seemingly related to postpartum depression. Her father, a hot-tempered, distant man, told her that her grandmother would be coming to stay with them and that Jan needed to be a “good girl” and take care of her younger siblings. Her father, a litigator, worked long hours and retreated to his study every evening after dinner. While Jan never saw him drunk, he did have a few drinks every night. She was afraid of him: he rarely hit the kids, but he had a tendency to be verbally abusive, especially with their mother. One of the reasons she married Sam was because he was “the exact opposite of my father — he was even-keeled, kind, and patient, and he loved children.”
Jan recounted an incident when she accidentally burned the collar of her father’s shirt when learning to iron. “I feared for my life — the veins in his neck bulged out, and he grabbed me by the arm so hard I thought it would break off. He cursed at me and sent me to my room without supper. My mother did nothing, as she was quite passive and was also afraid of his anger.” As Jan recounted the story, I inquired as to whether her daughter’s “rage fests” felt similar to her father’s bouts of anger. She said that she had never made this connection because of their age difference, but agreed that they were similar and that her response was the same to both — to run for cover. Clearly this wasn’t helping Jan or her daughter.
The year her mother was hospitalized was a difficult and lonely year for Jan. She remembered being afraid that her mother would die. But it was no use sharing her concerns with her father or grandmother. “My father couldn’t be bothered with us kids, and my grandmother was a cold and stern woman. If I complained about anything, she would remind me how hard she had had it in her childhood, as one of nine children.”
Her mother’s recuperation lasted over a year. Jan remembered wanting to be closer to her mother but finding it difficult because her mother suffered from anxiety and depression, and was overwhelmed with raising three kids and coping with a volatile husband. She often went to bed early, leaving Jan to tend to the little ones. As Jan described this period of her life, her head and shoulders drooped, and her body slumped in the chair. I was sure that I could see some sadness in her eyes, but when I inquired, she said she felt nothing. She knew it was a sad experience and that she should feel sad, but she felt numb.
Escaping from the Pain
When I asked Jan if she remembered feeling sad or lonely in her childhood, she replied that she learned early in life to block out unpleasant emotions and retreat into food and things she was good at. From elementary school on, she excelled at schoolwork, and, like her father, she was a voracious reader. She was also athletic and took part in team sports like soccer and volleyball. Studies, reading, sports, and caregiving duties at home kept her away from “all those terrible memories and feelings.” I had a hunch that her older daughter might be following in her footsteps.
“Because I was a good student, I was allowed to stay in my room for hours on end, and I could block out all the family drama.” Jan told me she rarely invited friends over because she never knew what to expect with her father’s moods. “During elementary school, my brother and sister started fighting regularly, and I would retreat to my room with my books and a stash of my favorite treats. I know this sounds crazy, but sneaking and hiding bags of cookies, pretzels, chips, and candy was really exciting. I always looked forward to coming home to my books and my stash. I think that’s why the ever-changing array of junk food at the office is so appealing to me.”
Jan was aware that the environment she grew up in might be playing a role in her current inability to cope with and manage relationships. She recounted a recent experience of being humiliated by a colleague in a professional meeting. Unable to process the flood of emotions, she described the experience as “feeling like I was falling apart.” When she left the meeting, she grabbed a box of four ice-cream bars from the freezer at work and ate them all on the drive home. A couple of glasses of wine at home finished off any residue of emotion.
Jan also revealed that she found it difficult to stay in the exam room when she had to share disturbing lab reports with her patients. While no physician enjoys delivering bad news, Jan found her patients’ emotional pain and occasional outbursts unbearable. She usually called in her nurse, a sweet older woman, to do the comforting and soothing. I didn’t need to be Sherlock Holmes — or a seasoned psychotherapist, for that matter — to see the parallel with her difficulties in handling her adolescent daughter’s outbursts.
Leaning to the Left
In traumatic, undernourished, emotionally empty childhoods, one side of the brain may be understimulated, while the other becomes more dominant. The right side of the upstairs brain is more directly connected to the downstairs brain: information flows up from the body to the brain stem, the limbic areas, and the right cortex. The right side, which develops earlier, offers us a more direct connection to our whole body and the electrical, chemical, and hormonal discharges that we call emotions. The left side of the upstairs brain is more removed from these sources of input.
Jan was raised in an academic family that emphasized education and work. She had learned to “lean to the left” — to stay logical, literal, and linear and to avoid right-hemisphere-generated emotion and body awareness. The right side of her brain’s neural circuits had, perhaps, been underutilized for decades. Jan strenuously avoided any situation — discussions with her daughter, intimacy with her husband, or interactions with upset patients and staff — that might trigger uncomfortable emotions and bodily sensations.
Jan’s adaptations to a traumatic childhood, including her determination to have a better life than her parents’, were resourceful and had helped her move through life and achieve professional success. But her unconscious “leaning to the left” was keeping her from connecting with herself and others. Imprisoned in a rigid and unemotional world, she was surviving but no longer thriving.
Listening to the Body
Infants and small children depend on their caregivers to help them regulate emotional and physical arousal. Our earliest social relationships are formative in the development of the stress-response apparatus, our body’s system for regulating arousal. The body’s stress apparatus involves the lower brain centers where emotions are perceived and processed, the immune system, the endocrine (hormonal) glands, and the nerves and nervous system. All these systems are joined together into a mind-body continuum through several pathways.
Children in the care of responsive, nurturing adults develop healthy stress-response mechanisms. Infant observation studies suggest that we are born with a high degree of “relational knowing.” We are keenly attuned to our caregivers’ subtle emotional shifts, such as the muscle changes in a mother’s face that convey softness or tension, fear or joy. We react to the tone and speed of their voices. We notice that their eyes are wide open or nearly shut. All these subtle or not-so-subtle shifts are linked together for us by a single regulatory system called the autonomic nervous system (ANS).
The ANS has two branches. The sympathetic nervous system (SNS) acts as our body’s accelerator and is responsible for arousal, and the parasympathetic nervous system (PNS) serves as the brake. The SNS includes our fight-or-flight response — it is responsible for the shot of adrenaline that speeds up our heart rate and prepares us for action when we almost rear-end the car in front of us. The PNS calms down arousal by slowing the heart rate, returning our breathing to normal, and relaxing our muscles when the danger has passed.
When we are exposed to chronic stress and negative emotional arousal in infancy and early childhood, we experience this high-intensity activation as contraction of our internal organs, muscles, and joints and tension in other parts of our body, like our eyes, our ears, and the base of the skull. When we have developed these patterns in childhood, it is highly likely that they will persist throughout life. High emotional arousal, or, as in Jan’s case, repression of emotion and arousal, can lead to physical changes that contribute to nervous system dysregulation and conditions
