Healing Transgenerational Cascades of Distress in Disadvantaged Indigenous Communities; Challenges, Opportunities, and a Case Study.

Here is the abstract for a paper that will be published over the next few months. A copy of the full text is available if  you e-mail me at <leon.petchkovsky@gmail.com>

Healing Transgenerational Cascades of Distress in Disadvantaged Indigenous Communities; Challenges, Opportunities, and a Case Study.

Leon Petchkovsky 1 , Rachel Johns 2

 1 Associate Professor Psychiatry,  Department of Psychiatry University of Queensland, Brisbane, QLD, Australia, 2 Mental Health Worker, Community Mental Health Services, Lismore, NSW, Australia

ABSTRACT:  Aboriginal Australians especially in disadvantaged communities suffer disproportionately; with reduced life expectancy, high suicide, violence, and imprisonment rates, and a range of illnesses (Metabolic Syndrome) associated with Hypophyseal Pituitary Adrenal (HPA) Axis damage resulting from high maternal and infantile stress.  Foetal Alcohol Spectrum Disorders, Attention Deficit Hyperactivity Disorders, Conduct Disorders and Learning Disorders are prevalent in the child population.

A substantive developmental neuro-psycho-biology research literature points to the centrality of early nurturance processes in facilitating the development of physical and psychological health and resilience.

The larger Australian community has failed to provide adequate repair despite interventionist programs deployed over many years.  The authors argue that this rests in part on a lack of mindfulness (awareness of one’s own processes) and empathy (tuning into others), at every level: cultural, political, organisational, and individual.

Dan Siegel’s neuro-developmental insights into individual and organisational function are used to explore these concerns, and identify early (peri-natal) supportive intervention (nurturing the nurturers) as the most central strategy of repair.

But damaged nurturers are very sensitive. Attempts to nurture them can be counterproductive if political programmes, organisational cultures, and individual case workers themselves have not developed sufficient mindfulness and empathy to address these sensitivities. Recent advances in developmental neuroscience help fine-tune this process. Guidelines are offered, with an illustrative Case Study.

 KEYWORDS: nurturance, attachment, disadvantaged, developmental neuroscience.

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Some change at last,

In conversation with Bev  Allen and Mel Watson at the August 2014 Child Trauma Conference in Melbourne, we learned about Babes to Bumps and Beyond  and listened to their presentation (Allen and Watson 2014).  This program has been going for 2 years, was initiated and maintained by local Aboriginal communities in the Mallee region of Victoria,  and informed by the latest understanding of attachment theory and developmental neuroscience. This is precisely what is needed nationally to begin the transgenerational healing process we support so strongly.

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a fractal view of nurturance

Empathy and mindfulness facilitate impulse control and make for both kindness and good limit setting.
A range of interventions (meditation, psychotherapy) can boost these, but they involve much hard work, essentially because of our ingrained resistances, which have much to do with the core unsatisfactoriness of human existence (the Buddhist “First Noble Truth”). If it were easier, we would all Dalai Lamas.
However, a good start in life helps a lot. As I have said so often before, developmental neuroscience tells us that “good enough” early nurturance makes for more mindful and compassionate beings. Babies and children find it hard enough to begin this developmental work, even with good nurturers. But various forms of nurturance failure, reactive attachment disorders, make things so much more difficult. Many of our interventions, no matter how well meaning, no matter how necessary, thus come too late.

But one of the lovely things about empathy is that it has a reverberating effect, a fractal “similarity across scale” property.

We recently treated a severely abused young Indigenous woman who was pregnant. A “reflective listening” engagement helped her develop a useful therapeutic alliance, and allowed us in turn to extend this to interactions between her and her new born baby girl. The successful bonding in turn gave the mother further vicarious repair.
We ourselves received support from regular videolinks with a tertiary perinatal service (SWOPS…Google it). This spread across the various members of the team…..midwives, obstetrician, post-natal workers, mental health workers, who could thus “sing from the same page” in their empathic care of the mother and baby.
The mother stopped drinking and using cannabis early on. HER mother, who had a severe drink problem, also gave up (without ANY prompting on our part) so as to be a better supporter for her daughter and grand-daughter. The relatives who used to come to the house and get drunk and violent also moderated themselves, again, without ANY prompting.
Fractal patterns everywhere. Now if ONLY this could spread further. Our politicians perhaps?

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Dr John Boulton is a pediatrician who has been working in Aboriginal communities for many many years. An article by Nicholas Rothwell in the Weekend Australian (June 1-2, 2013) reviews some of this work. 

In essence , (and I quote from Nicholas’ article), “if an unborn child is malnourished in the womb “….( but also if the mother is subject to high stress levels, and also if she overdoes alcohol and drugs because she feels so miserable)…..”blood is directed as the first priority  to the brain, leaving the kidneys and other organs insufficiently developed……the child will grow up with a degree of insulin resistance”….(but  also more broadly, with HPA Axis dysfunction…AND Metabolic Syndrome, which are explained in detail in earlier posts on this blog)……”This in turn leads to early-onset diabetes……..(and) the child will have a propensity to high blood pressure, heart disease, stroke and eventual kidney failure”.

Key signs in young kids are a combination of poor growth plus a tendency to put fat on in the middle of the body. 

But the psychological effects are also dreadful…ADHD, poor impulse control, chronic dysthymia (feeling miserable), learning difficulties  etc…again, I have detailed this in earlier blogs. 


The whole point is, IF WE COULD ONLY GET IN EARLIER, and protect and nurture the mothers, we would spare each generation from the dreadful consequences.





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what relevance does the fMRI study have for nurturance?
Well, the things that light up are the so-called “resonance circuitry” or the “shared circuitry”. This is the mirror neuron/self-awareness/self-monitoring circuitry, that mediates mindfulness and empathy……..the very stuff that develops properly if you get good enough nurturing…..and that doesn’t do so well otherwise.

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nurturance deniers

Climate change deniers are unwilling to concede that human activities are affecting the planet, despite all the research.
Even if the research were overly pessimistic, this is still such a big issue that we can’t really afford to take a complacent attitude.
Most of us would not let our 5 year old children cross the road unsupervised, even though the risk of them being killed may only be 1 in 100 per crossing. The stakes are just too high.
Ditto with climate warming. If the research is wrong, we haven’t lost much. If it proves right, we’ll eventually lose the planet.

The nurturance issue faces a similar denial process. The science is convincing, but the politicians (and the media) behave even WORSE than the climate deniers. They don’t even acknowledged it, let alone deny it. What on earth does it take to bring this to a wider consciousness????

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fMRI responses to Jung’s Word Association Test. Implications for Theory, Treatment, and Research. Leon Petchkovsky, Michael Petchkovsky, Philip Morris, Paul Dickson, Danielle Montgomery, Jonathan Dwyer, Patrick Burnett.

We are presenting a version of this at the RANZCP Psychotherapy Conference in Sydney (Coogee Crown Plaza) 24th of Aug. 

The research looks at “internal conflict”…how the “Internal I” interacts with the “Internal Other”…what emerges is that the mindfulness and empathy circuits light up.  See the pretty picture.

Details are in the Abstract below. Image


 Jung’s Word Association Test was performed under fMRI conditions by 12 normal subjects. Pooled complexed responses were contrasted against pooled neutral ones.  The fMRI activation pattern of this generic “complexed response” was very strong (corrected Z scores ranging from 4.90 to 5.69).  The activation pattern in each hemisphere  includes mirror neurone areas  that track “otherness” (perspectival empathy), anterior insula (both self-awareness and emotional empathy), and cingulate gyrus (self-awareness and conflict-monitoring). These are the sites described by Seigel and colleagues as the “resonance circuitry” in the brain which is central to mindfulness (awareness of self) and empathy (sense of the other),   negotiations between self awareness and the “internal other”.  

But there is also an interhemispheric dialogue. Within 3 seconds, the left hemisphere over-rides the right (at least in our normal subjects).

Mindfulness and empathy are central to good  psychotherapy, and complexes can be  windows of opportunity if  left-brain hegemony is resisted. 

This study sets foundations for further research:  (i) QEEG studies (with their finer temporal resolution)  of complexed responses in normal subjects  (ii) QEEG and fMRI studies of complexed responses in  other conditions, like schizophrenia, PTSD, disorders of self organisation. 

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