In an Unspoken Voice

by Peter A Levine

  Feelings and emotions have evolved, at least in part, to amplify the hedonic sensations of approach and avoidance. When, for example, we taste something that is mildly bitter, sensations of “distaste” are registered upon our consciousness. However, when something tastes extremely bitter (and therefore, likely to be toxic), we are more apt to have the compelling emotion of disgust, with the associated sensation of nausea. With this emotional red flag (disgust), we are very likely to avoid such substances (or those that taste, smell or look like them) in the future. In addition, other members of the group who see our reaction will be less likely to ingest the same substance. Because we may not get the chance to avoid a poison (such as a rancid carcass) more than once, these emotional signaling reactions are meant to be compelling to us and others, making a long-lasting survival imprint. This is why if you get violently ill after eating steak béarnaise at your favorite restaurant, you are likely to avoid this particular dish and even that restaurant for years—if not going to the extreme of becoming a vegetarian.

  By being able to feel things out, we are afforded the precision and overall adaptability that have put us at the top of the heap. There is a significant downside to this solution of imparting to feelings such a kingly executive function. If the emotional feeling systems were to fail and become disordered, as they do in stress and trauma, this disarray would reflect throughout the myriad of the physiological, behavioral and perceptual subsystems. This leaves us susceptible to fundamental misperceptions. A disturbing example of this flaw is when we detect danger where it does not exist—and, on the flip side, when we fail to detect it when it’s actually in our face. Another poignant example of our “feeling system” gone awry is the presence of every sort of stress, autoimmune illness and “psychosomatic” disease, which have been the bane of modern medicine. It has been estimated, for example, that between 75 to 90% or more of all visits to the doctor’s office are stress related. Fortunately, the evolution of conscious emotional feeling states provides, in itself, a remarkable solution if we can learn to register and respond to the inner promptings of our bodies.

  Our instinctual feeling-programs are the foundation for what allows us to plan and move ahead with purpose and direction. It is the fabric of what connects us to one another. When this critical map becomes disordered and maladaptive with trauma or protracted stress, as a consequence, we simply become lost.

  Losing our Way in the World: Serendipity Gained

  Ivan Pavlov was born in a small village in central Russia. His family, wanting him to become a priest, enrolled him in a theological seminary. After reading the revolutionary Charles Darwin, however, he dropped out, leaving the seminary for the University of St. Petersburg, where he pursued a scientific career studying chemistry and physiology. He received his doctorate in 1879. In 1904 he was awarded the Nobel Prize in Physiology or Medicine for his prodigious research on the conditioned reflex. Pavlov is most well known for his methodically controlled conditioning studies. Yet his pivotal contribution to the understanding of trauma was spontaneously provoked by an unexpected and uncontrolled experiment, a natural disaster that disrupted his rigidly structured laboratory protocols. He had been resting on his Nobel laurels for almost two decades when a chance occurrence opened a new vista—a discovery that is little appreciated as the first, and arguably the single most critical, experimental antecedent for understanding the physiology and behaviors of trauma.

  The great Leningrad flood of 1924 caused the water to rise in Pavlov’s basement laboratory precipitously close to the level of his caged experimental dogs. Fortunately, his assistant rescued the dogs from their cages and carried them to safety. While the animals had suffered no physical harm, and looked from all outward appearances to be completely normal, very strange changes had come over them. First of all, these terrorized animals had “forgotten” or had reversed the conditioning that they had learned prior to the event. Secondly, some of the dogs that were previously docile in nature attacked anyone who approached them, while those with previous aggressive tendencies often shook and cowered in their cages. In addition, Pavlov observed physiological changes such as elevated and depressed heart rates under mild stress and full startle reactions to mild stimuli, such as tones or the sounds and movements of an approaching experimenter. Embarking (no pun intended) on his new career, Pavlov began to systematically study these phenomena with his dogs. He must have been aware of the traumatic breakdown of soldiers and the salient need for treatment considering that Russian military losses in October 1916 were between 1.6 and 1.8 million killed and another two million held as prisoners of war.

  Pavlov remained focused on his experimental study of animals breaking down under stress during this epoch. He formulated the following sequence by which his dogs (and presumably humans) break down under extreme or protracted stress, thereby losing our sense of direction and purpose.

  In the first stage, the equivalent phase, the animal gives the same response to both weak and strong stimuli. This can be observed in humans who are deprived of sleep for even a couple of days. Under this type of stress, people may react to an innocuous question with the same degree of irritability and confusion as when they are exposed to a significant provocation. One wonders how many domestic arguments, often around trite frictions, arise out of simple sleep deprivation.

  In the paradoxical phase, or Pavlov’s second reaction to protracted stress, the animals exhibited a reversal of their conditioned responses. Something had happened in their brains that made the dogs respond more actively to weak stimuli than to strong ones. This is something that does not normally happen to individuals unless they have been traumatized. The Vietnam veteran who ducks for cover when a distant car backfires, but spends his afternoon at the firing range, demonstrates this phase of breakdown. Another example might be the rape victim who startles to every passing shadow yet hangs out in seedy bars.

  Pavlov named the third and final chapter in the breakdown saga following unmitigated stress ultra-paradoxical but also referred to it as the transmarginal phase. In this final phase of “supramaximal” stimulation, a critical point was reached. Going beyond this apex would cause many of his dogs to just shut down; they became unresponsive for an extended period of time. Pavlov believed that this shutdown was a biological defense against neural overload. (In this way Pavlov set the stage for the study of conservation-withdrawal as investigated by Engle and later by Porges with the formation of his polyvagal theory.) In addition, as his animals “recovered” from being stunned, they exhibited extremely odd and inexplicable behaviors. The aggressive dogs became docile while the timid ones turned hyper-aggressive, as mentioned earlier. Similarly, trainers for whom the dogs had shown affection prior to the flood were now confronted with aggressive snarls and lunges. Other dogs, who had previously disliked their handlers, greeted them with showers of tail wagging and affection.

  These about-face counterintuitive behaviors are analogous to those of highly traumatized humans. The loving husband who attacks his wife upon returning from the Iraq War is one such possible example. Another involves hostages who exhibit the Stockholm syndrome. They are not only compliant but may behave as though they have fallen in love with their captors, even refusing to leave when their rescuers arrive. There are a multitude of examples where victims of kidnapping have regularly visited their previous attackers in prison for years and have even married them. Jill Carroll, the Christian Science Monitor reporter, described her Iraq abduction in almost cheerful terms but then, a day or two later, talked about being in seclusion because of her trauma. And then, hopefully back to equilibrium, she made the statement, “I finally feel like I am alive again.”

  In addition, traumatized individuals generally find themselves, as with Pavlov’s transmarginal phase, swinging wildly and unpredictably between being numb and shut down on the one hand and being flooded by emotions, including terror and rage, on the other. These bipolar swings are often erratic and capricious. With human posttraumatic stress disor
der, chronic sufferers tend to gravitate, over time, toward shutdown. This shows up as symptoms of alexithymia (the inability to describe or elaborate feelings due to a deficiency in emotional awareness), depression and somatization.

  Pavlov, observing his dogs suffering with their debilitating and intractable symptoms, concluded that they had lost their capacity to make adaptive approach/avoidance responses; they had essentially “lost their purpose.” In summarizing the plight of these poor creatures, he remarked that they had lost the “reflex” or instinct of purpose; they had lost their way. A similar example of breakdown comes from nature. A Galapagos Island guide told the following story to one of my students: “When a volcano erupts, the animals frequently lose their survival instincts, get confused, and some walk straight into the oncoming lava. This includes sea lions and marine iguanas capable of swimming to another island.” It appears that under this form of extreme duress, even animals in the wild may lose their bearings in the chaos. With a rare prescience Pavlov also inferred the natural, instinctive mechanisms by which traumatized organisms could regain their purpose and will to live. In particular he realized that approach and avoidance were aligned with what he called the defensive and orienting response. In his further study of the orientation responses (approach) and defensive responses (avoidance), Pavlov provided us with the key to establishing a healthy encounter between an organism and its environment: an optimal balance between curiosity and the need to defend and protect oneself.

  Pavlov discovered that when animals are exposed to something novel in their environment, they first arrest their movement. Next they direct their eyes, head and neck in the direction of a momentary sound, fleeting shadow or novel scent (or follow the lead of other members of the group as they go into an arrest and alert response.). During arrest there is a brief deceleration of the heart rate, which apparently “tunes” and opens sensory perception.122

  Pavlov discovered that these orienting responses served the function of both locating a source of novelty as well as accessing its meaning (i.e., is it a source of threat, mating, food or shelter?). It was likely that Pavlov was aware of this dual function. He called the innate characteristic of the orienting response the chto eta takoe reflex (instead of the simpler chto eta). Attempts at a literal translation have resulted in its being called the “What is it?” reflex. A more exact translation, however, suggests something closer to “What is that?” or “What is going on here?” or “Hey man, what’s happening?!?”b This labelling emphasizes the amazement and curiosity inherent in the response. This dual response (reacting plus inquiring) is the dominant feature of orienting behaviors. For humans, as well as other animals, this includes expectancy, surprise, alertness and curiosity.

  Let’s end this chapter by tracking what Pavlov taught us back to its therapeutic application with clients: In virtually every session, as (formally) traumatized individuals emerge from immobility and shutdown, they are biologically wired to have the nascent impulse to orient to the room, to the therapist and others (as in group sessions) and to the here and now. So as Pavlov showed us how we lose our way, he also illuminated the way back. Recall for a moment an example of this during the session with Adam (the Holocaust survivor in Chapter 8). By embodying the image of the slum children joyfully flying their kites, Adam was able to emerge from his profound shutdown and began to orient to the various objects in the room and, then, to engage with me in a fresh and vital way. In that moment he came back into life long enough to embody new possibilities.

  So you see, we are, in the final analysis, just a bunch of animals—instinctive, feeling and reasoning. In closing, I would like to repeat the quote from Massimo Pigliucci that opened this chapter because it seems to sum it all up succinctly: “We may be special animals, we may be particular animals with very special characteristics, but we’re animals nonetheless.”

  * Oxytocin and the endorphins have been implicated in this feel-good and trust-promoting chemical cascade.

  † These include Ivan Pavlov, Sir Charles Sherrington, Nikolaas Tinbergen, Konrad Lorenz, Karl von Frisch and Roger W. Sperry.

  ‡ Jim Anderson, a psychologist and primate researcher at the University of Stirling, in Scotland, described a recent videoing of the death of Chimp and the reaction of others in the same pen (BBC News, April 26, 2010): “As the breathing of the old female chimp slowed, and finally stopped, the others bent down to look intently into her face … We had never seen that before.” They poked and gently shook her body for 30 or 40 seconds. They looked puzzled, Anderson reported, and slept more fitfully that night than usual. The dead chimp’s adult daughter slept on the platform where her mother’s body lay—close but not touching or inspecting it. Reporting in the April 27, 2010, issue of the scientific journal Current Biology, Anderson said that these observations add to the growing body of evidence suggesting that chimps have a rich emotional life. “It might well be that they do have some awareness of death. We know from other work that chimpanzees, more than monkeys, are capable of showing empathy toward others who have a problem, or have been attacked. We see consolation behavior.” Chimps clearly have a sense of self, Anderson said, and some sense of future and past.

  § In the tradition of St. Francis of Assisi, both David Rothenberg, in Why Birds Sing, and Maya Angelou, in I Know Why the Caged Bird Sings, write about this creative core in birdsong. Rothenberg asks the question of why birdsong sounds so musical, and after earlier “duets” with birds and cello and flute, he has recorded a series of live duets between bird and clarinet.

  ‖ Note that one of the moth’s camouflages is an eye on its wings.

  a There may, of course, have been multitudes of soft-bodied creatures that are not preserved in the fossil records. See Richard Dawkins, The Ancestor’s Tale: A Pilgrimage to the Dawn of Evolution (New York: Houghton Mifflin, 2005).

  b I recently spoke to the Russian translator for my first book, Waking the Tiger: Healing Trauma, and she confirmed this analysis.

  CHAPTER 11

  Bottoms-Up

  Three Brains, One Mind

  Understanding the laws of gravity does not make us free of gravity … it means we can use it to do other things. Until we have informed mankind about the way our brains function, of the way we use them … until we acknowledge that it has been to dominate others, there’s little chance anything will change.

  —Henri Laborit (Mon oncle d’Amérique)

  Give me a place to put my lever and I will move the world.

  —Archimedes

  Surely, no one would reasonably dispute that we are the product of how our brains and bodies operate. While this may not be the whole story, it is a reasonable working approximation. However, at the same time it would be hubris to say that all of subjective experience is precisely explained by the anatomy and physiology of the brain, just as it would be absurd to believe that everything we feel and know is understandable by how the brain functions. In the final analysis, for better or for worse, we cannot escape the fact that we are constrained by the brain’s influences and operations on our bodies. To know ourselves is to know our brains, and to know our brains is to know ourselves—more or less.

  Following the visionary and experiential work of William James in the early twentieth century, there followed a shift in emphasis on the study of brain function. While James focused on the subjective experience of emotion, the research that followed involved stimulating and excising animal brain tissue and then correlating those sites with observed emotional behaviors (such as rage and fear). First, Walter B. Cannon, the preeminent physiologist of his times (1920s–40s), along with William Bard, underscored the control of emotion in the brain rather than (its experience in) the body.* Their central theory was furthered by James Papez, an obscure physician and neuroanatomist working independently in his small-town office in upstate New York. In his landmark 1937 article titled “A Proposed Mechanism of Emotion,”123 Papez described an “emotional circuit” that was centered upon the upper part of the brain stem,
the thalamus. Surrounding the thalamus was a circle, or “limbus,” of nuclei including the hippocampus, hypothalamus and cingulate. The cingulate is an important intermediary, as we shall see, between emotion and reason. Notably, Papez did not include the amygdala (now recognized as an important mediator of emotions, particularly those associated with novelty and threat) in his papers on emotional circuitry.

  Papez gave his circuit the catchy title, “the stream of feeling.” Today this region is known as the limbic system, or the emotional brain. The latter descriptive title was coined by the well-known brain researcher Joseph LeDoux. It should be noted that these twentieth-century students of the brain concerned themselves exclusively with the expression of emotion while ignoring subjective emotional experience altogether. Freud’s metaphoric framework and James’s introspective focus on sensations and feelings had been eclipsed by research technology and a fascination with the concrete neural mechanisms and behavioral components of emotional expression. And yet, one might take the liberty here to speculate that Freud (originally a neurologist) would have been delighted, at least, with the locus of emotions. After all, it sat at the core of the brain where he believed that the instincts (or what he dubbed the “id”) resided, well out of range of the “ego” and deliberate consciousness. However, as we shall see, while there may be no direct connection between the instincts (id) and rational consciousness (ego), there are vitally important two-way conduits between the id (instincts) and self-awareness.