WCW's Women Change Worlds Blog

The following is an excerpt of a blog post written by Amy Banks, M.D., that appeared on her Psychology Today blog, Wired for Love.

To say that race relations were not on my radar growing up would be an understatement. In fact, in high school I was just coming out to myself as a lesbian and was preoccupied with the injustices in the LGBTQ community in the late 1970s. However, for my family, that changed in the spring of 1979 when my father traveled on business to New Orleans. On his first day in NOLA, after eating dinner in the French Quarter, he and a colleague walked back to the Hyatt Regency. At the entry to the hotel, they were held up by two young men, and my father was shot and killed.

Within hours, my family was told that “two Black men” had tried to rob my father and his colleague. Having grown up in Maine—which remains the whitest state in the U.S.—this was my first substantive exposure to someone from the Black community. My family was shattered by the murder and naïvely believed that the legal system in New Orleans would help us seek justice.

When the photos of the suspects, Isaac Knapper and Leroy Williams, popped up in our local newspaper, I remember looking at them closely and wondering what in their lives would have caused them to rob and kill. It never occurred to me that the prosecution would withhold exculpatory evidence at the trial and that one of the young men, Isaac, would be wrongly convicted for murder and sent to prison for the rest of his life. My family did not question the arrest and verdict for many reasons, but the biggest was that we were solidly part of the white, dominant culture. One does not have to be an avowed white supremist to be racist—you simply have to be brainwashed 24/7 by a culture that defines health and acceptability as the birthright of all white people and associates people of color with violence.

The traumatic memory of my father’s murder was exponentially more painful as it now involved the wrongful conviction of a 16-year-old boy.

When I found out in 2005 that Isaac had been exonerated in the early 1990s, I was shocked and sickened. By then I had become a psychiatrist with a deep interest in issues of social justice and was well aware of the gross inequities that exist in America between people of color and white people. However, until I learned of Isaac's exoneration, I had no way of knowing how entwined my own story was in America’s racism. The traumatic memory of my father’s murder was exponentially more painful as it now involved the wrongful conviction of a 16-year-old boy.

By 2015, I was both curious and furious. Eric Garner, Freddie Gray, Michael Brown—the killings of Black men by police just kept happening. I decided to take personal action to more fully understand the horrendous racist event that my family had unwittingly been involved in. With much fear, I reached out to Isaac (who had been released and was living in NOLA) and asked to meet. In December of that year, my sister and I met with Isaac and his wife in New Orleans. The meeting and our friendship have transformed my life.

What surprised me the most was how easy it was to be together—how we didn’t stop talking and sharing the entire weekend we spent together. What disturbed me to my core was hearing Isaac’s personal experience of police brutality. How much worse his experience had been than I could even imagine. He shared his violent arrest at 5:45 a.m. when he was awoken with guns pointing at his head, the brutal interrogation where police beat him to within an inch of his life in an attempt to force a confession (it failed), and the utter disregard for his humanity at every turn of the legal proceedings. Yet, despite all he had been through (and continues to go through as a Black man in this society), he also listened to our story and our pain with deep compassion and caring.

Feeling unspeakable pain may mean you have finally begun to feel clear empathy and resonance with the relentless agonies and indignities faced by people of color. You must walk directly into that pain to fully understand the price Black and brown people have paid for your/our white privilege.

One lesson I have learned from Isaac and his family is that the process of healing racism will hurt and at times, the risks you will need to take will be terrifying. But when you hurt so badly you feel you will die—pay close attention. Feeling unspeakable pain may mean you have finally begun to feel clear empathy and resonance with the relentless agonies and indignities faced by people of color. You must walk directly into that pain to fully understand the price Black and brown people have paid for your/our white privilege. If you can’t stand it, don’t stop feeling, find someone who can help you hold it.

Isaac and I have established a deep friendship—one that feels more like family. Within it I have had the opportunity to heal and to grow and to witness my own biases in a way that humbles me. We have chosen to write our story in an upcoming book, Fighting Time. In sharing our story we hope to inspire people to move into the fear and the pain of systemic racism and to have the conversations that are desperately needed to see and feel one another and to help our society grow beyond our tragically racist roots.

Amy Banks, M.D., is a senior scholar at the Wellesley Centers for Women and the director of advanced training at the Jean Baker Miller Training Institute. The book she co-authored with Isaac Knapper, Fighting Time, will be released on November 5 and is available for preorder now.

This article was originally posted by Amy Banks, M.D., on April 12, 2020, on her Wired for Love blog on Psychology Today.

To protect ourselves, our families, and our communities from the devastation of the coronavirus health experts are strongly encouraging everyone to “socially distance” — to stay 6-10 feet away from other people.

I am concerned — not by the strategy but by the way people are enacting it. The few times I have ventured out to a grocery store or for a walk around my neighborhood, I've seen people not only keeping distant from one another but also seeming afraid. They pass each other on the street or in a store without looking at each other or exchanging greetings.

It’s as if we were each locked in a personal bubble that no one can enter. The threat of COVID-19 and the stress it induces can understandably cause individuals to become terrified and myopic — to turn inward in an attempt to stay safe. While a week of that may be more stressful to some than others, months of this type of social isolation is dangerous. Research clearly shows us that our physical and emotional health and well-being are dependent on loving relationships and physical touch. To weather this pandemic, we need one another.

Weeks ago, my colleague and friend, Roseann Adams, LCSW, recognized that the national strategy of social distancing was a double-edged sword. She identified that social distancing can be a threat to all of us as it leads some people to socially isolate potentially causing further stress and, over the long haul, impairing our bodies’ immune system. In fact, strict social distancing may set us up for other illnesses.

Within the first few days, she was encouraging people to physically distance with social connection. Differentiating physical distance from social distance acknowledges the virus’s malignant ability to be transmitted from person to person but also acknowledges that the virus has no power over our ability to support and nurture one another in this time of extraordinary threat.

Think about the power of social isolation in society. Solitary confinement is considered the worst punishment a human can receive. In fact, most civilized communities consider it a form of torture. The physical and emotional toll it takes over time includes a worsening of mental health issues, an increase in self-injurious behavior and even suicide.

Isolating individuals is perhaps the most common first step domestic abusers use to gain power and control over their victims. He or she begins to control who you can see, where you can go, what you can wear. When a person violates the rules set by the perpetrator the punishment is harsh and swift.

Social distancing, as it has been presented, can feel like that. In fact, in my work with trauma survivors during this time, I have heard people describe feeling trapped and threatened again. That is not sustainable. Becoming socially isolated may keep the majority of us alive, but not well.

By naming the national strategy as physical distancing rather than social distancing and emphasizing the need for human connection we can stay safe from the virus but also hold onto the heightened need we all have for one another right now. Each of us needs an extra dose of being seen and held within our connections during this extraordinary time. Perhaps now more than ever we must be intentional about giving our neural pathways for connection a workout.

In fact, we need to go out of our way to make eye contact, wave, move, or loudly say "hello" from behind the mask. This gives our smart vagus nerve and our mirror neurons a workout. Literally, the sound of a friendly voice and seeing the eyebrows of another person raise in greeting stimulates your social engagement system, which in turn sends a signal to your stress response system to stand down. Those moments of interaction may make the difference in the long run as to how we, as a society, survive the pandemic.

The human nervous system is amazingly adaptive. Our brains will adapt to social isolation over time, but the burden of stress the isolation causes will lead to long-term health problems. As a society we will not be well at the end of all of this — not because of COVID-19 but because of the message we take in that being with others can be dangerous.

That is why each of us must do our part to not only stay physically six feet apart and to wear masks but also to go out of our way on the street, in the grocery store, through FaceTime, Zoom, or whatever platform you can use to reach out to one another. We all must know that nurturing the relationships we have and reaching out to others who may be isolated is as essential to surviving the pandemic as physical distancing.

Let’s add another important directive to our national policy of containing the coronavirus — to reach out each day to three other people — to check in on them, simply hear their voice, or share the pain or joy of the day. This is a wider strategy to not only survive the pandemic but to keep our humanity alive.

Amy Banks, M.D., is a senior scholar at WCW and founding scholar of the International Center for Growth in Connection, which began as the Jean Baker Miller Training Institute at WCW. Dr. Banks has spoken throughout the U.S. on the neurobiology of relationships and is the co-author, with Leigh Ann Hirschman, of Four Ways to Click: Rewire Your Brain for Stronger, More Rewarding Relationships.

This blog was originally posted on Psychology Today and is reproduced with the permission of the author.

The #MeToo movement is giving a viral voice to women (and men) who have been the targets of violence and harassment. It is a social change campaign that I never thought would happen in my lifetime. Honestly, when it first started to spread on Facebook I thought it might be cathartic for the people who joined, but I didn’t anticipate it having wider social change potential. My bad—because I temporarily forgot about relational neuroscience and the power that can be unleashed when groups of individuals come together and support one another.

What does the #MeToo movement look like through the lens of relational neuroscience? A few studies come to mind that might help shed some light on interpersonal dynamics across power differences. Check-out "The Cookie Monster Study" as described by Dacher Keltner and his colleagues at University of California at Berkeley.

For those too busy to watch the five-minute video, here is a summary of the study. The researchers brought three individuals to the social science lab and told one of them that they were in charge—essentially giving that person power over the other two. While the group was busy with the assigned task of writing boring university policy, the researchers brought out a plate of four cookies. Initially, each of the three participants ate one cookie each, leaving one on the plate. Interestingly, most of the time, the person given the power eventually ate the fourth cookie. In Dr. Keltner's study taking the fourth cookie correlated with having power and also with a decrease in activity of the mirror neuron system (the circuits in your brain that produce empathy and allow appreciation of the impact of your actions on others). Further, as the researchers watched the behavior of those given power, they observed that the people in charge ate differently. They chewed with their mouths open and occasionally had little pieces of food dropping out of their mouths. Dr. Keltner describes this change in the level of interpersonal awareness as the "paradox of power"—the qualities that often bring someone to power, like empathy and the ability to listen to others, diminish once a person is in power.

Kelner's research and theory suggests that for many people simply having power over others decreases the activity in the part of the brain needed to understand the impact of your behavior on others. Just the opposite of what is needed to be an engaged, respectful leader.

The potential corrupting and disconnecting impact of power is an enormous problem in Western societies where success is often culturally prescribed as gaining power over others and obtaining more resources than those around you. In the US, the myth of individual success is promoted in business, politics, and sports. This model of capitalism is great for making money but not great at creating cooperative, balanced human beings. In fact, one of the "benefits" of making it to the top of the power hierarchy has been a blissful ability to do whatever you want to whomever you want, and because your empathy pathways may be immobilized by power you don’t have to feel the pain you are causing. Essentially, the abuse of power goes hand in hand with power over others, the dominant organizational model in our country. Because power over environments is everywhere, most people have witnessed power abuse at work or family gatherings, in religious communities and on sports teams. Sexual harassment and abuse has been and continues to be ubiquitous which makes the rather sudden rise of the #MeToo movement all the more stunning.

Amy Banks, M.D., is a senior scholar at the Wellesley Centers for Women who has devoted her career to understanding the neurobiology of relationships.

Everyone Needs to STOP the Pain!
Everyone Needs the Pain to STOP!

“Hands up!” The universal symbol of surrender, sign of protest, and signal for self-selection to take action. All of these are integral in stopping the pain of social exclusion.

Human beings are built to function physically, emotionally, and spiritually in supportive groups. This simple fact has recently been supported by neuroscience research and helps explain why individuals and groups of people that are marginalized or socially excluded often suffer from higher levels of chronic health problems and shorter life expectancy.

SPOT – Social Pain Overlap Theory1: How and Why Social Exclusion Hurts All of Us

Being part of a group is so critical to humans that our nervous system literally uses the same alarm (the dorsal anterior cingulate cortex) to register the danger and distress of physical pain or injury AND social exclusion. This neuroscience finding requires that we stop bifurcating pain into physical and emotional and start realizing that pain is pain and that social exclusion and marginalization are forms of violence that impact individuals and whole groups of people.

Social Pain forms – Covert and Overt

Social pain occurs in a number of different forms, some obvious, some not so obvious. The not so obvious may be hard to see, they are insidious like the background noise or the air we breathe. They are chronic assumptions about who we are and what our interests, strengths, and weaknesses might be. They are assumed by others and attached to our identities such as race, ethnicity, sexual orientation, and gender.

These subtle daily attacks or microaggressions can have devastating short- and long-term impact. For example, Native or Indigenous Americans constantly having to combat broad assumptions about cultural sacred practices, misuse of regalia, offensive displays of imagery in athletic team mascots, or even the ongoing challenge to defend one’s very existence.

The obvious forms of social pain are glaringly obvious, often flagrant and extreme. Black men and women being stopped by police, detained or harassed, and imprisoned at sweepingly disproportionate rates compared to White people; too often resulting in violence and even murder.

Both the subtle and blatant forms of social pain emerge together and take place across a range of areas including reliable public safety, access to and quality of healthcare, education and jobs, affordable sustainable housing, and more. Both institutional and personal marginalization is the bedrock for social pain to occur in all of its many forms.

Psychological Resistance to Marginalization

What we know is that people who have been and are being marginalized have always pushed back in ... READ FULL ARTICLE>>

The Dopamine Reward System—Friend or Foe?

Dopamine is trending as the most popular neurotransmitter. And why not? There are days I think it rules the world or at least the day–to-day activities of my friends and family. The craving you have when you smell the coffee brewing in the morning—thank dopamine. That elation you feel throughout your body when you fall hopelessly and deeply in love? Again, dopamine. The thrill of a shopping spree at the mall, the desire for the second and third glass of wine at dinner. You guessed it, dopamine. Dopamine seems to be everywhere giving people a little rush of pleasure and energy when we need it most. So what’s the harm? It’s a natural, biologically based chemical that provides energy and motivation.

The harm is best understood by remembering the infamous rats in Skinner boxes back in the 1950s. Scientists put electrodes into the limbic system (feeling centers) of the rats’ brain and sent a little shock to the area when the rat entered a particular corner. The theory was that if the shock was unpleasant enough it would cause the rat to stay away from the corner. Enough shocks and the rat’s brain would wire the corner with the aversive stimuli. However, a strange and unexpected thing happened when the electrode was placed in the nucleus accumbens (a dopamine pathway that is part of the limbic system)—the rats did just the opposite. Instead of avoiding the corner, they went back to get the shock over and over and over again. Up to 700 times an hour! In fact, this was so compelling to the rats that they opted for the stimulation over food. The rats could not describe “craving “ to us, but certainly, the repetitive nature of their dopamine seeking made it clear that this was something they “needed” to do. The increase in motivation and energy that dopamine provides can be a good thing, but when your brain gets wired to compulsive behaviors that stimulate the dopamine reward pathway (addictions) then your life can be as out of control as the poor rat in Skinner’s Box.

So dopamine itself is not the problem, nor is the dopamine reward system. Dopamine is simply the carrot on a stick designed to give a reward to life-sustaining activities like eating healthy food, having sex, drinking water, and being held in nurturing relationships so that you would keep doing these healthy things over and over again. The problem is how we stimulate the dopamine pathway. In an ideal world—one that understands the centrality of healthy relationship to health and wellness—the dopamine reward system stays connected to human connection as the primary source of stimulation. Unfortunately, we do not live in this ideal world. We live in a culture that actively undermines this precious dopamine-relationship connection. We raise children to stand on their own two feet while the separate self is an American icon of maturity. It is making us sick.

This disconnection is a set-up for addiction as we search for other sources of dopamine. The “other sources” look shockingly similar to the list of common cultural complaints—overeating and obesity, drug and alcohol abuse, consumerism, chronic hooking up. Not only do these addictive, destructive behaviors get paired to the dopamine reward system but they create a feedback loop of isolation that pushes people towards more addictions.

Without healthy relationships we each become like the rats in Skinners box—seeking dopamine from all the wrong places. Let’s rewire our brains for the healthy relationships and connections that reward us with positive energy and motivation.

Amy Banks, M.D., has devoted her career to understanding the neurobiology of relationships. She was an instructor of psychiatry at Harvard Medical School and is the Director of Advanced Training at the Jean Baker Miller Training Institute (JBMTI) at the Wellesley Centers for Women at Wellesley College. She is the author with Leigh Ann Hirschman of the forthcoming book, Four Ways to Click: Rewire your Brain for Stronger, More Rewarding Relationships (Penguin Random House).

The Four R’s – Reading, ’Riting, ’Rithmetic, and Resonance

Do you have someone in your life that “gets” you? I do. My friend Angel and I see each other every six weeks or so but each time we get together I am struck by the resonance we share, the ability to jump back into a conversation as if no time has passed. How does that happen? When I heard about the discovery of mirror neurons I thought I had found the answer.

First discovered by accident in 1998 by scientists studying arm movements in monkeys, mirror neurons were originally described as individual, specialized brain cells with the sole purpose to help us “get” or read other people. They were thought to be unique among brain cells because of their ability to multitask—registering actions, feelings and sensations all in a single specialized cell. I loved this! My heart already believed that relationships were central to health and wellness and these mirror neurons could be the proof my brain needed to believe that humans are “hardwired to connect.” But, even as I was sharing the news with others, I felt a little worried. How could Angel and I click so easily when I struggled with many other relationships in my life?

Also, when I looked at my friends and family, I noticed I was not alone. Everyone I know has some variability in his or her capacity to read others and to be read. So, if we’re hardwired to connect, what explains the variability? Is people-reading something we learn how to do or are we blessed with the hardware to automatically understand what others close to us are doing or feeling? Turns out, it’s both.

As babies, we are born with reflexes to connect with others. Watch an infant for a few minutes and you can see the vast amount of energy devoted to connection. The wiggling and writhing invested in finding the nipple of a full breast, the waving of a tiny, unsteady hand in search of a finger to wrap around or the neck to grab hold of. These reflexes are a pretty good start for connection, but, are not nuanced enough to allow an infant to “read the room.” A baby may become fussy when held by a distracted, tense mother but could not “know” the mother arrived home from work exhausted and irritable after being up all night working on an important presentation.

Researchers are now describing a mirror neuron system rather than unique mirror neurons. This is a more complex, efficient, and coordinated wiring of existing of neural pathways that communicate the actions feelings, and sensations of those around us. It is the way these pathways become interconnected through experience that really counts in clicking with others and making sense of relationships. Imitation plays a key role. Each of us literally “knows” other people by mimicking them internally. This mimicking is concrete. If I watch you walk toward the door with your hand out, I “spontaneously and automatically “know you are going to open the door and leave. I do not need to ask. Deep in my brain, the area in the prefrontal cortex that plans and executes the physical movement of walking out the door is being stimulated. Though I am not moving, the same nerve cells are firing. When you touch the door and pull your hand away quickly and shake it a little I “know” that the door was quite hot from the pounding sunshine on the glass. My somatosensory cortex that creates sensations fires and my hand feels a low-grade sense of heat and smoothness from the window window. That is added to the immediate mix of how I am reading your experience. And finally, you walk through the door and a large smile crosses your face as you fall into the arms of a loved one. In my brain and body the nerve signal has now traveled through the insula into my “feeling centers” in my body and I feel a similar joy and lightness. I “know” you are with someone you love. All of this has happened in the blink of an eye and without you sharing any of your experience with me. My brain and body uses itself as a template to have a shared experience with you and the closer our life experiences internally have been, the more resonant we feel.

But imitating is not the whole story. Grown-ups must name feelings and experiences accurately when you are little so that when you name them in others later they match. You fall down and skin your knee and your parent says, “Ouch, that hurts.” The pain in your knee and the tears running down your face are paired with being hurt. A friend knocks over your block tower and the energy surging through your body and the tension in your eyebrows and face gets paired with a teacher saying, “You feel angry because Tom knocked over your blocks.” It seems like an easy process except that many people don’t know what feelings feel like in their body. Even as adults, well-meaning parents can mislabel a child’s experience and potentially confuse the development of the mirror neuron system.

Here’s an example. Ten years ago my pre-school aged twins and I were in a terrifying accident. I had driven the one-mile route to school mindlessly for a couple of years. On this day, as we approached a four-way intersection, another van turned left and hit us almost head on. Both vans were totaled and immediately chaos ensued. The front airbags in our car deployed filling up most of the front seat and giving off a pungent, rubber smell; the engine hissed and sent water and steam spraying into the air. Within minutes the local rescue teams arrived en masse—fire, police, and ambulance sped to the accident with blaring sirens and lights. In the midst of the overstimulation, I crawled into the back seat and looked directly into the trusting, scared faces of my children and said, “Everything is fine”—a delusional thought if ever I had one. My son looked right back at me and said, “Everything is not fine, this is a bad accident. “ A reality check for sure, I immediately backtracked and agreed that it was a bad accident and that it was scary.

We develop these pathways for accurate reading in the context of being accurately read by others! When I tell my children everything is fine at the same time their bodies are registering that things are dangerous, their developing people-reading pathways are getting a mixed message. Done often enough, as is often the case with childhood trauma or domestic violence, and the person’s mirror neuron system wires in an inaccurate and confusing way. They drift into isolation as their capacity for resonance is diminished.

A cultural belief that human development should be towards increased levels of separation and individuation can create a mirror neuron system that is not accurate. If I am busy “hiding my feelings” from you for fear of being seen as weak or needy, or if I believe that being impacted by another person’s feelings or experiences diminishes my strength, then chances are my mirror neuron system is not getting the stimulation needed to develop the essential human capacity of resonating and reading others and being read. And the impact of this is far reaching. Human beings are built to be healthiest in mind and body when in strong connections with others. Connection and cooperation are part of the everyday lives of most people and a strong mirror neuron system is essential in each and every one of life’s negotiations. It is high time that we add the fourth “R” to the basic skills taught in education—reading, ‘riting, ’rithmetic, and resonance!

Amy Banks, M.D., has devoted her career to understanding the neurobiology of relationships. She was an instructor of psychiatry at Harvard Medical School and is the Director of Advanced Training at the Jean Baker Miller Training Institute (JBMTI) at the Wellesley Centers for Women at Wellesley College. She is the author with Leigh Ann Hirschman of the forthcoming book, Four Ways to Click: Rewire your Brain for Stronger, More Rewarding Relationships (Penguin Random House).

I was many things at ten years old, but one thing I wasn't was accepted. My family moved to a new town that summer—it was 1972—and on the first day of school when the school bell rang I stood in the middle of the girls’ line anxiously waiting to meet my new classmates. As I was studying my shoes I heard the laughter and the whispering, “What is that new boy doing in the girls line!” They were talking about me, well-dressed in boys clothing. I was humiliated, filled with shame, desperate to go back to my old school where people knew and accepted me. It was a long year of pain, accentuated by my teacher who routinely tried to force me to join the Girl Scouts.

This memory popped back into my mind when I first discovered social pain overlap theory (SPOT) by Eisenberger and Lieberman at UCLA. These researchers study the brain in social situations. They devised a clever experiment during which people were asked to join a virtual cyberball game on a computer screen. As the game progresses, the research subject is attached to a functional brain imaging machine. Now, being left out of a cyberball toss experiment where you do not even know or see the other players is nothing compared to my year of ridicule and ostracism in fifth grade, nor does it compare to the many forms of being socially rejected from bullying, to racism and homophobia, but still, this rather mild social exclusion told these researchers something very important: Being left out hurts most people. They feel uncomfortable, unsettled, irritated… distressed. The next step was to see what area of the brain was activated with this distress.

This is where the story gets really interesting. The area that lit up when a subject was excluded is a strip of brain called the dorsal anterior cingulate gyrus (dACC). The dACC already had been mapped as the area of the brain that is activated when a person is distressed by physical pain. To humans, being socially excluded is so important that it uses the same neurological pathways used to register when you are in danger from a physical injury or illness. Remember the old saying, “sticks and stones will break your bones and names will never hurt you”? Not true. It should have been “sticks and stones will break you bones and names will hurt you too!”

The human nervous system has evolved to be held within the safety of safe relationships. When we drift away from our group or are pushed out, when we are ridiculed, bullied, or shunned it creates real pain. This happens to individuals within groups and to groups of people within the larger society. SPOT theory confirms that people who live in glass houses shouldn’t throw stones—but it also tells us that we all live in glass houses, we are all vulnerable to the pain of being left out. It is simply how we are wired.

Amy Banks, M.D., has devoted her career to understanding the neurobiology of relationships. She was an instructor of psychiatry at Harvard Medical School and is the Director of Advanced Training at the Jean Baker Miller Training Institute (JBMTI) at the Wellesley Centers for Women at Wellesley College. She is the author with Leigh Ann Hirschman of the forthcoming book, Four Ways to Click: Rewire your Brain for Stronger, More Rewarding Relationships (Penguin Random House).

Twenty-five years ago, when I was studying the human nervous system in medical school, I learned that the body has an automatic system running in the back ground 24/7—the autonomic nervous system—like the system that runs in the back ground of your computer updating time and date without needing to be asked. I was taught that the autonomic nervous system had two branches with opposite functions. The sympathetic nervous system (SNS) keeps you awake, alert, and engaged in life when it is running at a steady level, while the parasympathetic nervous system (PNS) helps you relax and rejuvenate yourself after a period of activity.

In popular science the SNS and the PNS are associated with their most dramatic functions—the fight, flight, or freeze responses that are activated when a person is threatened. If a bear charges you on a hike or your boss yells at you at work, bam, your SNS fires causing energy and blood flow to be diverted to your large muscles, heart, and lungs. You automatically assess the situation and either gear up for a fight or run like hell away from the threat. On the other hand, if you come across a mother bear with her cubs and she is standing over you ready to pounce and there is nowhere to run or your spouse comes home drunk and mean again and has a history of attacking you, your parasympathetic nervous system might activate causing you to freeze and even fall on the spot as your heart and respiratory rate decrease dramatically and your body’s pain killers flood your system buffering the pain. Neither of these reactions are under your conscious control. You are automatically protected.

What happens, though, when what you are facing is a kind, welcoming face or your favorite pet? Do you need to then rely on conscious functioning, do you need to think about it before you act and engage? According to Stephen Porges, the answer is “non.” He has discovered a third branch of the autonomic nervous system—one he calls the smart vagus nerve—that innervates the muscles in the face, throat, vocal chords, even the tiny muscles in your inner ear. The smart vagus balances the SNS and PNS and gives us automatic responses to safety. Imagine meeting your best friend—chances are your mouth breaks into a smile, your eyebrows raise, and you tune in and listen a little more attentively. You share stories and maybe even eat a meal together. All of these activities stimulate the smart vagus nerve which travels to the heart and lungs and tells the SNS and PNS they are not needed. You feel calmer.

The capacity to feel calm in a healthy relationship is as natural and automatic as the ability to feel terrified in Friday the 13th. It is how we are wired. A culture that teaches “self-regulation” and finding comfort by standing on your own two feet over stimulates your SNS making it harder to recognize a healthy connection. In Four Ways to Click: Rewire your Brain for Stronger, More Rewarding Relationships you can evaluate your neural pathways for connection and strategize ways to rebalance your autonomic nervous system to help you feel responsive and less reactive in your healthiest relationships.

Amy Banks, M.D., has devoted her career to understanding the neurobiology of relationships. She was an instructor of psychiatry at Harvard Medical School and is the Director of Advanced Training at the Jean Baker Miller Training Institute (JBMTI) at the Wellesley Centers for Women at Wellesley College. She is the author with Leigh Ann Hirschman of the forthcoming book, Four Ways to Click: Rewire your Brain for Stronger, More Rewarding Relationships (Penguin Random House).

October 10th is Mental Health Awareness Day.

We live in a time of easy access and quick fixes. People expect to be able to stream a video in less than 60 seconds, to have the entire written history of the world at their fingertips, even to have a complete dinner delivered in under 30 minutes. Given the mind-numbing pace of life, perhaps I shouldn’t be surprised by my clients’ impatience and disappointment when I offer an antidepressant to treat disabling anxiety or severe depression that takes three to six weeks to kick in. Just 100 years ago they would be resigned to a life of tormenting melancholia. Sure, there are new treatments on the horizon that promise quicker response times. Maybe ketamine will be the Netflix of mental health treatment. Most people overlook the one thing that unequivocally helps our emotional and physical health--supportive human relationships.

The fact that healthy human relationships are central to all human growth and development is not self-evident in a culture that values and promotes separating from and competing with others as the pinnacle of maturity. But research now shows the human nervous system is literally wired to function best when in healthy relationships. If you do not believe it, try a very simple experiment to see and feel the impact of healthy relationships on your mind and body. Close your eyes and think about a positive interaction you have had with a friend or partner. As you play it out in your mind, watch how your body changes. Most people describe an openness in their chest, a smile forming on their face, a lift in their mood. This simple visualization, something I call a positive relational moment, allows you to tap into the healing physiology of connection and changes your neural chemistry just as clearly as Ativan or Prozac--but with fewer side effects! In honor of National Mental Health Day, reach out to others, engage in healthy interactions, and build new positive relational moments. It is perhaps the ultimate win-win in this culture of competition.

Amy Banks, M.D., is the Director of Advanced Training at the Jean Baker Miller Training Institute at the Wellesley Centers for Women, Wellesley College. She is the author with Leigh Ann Hirschman of Four Ways to Click: Rewiring your Brain for Stronger, More Rewarding Relationships, forthcoming from Penguin Random House (Feb. 2015).

May is National Mental Health Awareness month, a fitting time to be mindful of the suffering caused by mental illness. Even though I am a psychiatrist, working daily with people diagnosed with mental illness, I am stunned by the statistics on the incidence of mental illness. According to the National Institute of Mental Health in any 12 month period, 26.2 percent of adults are diagnosed with a mental illness. That is one in four adults who are experiencing disturbing and often debilitating symptoms--the constant distress of an anxiety disorder, the aching despair of a major depression, the terror of psychosis. The lifetime incidence of mental illness is over 50 percent. These statistics tell us that if you have not been diagnosed with some form of mental illness, someone you know and love has. When you go to work today or even out with friends in the evening, see if you can identify the one in four people who has a mental illness. Don’t be surprised to walk away thinking there are none in your group. Also don’t be surprised to find out that you are wrong.

So, where are all the people with mental illness? From what I hear in my office, many are hiding and suffering in silence for fear of being stigmatized, pitied, or seen as weak. American, Westernized culture plays a large role in this fear. The pervasive image of an American is a person who is strong, independent, and can “make it” on his or her own. There is no direct media campaign telling people who have a mental illness to stay in the closet, but the chronic cultural myth of the “self made man” acts as a reference point from which we all measure our worth. The more dependent you are on others, the less value you hold. This cultural bias is insidious and contributes to an environment that makes each of us hide our vulnerabilities behind a wall of shame at not being strong enough to manage our day to day lives on our own.

The idea that we are stronger on our own is destructive, dangerous, and undermines our natural physiology that works best in healthy interdependency. Professor Emeritus at the University of British Columbia, Jilek Wolfgang, M.D., M.Sc. reports that people who develop a psychotic illness actually heal faster in a non-Westernized world. A stunning finding given that Western societies are known to have the most educated doctors and best hospitals in the world. So what accounts for the improvement? A lack of stigma. In the West, psychosis or the loss of reality testing is seen as the ultimate failure of individual strength. It is frightening and dangerous. On the other hand, in many parts of Africa, extended family and community reach out and embrace the individual with psychosis rather than fearing or shunning him.

Relational neuroscience offers some explanation for this finding. Researchers at UCLA, Eisenberger and Leiberman, have discovered that the pain of social exclusion is registered in the exact area of the brain, the dorsal anterior cingulate gyrus, as the pain from a physical illness or injury. Because humans are meant to function best in healthy human connection, this area of the brain fires an alarm for things that are life threatening. The chronic pain of an acute physical injury or illness can be lethal, but Social Pain Overlap Theory (SPOT Theory) tells us that being socially rejected is every bit as dangerous. When we stigmatize and ostracize people with mental illness we increase their stress levels, decrease their ability to fight illness, and prolong their healing process.  

The range of functioning in the people I treat everyday is tremendous--from CEOs capable of running a company while having a mental illness to individuals on disability unable to work because of severe symptoms. Almost every person I see is hiding their diagnosis from at least one important person in their lives out of fear of the anticipated rejection. In this month of May let’s all open our eyes and our hearts to see and embrace someone with a mental illness and to support those who are suffering knowing full well that statistics show having a mental illness is not an individual failure nor a weakness. Mental illness is, well, an illness and the best hope for a speedy recovery is the support of extended families and friends. This cultural shift from pathological independence to healthy interdependence holds the power to heal many wounds and to improve the lives of all of us who will experience the pain of mental illness.

Amy Banks, M.D. is the director of Advanced Training at the Jean Baker Miller Training Institute at the Wellesley Centers for Women, Wellesley College. Over the last ten years at the JBMTI, she has been integrating emerging neuroscience information with relational-cultural theory.