, past influences, such as attachment, culture, and trauma, should not be considered when looking at present-day behavior. In contrast, attachment theory is held by a connectionist worldview. That is to say, at the heart of attachment theory (and any modality guided by it) is the idea that past influences should be looked at and connected to present-day behavior. What Ippen-Ghosh did next surprised me (and I’ll explain why in a moment). She told us to simply place the ACT triangle on top of the BFT triangle. In this way, we can (hopefully) see the following “connections”:
- Attachment <==> Behavior
- Culture <==> Feelings
- Trauma <==> Thoughts
- In essence, Ippen-Ghosh would have us impose a connectionist worldview on to a non-connectionist worldview without regard for the worldview clash that might ensue. Let me explain why this may not be such a great idea.
- When I worked for the now defunct Charter Behavioral Health Services as a psychotherapist, one of the tools we were given was the Behavioral Acting Out Cycle. The Behavioral Acting Out Cycle had stations such as:
- normal behavior
- something happens
- feelings begin to surface
- thoughts about the feelings arise
- thoughts of shame and guilt appear
- feeling helpless to control emotions creeps in
- thoughts of acting out behavior to assuage guilt and shame begin
- scanning for a victim begins
- offense against the victim occurs
- feelings of regaining power and control creep in
- an eventual return to normal behavior takes place
- Click on this Wikipedia link for a simplified version of this cycle used over in the abuse arena. At Charter Hospital, the only real technique we were given to treat acting out behavior was what is known in behavioral circles as thought stopping. Click on this link for an article on thought stopping (and why it doesn’t work) by Robert L. Leahy, Ph.D. While at Charter, I tried to bring more of an ACT—attachment, culture, and trauma—perspective to the BFT model that we were being forced to use. Like Ippen-Ghosh, I wondered how early attachment relationships may be playing a role in fueling present-day acting out behavior. When I suggested to my supervisor that we bring an ACT worldview (i.e., see Ippen-Ghosh’s scheme talked about in Part III) to the BFT model we were using I was—how shall I put this—slammed. The message I received was loud and clear. My supervisor told me in no uncertain terms that a behaviorist holds that such things as early attachment, culture, or trauma should not be brought into the therapeutic picture because if it is, it then gives the perpetrator an excuse to not take full and compete responsibility for his or her actions. Behaviorists, who tend to operate within a conservative worldview, see all problems as residing solely within the individual and never within society, culture, or history. To simply place a connectionist model (i.e., ACT) on top of a non-connectionist model is folly. It’s tantamount to simply walking up to a staunch conservative and telling him or her to vote for a liberal in the next election. It is not going to happen. In the same way you cannot simply will thoughts away (by using a technique like thought stopping), you cannot simply will worldviews away. Behaviorists operate within a conservative worldview that places all social problems and ills within the individual. I’d be remiss if I did not point out that the marketplace loves behaviorism because it is easier to sell an individual (as opposed to a society) a cure to a problem. This is why cognitive behavioral and psychopharmacology therapies are such chummy bedfellows. I’ll leave this tear and move on.
- Ippen-Gosh mentioned Bessel van der Kolk’s work again and his idea that “the body remembers all.” Ippen-Ghosh reminded us that body-based reactions (i.e. , those that take place below consciousness) can trigger a trauma state. As talked about earlier, transitions to a more body-based state, such as transitioning to sleep, can trigger a trauma reaction.
- Ippen-Ghosh next told us that parents will often socialize their kids—using various attachment patterns as an aid—to fit a particular cultural context in an attempt to bring about higher levels of survival. As an example, Ippen-Ghosh told us that the Tamang, back in the 1800s, socialized their kids to show shame because it was an adaptive behavior. The Tamang were a conquered people and to show shame was a survival technique. In essence, the Tamang collectively used a distanced form of attachment as a way of surviving their oppression. Ippen-Ghosh told us that you can still see that adaptive pattern today thus giving us an example of how trauma can be passed on transgenerationally. Ippen-Ghosh suggested that other culturally oppressed groups may have also used a form of insecure attachment as an adaptive pattern of survival. She suggested that we think about the US’s history (taking a connectionist perspective) of enslaving people such as African Americans and Native Americans. Ippen-Ghoash pointed out that in China back in the 1800s, Mao Zedong used to take children without warning and without cause. Apparently the abductions could be rather brutal for both the child and parent if any display of attachment could be discerned. It is for this reason that the parents, again, used a form of distanced attachment in order to survive.
- At this point, Ippen-Ghosh wrapped up by talking about the research that suggests that elephant herds can experience and express (in the form of rogue behavior) PTSD or post traumatic stress disorder. I won’t be covering this information here. I will instead refer you to the work of Gay Bradshaw in this area.
If you have any questions concerning this multi-part summary of Dr. Ippen-Ghosh’s workshop, feel free to contact the Foundation using the CONTACT US link above.
