OPPOSITIONAL DEFIANCE SYNDROME IN THE TRUMP ERA

A dramatic plea for help has come in response to “Oppositional Defiant Disorder” posted 2-18-12, which always gets more hits than most other posts on this blog.  In fact, I’ve been thinking about it again myself because of Trump, who makes a good illustration.

The person, calling herself “Raven Albatross” because I stopped accepting anonymous comments, tells a long story.  She is a perpetual student, caught in that terrible national vortex of going to school, finding the degree doesn’t lead to an income, going back for another degree, repeating the same experience until debt levels are too high to function.  She is clearly intelligent and researches her dilemmas, but she doesn’t say how or whom she has contacted in terms of research.  She has come to the attention of cops, which meant visiting a “shrink”.  Neither was helpful.

I’m not an expert.  I cannot cure ODD.  It’s a great temptation to create a term like ODD and then treat it as though it were something real, with clear boundaries.  Then the definition begins to suggest how to think about it and we get stuck.  Or someone comes up with a pet reason or cure and bends the evidence and results to match their original concept. It may be part of something bigger or it may be a big consequence of a small thing, or sometimes it’s a legitimate survival mechanism in a bad situation.  It’s important not to get captured by one idea so as to look from different angles. 

As they say,  it’s not paranoia if something is really after you.  Right now, everyone in the country is paranoid.  It’s a marketing strategy:  the two major themes are sex and danger, esp. economic danger.  No one will sleep with you and you’re bound to go broke and live on the street.

Lately we’ve all been fascinated by the brain mechanisms behind the forehead, the prefrontal cortex and its function as a dashboard for a multitude of perceptions, assumptions and judgements.  Also, a team headed by Joseph LeDoux is very interested in the amygdala which decides whether danger should be responded to by fight, flight or freeze actions.  It’s a little blob, often compared to an almond but turning out to be complex;  a problem there can definitely make you nutty.

When people begin to feel or act in atypical ways, sometimes inconvenient, authorities (since they are supposed to “know”) define a “syndrome” according to some psychiatric model or system devised by someone like Freud or Jung, which was only invented from reflection with no physical evidence.  Today’s psychological community uses thought experiments to discover unconscious functions of the brain and there are a LOT of them, sometimes very powerful.  These ideas get sucked up by the media, not entirely understood, and gradually turn into something approaching morality.  That is, people are blamed for narcissism or punished for being defiant or oppositional, sometimes criminalized and arrested for not accepting the commands of authority.  Jobs and marriages are lost.

Generally, most people accept the idea that a child goes through a stage of defiance, evidently in service to separation from care-givers so as to become their own identity.  Sometimes it’s funny.  (“Would you like some ice cream?”  Toddler, bellowing:  “NO!”)  If a child (meaning too young to turn away force) is afraid or enraged, punished to the point of trauma (which might be what came first), a cycle of defiance and force may develop that is life-threatening.  Even a surviving child may be too quick to throw up an impenetrable wall that could blight their life.

There is some thought, and probably research, into the coincidence of this emotional refusal with the time that toddler’s brains are being “pruned” by the withering of any neurological branches that are unused.  Sometimes very old people become oppositional in the same way.

When we get into the work of Joseph LeDoux, we are on new ground that doesn’t use philosophical constructs of what theoretical forces are clambering around in your unconscious.  Rather they look at the molecular and cell structures, how they interact, and what can be done about it.  Neuroresearch is evidence-based and not very well reconciled with the traditional “talking cure” psychoanalytic approaches so far.

The commenter was in a car accident, quite serious, but seemingly only suffered minor injuries.  She says, “I went into a traumatic like withdrawal from reality. Weird thing is for two months after the accident (when I became so reclusive that I ended up diagnosed agoraphobic as well as manic depressive, which is a form of bipolar).”  It was not LIKE trauma! A serious car accident IS trauma!  The withdrawal from reality might be called “dissociation” which offers another term to look up, though it’s not that well understood.  Sometimes it’s related to split personality.  Other times it’s seen as a way of coping with abuse.  PTSD is the acronym for combat dissociation: “post-traumatic stress disorder”.  Flashbacks, unwanted thoughts, difficulty in controlling mood,  going to violence easily, and a lot of other unpleasant things.

Agoraphobia, reclusiveness, manic depression, bipolar or ODD, general balkiness and refusal to agree, are all psychoanalytic concepts, labels about emotional and rational life that make a person anti-social, thus attracting treatment, adjustment, even incarceration.  They are REAL and there are a lot of people struggling with them.  They can serve an important purpose.  But that’s not the same thing as neurology, which is how the tissue of the body functions, actually DOES things at the cell level.

These syndromes can be triggered by drug episodes (legal or illegal) and by viral infections of the brain, which we begin to recognize are more common than we previously thought.  The brain had been thought to be protected by blood barriers but now we locate slippery little by-paths.

One of the major changes in the way we think about a person is in terms of identity, which was once seen as a steady state, a box with labels or a sculptured construct that stays the same through life.  It’s YOU and others recognize it that way, though each relationship is a little different. 

Now the idea that seems to fit the best is that a person is an interacting set of processes that is assembled from the unconsciousness of sleep into the consciousness of waking, subtly new every time because the work of sleep does memory sorting and makes new connections.  The “connectome” is the word for the networking (internal internet) of signals shuttling around, ESPECIALLY IN THE OLD PARTS OF THE BRAIN.  You might not be conscious of all the commotion, but it can be detected with special machines like the fMRI.  Even when asleep, the brain is still busy keeping heart, lungs, kidneys and so on operating or you won’t wake up.  The brain’s main work is NOT thinking, but rather the maintenance of homeostasis in the body for the purpose of survival.  

Concurrent with this paradigm shift from box to something more like music, is that there is no reality.  NO REALITY.  All the aspects of the world that impact our skins and organs are things like electromagnetic light waves or sound vibrations — so you’re right to suspect all the waves we’re producing as well as waves from the sun and the cosmos, but that’s not what I mean.  I mean that the brain does not receive faces or words or tunes — it composes them from whatever the nerves attached to sensory receivers produce in the way of code.  Not everyone has the same sort of receivers.  More than that, much of the “wet ware” in the brain will interpret what it receives in possibly inaccurate ways.  It can only work with the categories it already has, until something happens to create a new category.  

There is a LOT to read about neurological research and I think it is far more helpful than “shrink advice”.  A good shrink is more than a diagnostician, but also a companion and support as the search goes on.  (Everyone’s search always goes on.)  A psychiatrist can handle drugs because of also earning MD credentials, but a clinical psychologist might be warmer because of NOT earning MD credentials, which encourage a cold objective approach.

As I say, I’m no medical or psychological expert, but my opinion is that when your car rolled, you got a significant head blow and should be checked for clots, bleeds, and tearing.  It would take very little damage to create ODD if it were in the right place.  Look for people who know about “closed skull trauma,” meaning that the damage doesn’t include cracks in your skull but rather damage in the soft tissue.  Go to the nearest university medical school and ask them to find you the closest neurology research lab.  

There’s a ton of things to read in the research.  Do not trust Wikipedia, but google can be very helpful if you’re looking for definitions or the work of someone like Joseph LeDoux.  In fact, he’s on YouTube, giving lectures.  I sometimes have to watch them three times to “get it” or there is sometimes a transcription feature with the vid.

Your advice to turn off the television and limit the radio is probably wise even for someone who has no apparent problem.  Television is jammed with plots meant to be sensational, frightening, and addictive.  And that’s just the news!  (Jokes.)

If you give me an email address, I can communicate more privately.

WE SEEM TO BE GETTING A LOT WRONG

Joseph LeDoux, in his latest column for “Psychology Today,” claims that research for effective anti-anxiety drugs has faltered.  The reason he suggests is that the definition of what anxiety is and our practice of treating the behavior instead of the cause or the actual physiological syndrome has proven inadequate.   Partly the assumed key value of white males as the measure and beneficiaries of all things has deformed or at least limited the science.

At the same time, in the online newsfeed called “Religion Today,” an article summarizes the unimportance of religious issues among Western Society millennials.  There is no suggestion that they are anti-religious, just that they don’t think it matters.  

In other words, in two major categories of culture, mental health and religion, the air has gone out of the balloon.  Has science out-flanked our traditions?  Or is it technology and money?  Or are we the victims of a “metonymy,” mistaking the part for the whole in the first place?   What IS the “whole” of existence?  Our species? (We’re wiping out all the others.) When I see male writers, old or young, making bold diagnostic statements about society, I ask them whether they have taken into account other cultures than their own.  Some shut me down at that point.  Others respond, bravely, “I guess I didn’t.”

It finally registered on some people around here that I’d come back to the edge of the rez. (I’m a borderline person in several ways.)  Two old guys had formed a tiny historical society devoted to visiting the local historical (encounter) places they knew and telling each other the stories.  They decided that I would be the next local historical “site” and took me to lunch.  We had a fine time.  They’re both dead now.  But it certified to me the idea of a particular kind of history, just over the time-line horizon.  I'm one of the few who remembers some things first hand.

Only a couple of weeks ago, a little delegation of Blackfoot scholars asked to interview me at the library.  I was acting as a refugia again, even as an aid in feeling their way towards a new future.  They were on their way to the site of a tragic confrontation, the location of the “Baker massacre.”

On my father’s side I’ve done a bit of family history, because my mother saved my father’s photos and my great-uncle wrote out the narrative.  I sort of “published” it with a xerox machine and so did my great-uncle.  A few cousins seemed to appreciate it.  Their children could care less.  Later today I’ll take a lot of it to the dump.  I sent many of the photos to the Oregon Historical Society.

Sweetgrass Hills

Off and on I’ve lived next to the rez for a half century. The culture of encounter between the indigenous and the invasive (both of them constructed in response to survival) slowly yield to an invasive wave though some niches (Heart Butte) have remained refugia.  (“I alone escaped to tell you. . . )  I myself am a culture refuge of sorts, the Sweetgrass Hills of the family landscape, the twining trails.  

Over the same decades I’ve searched for a way to be a meta-cultural person, mostly through the idea of “religion.” Study and experience reveal the term to mean institutionalized systems, too rigid to survive.  But at the same time holiness is gaining strength both in relation to the land and at the limits of science.  Mystical science is slowly forming into something like a community, but not yet institutionalized, only commodified in this invasive society.  (New Age)  In Afri/Asia sacredness is still a walking meditation, indigenous because it’s on foot.  

A squid

My thought has taken into account all mammals, which is part of the reason I respond to LeDoux’s understanding of the pre-conscious brain -- which has to include the whole body to be meaningful.  Muscles remember, the nerves of distended tissues can be erotic.  I have to think about sentient molluscs, who have followed another path of development.  Consciousness is only foam on the surface.

In seminary I was part of a “formation group” not so different from therapy.  The black male leader became fascinated with my Celtic skin, meant for dark rain, pale and freckled.  Change in emotional blood flow made my face as changeable as the skin of an octopus.  If I scratched an itch, the tracks of my nails persisted for a second or two.  Terror made me blanch.  This was new to him, for some reason, and he tracked it carefully as a window to my innards.  The other group members had no interest and looked away.  But he was a good Christian, intent on being compassionate, benign, and helpful.  Therefore he never saw my poisonous beak, which all octopuses have.  A few women in the circle saw.  

Religions are detached tentacles, even when they try to return to gospel days, even when they try to join ideas from times and places where survival was nothing like it is today and here.  Even when they are so easily morphed that they can fit into small spaces.  But I already covered that.

I want to look at the refugia of confrontation, which prove that it’s not over -- “con” meaning “with” and “front” meaning “plane of contact” -- is a kind of intimacy, accepting the same terms of survival, but interpreting them in quite different ways.  So some therapists try to make the client conform (with-shape) and others try to set the client free (go roam to see what else there is).  I’m just fooling around -- this is a kind of thought-jazz.  Riffs.

So much has gone underground both in our government and in our business worlds that there’s little confrontation.  Maybe that’s why Trump is interesting.  But there’s an excess that becomes bullying and even madness.  The only way to argue with a predator drone is a ground weapon of equal devastation, between the two forces reducing humans to bloody ash.  So fear is legitimate. 

Whole landscapes and built environments are destroyed.  This is anti-survival.  Distancing.  Emptying.  Millennia of orchards, vineyards, and irrigation systems all destroyed.  Something similar is happening financially.  Eurasia is depopulating except for the cities, and replenishment is coming from entirely other people. 

This makes the urgency of refugia stronger.  The old Blackfeet indigenous practice was to go to a high place, build a little rock wall to mark the spot, lie down and dream, echoing the refuge nature of the hills, old volcanic cones that stuck up above the grinding glaciers so that earthworms as long as your arm and plants not seen elsewhere persisted and survived. 

I wrote a story about it.  The confrontation was between a Blackfeet boy who wanted the old days and a modern white girl who wanted reconciliation.  There were animals.  (“Twelve Blackfeet Stories” available at www.lulu.com/prairiemary)   I’m a little wary about telling you this.  Refugia are endangered by exposure.

JOSEPH LEDOUX AND THE AMYGDALA

The Amygdaloids

Joseph LeDoux, vocals and guitar; Tyler Volk, lead guitar and vocals; 

Nina Curley, Bass; and Daniela Schiller, drums

It has taken a while to read enough material to understand how various the brain neuron researchers are and what that implies in terms of what they study.  More reading is necessary because things are happening so quickly and in so many different ways.  Joe LeDoux is quite explicit about dissecting out what he works on and why he thinks as he does.  So far as I know, he’s the only one with a band, the Amygdaloids, and the only one with a video blog.  He reminds me of Saul Bellow, which is partly about his stingy brim hat and partly about his clear openness.  http://www.amygdaloids.com

But he doesn’t spare sensibilities.  To locate the two amydalae, one on each side of the brain, he suggests one imagine an arrow thrust into the ear and another one thrust into the eye and where they meet, that’s where the amydala on that side is located.  Part of this little organ is almond-shaped, so the early anatomists gave it that name, but it turned out that there are other pieces attached to the “almond” which makes the organ quite differently shaped.  Also, it is tightly wired to the surrounding cortex with strands of neuron. 

There are basically two nerve systems in the body, so different that some of the controlled muscles are smooth (autonomic: guts) and some are striped (striated: voluntary muscles).  It has served me well that I took high school physiology from Miss Jean Hill at Jefferson in 1955.  A small brisk woman with a female partner, she made everything so clear and memorable that it has been a reliable foundation.  But now that scientists are tracing where the neuron impulses go and what they do, instead of relying on shapes of the tissues and physical connections, the autonomic systems turn out to be a little different from what we thought then.

http://blogs.scientificamerican.com/observations/2014/06/30/free-will-is-your-brain-the-boss-of-you-video/

Gazzinaga, another key brain neuron researcher.  A no-tie guy.  (California)

LeDoux does NOT address the issue of free will, nor the relationship between the tissue of the brain and the self-conscious mind, nor the functions of the pre-frontal cortex, nor the origin of consciousness, though all these are hot topics.  Rather he is focussed on the function of the amygdala, which appears to be the switchboard of the brain functions that are "under" consciousness, and yet are the great bulk of what goes on in the brain.  The brain NEEDS a switchboard because it’s real job is sorting and weighting the information that comes in through many different sources and channels -- then deciding what to do about it.  But the amygdala doesn't wait around for speculation: it just reacts.  REFLEXES. 

True enough, everything in the beginning comes from the world outside the skin through the sensory organs and cells, which are more subtle and ingenious that we ever knew.  The grid cells, compass cells, mirror cells, and others yet to be discovered, are in the prefrontal cortex.  The eyes and nose are so connected to the brain that some consider them brain parts.  And so on.  But two things are recent discoveries.  One is the many sorting “matrixes” or nexuses or what LeDoux calls “buffering” centers, at least as many as there are major senses, each with the power to edit, weight, or block neural information.

http://blogs.scientificamerican.com/observations/2014/08/20/how-does-our-brain-remember-video/

Eric Kandel, a bow-tie guy (NYC)

And another is that the amygdala gives priority to anything that would threaten survival: tigers, snakes, sudden strangeness in general.  It triggers reactions before a person even knows they will act.  The person doesn’t have control over this.  Some reactions appear to be hard-wired and some seem due to conditioning so intense and instant that it can never really be undone.  A little boy abused as a toddler before he is able to form enough brain function to remember consciously will, as an adult, react to that undermemory to the extent of his ability to fight, flight or freeze.  It cannot be erased.  If an abused kid was thought to be “safe” to molest because he hasn’t learned to talk, he might still be able to tell the story through his body’s reactions to the amygdala's monitors.

Moving on to another kind of memory is the complex in the hippocampi, two little “sea horses,” one over each ear.  This is where one stores sensory information, consciously acquired information, and memory of strategy that worked -- all the prefrontal cortex stuff.  The primary neuronal code that comes into the brain is routed by the thalamus to either the amygdala system or the hippocampus system.   After that, they don’t communicate, though the hippocampus system might remember the emotion connected to a memory. 

This is the way we understand it now, at least how I understand the enormous, complex and technical content of books like LeDoux’:   “The Emotional Brain: the Mysterious Underpinnings of Emotional Life.”  It is rewriting, or at least reframing, the Freudian theories, which is very helpful in dealing with things like PTSD.  Until now these two systems of thought have been as separated as the two physiological systems, but they have a lot to say to each other.  Freud was frustrated by not being able to get at the very things our machinery can record now.

The following are the steps of how things from outside the skin are brought into the body and transformed into identity and “mind.”

Aplysia fasciata:  research sea slug

1. Physical responses to the environment are universal among all living things, even invertebrates.  It is the definition of “living.”  There is a constant flow of interactions in the body.  There is no such thing as “emotionless” in a living vertebrate creature.  Invertebrates have no amygdalas, but what the amygdala does is done in the cell. 

2.  Feelings are the reactions of the brain/body, the stuff that could be measured on a lie detector test, but aren’t necessarily conscious.  This is what LeDoux is getting at: that the changes perceived and recorded in the amygdala and the cerebral cortex surrounding it, plus the wiring that reaches into older parts of the brain clear back to the brain stem, partly because of evolution and partly because of evolving alternative ways of perceiving, is very DIFFERENT and not accessible to the hippocampus-mediated re-consolidated memories, which are themselves undependable.  (Not because they are lies, but because they are reassembled from various sources, not always in the same pattern and sometimes including extraneous material.)

3.  Emotion never stops but is overlain and restrained, formed into the person’s awareness of self and ability to project an idea of what to do.  Stress will throw people back to their earliest conditioned reflexes, especially those involving trauma.

Much fancier sea slug suggesting hair on fire!

4.  Naming the emotion (happiness, rage, sadness) happens after the emotion has become conscious.  But it can control behavior without ever having a name.  There have been three approaches to LeDoux’s sort of material.  One was the idea that all emotion was in the “limbic”  middle third of the brain.  The idea of the “limbic” came undone when there were too many cross-connections to claim the middle third of the brain was a separate entity.  Then there was the reflective idea that there were six or five or seven basic emotions, each managed by a different system -- but that fell apart.  Then there were theories about “arousal” -- sort of parallel to the Hans Selye idea of one basic unified response to stress.  So?  None really worked.

5. Behavior triggered by emotion can convert to something besides violence and more sophisticated than flight or freezing, but the emotion itself remains.  Fifty per cent of mental disorders are the result of fear and anxiety (“fear lite”) that are not quite managed well enough to keep them resolved.  FEAR is the big controller in our American “civilized” society even more than in the close-to-the-land villages of Africa.  I mean it is consciously and cynically used in politics, marketing and religion.

Do not mock or tease a kid in melt-down.

He will associate you with distress.  Give him space and, when he's ready, comforting.

6.  Social attitudes about the behavior produced by the emotion are both responsive and shaping.  How people react to strong emotion in others certainly influences their attempts to control themselves or even explain themselves.  But people rarely understand the basic physiological connections between a stimulus, the perception of it, and what the person has learned in a deep amygdalan way.  That is, in our culture we don't explain, comfort or make space.  Instead we come down hard on the behavior and try to extinguish it with punishment.  What we create is a gasoline piston which compresses the fuel until a spark sets off an explosion.  This is especially true for boys.

Most of LeDoux’s work is practical and at the cellular and molecular levels.  An amygdala has a dozen parts, only three of which control fear responses.   One of the three is connected directly to the brain stem, the earliest "brain" structure.  The team is using optogenetics to test many people so as to build a bell curve of reactions in different individuals.  Then the subjects are tested to see what different drugs can do.  In the past norepinephrine has been considered key.  The team sometimes uses propanalol, which was what sedated Michael Jackson to death.  It seems to shuts off fear.  Sometimes it's used to suppress stage fright.

Twenty per cent of the rat subjects failed to become conditioned by scientific funny business with shocks and barriers and rewards.  At first the experimenters thought they were Braveheart rats who had no fear, but more investigation revealed that they were actually feeling the fear, but somehow molecularly suppressing the reaction to it.  Is courage not being afraid or acting brave in the face of lethal danger?  For rats, we now know it might be either.  It was like the situation of the pigs routinely killed with succinylcholine because they looked so peaceful.  But they were only paralyzed.  Lie detector equipment revealed they were beyond terror, screaming inside.  

Like children assaulted but too afraid to show what they felt.  For the rest of their lives they will be trapped between terror and rage, denying both, looking for survival.  No wonder we recognize super monsters.

https://www.youtube.com/watch?v=zRuUQiIgyj4    Using proper timing and drugs, we can now block memories, as described in this vid.  But, as usual, we have ethical issues.  More to read and think about.