Adam Blatner, M.D.

December 3, 2007

This essay is a contemplation of the nature of human vulnerability and an invitation to reconsider the challenge of psychotherapy. The point is that trauma, addiction, and other factors combine to entrench pathological problems. The African saying, “It takes a village to raise a child,” also has implications for what is required for healing. Attending to the broader challenge of promoting cultural evolution may be as important as anything that goes on in a psychotherapist’s office.

Entrenching Pathology

The need for self-protection runs deep, and these protections accumulate and become entrenched in proportion to the stresses on the organism. When people are strongly stressed or traumatized, they marshal defenses that operate in layers. It helps to recognize a number of extensions of this principle:
   1. Each complex of fears and defense response may be reinforced if other stress-defense complexes are also operating. A person with a simple neurotic disorder will have that problem made worse if there is another “co-morbid” problem, such as a post-traumatic disorder, an addiction, or a personality disorder.
   2. The treatment of a person with a given condition becomes more difficult and the prognosis more guarded in proportion to co-morbidity, and it is more than merely additive. Because conditions can reinforce each other, the difficulty may be exponentially increased.
   3. There is also a “vital balance” (the term having been used by Karl Menninger as the title of a major book on dynamic psychology in the 1960s) among many factors, some of which reflect the general health and resilience of the mind-body, and some which reflect deficiencies or other weaknesses. These must further be included in a holistic appreciation of the situation.
   4. Cultural factors should not be underestimated. It’s more obvious if the client is operating within a war zone, but many seemingly peaceable communities still have more stressful and near-traumatic conditions! (For example, the degrees of teasing and bullying in schools can be excessively stressful.)
   5. Themes of innate temperament and sensitivity, ability, size, intelligence (and types of intelligence), experience in certain roles, and the like all affect the degrees of stress experienced in a given situation. Some people become hardened early, tough, and in many ways somewhat stoical—at least in terms of how they consciously register and respond to stresses.
   6. Of course, early and mid-childhood experiences, in families and with peers, teachers, ministers, and others, all affect the construction of mental “maps” (also called “schema”), basic attitudes, expectations, and the structure of different characterological, neurotic, and healthy responses.

Degrees of Vulnerability

I have become impressed with the degrees of vulnerability, psychopathology, and sealing-over compensatory maneuvers that are prevalent in the great majority of apparently normal people. I am only recognizing this as I observe the ranges of vitality and flourishing health in some, and the more attenuated, constrained life styles of many. Some of the other variables include degrees of psychological-mindedness, or interest in self-examination and self-correction; ability to talk about feelings and attitudes, in part supported by culture and various learning experiences; some capacity for attenuating shame and allowing for the humility required for continued learning; and so forth.

In fact, most of our culture doesn’t promote or support any of these “infrastructure” elements that are needed so that people can cultivate optimal adaptation in a changing world. Rather, there remain many forces and structures that continue to promote false pride, a misunderstanding of the nature of “strength,” and a lack of appreciation for the value or benefits of practical psychology—also known as “meta-cognition” or “thinking about the way we think.” I might even suggest that there remains a fair amount of resistance to reflective consciousness among a large part, perhaps the great majority of the population.


A major defense maneuver is compensation, which has some highly adaptive aspects, and others that are very maladaptive. On the negative side, this often unconscious maneuver tends to imagine that because one is fairly competent in certain ways, that establishes competence as a general status. The problem, of course, is that we play many roles, and one can be competent in some—indeed, masterful in some!—while yet remaining underdeveloped or unskilled in other roles. In the course of time, though, those more unskilled roles are required for optimal adaptation and they are not available for upgrading, learning, refining. This is because the person is afflicted with a mixture of false pride and a subtly willed ignorance about what might be his weaknesses. In other words, there’s a lack of authentic and intelligent humility. Instead, there is an illusion that what one knows is sufficient.

This sealing-over represents a kind of resting on one’s laurels. There is a lapse into complacency, and confrontations with arenas of marginal competence or incompetence is responded to in ways that only compound the problem: denial, blaming others, making excuses and believing them, and so forth.

This is pretty common. Add to it the various weaknesses, eccentricities, distortions, fixations, and other issues that accumulate in life, and it becomes more clear that what’s needed is a periodic overhaul. People need to feel free and become skilled in seeking help in taking stock of themselves, identifying and correcting problems. There is no end to this—one is never “too old.” There is no final enlightenment that can be achieved. While there are more inclusive, alert, and growing modes of being, that’s not the same as the illusion of “getting there once and for all” and not needing to continue the processes of re-evaluation and re-training.

Cultural Evolution

Humanity is by no means as civilized as it imagines itself to be. If by civilized we mean that there is a relative lack of oppression, coercion, anxiety, resentment, alienation, and other undesirable emotions, well, we are perhaps better than a few centuries ago (in some regions), but still very far from having those positive values dominant in the society. (I imagine that if there were a scale from savage and non-civilized at 0 and almost fully civilized, with rare experiences of trauma in the population, being near 100, then the human race might be functioning on this scale at only perhaps 25. In terms of humanity’s fullest potential, then, I suspect that we are only about a quarter evolved, rather than over three-quarters.)

There are several implications of this larger view of humanity in the process of its own psychological and cultural evolution: We should practice humility and be interested in identifying various ways that we can evolve further. We need to be a bit dis-illusioned in terms of recognizing our continuing types of individual and collective folly, and yet a bit innocent in being interested in discovering new ways to tap into our best potentials.

In another paper (i.e., the “Inner Brat: The Primal Illusions”), I describe some common forms of immaturity that are formed in early-mid childhood and that tend to continue, unconsciously, unless they are consciously identified, relinquished, and more mature attitudes and behavior patterns substituted.


Stress is inevitable. There is a degree of stress in all major learning, and stress in needing to unlearn and re-learn as one moves to another level of maturity. There is an optimal amount of this kind of challenge, and less leads to, well, spoiling. The child is not pressed to give up the aforementioned primal illusions and take on more responsibility at a more mature level. Part of child-rearing should keep this in mind.

On the other hand, there is such a thing as too much stress, and this, especially if it is chronic and compounded by other stresses, and especially if these stresses seem arbitrary or meaningless, can lead to an intensification and entrenchment of neurotic or characterological patterns.

There is a related dynamic, though: Trauma occurs when stresses are intense enough and/or chronic enough to be deeply disorienting regarding levels of trust in oneself, others, family, culture, and the meaning of life itself. These are states of overload to which the unconscious defensive system responds automatically: flight or fight. Familiar defensive patterns kick in and may become entrenched. There’s an increased vulnerability to addiction as a form of self-medication—and the consequences of that often compound the trauma.

I want to suggest that a significant proportion of the society—perhaps even a majority—, until the middle of the last century, were exposed to types and levels of trauma that are far less common today: the death and disability of loved ones due to disease, war, and other causes; levels of physical discomfort, loneliness, work demands, lack of adequate stimuli, boredom, social pressures that for many felt oppressive, prejudice and its civil consequences, immigration and language problems; and so forth.

A century earlier, it was even worse! There was also serfdom; pogroms (or state-supported organized vandalism, murder, rape, and pillage); physical attacks by neighboring tribes or countries; slavery; the tyranny and capricious oppression of kings and aristocrats; the threat of execution or horrible jail conditions for minor offenses—and also for political opposition; for many, the oppression also of established churches; and so forth.

Child-rearing was for many a fairly brutal affair. Not just spanking but cruel beatings were common, from parents and teachers, and this was sanctioned by the larger culture. Fights and beatings, extortion and torture by older peers was also common.

The plight of women, the lack of control over reproduction, the vulnerability to domestic violence, sexual abuse, these and other circumstances were also not only stressful, but frequently overtly traumatic for half the population.

In contrast, an increasing number of people have been raised in the last generation with a relatively pleasant childhood. Of course there are stresses, because just the developmental challenges of an ideal life bring a fair amount of stress into the picture; but rarely necessary extra load can make a difference, and there’s not so much of that. On the other hand, children face other kinds of stress, new stresses, due to the emerging technology, increasing cultural diversity, and other postmodern situations.

Psychosomatic Illness

Stress and trauma evokes not only mental defenses but also physical ones. People get “up tight,” stressed out, and they carry a great deal of tension in various parts of their body. There are certain common areas—the jaw, the lower pelvis, the forehead—but really everyone has their own body areas of vulnerability. These often express not only temperamental and genetic predispositions, but also, symbolically, their deeper attitudes about the situation. In time, physical symptoms and sometimes overt disease and dysfunction emerge from these psychosomatic points of stres.

Residual Fears

People suffer, I suspect, not only from trauma in their own lives, but also pick up their parents’ and relatives’ residual hate and fear. This may go back again not just to the parents’ own experiences of trauma, such as experienced by the children of the survivors of the Holocaust, but also to ancestors further back. There may be legends, stories about how “we” were persecuted by “them,” that leave young people with an uneasy sense that it could all happen again.

I confess that I’ve become a little more open to the possibility of some psychic or telepathic influences, because there are numerous stories of recall, not just of “past lives,” but rather of the traumatic experiences of ancestors. Even if that weren’t so, the point is that young people grow with a background sense of varying doses of fear and hate, emotions that harden the limbic system and the sensitivities for compassion that are mythically related to the “Opening of the Heart.”

The point I’m making is that I suspect that one way to think about history is from the point of view of decreasing loads of fear and vulnerability, oppression and subtle PTSD. I’ve even begun to consider that Anne Schutzenberger’s theories about collective memory “inherited” from generations earlier might have some validity. A mixture of adrenaline bursts in pregnant mothers, experiences in infancy (if nothing else, picking up on mother’s fear), and, equally important, a cultural matrix of attitudes of fear and resentment, all combine in producing the next generation of warriors.

Compared to warriors, a culture in relative peace and safety may seem “soft.” They are, if the culture is then plunged into dire circumstances. On the other hand, “soft” may not be maladaptive in all respects: It could be that only in more civilized or generally safe contexts can non-warrior dimensions of the human potential—philosophy, art, music, spirituality, and more empathic and loving human feelings—be able to be released!

“Softness” may be a contemptuous way to describe a lack of body armoring and mental armoring, a state of mind that is relatively narrow: Survive, support one’s fellow-warriors, experience the glory of a good fight, the triumph of having fought well, the determination to get revenge if defeated in a battle, and no room in the mind for soft feelings of pity. The discomforts of the battlefield—heat, cold, hunger, thirst, insect bites, fatigue, sweat, blood, horror of violent dismemberment—for the warrior, all must be ignored! This is what hardening means! Less than that leads to defeat, and defeat means not only death, but probable torture and the threat of disaster—destruction of one’s family, loved ones, enslavement, rape, torture of one’s family— it is that desperate. So for certain kinds of culture—tribal cultures, even early so-called civilizations who practice total war with each other—the warrior mentality is a most adaptable virtue.

Alas, the dark side is that a warrior’s circle of caring is fairly narrow—self, leader, comrades in arms, and, less directly, one’s nation and family. Occasionally religion adds to the mix. But compassion for one’s enemies or their families, and sensitivity to the reality of feelings of women one encounters in one’s travels—these tend to become objects for conquest. The people in whose lands one travels? Also objects for exploitation, robbery, sexual enjoyment—or what in recent years has been treated euphemistically with the term “collateral damage.”

Addictions and Other Factors

In addition to varying degrees of intensity and chronicity of trauma—and the point is not to underestimate the continuing prevalence of this dynamic, even in people who don’t fit the criteria for full PTSD. For every person with a diagnosable disorder, consider that there may be ten or a hundred with what is known as “sub-clinical” conditions, activation of some of the dynamics, entrenching certain defensive maneuvers, that still generate deep emotional disturbance (the opposite of peace of mind) and often behavioral reactions that compound the problem.

If someone becomes excessively irritable, grumpy, inclined to outbursts of anger, mean, insensitive, and the like, family and friends will draw away or engage in a variety of negative feedback cycles, thus worsening the problem. If the person, reacting to earlier or more recent trauma, withdraws, sulks, blanks out, that engages another set of interpersonal dynamics— usually again of a non-constructive type. A common associated maneuver is to seek to numb the psychic pain with drugs or alcohol, violent or dangerous behavior, or some other escape, and this, too, tends to set up complex often rather self-destructive cycles.

Addictions can occur even without trauma. They have their own allure, even if there isn’t much stress to escape from. Addictions, in turn, generate all kinds of physical, mental, and especially social disturbances which feed back in negative ways. Then the person feels betrayed, victimized, neglected, picked on, abandoned—even though most of these reactions have been triggered by the addict’s own behaviors. The point is that all these situations bring out a host of interlocking defensive maneuvers, usually associated with denial of the problem—so that it’s hard to turn these problems around.

Note also that there may be many kinds of addictive-like behaviors, cop-outs, preoccupations, some of them even masking as successful adaptations (such as work-a-holism). What is absent is the function of the self who assesses longer-term goals and values and selects a balanced portfolio of involvements. Instead, the person slips into a more unconscious reliance on a relatively narrow set of gratifications and games with which to obtain them.

The point is, then, that we should recognized a pervasive resistance to the experience of being explicitly aware of one’s own mind-processes. For the brain habituated to sub-clinical PTSD dynamics, chronic defensiveness, a more warrior mentality seems not only normal, but virtuous. The aforementioned vision seems weird and wussy, too weak—this in an era in which strength is given near mythic value, and strength is mainly envisioned not as maturity and flexibility, but brute coercive power, violence or the threat of violence. There’s a saying that a pickpocket at a conference of saints would only see their pockets. One must warm up to the very concept of their being a higher type of consciousness, more inclusive, sensitive, creative—and that this might be a desirable state, more valuable than one’s own habitual frame of mind.

Within Civilization (Such as It Is)

Asked by a reporter what he thought of Western Civilization, Mahatma Gandhi is said to have replied, “I think it would be a very good thing.” It has been a conceit of the developed countries that their civilization, their culture, is as relatively advanced as their technology, but this is very untrue. Often the technology—the weapons, mainly—have allowed for the worst of colonialization: exploitation, destruction of indigenous cultures, the importation of disease, slavery and near-slavery, and so forth. The behavior of the most civilized country on Earth (according to themselves)—i.e., the British Empire—was, in the eyes of the less privileged class, a grossly elitist, prejudiced, racist, oppressive and exploitative business! Hardly civilized if any of the more humanistic criteria were to be applied. The financial success, the military success—these were confused with true virtue.

Indeed, in the last century, much of historical “greatness” was more associated with these materialistic and political criteria, while there was (on reflection) a gross denial that much of this so-called greatness was really highly organized gangsterhood, brute force, terror, institutionalized on a national level. Alas, “might makes right” has characterized much of politics in the last three hundred years, and we are still reaping the benefits of this savage exploitation. We do not question the right of the heirs of such kleptocrats (those who rule by stealing) to their wealth and estates, because “property” is sacred—and no one seems to care that the property was stolen or obtained by near-fraudulent or only technically legal but still immoral ways.

So the society still values peacemaking over justice—which is often wise, but sometimes perhaps foolish. The subtle implications, though, continue to rankle at an unconscious level.

Different Needs, Future Sensitivities

In this regard, youngsters need access to skills and sensitivities that will facilitate optimal adaptation in a changing world, and this requires the opposite of what trauma generates: Not hardening, but flexibility; not deeply-entrenched patterns driven by the mid-brain “limbic system,” but creativity and critical thinking driven more by the surface of the brain, the cortex. These “higher” inputs don’t get through if the brain is in a state of defensive arousal, so what needs to happen is that people need to feel less anxious. How to achieve this is another paper or two; for now, though, let us return to the darker depths of psychology.

I envision an era in which most infants are not subjected to much more than mere stress, intra-uterine and during infancy. Actual overload and trauma is minimal. Child rearing is relatively attuned, as described by Daniel Stern in his books. Culture is relatively peaceful. There are stresses—and, indeed, it might be argued that there is a certain optimal amount of stress-as-challenge for optimal growth. But the point is that the reaction patterns of the emotional defensive “limbic” system remain un-fixated, relatively flexible, and, on the whole, quiescent.

In this envisioned culture, a certain amount of imagination training, self-hypnosis, relaxation, letting go, meditation, contemplation, and intuition cultivation is all part of normal early childhood education, as much as learning letters and numbers are today. In this era, social connectedness, the cultivation of social intelligence (as hinted at by Dan Goleman in his recent book by this title), and learning how to be open to “extraordinary” modes of knowing—telepathy, dream sensitivity, and other arenas now addressed by parapsychology—these have become part of what is considered “common sense,” the ordinary norms of culture.

Spontaneity training, improvisation, channeling the muses, allowing for inspiration, leads not only to a flowering of the arts by a far wider sector of the population (considering that new, more participatory, improvisational, collaborative, and less competitive modes of art and other activities are also cultivated), but also a flowering of imagination and innovation in all other endeavors—in politics, religion, human relationships, family dynamics, recreation, and so forth.

Such behaviors require a relaxation of the defensive mid-brain, an openness to inflow of the neo-cortex, the cerebrum, the higher mind centers. In turn, these are re-visioned as antennae that open to transpersonal sources of knowing, inspiration, spontaneity, joy, mysticism, and so forth. The brain isn’t just a manufacturer and transmitter of psychic energy, but even more—if it can feel safe and relaxed—an antenna, a receiver of trans-dimensional “higher intelligence.”

(There is increasing evidence that this paradigm shift, opening to the presence of a dynamic “implicate order” (as the late physicist David Bohm called it), may become far more widely accepted, replacing the now reigning purely materialist and reductionist scientistic paradigm.)

Revising Depth Psychology

With the humble awareness I may revise my thinking further, at this point, what impresses me as a core dynamic at the depths of mind is the sheer vulnerability of what I’ll call primal anxiety. (I think this is also closer to what the neo-Freudian Harry Stack Sullivan was referring to, and he, too, used the term anxiety.) This is what gets triggered when there is a strong non-attunement or states of significant stimulus overload / trauma in infants and young children. It may be more fundamental or an aspect at the root of bonding and the sense of the breaking of the bond. It may be more fundamental or an aspect of the sense of loss of self. (I’m trying to connect this with some of the “schools” of psychoanalysis. It certainly involves dynamics that are more primal than the vicissitudes of sexuality.)

This primal anxiety is what gets evoked in states of trauma, and sometimes operates at the root of panic or profound agitated depression. In those latter conditions, it is difficult to marshal coping mechanism, but in many other ways, layers upon layers of coping strategies are imposed.

One layer of coping that is sometimes problematic and sometimes healing is the re-bonding to a “higher power,” through religious involvement, imagining, surrendering. That larger psychic and cultural field has the kind of strength to match and more-than-match the depth of the intuitively felt vulnerability. Indeed, I have come to feel more understanding and sympathy for the functions of religiosity as a deep coping. This is not meant to imply that I view spirituality as “nothing but” a neurotic need. Rather, I see faith as a multi-leveled process—psycho-somatic, intrapsychic, interpersonal, collective, and cultural.

Another point emphasized in this paper is that the cultural vulnerability sense may be becoming more dilute with relative affluence, community safety, and advances in civilization. Alas, there are also cultural, political, ecological tendencies that make civilization itself more vulnerable than I would prefer, and should civilization decay, become more vulnerable to the great “horsemen of the apocalypse” through disease, political disorder, famine, drought, floods, and the like, a cultural and individual need to regress to the more survival mode may dominate humanity’s trajectory.

At this point, the implications of all this include, among other things:
 1. Promote psychological literacy as a part of the core curriculum in education, and train teachers in ways of teaching the basic skills. Role theory makes for a user-friendly language, and role playing a good pedagogic method.
 2. Explore and promote more inclusive approaches to spirituality in religious education, at retreats, in seminaries.
 3. Develop ways to help integrate practical psychology and spirituality. Psychotherapy training should include attention to how to work with and utilize spiritual concerns; and religious education and programs should include activities that help people integrate their own personal psychological issues, social-psychological issues, the influence of culture on psychology, all within their systems of higher values.
 4. The fields that have psychotherapy as a major application (e.g., psychiatry, psychology, clinical social work, pastoral counseling, etc.) should take the aforementioned issues into consideration and prepare future practitioners to be more aware of the problematic nature of a significant number of their clients. Prognosis should be more guarded in many cases. Attention should also be given to promoting more preventive programs and supporting the overall thickening of the infrastructure of skills throughout the culture.

I have been impressed, though, with the way that when civilization is more stable, psychic energies are released that allow for more compassion and possibly an openness even to what used to be called psychic experiences and abilities. I hope this capacity is explored further.

I'm interested in your suggestions for revision. Email me at adam@blatner.com