Turgor and Colloid–Any Connection With Fascia?

There is now on Youtube a very interesting video about the role of fascia in health The information certainly supports the Reich and Lowen tradition’s emphasis on the muscular system as a main point of limitation in emotional human functioning. Neither Reich and Lowen considered the fascia much apart from muscles proper. Today fascial dysfunction is so evident that the distinction may have concrete benefits in pointing to remedial practices such as deep tissue massage techniques that separate muscles etc..

However, in the above linked documentary, there is also a fascinating look at the conductive properties of fascia. As reported, conductive ‘spots’ exist in the fascial layer that correspond to points along the energy meridians of traditional Asian medicine. A barrier to acceptance in Western medicine for the meridian model is that the meridians do not line up with nerves. Western concepts of physiology are very nerve-centric, perhaps because nerves are extensions of the brain, and Western concepts of physiology are very brain-centric.

Another non-neuronal energy system is turgor and colloid. Reich researched this, but Lowen did not address it other than in a ‘diagnostic’ sense, perhaps because it wasn’t apparent how to work with turgor and colloid directly. The area truly has been orphaned with only the cosmetic industry taking interest but of course only in a specious framework of adding supplemental colloid from the skin inward rather than addressing the process from the core outward

A question occurs to me–do the fascia and turgor and colloid interact?

Michael Samsel

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Missions and Tending

In my work with couples, I frequently encounter a difference in meeting responsibility. The masculine tends toward organizing responsibility in the format of ‘missions,’ discrete bursts of goal directed behavior, while the feminine tends to implement responsibility through ‘tending,’ a more continuous attention to maintaining good and desirable conditions.

Elements of Mission Focus

  • A Clear, Definable Objective
  • A Definite Start Time This can a trigger by circumstances, or based on when the ‘team’ is ready, or set arbitrarily.
  • A Stopping Rule This can be achieving the objective, ascertaining the impossibility of achieving the objective, reaching a pre-determined time limit, exhaustion, or loss of interest
  • On/Off Nature
  • A Team Who is in the mission and who is not is clear. Efforts by people not in the mission to participate are considered intrusive
  • Set Responsibilities of Team Members If one person is lucky and has nothing to do, there is not only no obligation to help others, but without an explicit request for help, trying to help is considered intrusive

Elements of Tending Focus

  • The Goal is Achieving A Feeling The feeling can be felt by those sensitive to it, but is hard to define.
  • Continuous Duration This may be at low intensity at times, but monitoring is always going on. There can be ‘soft’ start and stop times for activity based on thresholds in environmental or interpersonal conditions.
  • No Set Participants Great efforts will be made to include everybody
  • No Set Roles. It is a point of honor to help others and tasks are considered joint responsibilities. Efficiency is a secondary consideration, and specialization is generally considered abhorrent.

This small model by no means summarizes the differences between the masculine and the feminine, it is just an aspect. However, it is an aspect at the core of much domestic discord.

Both foci are biological, they are at base complementary. Some  weaknesses of the mission focus is that 1) conditions slowly deteriorate because there are not clear triggers to action–the oft cited example is the infant with a diaper saturated with urine because there was no point at which the situation became critical, 2) the mission format can make some wasteful and pointless objectives seem worthwhile.

Some weakness of the tending focus are 1) it is a closed system and a type of psychological starvation happens when nothing is brought into the situation, and 2) novelty, adventure, and major renovations get framed as disruptive and messy.

In our economic life, most jobs now involve to tending to large systems. Only the highest status workers get to ‘go on mission’. An exception to this is construction, where every job is a new mission. But most freedom of action is in the domestic arena where tending is again disproportionately called for.  The result is that the masculine gets unjustly identified with uselessness and unresponsiveness. Situation comedies exagerate this. The solution is not more supression of the mission instinct. The solution is in more missions but ones in which the domestic situation is enriched and renewed.

Michael Samsel LMHC

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The Darn Placebo Effect

Human suffering can be reduced considerably but temporarily by the initiation of any intervention that the sufferer believes in. This is the ‘placebo’ effect. This is why the tooth immediately hurts a lot less as soon as the dentist appointment is made and one hangs up the phone. I have mentioned before how the placebo effect interferes with the study of Reich and Lowen therapy. I now come to see how it also interferes with the delivery of it.

There are two problems with the placebo effect: 1) it decays over time, and 2) it cannot work synergistically with growth strategies to relieve suffering.

There are two seductions (or assets, depending on one’s point of view) of the placebo effect: 1) It is immediate (unlike growth) and, 2) it is considerably stronger in effect initially than true growth effects.

The placebo effect is based on dissociation. Real growth is based on association (or re-association) In research, if another dissociative method (say a drug) is employed as the experimental condition, then the effects of that and the placebo may be additive. When the control group (which only has the placebo effect) is compared, the placebo effect subtracts out and demonstrates a treatment effect. Associative effects, however, are not additive to the placebo effect, in fact they may undermine it. Therefore, in testing something that leads to growth, when the experimental and the control group are compared, the shared placebo effect is like tall grass that hides what is happening on the surface, and no treatment effect is demonstrated. This is particularly true since studies tend to last less than 6 months, and the effects of growth in this arena usually take several years to manifest. This why effective ‘alternative’ treatments cannot be distinguished from ineffective alternative treatments by present day random-controlled trials—the subtle balancing and regulating effects (or their absence) are all hidden under the tall grass of the placebo effect.

In emotional well-being, the placebo effect is synonymous with what Alexander Lowen described as elation or illusion. As he often pointed out in his writings, the therapist’s ‘window of opportunity’ for change is often to prevent the client from ‘climbing back onto’ the illusion (and the placebo effect,) after a collapse.

Placebo effects are in fact part of healthy human adaptation for causes of suffering that 1) will pass on their own, or 2) cannot be addressed immediately but which will be effectively addressed in the near future (such as the tooth example above.) Where the cause of suffering is persistent, placebo effects support an increasing dissociation that covers a slowly depleting work and pleasure function.

Placebo effects have to be renewed periodically, by finding some ‘great new thing.’  This leads to a very disorderly approach to health where the sufferer travels from one type of practitioner to another, never really committing to the practices. The immediate positive placebo effects are mistaken for the treatment effects, but as the novelty wears off, the practices seem to stop working, and something new becomes overwhelmingly attractive. This is placebo abuse. In my practice as a therapist, it greatly interferes with forming a working relationship because new clients compare the subtle differences I am pointing out to the strong if temporary morale-boosting available through starting ‘something new.’

Michael Samsel

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Deficit and Conflicts

Psychotherapy is about overcoming inabilities–and there are two main ways to approach these inabilities, as the result of deficits or as the result of conflicts. From the deficit point of view, the ability to proceed in life in a certain manner never developed, and encouragement is appropriate from the therapist. From a conflict point of view,  desire or fear interferes with straightforward living, and judicious exposure and confrontation  is appropriate from the therapist. Moreover, encouragement (and its cousin reassurance) could be detrimental because it parcels out the conflict between therapist and client instead of ‘forcing’ the client to handle both sides of it.

Deficits can be handled gently and non-confrontationally. In fact in this regard it is said it is better to “work with the client than with the client’s defenses.” Conflicts, on the other hand, do not succumb to half measures. Defenses must be aroused, named, stressed, and broken in titanic struggles. Therapists often divide into the two camps based on their individual eagerness or reluctance to challenge and confront.

Freud of course is the man who gets credit for ‘inventing’ the conflict model. The psycho-dynamic tradition is named in part for an emphasis on conflict The humanist psychology tradition arose partly in response to the inherent asymmetry of the conflict model where the therapist does the confronting and the client does the adjusting (possibly recreating the original narcissistic injury). However, humanism took the deficit model a step further by implying that all deficits were really only deficits in morale, and so the therapist does not have to have greater understanding (just great empathy).

Wilhelm Reich and Alexander Lowen in some way married the two models by describing a process in which early conflict produced body and nervous system development that was deficient. The conflict existed in the past but the deficits exists now (but importantly the deficits are not just ones of morale, but ones of neuro-muscular capacities). Bodywork addresses the deficit model and character analysis addresses the conflict model.

However, within bodywork, the polarity recreates itself. Classic bio-energetic exercises are about confronting a conflict physically. They are ‘stress’ positions. Alexander Lowen prescribed bodywork on the basis of deficit but led it on the basis of conflict. But in my work, it has come to be my conviction that the idea of developmental stall is very relevant especially to ‘early’ characters, and that a less conflictual type of bodywork, neuro-muscular training, is beneficial. After all, a stressed system may adapt further, but it does not grow, either in strength or discrimination.

The extent to which character armor is given teleological explanations in the Lowenian analysis has been unsatisfying to me. That is, that the ultimate effect of character armor being the cause of that very armor’s original development would make sense if a human will had interceded and managed the process, but it seems too glib in itself to explain a purely biological event. Likelier, character armor is the oft-repeated result of trial and error in adaptation among the biological and developmental forces occurring in a young human.

In Reich and Lowen therapy, (and all effective therapy) deficit work will itself lead to a particular conflict. Most early ‘pre-oedipal’ character structure have adapted secondarily to a regressed role. Assuming the adult role–both the burdens and the prerogatives is the implied goal of deficit work and so may be resisted.

Michael Samsel

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Substituting the Extraordinary for the Ordinary

The drive to do extraordinary things is driven by three things: 1) genuine creativity, 2) narcissistic injury, and 3) a difficulty doing ordinary things.

Most recently I have been  intrigued by the third reason. It seems that when activities of daily living, through sensory defensiveness or other reasons, lack satisfaction, that compensation is attempted through doing the extraordinary. Examples are being an astronaut or achieving samadhi, etc..

But when there is no satisfaction in the ordinary, there will be no satisfaction in the extraordinary.

Michael Samsel

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Describing as Prescribing

There is a small trend in popular works on emotional health. A healthy state, like social adjustment or self-confidence, is described by the specific elements that indicate it. So far so good, sometimes this clarification has value. But then it is suggested or implied that reading the description is in itself a means to achieve this state–that is the description is presented as a prescription. The work of John Gottmann comes to mind–the excellence and accuracy of description is indisputable, and that must have considerable value, but it is not clear how to get from ‘bad’ to ‘good.’

Generally a good thing is recognized when one sees it, but in the arena of good feelings there are usually barriers to achieving this by mere imitation.

Michael Samsel

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Four Ways to Get Stuck

Stephen M Johnson is certainly a proponent of the Reich and Lowen tradition, but he does work more from the object relations end than the drive end. In his book Symbiotic Character, he takes Ronald Fairbairn’s internal object relations and describes four adaptive styles to a negating force (internalized bad object). I think for clinicians, this description has great value, so using Johnson’s/Fairbairn’s work as a starting point I would like to expand on these styles below (including naming them descriptively rather than numerically):

Overcontrolled

Here the person identifies with the bad object against the self. The bad object is veiled in the guise of principles or scruples.

  • Applies inhuman or impossible standards to themselves, somewhat more lenient standards to others. Identifies with succeeding in meeting these demands.
  • Appraises self quite harshly, and others merely harshly.
  • Keeps others involved by keeping the focus on should/good/right/best
  • Self-observation  over-active, and action is not natural or spontaneous.
  • Exaggerates the rights of others.  Considers violating social norms the same as violating the rights of others. Tries to follow social norms assiduously. In quite a quandary when social norms conflict because there is no option except to try to make things work.
  • Internalizes responsibility, internalizes failure.
  • Takes responsibility for all bad outcomes, even unforeseeable ones where he or she acted reasonably and responsibly.
  • Assigns self tasks where the effort and cost obviously exceeds the benefit
  • Behavioral and expressive repertoire constricted, but subjectively, this is viewed as discipline and not incapacity.
  • Views self as deficient, although may have substituted his or her own reasons and superficially rejected parental criteria for criticism. Strong sense of guilt.
  • May have superficially replaced family-of-origin repressions for a set of ‘more enlightened’ but equally limiting beliefs.
  • Difficulty relaxing, must keep busy to control feeling (unless depressed)
  • Uncomfortable in unstructured situations where there is no ‘normal’ or ‘correct’ behavior. (Fears punishment for inappropriate behavior of course but also does not trust self to be able to determine that)
  • Resents less constricted people, but has trouble criticizing them plainly.
  • Will inconvenience his- or herself greatly to prevent small inconveniences to others.
  • Has trouble distinguishing between the wishes of others and the demands of others
  • Will tend to punish self, calling it self discipline. May punish others, but this is completely unconscious

Excitable/Escaping

Here the ‘self’ ‘sneaks’ out on the bad object periodically, which blows off tension, but ultimately returns, like a runaway child, for punishment.

  • Inconsistent in applying standards, to self and others, being harsh or lenient and having difficulty finding a balance.
  • Usually fairly balanced (if not objective) in appraising self and others
  • Keeps others involved by exciting/seductive/bad/dangerous behavior
  • Self-observation  inconsistent
  • Blames self for keeping others from acting effectively in their own behalf
  • Respects the rights of others
  • Externalizes responsibility (usually), internalizes failure (usually)
  • Tends to comply superficially with expectations, but episodically rebels or ‘acts out’
  • Does not try very hard not to get caught
  • Violates social norms (sometimes flagrantly) but does not violate the rights of others

Protesting

Here the person, like in the over-controlled ego state, identifies with the bad object against the self, but will start to protest at times of stress. Sometimes psychotherapy will help the person move from over-controlled to protesting, but if that is all that happens, there is little real benefit as this is still a very repressed condition.

  • Applies inhuman or impossible standards to his or herself, but protests the demands as if they come from others, and identifies with failure to meet the demands. In the course of this, applies such demands to others but doesn’t enforce them.
  • Appraises others quite harshly, appraises self merely harshly
  • Keeps others involved by keeping the focus on what has been unfair/hard/out-of-reach (reproaches and laments)
  • Self-observation over-active generally, dissociates from own hostile displays
  • Exagerates the rights of others, except where he or she feels they cannot succeed in giving those rights, then flips and protests the other has no right to expect this etc…
  • Considers violating social norms the same as violating the rights of others. When social norms conflict, blames somebody
  • Internalizes responsibility, but externalizes failure
  • Complains of powerlessness

Punishing/Abusive

This is the ego state that is described by “identification with the aggressor.” The person ‘becomes’ the bad object, and projects the vulnerable (and hated) self out onto others.

  • Applies inhuman or impossible standards to others, and enforces them sadistically. Holds self apart from and vigorously resists standards being applied to self.
  • Appraises others quite harshly, although may be seductive. Appraises self quite highly (though may not believe it.)
  • Keeps others involved by demands and accusations
  • Self-observation  under-active
  • Violates the rights of others, justifying it as righting wrongs
  • Disregards social norms, but may try to enforce them on others
  • Externalizes responsibility, externalizes failure
  • Often gravitates toward positions of power, police and military are obvious, and can be plainly abusive,  but may also be in a position where others can be judged and limited such as teaching, criminal justice, and social work.

Common Features

  • Joylessness and pleasurelessness
  • Lack of real desire or purpose
  • Tension in body
  • Insecurity
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Inspiration as Junk Food

As a therapist, I am chronically engaged in the study of what practices decrease human suffering. I am also engaged in the study of human growth, to the extent that growth can decrease suffering.

Everyone is aware that the most popular approaches to this undertaking are inspirational ones–Wayne Dyer, Eckhardt Tolle, Deepak Chopra, Tony Robbins, John Bradshaw to name a few. In these approaches, the recipient listens to a colorful speech or reads a book and feels his or her outlook on life has really changed. Now I am sure that these speakers help people and say many true and profound things. But largely this is just a transference cure through identification with someone who acts out the image of ‘having it really together.’ And the image of having it really together is put across with a flow of truisms.

Truisms are abstract summaries that don’t include any actual practices. Any topic discussed at a high enough level of abstraction sounds profound. But there are no choices to make! Hearing truisms provides a sense of fitness without  any steps being taken. The preference for live speaking or video in this area is not incidental. With every truism, the brain receives a blip of dopamine, and the mental state may be positive briefly. Almost never does this transfer to doing something differently. On the other hand, concrete practices, like breathing exercises, stretching, or even regular self-disclosure in a close relationship, if stayed with, bring about substantial if subtle changes in a life. It’s about changing the body, not the slogans.

I have had therapy clients that were quite laudatory about the truisms in my web site (I admit I have quite a few!) but quite surprised that therapy was not about generating more truisms but about actual practices that had been summarized by those statements.

Michael Samsel

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Durable Helplessness Not a Mental Mistake

There is an undisputable phenomenon in mice and humans (and all mammals in between.) The experience of being helpless to protect oneself can induce a durable (that is not necessarily permanent but possibly permanent) biological state in which attempts to help oneself diminish markedly, even in subsequent situations where the possibility of helping oneself is available and not even strongly hidden or hard to see.

This is called learned helplessness and it is a term and a construct that I have not questioned until recently. Now with mice of course, ‘learned’ implies conditioning, but with humans ‘learned’ implies a mental (or worse moral) mistake, since even if conditioning is an element, humans are ‘expected’ to recognize what is happening and either assent or contravene the conditioning by force of will.

A couple of definitions are in order. Powerlessness is the inability to control other people and events to further one’s interests. Police and politicians have limited legal power, for instance, and the rich have some power to control conditions, but as humans, powerlessness is actually the normal state. It becomes an issue after narcissistic injury when the wounded party believes he or she should have this power, to make things right. Powerless is not the subject of this post but I define it here to better define helplessness, because in our deeply narcissistic and narcissistically-injured culture the two are confused.

Helplessness is the inability to protect one’s integrity because one’s native abilities are exceeded by the threat, and help cannot be recruited. A baby for instance is constantly on the verge of helplessness except for being able to recruit help from caregivers. If the caregiver is inadequate, the baby is actually helpless. Action-adventure movies often display implausible situations where the hero is rendered temporarily helpless by an evil genius–this is an primitive universal fear that fascinates us. However, in the movies, the hero is never daunted. That is inaccurate physiology.

The actuality of being helpless strongly induces the dorsal vagal freeze response. If this is not promptly reversed (in superheroes this is by implausibly skillful active defensive actions, but in normal humans needs to be done by say by trembling or crying), the freeze response becomes embedded in the person.

In chronic threat, there is no time to recover.  Freeze becomes chronic physiologically which means submission becomes chronic interpersonally. Submission of course at times is the best response objectively, and so may be simulated. But physiological submission is involuntary, and renders the person truly helpless. Some would say that is its purpose–to create a circumstance in which predators have no worry and so relax–but I dislike teleological explanations. The question has been why  is this state sustained well past the point when circumstance have changed?

An example is the actions of some recipients of intimate partner violence. Often it is noted that even after successful separation from the abusive partner, there is an ineffectiveness of self-protection, even if there is high-level performance in other areas of life. Learned helplessness disables the normal threat detection system of everyday life.

For this phenomenon I think the term durable helplessness is more accurate and less pejorative. Physiology as basic as the autonomic system is much more powerful than objective insight and this is true as well within the bodies of scientists. An avoidant attachment style may mean that little submission occurs short of gunpoint, but this does not rule out a strong chronic freeze response. Intellectualism is in part a by-product of the dissociative aspect of a dorsal vagal state.

Michael Samsel

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Modern Medicine Dismisses Skill

Well at least health skills in patients. Health behaviors are requested from patients, but only unskilled ones! For instance, in asthma and obstructive pulmonary disease, no breathing skill is taught or even considered. In diabetes, eating (more than just avoiding something) might be considered a skill, but patients are told to eat anything and just keep adding insulin. And of course, in the voluminous area of inflammatory disease (which includes most ‘auto-immune’ disease) patients are steered away from any social, spiritual, or even breathing or kinesiological skill that would reduce physiological stress or inflammation. Drugs of course, are the epitome of ‘unskilled’ interventions–certainly unskilled for the recipient and perhaps largely unskilled for the prescriber.

It wasn’t so drastically that way say 50, 40 or even 30 years ago. I don’t think allopathy is intrinsically against patient skill. Why the change? Well Big Pharma has certainly been a factor. It funds most research and it certainly won’t fund research on drug-less skills in living. Traditional health recommendations, like rest, relaxation, vacations, enjoying life, breathing slower, romance, meaningful hobbies, eating for true pleasure, etc are not based on double-blind studies and so it is now considered malpractice to recommend them. Physical therapy, formerly a storehouse of advice and training in posture and movement, is now treated as a crutch and wheelchair dispensary service.

Also skills are hard to make into independent variables for research because some participants might not really master the skill (and some of the ‘controls’ might already being practicing the skill) In this way, skills are never proven ‘scientifically’ and so no longer get recommended. Over the last few decades, health skills have been lost in the mainstream, and in medical education.

Michael Samsel

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The Most Important Difference

The most important difference in growth is between almost nothing happening and actually nothing happening. Think of a child at 8 or 9 years of age. Nothing seems different than the day before but the child is growing rapidly and this is readily apparent over the months and years. Almost nothing happening is in fact the pace of even rapid change from the viewpoint of the ego.

When a therapy client reports to me rapid change or a breakthrough, it is almost surely a placebo effect or a demand characteristic. These are much larger and much quicker, but of course not cumulative or synergistic with growth. Real growth, where it is happening, is always concealed in the troughs of the placebo effect, which confounds the results of therapy no end (unless therapy is multi-year).

Of course, actually nothing happening is possible as well. How does one tell the difference? Well real growth is noticed by other people first. Other people do not feel our placebo effect. And unless they are the one ‘demanding’, they are unimpressed by demand characteristics. A slang term for this is JND, or ‘just noticeable difference.’ Often other people won’t mention this, because they are unsure it is real. They also may have a hard-time putting their finger on exactly what is different.

Michael Samsel

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