Tami Simon: You’re listening to Insights at the Edge. Today, my guest is Diane Poole Heller. Diane Poole Heller is an established expert in the fields of adult attachment theory and models, trauma resolution, and integrative healing techniques. She is a trainer, presenter, and speaker, offering workshops, tele-seminars, and educational materials on trauma, attachment models, and their dynamics in childhood and adult relationships.
With Sounds True, Diane Poole Heller will be hosting a premiere online event called Psychotherapy 2.0. Psychotherapy 2.0 is an online training summit, which brings together leading experts in the fields of attachment theory, somatic therapy, neuroscience, mindfulness research, trauma resolution, and more. Experts included in the series include Rick Hanson, Ron Siegel, Stephen Porges, Bonnie Badenoch, David Wallin, Peter Levine, and Dan Siegel. If you’re interested in learning more about Psychotherapy 2.0, this online training begins on September 18 and runs through October 1—and registration is free for each day of the summit. You can visit psychotherapysummit.com for more information.
In this episode of Insights at the Edge, Diane and I spoke about her background as a trauma specialist and how this led her to her current work with attachment re-patterning. We also talked about the trauma freeze response and what to do when you feel like you’ve entered a traumatic state and are experiencing what she calls “a death preparation response.” We talked about how psychotherapy can help us access implicit memory and make it explicit, and how psychotherapists can best work with their clients to heal attachment wounds and create a secure holding environment. Quite honestly, we talked about so much more—including the latest discoveries in brain science that psychotherapists need to know. We talked about Diane Poole Heller’s work in the corporate world and more. Here’s my very rich conversation with Diane Poole Heller:
Diane, one of the premises of Psychotherapy 2.0—and, it seems to me, also one of the premises of your online teaching work—is the notion that psychotherapy right now is going through what you call “an evolutionary upgrade”—that the field is changing dramatically. To begin our conversation, I’d like to know: is that really true? Isn’t healing the human heart an ancient need—an ancient endeavor, if you will? What’s really new in the field of psychotherapy that matters?
Diane Poole Heller: Well, certainly we’re incorporating the ancient wisdom and we never want to separate ourselves from that. But, kind of building a bridge to what we’re learning I think exponentially now. That involves a couple things.
One is, I really believe understanding physiology as well as psychology and even spirituality is a really big addition, and I really think that’s been highlighted in the last 25 years with somatic experiencing, sensory motor processing—different bodies of knowledge that are incorporating how our physiology responds to traumatic events—to different expansions. That certainly includes Stephen Porges’s work. A lot of these folks we’re going to be interviewing in the series, too—which I’m really excited about.
But, the other thing that I think is really cutting-edge is kind of this integration. We have a lot more in the field, a sense of synthesis—like synthesizing neuroscience, synthesizing physiology and psychology and spirituality—and we’re bringing the benefits and kind of gathering all those wisdoms together in a more integrated and more functional way. We have this explosion of research. And then the big question for all of us as caregivers is: how do we clinical-ize that knowledge?
For instance, [the fact that] Rick Hanson talks about—that the brain is so biased toward fear and anxiety and negativity that positive experiences—even healing experiences in the session—kind of like he says—run through the brain like water through a sieve. Well, my goodness. If that’s true, and we’re not really orienting our clients to what’s healthy and experiencing that in their physiology and their body and their emotional awareness—and also building it as a skill to take out into their life—then it could just run through, and the person remembers the session as a positive experience, but it doesn’t translate to their life.
So, what we’re learning—instead of just focusing on wound, which in my training—which is not that long ago. I finished graduate school, my goodness, at least 20 years ago. More than that. Twenty-five years ago, probably. It was all focused on wound—even Rogerian work, which I love—unconditional positive regard, all of that. If you’re not in the pain, you’re not doing the therapy.
Well, now we know [that] as much as we have to help people excavate wound and allow that vulnerability and touch into that with the support of a therapist—or partner or whoever the caring presence is—we also need to be feeding the attachment system and feeding the body and feeding the emotional self deeply positive, fulfilling experiences of unmet needs being met.
There’s lots of ways we do that now in the fields that really nourish health as much as really help heal wounds.
TS: Now, you mentioned your own training 25-plus years ago. Tell me a little bit about that and how you came to be sitting here now as someone who trains psychotherapists.
DPH: Well, I started—it seems like another lifetime ago—gosh, way back in the mid-70s in really studying—I had a spiritual practice in the Diamond work, which is an integration of spirituality and psychology. Then, in that—as I was understanding that—I happened to have a head-on collision back in 1988, which was—I kind of broke the windshield with my head. It was a big deal. I got a brain injury and all that.
In that process of that 110-mile-an-hour impact—because both of us were going 55 when we hit each other—it opened my trauma history. In my spiritual work, there wasn’t really an orientation for that level of difficulty. So, I went on a search for someone who really understood trauma and ran into Peter Levine, who I am deeply grateful for also in our series. He really helped me understand how to come out of the physiology of shock, which is a whole body of knowledge that still is extremely important and I rely on in my work all the time.
He also connected me to Stephen Porges’s work, which then makes a bridge in a way from really understanding what happens physiologically when we go into a death preparation state—which is actually compassionate, because in that state there’s a conservation of energy. We tend to disconnect and dissociate so we’re not in our bodies if we’re going to meet death. We’re actually not present if there’s going to be pain involved in that.
So, some traumas will take us there. Certainly a head-on collision will put you there. Right? Then, it’s not so hard to go into a shutdown state, but much harder to bring someone out of it so they can actually feel their passion, their aliveness, their joy, their vitality again.
Stephen really did the research that validates so many other bodies of work out there right now—including mine—of as you untangle the threat response, calm the amygdala—the alarm center—then you will sequentially start to shift physiologically from this really shut-down, frozen, immobile state to a more active—in Peter’s work, it would be completing defensive responses. Saying no or pushing away or fighting or running or whatever. Fight or flight.
And as you finish that, then you naturally move sequentially into the prefrontal cortex, which you actually become interested in others but also capable of connecting to your authentic self—capable of discovering your own presence—and usually there’s this curiosity that rises from that to really wanting to be available and connect to others. I think it was Lipton that said, “Another definition of trauma is broken connection.” Trauma really isolates us.
I’ve certainly experienced that in my own journey—the isolation, the effects of being stopped in a death preparation state, and the challenge of coming back out of that into aliveness again.
TS: So, it was this car crash—and then your own process—that actually drove your development as a psychotherapist?
DPH: Well, I was really curious about self-awareness when I started the Diamond work. The car crash opened up a trauma history beyond just the car crash that I had so well-scaffolded and structured an amnesia about that [I guess] it took the car crash to open it up.
So, I had sort of a double-whammy. I had the physical injury—which was serious—to recover from and I could see these were cards I was dealt. If I was really going to be fully aware and be able to be present and move into the life I wanted to have, I was going to need to really take a lot of time to work through that history. Which was not easy, but also really fulfilling.
From this point, now that I’ve done so much work with it and everything, I can feel the value of it—almost like it was a gift. It was me being sent to university in a way to understand trauma the way I understand it now and, now, really to see the value of the attachment work that’s my newest passion. It’s like all these things build on each other to really heal the lack of connection that so many of us struggle with.
Dan Siegel would be the first to say that we’ve conquered—in our pursuit for growth—so many things. Understanding cognition, understanding emotion. Even now, really understanding sensation and body awareness. Understanding even awareness of awareness from a spiritual perspective—like going into the absolute and complete, just pure transparency—pure awareness without even phenomena.
But, what he feels—and I have to say I heartily agree—is really the frontier for our work is, in humanity—we’re talking meta now—is to really understand what happens when we connect—what happens between us as we’re talking. How do we show up as authentically as we can and then be available for all the intricacies of intimacy or real connection with strangers, with people that we love, with our kids, with our dogs, with our friends, with our clients—all of that. I think that’s a really big challenge because it covers so many different dimensions and difficulties. I’m just really dedicated to understanding that.
Really, we’re talking about love. We don’t often throw that word around a lot in the field, but it is what we’re doing. I think we’re really healing our clients through love and we also are learning [what that is], because we can’t measure it. We don’t use that word much, but I think it’s the right word.
TS: Now, I want to talk for a moment about this trauma freeze response, because what I noticed is as you were describing it and you were talking about the car crash—and you were talking about the work of Stephen Porges and you talked about going into this dissociated freeze state—I was able to connect to that just as you were describing it. I’m imagining a listener might have the same experience and recognize times in their life where they felt that way—where they just felt, “I’m dissociated now in this experience.” I thought of the dentist’s chair as an example from my own life. But, I’m sure other things came up for other people.
I’d love to know—right now, at this point in our conversation—if somebody’s in an experience like that or connecting to an experience like that—what’s your recommendation [as to] how they work with that?
DPH: Well, I think one of the most important things is being with someone that you feel comfortable with—that you feel safe with. You feel like they have a caring, reasonably attuned presence. They don’t have to know exactly what you’re experiencing, but they’re there in as real a way as possible.
Human beings experience safety through connection. Some species— you may watch dogs marking and all that—they feel safety by marking territory. I think they also experience connection safety too, but humans in particular restore a sense of safety through connection. When you’ve gone into what Stephen Porges calls dorsal-Vagal shutdown—or a dissociative state or he also calls is a “death preparation state”—it means that your physiology has perceived a situation that might be getting triggered or that you’re in at the moment—and then have it afterwards—that your life could end.
It’s technically called “The Oh-Shit Moment.” Like, “Oh, here’s a car coming at me,” like when I had the head-on collision. You have that, “Oh my God, this is it,” sort of feeling. Very often then, your body moves into this experience.
So, part of what the challenge is—first of all, you could be stuck in depression, lethargy, kind of a zombie, death-ish kind of no-energy state. You could have shallow breathing, so your brain’s not even getting enough oxygen to really run properly on your whole body, too. You could feel cold. You could feel paralyzed—especially when triggered into the event.
So, part of what we’re trying to do is help people move from a passive response to an active response. So, they’re going from immobility to mobility. In therapy, for instance, I would help someone gradually go towards that moment, but also probably talk about “after” first. Like, “When’s the first time you felt safe after the car accident?” or the assault or whatever, and see if I can build a little bit of awareness that there is an “after”—that I survived and made it to get home, where I started to relax a little bit with my partner, having a cup of tea and a hot bath. Or getting medical care that was just really loving and helpful.
So, you’re looking for resources [and] experiences that you can build on after the event so that you start to build an awareness of “after,” because people are kind of stuck in that moment or the moment it happened to try to avoid being in that moment. Right?
So, part of it has to do with movement and time. Part of it has to do with what I’ll say is [that] we now know that you survived this event. When you were going into it, you had no idea what was going to happen. You thought that was it, right? So, now that we know you did the hard job of surviving it—that’s the biological success—I want to slow this down or even put that other car as far away from you as you want it to be. This time, I want you to have plenty of time to say whatever you say, to make any movement—like turning your car off the highway.
So, you’re giving them a safe, logistical space—and I actually talk about this a lot in my first book, The Crash Course, because it was written about this whole experience of how to come out of these states. But, you want to make sure that your body has a chance to actually, slowly feel the intention of the movement it would have wanted to make if it had had enough time. Or, if it’s an attack, I have protectors show up and imagine them saving you. Or getting distance from the people that hurt you. You survive in a supported way.
And so, you can create a sort of fantasy movie of a better resolution, but actually feel it in your body and actually make the movements. Or, if there’s words that come, if you can either say them internally or say them out loud. You want to move from passive to active.
As you move from passive to active, you’re switching from an overloaded parasympathetic nervous system to a sympathetic nervous system. From Stephen’s work, it’s moving you physiologically up the scale. It calms the amygdala. It actually gives your threat response a signal that you’re completing a defense and you’re coming out in more of a sense of mastery and empowerment than being defeated and collapsed.
Then, as you experience that physiologically—whether it happened in reality or not, it doesn’t matter. When you feel it physiologically, then that naturally opens the pathway to your medial prefrontal cortex, where a lot of our capacity in the brain is oriented to deep connection with oneself, which takes you out of the dissociation. Then, as you’re finding your authentic self, then usually very shortly after that is a curiosity and an openness to wanting to connect with other people.
So, we’re designed to heal. But, I think it’s so important that we understand—along with everything else that we’ve all been studying—that we understand this physiological piece because it shortens what needs to happen in talk therapy or any other type of therapy a lot. There is necessary suffering, but I’m all about eliminating as much unnecessary suffering as we can. Let’s be efficient about this, because it’s not easy.
TS: Now, help me understand in your own life path how you moved from being an expert in trauma resolution to now focusing on the attachment therapy work that you do. How did that development take place?
DPH: It’s kind of like Ken Wilbur says: “Include and transcend.” I’ve included everything I’ve learned in all these different stages and then synthesized them, [building] upon them. In the trauma work—which I’m a big fan of. I think it’s a fabulous, really life-saving understanding—adding the somatic piece and what Peter Levine has put together and Stephen Porges.
But, when I was working specifically with just focusing on trauma resolution, the orientation was so much about self-regulation—which is important—and working with the nervous system and physiology and defensive responses. What I was highly aware of even from the beginning was there’s such big relational component to this. Really, people who are traumatized will feel isolated not just because they want to go home and lick their wounds—and maybe they don’t feel people understand—but they literally go to a place in the brain and the physiology that doesn’t give them access to their ability—or their equipment, you could say—to connect.
I thought, “This is a really, really huge deal.” So, how do we find a way to bring this ability to connect to oneself, find ourselves again, and also find others—which is so important? I’d go as far as to say [that] I don’t think people can really heal in isolation. I think it’s almost always true—and I would go more with the “always”—that you need to be in the presence of a caring other to really be able to have the healing happen. It’s just too easy to let those dissociated fragments stay in place in isolation. I think isolation perpetuates trauma.
So, this whole movement to what helps us connect took me to attachment theory. I just sort of had this calling all of a sudden. I couldn’t resist.
I was actually trying to get integrated in the somatic experiencing model for 15 years. You can’t teach everything. No training can teach everything.
But, then it just became an overwhelming orientation for me. I just dove into it and started to get so much significant results. It’s sort of like the missing piece, you know? I felt like when I added that in—and then that became a really total focus in itself—geez, the results people were getting in session. It was just amazing. I found it was so, so helpful for people.
And I’ve gotten that replicated as I’ve taught therapists. They keep saying the same thing: “This is like the missing link!” I’ve had people say that exact phrase probably about 15 times.
TS: So, I know it’s a big question, but if you could summarize for me this missing link . . .
DPH: In a way, for me, it’s like going back into the DNA of human relationship or something—and going into the blueprint of what gives us the capacity for healthy connection. So much of that started in implicit memory—which I know is [probably] another question.
But, implicit memory is—I mean, babies are absorbing our culture, their mother, the world. They’re absorbing their mother especially internally before they’re born. But then they’re just like little sponges. They’re absorbing everything.
One of the biggest orientations that baby brain and baby body has is absorbing the relational field it’s in. So, what’s going on between mom and dad—the relationship between the parents is really important—each parent or each caregiver’s relationship with the baby. The baby’s just really completely building a blueprint of, “This is how it is with humans and this is how it is in the world.”
So, depending on what happened there, this template is getting really embedded. But, you don’t have a mind yet to make a story about it. You don’t have an ego structure to put that anywhere. It goes directly into the body. It’s in the blood cells, muscles, tissue of the body.
So, when we’re trying to work with it, we have to know how to—that’s why somatic strategies are so important. We have to know [how we] access implicit memory, bring it up into explicit memory—which then has a sense of time and location.
Implicit just feels like now. Now, now, now, now, now. Forever now. That’s why later I could be talking to somebody who’s 60. When they hit one of those memories, it takes over their awareness and they feel like they’re in the now of it even though it happened 60 years ago.
But, when we go to explicit, you have a sense of time and location because you’re accessing the higher functions of the brain—including the hippocampus, which gives us that awareness. You don’t have a hippocampus formed as a baby. It gradually forms and it really isn’t very much formed until 18 months to two years. So, you don’t even have any way to organize that experience.
We didn’t used to know about that very much as therapists. That’s kind of—again, like you said, the evolutionary path—that’s a new understanding. I think what’s even newer—and what we’re trying to do in my model—is how do we tap into implicit memory, how do we bring it up to explicit, how do we bring it forward so that people can mature into their life experiences as their current age? And [how do we] repair what didn’t go so well—that created implicit memory wounds that you won’t have awareness of? The tricky part as a therapist is that people won’t bring that in very much as a presenting issue because they’re unaware of it.
TS: Well, let’s try to break a couple of these things down. First of all, how do you access implicit memory in your work as a psychotherapist?
DPH: Because it’s non-conscious, preverbal, sub-psychological, you have to do something to trigger it. That could be a questionnaire—I have attachment questionnaires.
It could be—like one gentleman I had, a lovely man. He was a doctor. He didn’t have very deep relationships and had never really dated. I took—in my office [and] as far away as I could get. I took a physio-ball and I said, “I want to imagine this is your best friend that you trust the most of anybody in the world. Let’s say that’s Jim.” So he imagined that. I said, “So, when you’re ready, I want you to ask me to roll this ball towards you. Let’s just see how that is for you.”
As he gave me permission and I rolled the ball toward him, his body went arched back in the chair as far away as he could get. His hands went out as if to protect himself. So, he was saying a really major “stay away from me.” He wasn’t aware of it. I had to do something to trigger that implicit response. The first time I did it, he didn’t even know he had done that.
So, I said, “Did you see what your body did?” He goes, “No.” I said, “Let’s do it again. But this time, I want you to really pay attention to what your body’s doing.” The second time we did it, the same response because it’s just encoded in the body. He did the same arching back and the pushing away.
I said, “When you have that reaction to your best friend in the entire world, what do you think the message is he’s getting?” It’s more of a rejection message. Then, as we started to shift that from a pushing-away to a receptive message or a welcoming message—and we had to do the work that we needed to do to do that—then that changes his relational dynamic.
But, you have to go into the foundation and then how it’s expressed in the world will shift.
TS: Now, again, I’m thinking of a listener who might be having a terrible experience right now thinking of their terrible childhood and various ways that they either pushed their parents away or felt they needed to because they weren’t safe or had parents who were fighting all the time. Something like that. [They are] asking the question, “Is psychotherapy really going to be able to help me with this, and how? How does that work? How is that operationalized? Can this really be healed? You gave a fabulous explanation of how to work with trauma, but this seems even more difficult and terrible and stuck.”
DPH: Well, what I’m so happily discovering is that with all the ways we understand—I mean, attachment theory’s been around for a long time. All the way back to John Bowlby, who really understood that it was part of our physiological design to want to bond and want to connect, and what we call “secure attachment.” Also, a lot of understanding has evolved since then about the disruption in attachment.
My main focus is on how do we clinicalize that. What do we do when we’re sitting in front of someone that’s trying to heal from those things? Partly it’s how we presence ourselves—our ability as a therapist to be in and mostly coming from secure attachment, which is being appropriately protective, being able to contain whatever arises in the client’s experience emotionally from everything from joy to anger to hate to sadness to ecstasy. Whatever might be their expansion.
[It’s about] how meet that with the right pacing and dosing, I would call it—depending on what a person’s capacity is to process. It could be a little bit each session. It could be a lot each session, depending on their window of tolerance or range of resiliency, I would call that— and our therapist’s ability to be attuned enough to match that.
What I really want people to hear is there’s so much hope. We are so designed to heal. Our fundamental design is secure attachment. We know what healthy bonding is. We might have to clear a lot of stuff that got dumped on it or interfered with it as kids, but fundamentally your body and your emotional self and all of you wants to go back there.
And you can recognize when you’ve had a healthy connection with someone. That needs to be emphasized.
What I think has to happen in therapy is therapists need to learn how to do a lot more feeding [of] the secure attachment system, like giving nourishment to what the skills are and what the awareness is in the client to highlight and help them rediscover that part of themselves—and then also help them heal the wounds that were in the way of it.
TS: “Feeding the secure attachment system.” So, how does a therapist do that?
DPH: Well, the main thing is—and you could be saying therapist or partner, because in attachment work, so many people heal in their important relationships. That could even be with a best friend or somebody that they really feel is reliable and mostly trustworthy. I mean, nobody’s perfect. People are going to make mistakes. But, they know how to repair the mistakes. They get through things. Their relationship gets stronger. That could be their mate or their partner. That could be a really close friend. I have a client who has this kind of relationship with her neighbor. They eventually ended up living together and they work all sorts of things out in the context of that relationship to restore secure attachment.
For instance, one of the most important things is your tone of voice—how a person’s prosody (that’s called) affects another person. When we’re in a relaxed, kind of soothing, modulated tone of voice, that’s very nourishing for the attachment system. The attachment system loves that. If we’re too shrill or too fast, that’s an alarm system from the female voice to the tribe that something’s wrong. That will activate your fear response. You can’t not be activated, because it’s biologically programmed.
When they’re threatened, [men] go into this kind of low, booming, loud voice which will automatically take people into their amygdala and bah! They go right into fear and threat.
So, people in couples—or parents to children, or friend to friend—we need to learn how to modulate our voice to keep people in a safe range as much as we can manage. So, prosody.
In a partner relationship, skin-to-skin, safe touch would be really appropriate. There’s certain safe touch that you can use as a therapist—like maybe a hand between somebody’s shoulder blades or a foot on their foot if they’re needing some grounding. There’s certain things that you can do if the client’s comfortable with it. That would be OK.
Eye contact. You can easily send—I like to call it a “beam gleam”—even to your partner across the room at a party. That’s a nourishment for the attachment. It doesn’t take anything. That’s like a split second. But, it’s like, “You’re special to me.” It could be like you’re talking to somebody else. Your kid—when they’re in the middle of a play—you can send this look of, “You’re special to me. I love you. I care about you.”
It’s that kind of look when maybe somebody didn’t know you were coming over and you surprise them. They open the door and it’s just so authentic and spontaneous. “Oh my gosh! Tami, it’s you! I’m so glad you’re here.” You can feel how real that is. That’s a beam gleam.
Try that with your dog and they’ll respond. It’s powerful.
So, there’s all these ways to feed the secure attachment system. The most important, probably, is presence—that you show up [and] that you’re there authentically. “Attunement” would be another word for secure attachment—that you’re attuned. When something goes off—which will always happen in a relationship; it’s not about being perfect. They say you only need—everybody should listen to this as parents and partners and therapists—you only need to be in attunement 20 to 30 percent of the time—according to Ed Tronick and Allan Schore—to have attunement and produce secure attachment.
TS: That’s very helpful.
DPH: You don’t need to be trying constantly to be this perfect—I mean, it’s not an unrealistic system. It’s very forgiving.
The caveat to that is when you feel like, “Oh, something was off. I kind of rushed my kid out the door and I was kind of abrupt about getting him off to school.” You can feel that kind of “ick” feeling, like it wasn’t quite good. If you remember later, when you have time or immediately if you can, to repair that. Just like, “Ah, honey, I know you were late this morning and didn’t brush your teeth or whatever and I needed to get you on the bus. I’d like us to have a more relaxed morning and I’m sorry I got a little abrupt with you.”
If you can repair it, then that bumps you up—from John Gottman’s research—to having [an] 80 percent chance of a sustainable, good-feeling, moving-forward, optimistic relationship. So, if you get 80 percent return on anything, it’s definitely worth learning. If you just learn to repair—initiating and receiving repair in relationships; to restore attunement—you’d be developing so many relationship skills.
But, you don’t have to be perfect. Remember: 20 to 30 percent attunement is all that’s needed for secure attachment to happen.
TS: Now, do you think that an effective psychotherapist needs to have created secure attachment in their own life—healed whatever their attachment wound might be—in order to do good work with clients?
DPH: Well, we’re all a work in progress. None of us are ever going to be perfect at anything. But, I think it’s critical. This is a really strong bias that I might have as a professional that therapists do deep work and that they do their own work.
The more we’ve gone into our own shame or our own trauma or our own maybe abandonment or neglect or intrusion—whatever those dynamics were in our early system or in our life in general—the more that strengthens our capacity to be able to meet our client in dark places and really stay present, be able to regulate ourselves, and help interactively regulate with the client. Sometimes I call that “co-mindfulness.” We’re being with our own process, we’re being with them, and we’re kind of being also with what’s in between the two of us.
That’s a tall order. I think therapists, caregivers, and nurses—all the people that are in those kinds of fields—they’re very courageous hearts, because not only are they processing their own human journey, they’re really deeply, intimately connected to other people’s deep, difficult spaces. That’s asking a lot, really.
To really be able to do that more and more effectively—and also not damaging yourself—I think for our own health and for what we can really give as many clients as we can manage—and some people we can’t manage. We need to refer out. That’s normal. Then we just bring a lot more to the table and it’s a good experience for the client [as well as] a good experience for us.
Part of secure attachment is containment. In an ideal world—which, of course, it isn’t—our parents would have been able to contain whatever emotional, physical state came up for us as babies. In an ideal world, therapists are repairing whatever parents couldn’t do by being able to contain and maintain presence and regulation for all the various states that come up in the client’s process—and, of course, your own personal reactions. Right? Because you’re a human being too.
It doesn’t require perfection. If you’re off, you can apologize. Go, “You know what? I really felt I missed the mark there. Let’s talk about that.” We need to be comfortable learning to initiate, receive, and repair also.
TS: So, I’ve been in very helpful, positive, long-term psychotherapy that’s really helped me. But, one of the things I notice is that often when I talk to my friends and they present in a way that I think illustrates some aspect of insecure attachment, I think to myself, “Wow! They would benefit so much from psychotherapy.” I recommend this to people often and I talk about how much benefit I’ve received. I often get some serious complaints.
“I don’t have the money for that, Tami.” “I’ve tried that before and we went around in circles. No real change happened.” “Most psychotherapists are more screwed up than I am in my experience, when I’ve really gotten to know them and talk to them.” “Really? That’s the best thing that you have for me, Tami? After running Sounds True for 30 years, this is your recommendation?”
I’m curious how you would respond to somebody like that, who was throwing up those objections.
DPH: Well, I think people have to find the path that really works for them. I’ve found—I’ve done therapy forever too and also spiritual work. I do a lot of work on myself. That’s one of the things that I have as a really high priority.
I mean, I see the benefit all over the place. It doesn’t mean you don’t go through some difficult times occasionally. I’ve had therapists I wanted to throw out the window too—and also even some spiritual teachers that I didn’t feel like were particularly helpful.
As I’ve sorted through and—as my needs changed—kept working to find people, I just feel like finding a good—it’s almost, in a way, [like] finding a partner. To find somebody that really can be the right person to do part of your journey with is just a huge blessing and a huge gift. I wouldn’t trade that for anything.
Then, some people really do a lot of their healing through—maybe they partner with somebody that has more access to secure attachment. If you have insecure attachment—if we look at attachment for a minute—and you partner with somebody that has a more stable, secure attachment, they say that most people will shift to secure attachment within three to four years. Sometimes two years.
[This is] because they’re constantly being responded to in a healthy way—like, securely attached people don’t get as ruffled by conflict. They don’t react so much. They don’t walk out the door. They hang in there. They’re not as dis-regulated by it.
When you’re around somebody that has that kind of stability and that kind of ability to stay connected, it starts to shift your attachment history. Your attachment history is very sensitive to the relational environment that it’s exposed to.
So, one of the smartest things any of us can do is find someone that’s willing to either work towards secure attachment or is already there. Some people heal completely outside of therapy to do that.
So, there’s a lot of different ways we can move towards health. But, I think it’s just sort of like if you have a toothache. You could learn to live with it, I suppose, but it’s just so much better to go to somebody that knows how to relieve that more quickly.
That goes to shopping for a therapist. I think—for me; this is just my Diane-ism. It doesn’t mean it would be true for everybody. But, for me—and I sometimes patchwork this together with different resources. But, I want resources in my life that understand physiology really deeply, that understand psychology, that understand spirituality because I’m synthesizing them. Some people have two out of three. Some people have one, but they’re really good at it.
So, I feel like there’s so many different ways that we’re designed to heal. At different stages, we need an emphasis on different things. Like, physiology is really important in my life right now because I’m recovering from a really difficult surgery. So, helping my body come out of that death preparation state is really on-target for me. But, I’m doing it on all levels. I’m working with my spiritual folks with that. I’m working with my therapy folks and physiology.
TS: Now, you talked a little bit about a parent that might be feeling regretful related to an interaction with a child. “I could have been more present and I wasn’t.” I’m curious to know: what would be your 411, if you will, for parents who are very interested [and] committed to creating secure attachment with their young children?
DPH: A couple things. First of all, secure attachment can be broken down into skills that you practice. So, protection. Are you appropriately protective? Do you let your kid be self-protective, and then you come in when they ask? Or do pay attention but you’re not hovering exactly, or not being intrusive—or taking over, so you’re disempowering a child—depending on their age, right? Age and stage.
Are you aware of what’s going on with them? Do you step in when they need help? Do you let them manage to learn their capacities as they can? So, protection.
Playfulness: Are you having good, quality play time? This is with your partner and your kid. You’re having a good play zone. Playfulness is really nourishment for the secure attachment system.
TS: Tell me why on that one.
DPH: Play is like this positive experience in the brain that Rick Hanson’s referring to. When we’re really having a deep experience of playfulness, it is one of the things that the secure attachment system just loves and shifts the brain.
When you have secure attachment—I’m answering a couple different questions at once here, so you might want to circle back. But, when you move towards secure attachment, you’re automatically moving towards affect and nervous system regulation. So, it regulates your body. Everything in your body works better. Your heart rate, your digestion, your lungs, your breathing. Everything works better. So, you’re in a good physiological state.
You definitely go towards brain integration. You start to get right and left, and all these different regions of the brain connecting to each other and sharing the information. So, a lot of us have different regions of our brain [that are] not as available to us because of past attachment issues or trauma.
The other thing that secure attachment will take us to is a natural resiliency to post-traumatic stress. [There is] lots of research that vets coming back even from the war now that had early secure attachment either don’t get PTSD or they recover much, much faster than the soldiers that are coming back from difficult experiences that we can only imagine.
But, when they’ve [also had] really difficult, disorganized, or attachment-disruptive histories, they have a much harder time. It’s [easier] for them to move into symptoms of post-traumatic stress and they also have a harder time recovering.
As we help people regain secure attachment now—even if they didn’t have it in the beginning—which [is] the big, hopeful message here. [It’s] you can learn—or Dan Siegel would say, “earn”—secure attachment even though you started with insecure. We could all learn to function in secure attachment.
So, protection, playfulness, presence—learning to show up and stay connected. Learn how to interactively regulate.
Even your comings and goings—how do you and your family shift from wakefulness to sleep at night? Is there a ritual? Is there something connecting? Is there a little story-telling or sharing of a piece of chocolate or something? Or a sharing of the day? You know—three things that went well, two things that whatever. Something where there’s a connection.
And then how do you get up in the morning? Do you share breakfast together? Are people just jumping out of bed and rushing out the door? How do you meet people when they come in the door? Do you drop what you’re doing, not be distracted, and actually hug them? [Do you] let your body regulate their body? Stan Tatkin has a lovely YouTube on the welcome-home hug that you can look up.
You’re teaching the family or the bodies to interactively regulate. That’s another big piece of it. I might have gone further with that than you—
TS: No, it’s good. You said something really interesting—that as we move into secure attachment, the way our brain function changes.
DPH: Yes. It’s so exciting. You’ll actually have some new behaviors and you don’t even know why you’re doing them. Like, all of a sudden, when somebody’s really appreciative towards you, whereas before you might have dismissed it, you actually take it in and you can feel the love and belonging that you couldn’t have felt before. Or you start to say hello to people in a different way. You start to make contact even in situations where you don’t know people so well, but there’s a friendliness or an availability or a willingness to be vulnerable that starts to happen that’s like, “Wow! You can see [that] two months ago, I wasn’t doing that. That wasn’t available to me.”
Those are symptoms of moving and reclaiming secure attachment. Another one is a natural compassion and your ability to love that just starts to happen. Another one is feeling more global—instead of, “I’m an American versus somebody who’s French or German or Afghan or whatever,” instead of us versus them kind of thinking, you move into “all of us.” That could include ecology and animals and insects. It’s just a feeling that there’s life everywhere that’s valuable. That’s part of regaining secure attachment. It’s big.
TS: I know, Diane, you also worked in the corporate world. You’re actually teaching people—executives and other people within corporations—how to develop secure attachment and how that might impact their work. Now, this seems very far out to me and visionary—that you could actually bring this kind of deep healing into businesses. So, tell me a little bit about that. How does that work?
DPH: Well, businesses are full of people. People feel safe through connection. So, how do we get to connection?
The brain is going to be very occupied. Everybody who’s listening can check this out for themselves. Our brain is very occupied with, “Am I safe?” It’s checking sometimes every four seconds for, “Am I safe? Do I belong? Do people like me? Are you there for me?” The brain is always looking to stabilize its environment and our neuroception—our looking into the environment.
If you can create an environment—whether it’s at work, at home, or at school—where those questions are somewhat calmed [and] they’re answered—like maybe you have a group meeting and people have a sense of belonging in that meeting. Everybody’s voice is heard or there’s a reasonable, “I’m there for you.” In terms of help on a project or mentor/mentee kind of thing, there’s a certain reasonable relational safety in the workplace or school—at home.
All that 80 percent focus calms down and you have all this room for creativity, innovation, getting the job done, all of that. So, I think—like Dan Siegel said—connection and our ability to do that is on the forefront of where our learning is in the human race, so to speak. One of the learning frontiers. How do we take that into every environment? So, really looking at how we bridge that into the corporate environment.
And—just like you said earlier—you can’t ask people to do therapy. That’s not really in your responsibility as an employer. But, to make things available or at least to have certain ways that people interact in the workplace can be really valuable.
TS: What do you think are some of the skills that can be brought into the workplace that would help people feel more safe? I think often people don’t feel safe at work. “I could get fired. My manager could take something away from me. I mean—I don’t feel safe at work.”
DPH: Yes. I think—partly, when it’s appropriate—to be transparent about what people need to do for their work to be appreciated and where their learning edges are and what you can do to help them. You’re not going to be able to—obviously, not everybody’s going to fit in an organization. Sometimes, people have to be let go. That’s the reality—just like in marriages. Sometimes, people can stay together—or partnerships—and sometimes they need to split.
But, I think the benefits of saying things like, “I really trust you to do your best,” or, “I know you made this mistake, and let’s look at what we can do to help this turn out differently next time. What would you do differently? Here’s what I might suggest would be helpful. Let’s look at the options.” Just how you interact and come into those conversations is really important. The languaging—if you yourself can be relational with somebody.
But, there are advantages to attachment disruptions. For instance, avoidant attachment is a little bit over left-brain, and one of the advantages to avoidant is there’s a lot of task focus. We need in society people that have a strong task focus.
So, at work, maybe understanding that some people need to be left alone to run with their project is also OK. It’s not all about teddy bears and hugs and all of that. But, recognizing what people’s needs are and also when things are getting in the way.
People that are tilted more towards ambivalent attachment—I know we haven’t described the definitions of these things. But, ambivalent attachment—where there was a lot of unpredictability in their history and some intrusion, that sort of thing—their attachment system is a little bit too “on,” whereas the avoidant is too “off.”
But, they tend to be thinking about relational things a lot. Like, if somebody doesn’t smile, they could potentially obsess all day about, “This person doesn’t like me. What did I do wrong?” That takes up too much of their brain.
But, that hypersensitivity to relationship can also eventually become a really strong quality of attunement. They might be sensing something in a group that’s off before somebody else might. So, there can be usefulness in that.
But, in general, I think the most important thing is that people aren’t over-occupied with, “Am I safe? Do I belong? Am I liked? Are you there for me?” Those questions—as much as we can answer them by the way we run a group or a place of business—will open up a lot more space literally for innovation, creativity, focus, getting things done.
TS: So, I want to circle back to where we started our conversation, which was talking about this evolutionary upgrade, if you will, that’s happening in the field of psychotherapy. I’d be curious to know: if you were to summarize what you think the biggest breakthrough discoveries are—the big ones; the ones that are really moving the needle and changing the way that psychotherapists actually practice and interact with their clients—what those discoveries would be?
DPH: I think the most relevant discoveries from my point of view are about the 20-year-old understanding of how to bring in somatic strategies, really working with physiology, and how that relates to physical symptoms like digestive problems that recur when we’re in that death preparation state. As a therapist, I wouldn’t have even been trained to know what that was. That piece is really important, so I’m very grateful to Peter Levine and Stephen Porges for that.
The other piece is really understanding that so much of our relational history is locked into implicit, non-conscious—or not conscious yet—preverbal, sub-psychological territory. If we don’t understand how to tap that, there’s statistics from Allan Schore and a few other people that suggest that 90 to 95 percent of what’s happening in our adult relationships—especially our intimate partnerships, marriages, people we date and are in committed relationships with—is really mostly informed by our attachment history.
If even half of that is true, think about all the havoc that we think is coming from our partner—or maybe we’re blaming ourself for—that is really coming from something we had no control over. Intergenerational transmission of attachment patterning and parenting style happens naturally. It’s not our parents’ fault either. It’s not our grandparents’ fault. This is a human journey issue. Blaming isn’t going to get us anywhere.
It’s just understanding how we can take what’s off and move it towards secure attachment—[which] is the word we would use in psychobabble, but we can just say “connection and love”—that takes us back to our healthy ability to relate. Connection is how we feel safe. Secure attachment insulates us against trauma responses. Understanding the inner relationship between all of these things is really paramount.
And then all these discoveries that are happening every minute now in neuroscience—like this understanding that you have to really challenge a neural pathway in the brain—something that’s kind of like a record player. That’s dating myself—even saying “a record player” anymore. But, a record—where there’s a groove in your relational history or your response to the world or what you project out from your history that gets projected out on the world and your relational field now.
To see that we have to challenge that with a different question—not just going around the track again, following it—and interrupt those associations with something new, [and] to create a little bit of dissonance so that the neural pathway—we have the firing from the old, but then we have the neural firing from what we’re suggesting as a new or what I would call a corrective experience. Then what fires together wires together, so change is actually happening. It’s to be repeated a few times, because history has a deeper groove, right?
One of the biggest things that people might think sounds like not that big a deal—but when you think about it, it’s huge—is that we’ve all been practicing and trained for wound-ology. “Go to the wound. Go to the pain. Go to the stress. Stay there, stay there, stay there.” We even completely overwhelm somebody and fragment someone by too much wound.
But now, we have the research from neuroscience to support what I’ve had a really strong feeling about since I started [practicing] in 1987—that we have to create a positive experience. Actually, instead of just feeling the unmet need or abandonment, to actually feel the person you have that is stable in your life now or to meet that need that wasn’t met where our wounds originated—that we meet things with a positive and nourishing experience, and hold our clients in the positivity until they’re able to embody it, expand, and kind of milk it—to say it a certain way.
We stretch the positive experience. We have to do that. This is what Rick Hanson’s work is about, when he wrote the book on happiness that’s so valuable. We have to hold the person [in] the positive experience long enough that the neural shift will happen. Otherwise, it just runs right through and they think, “OK, that was a great session,” but they don’t take it out in their life. It doesn’t fundamentally transform and change.
So, I think we’re getting better. It’s probably going to get better next year and five years from now. The ingredients it really takes for positive change and transformation. We’ve been designed for it forever. The ancient techniques work too, right? We are fundamentally designed to grow, heal, and transform. I think it’s a very optimistic process.
I think you were mentioning friends who might have some resistance to this. I think finding a therapist that has integrated a lot of these things—I would say has a somatic and attachment focus. That’s my bias, right? And then [the therapist] understands how to work with neuroscience.
There’s just a lot to know, and one of our goals in Psychotherapy 2.0 is to bring as much information as we can in a very efficient way to our whole community to start to bring some of those awarenesses [and] highlights into focus from a training perspective. Like, how do we take that into our practice and use it?
That’s what I’m trying to do online every day too. How do we create a safe haven—this is my personal mission. How do we create a safe haven for therapists to dive deep into their own work and to experience their own transformation so that that’s a just natural extension of what they are able to provide everyone that comes to see them?
I would extend that into the wonder and the amazing healing possibility that happens in intimate relationships, too.
TS: Now, you said something that I thought was very important—which is that our brains can go in these record-player grooves, and that something can happen in the psychotherapeutic meeting that could help someone create a new groove. I’m wondering if you could give me an actual example of how that works and what the therapist is doing to help somebody create a new groove.
DPH: You know, part of it is we’ve been really married to this idea of talk therapy—which has its place in creating a coherent narrative out of your trauma history or whatever is part of a sign of healing. But, it’s so important that we’re not just focusing on content. We’ve been very content-focused.
I use content very rarely, actually. If I know somebody had an attack, I don’t even go into the details of that. I might in some sessions. But, I’d know then that there’s a victim-perpetrator dynamic and I know that I need to give distance from the threat—freeze-frame the threat far away from the patient, the client—and then have them mobilize active responses. Maybe they have people they draw into their awareness—people that they feel are protective towards them. They have help and they defend against that distant threat at that point. So, they start to feel this empowerment versus being defeated and demolished by this attack.
So, there’s so many things we know the mechanics of. I’m using the mechanics of going from immobility to mobility; going from passive to active; completing an active response [and] as that completes, the threat response decreases. That’s a physiological reality. As the amygdala calms down and the nervous system regulates a bit more, it takes us right back into social engagement or the capacity to connect—which you could also call “resurrecting secure attachment more completely.”
But, very often in that transition from defending to then inviting connection, if somebody had an attachment disruption, that’s where it will come up. Like, I’ve had clients where they’re coming out of their process. They’ve just come out of some resolution of a piece of trauma. They look at me and it’s just like they woke up. They show up. There’s this light coming out of their eyes and it’s like they’re back. It lasts for a second or two, and then all of a sudden they’re into a shame or a disconnection. That’s where their attachment history is showing up.
So then, how do we help them move through that history so that presence and that light coming from them is able to be sustainable? There’s all sorts of ways, depending on what their history was—interventions that I teach specifically in my courses about that.
TS: Now, you’re hosting this online training summit. You talked about your passion to be able to share so many of these different tools and—really—perspectives from different types of approaches and techniques. I’m curious: do you really think that therapists can learn the newest discoveries and applications from an online offering—from online training?
DPH: I started doing online training for therapists—it’s been about two years now. It’s been kind of shocking how well it works. For five years before that, people were telling me to do it. I kept thinking, “It won’t be effective. It won’t work.” I was a cynic about it, [actually]. When I finally dove in, I just can’t tell you how many emails I get—and thank you’s and gratitude.
I’m very focused on making it practical. I mean, a lot of this is teachable and practical. Then we also do case consults. We do question-answers online. It’s like a closed group where the other therapists can comment on cases or concerns or people’s own private process if they’re willing to share that and get support. I’m really trying to create a safe haven for therapists to meet and not be isolated, because it’s a very isolating field. People are often in their office. And even if they’re in a group of therapists—like they have a group practice—they don’t see each other very often. They’re all in their own offices seeing their own clients.
So, it’s hard to have the kind of community that I think we especially need because our job is healing and we’re having—I call them “activation injections”—from other people’s histories coming at us all day long. How do we stay stable and do enough self-care? All of those things come up.
I think the online communities we’ve created—and I’m always thinking of ways to improve it too. So, I’m always constantly looking for better ways to do that, but I am really convinced now that to have the impact and the ability to get education out there—my PhD is in higher education and social change.
How do we get information out there in an efficient way and in a global way? We had 15 different countries involved in our programs. Even Kuwait! I’m like, “How did they even find out about this program in Kuwait?” It’s a mystery to me still.
That’s the power of the Internet. Instead of the Internet being used for yucky stuff or whatever, we can use it for something transformative. Even Tibetan Buddhist teachers are on the Internet sharing their wisdom in this way.
So, I think it’s a great tool that we never had before. For me, it was like getting a brain transplant—seriously—to shift from my face-to-face, only doing live trainings to doing this. And of course, I do some live trainings as part of it.
It’s exciting to see what can happen with this new tool that we’re just learning how to use.
TS: With Sounds True, Diane Poole Heller will be hosting a premiere online event called Psychotherapy 2.0—an online training summit which brings together leading experts in the fields of attachment theory, somatic therapy, trauma resolution, neuroscience, mindfulness research, and brings forward other new discoveries in psychotherapy. Experts featured on the series include Rick Hanson, Ellen Bader, Sue Johnson, Ron Siegel, Stephen Porges, Michelle Weiner-Davis, Bonnie Badenoch, David Wallin, Peter Levine, Dan Siegel, and Esther Perel. All of these presenters and more are featured as part of Psychotherapy 2.0. This online training summit begins on September 18 and runs through October 1. Best of all, you can listen each day for free.
So, if you’re interested and want to attend Psychotherapy 2.0: The Online Training Summit, you can visit psychotherapysummit.com.
Diane, thank you so much for really being at the frontier of being education to people online. It’s tremendous to have this chance to talk to you. Thank you so much.
DPH: Thank you. I loved being here, and I’m so excited for this event.
TS: SoundsTrue.com. Many voices, one journey. Thanks for listening.
