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Although if I understand correctly, Carl Rogers was not a doctor.

Anyhow. Another Saturday, another seminar, this one on CBT. We had a nice lecture by a nice psychologist whom nobody but me apparently liked. I found his lesson immensely interesting, but hey, my course is built on not wanting to know about CBT.

One of the things he did say at one point was "I am not forgetting Albert Ellis... although most of us have." Hint: CBT practicioners and not so keen on Dr. Ellis.

So in the afternoon, we saw a video of Ellis working with a patient. Turns out it is one of a series of videos of three therapists of three different approaches working with the same client, a woman called Gloria. Another one of them was Carl Rogers, and so we got to see that video too.

What can I say? There's theory, and then there's human beings. And you cannot spend more than five minutes listening to Rogers, even when he is just nodding understandingly, without thinking, Gosh, this is a very, very nice man.

It's hard to say if his approach or Ellis' is the most useful, but there is no doubt which one a client would prefer.

Ok, it went like this.

Yesterday we were at one of four Saturday seminars. This one was about attachement theory, which is a theory developed by an English physician and psychoanalyst (and "competent etologist", to quote his son) to explain how relationships with caregivers early in life affect our development and personality.

John Bowlby's son, a very nice man (now in his seventies) who was for all of his life a medical photographer (and whose son's racing team won the Indy 500 this year, he was proud to tell us), came and gave us a very clear and very touching lecture about it, complete with BABY ANIMALS footage. He particularly won me over because he stressed repeatedly that attachment theory was a way of explaining facts, and that if new facts came to light that contradicted it, it should be changed, because this is how science works. He also stressed that AT is not a therapy: it is just a way of explaining what goes on in the first two years of life.

(One of the most touching and chilling moments came when he showed a card given by the mother of a two-year old on the baby entering hospital for ten days. The card detailed the visiting hours for parents, which were on every first Sunday of the month from 3:00 pm to 4:30 pm.)

Anyway, Richard Bowlby (the son) has put together a very nice documentary explaining the theory, in which he interviews among others a psychoneurologist who says:

'People often things that "genetical" means "everything that happens after birth". But at birth, your genes have still a lot of work to do as far as the brain is concerned.'

Photo of an infant brain, followed by one of an adult brain.

'The cortex has yet to develop, and most of the neurons are not even myelinized yet. Various part of the brain, including the areas that make language possible, only come "on line" much later in life.'

Scan of a normal child brain and of a severely deprived child brain (I think one of the Romanian orphanages children). Circles around the temporal lobes, which are red in the normal scan, and dark in the deprived child's scan.

'This is a particularly chilling image. The temporal lobes are literally black holes. The structures are simply not developed'.

Oh and of course the movie often mentions how poor parenting skills are transmitted from generation to generation, and it spends quite a long time over one particular family, whose shoplifting eleven-year old child is the product of two parents who have been deprived of love and affection themselves.

The documentary starts with cheerful baby elephants but ends with lots of damaged lives and the heartbreaking glint of unshed tears in Evan's eleven-year old eyes.

Anyway. At this point, lights up.

My tutor goes: "I find it so incredible to see how social factors can change your brain."

I just listen, silently, because after the telepathic bushmen of the Kalahari I'm resigned to anything.

At this point my colleague Julia, which I like very much but is a bit of a hippie (in both the good and the bad senses!), says: "But then, if this social situations can change the brain at a genetic level, they can be passed down from generation to generation?"

I wait for somebody to explain. Preferably the tutor. There is instead a murmor of approval. Anna boggles. Anna tries to point out that no, it is not genetic. Is ignored. People are agreeing with the terrible prospect of the brain changing at a genetic level.

Anna loses it, goes into arrogant prick mode because that's what happen when she loses it, and says, "EXCUSE me, can I say something as a biology student? This is... the genes are... well, ok, there was this guy called Lamark, and he thought that evolution happened more or less like this, that a giraffe stretches her neck, and the neck becomes longer, so the giraffe's children inherited a longer neck, and then stretched it even more, and that is how they got a long neck and IT DOESN REALLY HAPPEN THAT WAY because then it was discovered how genes work, and genes are... are a project, and it can... and genes can be expressed in several different ways but you still inherit them from your parents, and..."

And I rambled on in this fashion for a bit. As you can see, Anna no good as biology teacher, especially in arrogant prick mode.

(BTW - I sent an apology note to my classmates this morning. I hope they get it, my guess is a lot of them are not too good with email).

Somebody, among the class that looks at me in stunned silence, gently says: "Yes, but we are talking about social factors here." As in, we are not talking of gross modifications as the giraffe's long necks, we are talking about much more refined modification, and That scientist just told us that genetics doesn't stop after birth did he?

Anna puts her face in her hands, trying to keep quiet, trying not to get up and walk out because how can a tutor who has not even grasp the basic facts of biology have anything to teach her about how the mind works? But instead starts to understand why Dawkins felt the need to bang on, and on, and on, and on, about evolution in "The God Delusion". "Why is he going on so much about it?" she though. "Everybody knows that."

Well, not everybody, apparently.

So yes: there was, before the Mendel's work was rediscovered, a great debate about how evolution worked. Lamark thought that acquired characteristics could be inherited, and Darwin didn't. Darwin thought that evolution acted by promoting the survival of individuals who were born with a different trait, while Lamark thought that use created the function, and non use would cause it to be lost (as is sightless moles, for example.) Darwin was right, but for a long tragic stretch of time in Stalinist Russia the central dogma of biology was that Lamark was right in this.

What confused my colleagues is that the brain does actually change is a way similar to Lamark's model of evolution: neural pathways that are in constant use remain, while dendritical connections that are seldom or never used disappear. And yes, the development of the brain happens largely after birth, and is indeed dictated by genes, but the particular structures that will or will not develop only come about from the interplay of genes and environment. This means that if your brain develops particular structures that will later in life make you, for example, more prone to violence or more prone to depression (there is good experimental evidence to suggest that early attachment patterns are predictors of such outcomes), your genes will still codify for a brain that, exposed to a different environment, can give rise to a sunny, pacific, laid-back disposition.

The style of parenting you will display is heavily influenced by the parenting style you were exposed to as a child, because parenting is in part instinctive and in part learned. This is why animals in zoos often have troubles raising their offspring: they haven't seen other animals like them raise their young. And this is also why zookeepers will try all they can before hand-raising animals: because a hand-raised animal has very poor chances of becoming a good mum.

But none of this is genetic. The way you respond to your child is not written in your genes - or if it is, it is only a predisposition to certain patterns of behaviour. Genes can only dictate your physicality: they can code for an easier production of certain hormones, for example. OK, I am not a biologist here, so you can correct me, but if you system is easily flooded with oxytocin then you are more likely to bond easily with your child. But no matter how many times you've been hit or gurgled at when you were one year old, the genes you will transmit to your children will still code for high or low oxytocin (of course, the other parent's genes will either moderate or increase this). Your experiences, no matter how hard-encoded in your body, will not change this.

One of the enchanting things about this lesson was that it is now possibile to see how the mother and child system is a feedback system for the production of feel-good hormones, dopamine, oxytocin, and so on. And apparently dopamine is trophic - the happier, more gurgly, more laughing the mother-child system, the more those neurones will grow and branch and form new connections.

(Sorry - for the whole lesson Richard Bowlby was careful to say "primary caregiver", not "mother". The primary caregiver can be anybody, a nanny, a nursery attendant, a father, anybody. It is just the person that mostly comes when the baby cries, the one that laughs and plays with it.)

Well, five now.
I can't sleep because I got to think about my mother, and how she nurtured and maintained my depression.

My mother's toxicity was that she wanted to empower me. She believed - still believes - that we are the masters of our fate.

I have a memory of deep happiness from my childhood. It stuck, for some reason, when little else did. I was leaning on the little wall supporting the chainlink fence around my primary school's playground. There was a tall shrub beside me. It must had been very early spring, the sky was completely blue, and there were tiny tiny white flowers on the shrub.

I looked up into the blue sky and the little flower and felt completely happy. Then I went back in and wrote a composition in which I said that I felt happy because I felt like that moment, that flower and that sky, existed just for me.

That was the problem. My mother had taught me that everything that happens to you, good or bad, is your doing. I didn't think that I had it in my to appreciate a flower that existed for its own sake. I thought the flower was put there specifically for me.

I have grown up never looking for excuses, and that's good. But I have also grown up convinced, deep down, that everything bad that happens to me is my own fault.

When it happens now I can see it and smile sort of ruefully and make a note: if I lose the car keys, it's because "you are always losing things, you really should be more careful". If I get sick, it's because I don't go to the doctor to find a way to prevent it (true). If I have migraine, it's because I gave up trying to get them "cured". If I am the shape and weight I am, it's because I don't make enough of an effort in losing weight.

If I am alone, it's because I am "too choosy", or, alternative explanation that still focuses on what I do, I am too good for most men ("men don't like somebody to be smarter than them). If I am depressed, it's because I am not strong enough. And so on and so forth.

In cognitive behavioural therapy, this is a very well known mechanism. I forget what it's called, I think something like universal responsibility. It happens when you lose the sense of boundary between things that are actually within your ability to influence and things that are unavoidable or not directly influenced by you.

Learning that slathering my hands with alcohol gel and spraying my desk with Dettol may reduce the number of colds I catch is learning how to influence your environment. Hoping that if you go to the doctor he'll find the magic reason why you are getting always sick and issue a cure is madness.

Learning how to manage migraine is reasonable. Hoping for a cure for migraine is not. Currently there just isn't one.

My therapist tried to tell this to me for twenty years. For some reason, I was never able to hear her. That is, I heard her, knew she was right, and still could not make the realization mine.

Maybe it was because I lived too close to my mom. I don't know.

Another favourite depression-inducing trick that my mom taught me is catastrophising. What happens if I don't pass this exam? The reasonable answer is: you'll take it again, and again if necessary, and if worse comes to worse, you'll drop out and do something else.

My mother's stance was: you know how competitive Medicine is, and if you don't get good grades you'll never get into a specialization school, and if you don't get your degree quickly you'll age out of the market. You know that most employers will never hire anybody past 29 years nowadays.

My mother thinks that extreme anxiety is motivating. Especially when not self-inflicted but inflicted by others.

This is why I never graduated.

Another trick that I haven't found in the books but that my mother excels at is the focus on the trivial. For example, when I went into my second major depressive episode following my breakup, and was feeling suicidal and increasingly desperate because it was the second such episode in two years, my mother was endlessly fretting about my buying the house. Note that there was no hurry: I had given no notice to my landlady, and if the sale of the house fell through, though titty, I'd start looking somewhere else. For my mother the fact that the sale didn't progress was a major source of anxiety. And I do mean major. While I was sobbing in fjm's bedroom last Christmas, I called my aunt on Skype and chatted and she told me that my mother was very worried about the house - but hadn't mentioned my breaking up with my boyfriend. This is my mother's closest friend and confidant.

She says that this is displacement. Yeah, no kidding. It is also a handy way of withdrawing any support, and even the acknowledgement that something is the matter. She did this during my university career as well.

Another depression trick is the all-or-nothing thinking. Things are never somewhat inconvenient or sad. They are catastrophic and tragic. My ex partner for example was not somewhat immature and sadly incompatible with me. He was an evil bastard who sucked my blood and lived off me. The fact that after moving house there were still several dozen boxes cluttering up the place was not inconvenient: it was a major tragedy worthy of sobbing and hysterics.

I can see all of these things clearly now, but I don't remember them from when I was growing up. They must have been there. Of course, I was an overachieving little girl and mom had few opportunities to worry, fret and chide me for not trying harder.

In other news: I really do think I have Shift Work Sleep Disorder. The symptoms are fatigue, headache, and excessive daytime sleepiness. And, oh, depression. There is not much I can do save try to change my job. One of the tasks for tomorrow is to track down Fiona and ask her if I can meet her out of the time slot we have on Wednesdays. Perhaps I can find somewhere else that pays more during daytime. If only the only place that does so didn't have my first supervisor...

I will have to write my own learning journal later, but today's counselling class brought up a lot of issues for me that have little to do with counselling per se, so I might as well put them down here. (Besides, I keep my journal private because it involves other people's experiences in the course - tonight I have nothing to disclose that is confidential)

We were shown a recording of one of Carl Rogers' sessions, taped around 1977. We were told to pay attention to Rogers' "core conditions" to create a therapeutic setting, but when the tape began I couldn't concentrate on them.

The fact is, the client was a young black man, and the more I watched the tape, the more I was struck by how different the past is.

First of all, I was amazed that the issue of race - as in, the therapist was a white man - was never openly discussed. If the session took place now (this was a second session, but let's assume that it was a beginning session) it would be unthinkable not to bring it up - too many things would be too loud if they were not spoken.

Secondly, this was what the client said: "It seems to me that you only have two options, you either are racist or anti-racist, and I don't want to be anti-racist". In 1977 it was possible to say this. And also: "If you are black and you are angry, you are militant, and militancy is frowned upon [in my milieu]". And here I thought: what innocent times.

It was very obvious that the client, despite sporting an afro (afros looked very cool - it didn't hurt that the client was cute - and a lot cooler than the shaved or closely cropped styles of today), and being sort of dressed like a black young man, spoke white, and very obviously believed that integration was possible if one could only be colorblind enough - this was what he meant by meaning that he didn't want to be "anti-racist". You could still think back then that you could escape the whole issue.

I could almost hear Tempest shouting in the background. :-)

In short, I could not concentrate on how the therapist showed acceptance and empathy, because it seemed to me that both of them were locked in oblivious times.

Then I came home and I watched an episode of Without a Trace that I hadn't seen before (which makes it a new series episode, I think) that centered about Katrina, and all my old outrage and helpless fury came back. I need to spoiler a bit here so I'll put it behind a cut:

( Spoilers for  )

And with those two lines the episode goes from being rather sloppy to being a rather hard indictment of all the wrongs that have been done, and let happen, and how they cannot be erased, ameliorated, washed away. It's easy of course to say "They", but as the storyline makes clear even people who "did the best they could" are not safe, are not absolved, are not able to sleep undisturbed.

So I found myself crying again, for a change.

You'd wonder why I keep treating myself to Without a Trace and Cold Case, who always make me cry and leave me blue.

Well... First of all, I have to add that I am sort of disappointed that in a subculture that rabidly watches and discusses TV shows, I always seem to be watching the wrong ones. For example, now everybody is watching Heroes, and of course Dr. Who here, and before that it was Buffy/Angel/Firefly. And here I am, glued to the set and completely absorbed by Dexter, and nobody to talk it over with! I feel so left out.

Anyway - back when I was in Italy I was addicted to this real-TV programme that was called "Have you seen...?" . It was about missing persons, and it consisted of two or three reconstructions of the missing person's life and circumstances, with an appeal to the public for sightings and hints of their whereabouts.

Most of my friends were horrified. Why do you watch that shit, they would say, it's a terrible programme, if people want to disappear why dont' they let them in peace.

There was indeed an element of intrusiveness and persecution, especially in the first seasons, but there was a lot about looking for the unmissed, caring for the unwanted, trying to understand crushed, lost lives, lives spiralling out of control, life slowly unravelling among the indifference or impotence of the surrounding family, friends, neighbours.

Cold Case and Without a Trace share this same quality (with, of course, my counselling course): they are exercises in understanding and empathy. As cop shows they are unusual as there is relatively little righteousness. Often the ending is bitter. They proceed not so much by detection as by inquiry, following the threads of a lost person with empathy and an effort at understanding. And the truth that is uncovered, even if it leads to a solution or justice, is often a painful truth. Cold Case very often tries to offer consolation or closure, but this acts on me more as an excuse for emotional release than as healing. (The coda, usually a meeting of the main characters who forgive, understand, hug, meet, or mourn together, is often so artificial as to be open to the interpretation that it is Lily's fantasy, her summing up of the case, her wish-fulfillment).

More worrying, as far as my possible future as a counsellor is concerned, is that I find it very hard to go beyond what is my own private emotional release to real empathy. The tutor today gently chided me because I couldn't let go of the notion that the client was in denial about his dread about dying (he had leukaemia, in remission), but I realized that I couldn't let go of MY dread, of MY feelings, what I would have felt in his situation. In fact, it would have been very difficult for me in a real client-counsellor situation not to let myself be overcome by feelings that are not so much empathetic as projective.

The more I go on, the more I realize that I would like very much to become a counsellor. But I am honestly doubtful if I have what it takes. I manage to be always so isolated. I pride myself on my empathy but what it could be is just that I am very much in contact with my feelings (and after twenty years in analysis and a counselling course and various and sundry other psychotherapies I bloody well should be). It remains to be seen if I can be of help to others.

I was very frustrated today because I had a hard time understanding what Rogers and his client were saying - the audio was 1977 quality. Also, I had a hard time sometimes understanding my fellow students. This goes alongside my immense frustration yesterday at Spaghetti House, where I found myself seated among interesting people that I liked very much saying interesting things and totally unable to take part in the conversation because I could only snatch floating snippets of conversations, enough to pique my interest but not enough to reconstruct what was being said (and there is a limit to the number of times you can ask "Who? What? What did she say? What are you talking about?").

Maybe it's the tiredness, but my comprehension, though better than it was, is still limited, and I wonder if it has hit its ceiling.

All in all, I felt alone and isolated, even though I knew I was among people who did care for me.

I am not depressed - but I am... sort of sad.