Changing States – Changing Worlds

LO Blog Badge 3In 1991 my world changed. It was 4:30 in the morning and the woods were still totally dark. My father had gone off to his deer stand and I was sitting still, waiting for the first glimmerings of light to filter through the trees. My rifle was cradled in my left arm with my right thumb on the safety, “just in case.” I lost myself in thought to distract myself from the cold. Suddenly a loud crack punctuated the silence. It wasn’t a soft noise like the falling of leaves or the creaking of wood with the change of temperature. It was the sound of a large piece of wood breaking as if under the hoof of a heavy animal. What happened next would amaze me for years to come.

The forest changed! Over the next 10 seconds all the sounds in the forest grew loud. I could hear the rustling of small animals in the leaves many yards away. What was once a silent forest became a symphony of blended sound. It was as if someone was turning up the volume knobs in my ears. My pounding heart formed a loud back-beat to the other noises. It might be a deer! Could he see me? Was he aware that I was there? But then another thought took center-stage. This is what Ye. N. Sokolov was talking about when he wrote his masterpiece in 1963: Perception and the Conditioned Reflex. The text had been required reading in one of my undergraduate courses at Columbia. I remembered Sokolov describing how novelty triggers dopaminergic activation of the cortex and how afferent collaterals either amplify or inhibit sensory tracts coming into the brain. I wondered if that was happening inside my own head. Were those pre-amplifiers working on my own auditory tracts? As my amazement grew stronger the thought of a deer diminished. What was going on was far more interesting than bagging some dumb animal.

I never found out what made the loud cracking sound in the forest. No deer was present when the morning sunlight finally illuminated my surroundings. What I do know is that morning’s experience changed the way that I perceived human nature and how we interact with the world. When I think back on that moment I’m now aware that there was more than one change that took place. There were two! The most obvious change was the alerting function as my senses grew sharper. That increased cortical activation is a well known component of the orienting response. However, the second change was even more subtle. It had to do with my motivational state. I had started out that morning in a play state. Hunting “game” is a form of masculine recreation. When I became fascinated with my internal alerting response then I had changed away from that state. My primary motivation had become exploratory instead of play. My interest in the hunt had faded.

If these esoteric motivational changes were limited to recreational behavior then this whole discussion would be an intellectual indulgence. But the reality is more serious. Nearly half of all marriages end in divorce. Nearly all of those marriages start with the partners “in love.” By the time of the divorce, love is nowhere to be found. Why the shift? What’s going on?

I recently attended an introductory workshop on Somatic Experiencing therapy for trauma. For me it was a disturbing experience. It disturbed me because the presenter illustrated a model for our defensive systems that I just couldn’t buy. He explained how novelty comes into the system and then spurs one of 4 possible responses: startle response, fight/flight response, freeze response or social-engagement. He was clearly focused on the 4 possible responses but that’s not what disturbed me. What didn’t compute was that I frequently use novelty to facilitate therapy. I consider it my ally to stimulate learning, not a negative force in therapy. Yet here the presenter was describing these 4 defensive reactions to novelty.

It took me several weeks to work it out. But they were productive weeks. The cognitive dissonance from that Somatic Experiencing workshop had prompted me to clarify my own model of how the mind works. The presenter had been right about the 4 defensive reactions. He was even right about how novelty can provoke those reactions. In fact his whole model was mostly accurate as far as it went. The problem was that it didn’t go far enough. It wasn’t complete. Something was missing.

Most of us in the behavioral sciences had started our careers learning about behaviorism. Simply put, we learned that conditioned responses to stimuli could be represented as:

S → R

More recently, the evolving field of neuroscience has emphasized how the organism’s state will influence how the organism responds. The contemporary model is now often expressed as:

S → O → R

The Somatic Experiencing presenter had been using that SOR model to describe how novelty can provoke different forms of defensiveness. But novelty can also stimulate effective learning. To solve this contradiction I had to reflect back on the studies by the soviet researchers Luria and Vinogradova. In 1959 these Moscow scientists were able to show that the same stimulus would provoke either a defensive reflex or an orienting reflex depending on the prevalent context being mapped in the brain. In other words, reflexes don’t just occur to stimuli. They occur to stimuli in the context of a mental representation of the world. Change the context and you get a different reflex to the same stimulus. This reveals why the SOR model is inadequate and why I was so disturbed with the presenter’s model.

A more viable model really needs to start with the “antecedent state.” In other words, one needs to know which action system is dominant in the organism BEFORE the stimulus. I like to describe this antecedent state as a combination of context and motivation. In her brilliant book Trauma and the Body, Pat Ogden lists different motivational action systems: attachment, play, fight/flight, exploratory and social-engagement. These motivational action systems are useful for describing different antecedent states. They also help explain why novelty can be toxic to a patient in a defensive (fight/flight) state versus beneficial to another patient in an exploratory state. If we incorporate the idea of antecedent state into the SOR model the we might represent it as follows:

O →S → O’ → R

The revised model starts with an antecedent state that reacts to a stimulus that produces a revised context/state in the person or organism. Research in the mid 1980’s on the EEG P300 indicated that this context revision occurs very quickly at around 300 milliseconds. If we apply the model to a person who starts off in an exploratory state, the person will likely respond to novelty with heightened excitement and pleasure. It’s fun to learn something new. If we start with a person in a defensive state, then novelty signals potential danger and the person reacts with one of the 4 defensive responses. It makes sense, except that the model still isn’t accurate. It’s linear and we’re more interactive than this. A more accurate model would be as follows:

(O x S) → O’ → R

In this final model we have the person or organism interacting with the stimulus. It’s useful to think of the nervous system reaching out to grab what it unconsciously determines as being most relevant to revise its expectancy model of the world. We don’t really react to stimuli. We react to updated models of the world that our brains interpret from information it has selectively retrieved. Which brings our geeky discussion to the topic of what’s happening in marriages and long-term relationships.

When we examine what happens to many relationships, it’s useful to use a geological metaphor. Dominant action states are like tectonic plates beneath the earth’s surface. You can’t see them but they have a profound effect on geography and continental drift. You have to go deep below the surface to know what ‘s really going on.

After the initial in-love phase of a relationship most of us have to get down to the hard work of maintaining affection with skill. Not only do we have to protect our partner’s feelings but we also have to reinforce each others’ affections by providing positive experiences. Some of our affection is reinforced by physical touch and some of it by service or thoughtful tokens of affection. You’ve heard about the 5 love languages. I really don’t buy into those as being nearly as important as the 6th love language: curious pursuit of mind. Think about it. Imagine that your partner is curious and shows delight in learning about what you want, what you love, how you feel and what you experience. As your partner asks about your core experience your partner shows in his/her face and eyes how much he/she enjoys your inner world. If that kind of experience occurs day in and day out then you will feel loved. Your feelings will most likely reciprocate and you’ll feel love in return. All of this depends on both partners creating enough safety so that each partner can maintain an exploratory action state.

The problem is that people often don’t have the emotional regulation or enough discipline to adequately protect either their partner’s emotions or their own. As the abusive bruising slowly accumulates in each person’s unconscious, their defensive action systems gradually becomes more dominant. It’s a very subtle process like the shifting of deep tectonic plates. However, there’s one reliable indicator of what’s happening: The exploratory action system is suppressed and curiosity dies. Partners no longer seek each others’ minds. Behavior becomes limited to routines that are safe. The partners calcify into predictable roles of responsibility that won’t get them into trouble. They only color between the lines. But without curiosity in an exploratory state, affection is no longer being reinforced. Love is no longer fed. Each partner starts feeling unimportant in the relationship. And when some partners feel unimportant the pain will often evoke their fight/flight defensive system. So there it is. Tectonic plates in our personalities. The perfect metaphor for how we become defensive instead of curious in our relationships. One plate dominates over the other and the volcanic action starts.

It’s interesting to extrapolate how motivational states profoundly affect therapy. I experienced a related insight while attending an EMDR therapy conference in 2001. Some of the top neuroscientists were brought in to speak. Cutting-edge discoveries were shared. Different disciplines mingled with unusual good will and comradery. Strangers spontaneously talked with strangers. One morning I went down to breakfast in the ground floor of the hotel. Different vendors displayed their wares in their respective booths. One vender named HeartMath displayed their device for measuring heart rate coherence. I had already read how this device was an accurate measure of stress hormones in the body. The vendor invited me to give it a try so I placed my thumb into the device. It showed that I had perfect coherence! The vendor exclaimed “This is amazing. Nearly everyone at this conference has perfect coherence! We’ve never seen this before.” I found his remarks interesting but I found them even more interesting a week later. I bought the device, took it home and started wrestling with my practice and managed care. And I wasn’t able to reach perfect coherence again for a long time. This gave me some perspective of what was happening in that conference. Let’s call it “neuro-resonance.” We all have mirror neurons that we use to model each others minds. In that EMDR conference, all the therapists were resonating with each other to create a collective world of profound safety. We were infecting each other with our exploratory states. The analogy is very much like college women in a dorm who come to cycle their periods together. But our hormones were probably neuropeptides such as dopamine and oxytocin.

Which brings us to the therapeutic relationship. Recent studies have shown that the quality of the therapist-patient relationship has twice as much effect on therapy outcome than the type of therapy applied. Some authors have referred to therapists as neuro-biological regulators of the patient’s state. I think that this is entirely accurate. It’s our job to infect our patients with enough dopamine-driven curiosity to elevate their exploratory state to overcome their defensive state. But if we’re narcissistically driven to prove that we’re good enough therapists then our patients will pick up on our defensiveness. Therapeutic outcome will suffer. If we’re secure enough within ourselves to enjoy exploring our patients’ mental worlds then our sense of safety will be contagious. Our patients will more likely feel safe enough to explore and learn.

I’ve come to strategize different ways to amplify my patients’ perception of novelty. Once they’re safe in our relationship, I’ll start using expressions that impart mystery and uncertainty. After I have them recall a traumatic event I’ll ask them to track their physical sensations in their own body. As I do that, I may use any one of the following expressions to heighten their curiosity and elicit an exploratory state:

When you’re ready to notice something else, let me know…”

I wonder what it’s going to do next.”

Isn’t it curious how these mysterious sensations change over time?”

Of course everything depends on safety. If the relationship isn’t strong enough to create a safe frame for the patient then novelty will be threatening. That’s why I consider humor and play to be an integral part of my therapy. Most of my relationships with patients start with a fair amount of humor, then progress to play and then finally to exploration. It involves a different view of how people operate. It’s not S –> R. It’s not even S → O → R. It’s (O x S) → O’ → R . We evolve implicit action states that steer our perceptions and behavior. These states influence all of our relationships. Moment to moment we create our own worlds. Then we infect each other with our prevailing states. It’s good reason to be mindful about the world we create within ourselves.