Thursday, April 01, 2021

MO-7: Integrating Challenges: A Common Thread in Stress, Trauma, Psychopathology and Societal Dysfunction

Book synopsis (so far)

0. Introduction. Psychological well-being and ill-being may be viewed from the perspective of how people overcome challenges, that is, seek to "integrate" them. Take an example. A person negotiating small puddles of rain on the sidewalk hardly registers them as challenges. Another person skipping successfully over large potholes certainly does. When an earthquake opens the road in front of a third person, that challenge will likely appear as a life-threatening. How trivial, optimal and overwhelming challenges are dealt with by human beings (and biological and social systems) is the topic of this book. 

1. Organisms are proactive. People are organisms and living systems, and as such they take in energy from the sun and from nutrients and transform it in ceaseless activity (Bertalanffy). An organism is proactive; it extends itself into the world with curiosity and seeks to integrate everything unknown into growth, thriving and flourishing. SDT calls it intrinsic motivation and it manifests as the interest that healthy people take in their surroundings (Ryan). 

2. Challenges. Some interactions with the environment are trivial, others are challenging and yet others are overwhelming. Trivial interactions are everyday and well-integrated, whereas challenging ones require active integration work, during which the person struggles to internalize and integrate the considerable challenge, such that it, too, will become trivial. Understanding new long words, for example. Resilient is what we call people adept at handling challenges or recovering from them (Masten).

3. Stress. Some challenges are very taxing and appear threatening to the person (such as predation, loss of parental contact in children, loss of social recognition in adults and hence exclusion from the group). This releases cortisol and other stress hormones, which activate the physiological and cognitive systems that deal with immediate danger. Allostasis (McEwen, Sterling) is the process by which an organism tries to predict challenges and mobilize and allocate the internal resources required to deal with them. I'll explain allostasis with examples. 

4. Allostatic overload. Evolutionarily, animals like humans have grown used to challenges lasting for only a short while (seconds to minutes), after which organic and brain systems return to normal (by various mechanisms, such as violent trembling (Levine), which dissolves stress hormones). If dangers persist (hours to days to months), the alarmed state of heightened arousal is prolonged and the organism overlearns its response to the danger. This is severe stress, also called allostatic overload. It impacts the person's physiology and affective system intensely.

5. Subintegration. Unable to integrate challenges in the normal way, people so exposed will take extraordinary measures, given that their life space is restricted and their reach diminished. Such a person will appear to cope in maladaptive or dysfunctional ways. Instead, such coping may be seen as highly adaptive, given the overwhelming or impossible circumstances. This I shall call subintegration: the organism tries to integrate the challenges as best it can. It may not be pretty, but it is survival (like a child splitting or dissociating in the face of sexual abuse, or lung cells metastazing as a last attempt to protect against inhaled toxins, or socially marginalized youths forming gangs and resorting to violence and criminal enrichment to obtain some social recognition).

6. Trauma is the impact left on the nervous system or brain by the organism's (desperate) attempts to deal with prolonged stress, the perception of lasting danger to its integrity or survival. Much is known about trauma, and I will review some of it here.

7. Psychopathology. Unlike primate or hominid life, modern life entails permanent stresses to most people, which may cause severe disturbances to mental and affective systems (psychopathology). This view of mental suffering contrasts with that of biological psychiatry and its multifarious symptom collections, not least because of its acknowledgement that every mental patient has a significant history. Allostatic overload, stress and trauma may be transdiagnostic factors explaining the common half-half comorbidities. The case of PTSD. Developmental trauma.

8. The causal chain of ill-being is thus (a) excessive challenges, (b) stress, or allostatic overload, (c) neuroendocrine response overlearning, (d) trauma and finally (e) psychopathology, all of it embedded in and exacerbated by repressive social structures. According to SDT, the path is (1) thwarting of psychological needs, (2) introjected internalization, (3) impaired emotional regulation, (4) psychopathology and on to (5) cultural, political and economic oppression or chaos. In this book, my emphasis is on this one line of explanation: dealing with challenges, by integration or subintegration.

9. Overcoming challenges. Preventing stress, dealing with trauma, treating psychopathology, improving society. Some principles here, maybe some generic advice, like (1) spot subintegration, (2) show compassion, (3) role-model integration. 

10. An overall framework of integration. SDT's potentials and vulnerabilities. Daniel Siegel's integration. Pierre Janet's unity  vs. Freud's fairy tales. Perennial philosophy's unity-through-diversity. Leibniz' perspectivism, whole-in-part. Weisskopf's union upwards and union downwards. Wilber's pre-trans fallacy. My flexstablity beyond chaos and rigidity.

11. The physics and biology beneath. Goodbye to static, atomistic, reductionist materialism. Oscillators carry energy (QM, Cosic) and waves distribute order (Bohm, Pribram). Reality is a symphony of harmonic resonance (Lehar). Form and wholeness are maintained and expanded (Waddington, Goodwin). Overcoming challenges is what proactive morphogenesis does. Subintegration is filling the restricted space available with information-carrying waves of energy. 

12. Conclusions. This implies a compassionate stance: recognize how all organic systems, people and social systems strive to integrate things alien and unknown, even when hardly possible. We may interpret many psychological, social and political ills as a consequence of modern civilization generating too many overwhelming challenges to people. Scale them down, slow down, make life manageable, design institutions and economic systems that help people meet their basic psychological needs. Human and societal development requires optimal-sized challenges.

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