Dr. David Van Nuys: Welcome to Wise Counsel, a podcast interview series, sponsored by CenterSite, LLC, covering topics in mental health, wellness and psychotherapy. My name is Dr. David Van Nuys. I'm a clinical psychologist and your host.
On today's show we'll be talking about repairing broken maternal-infant bonds with my guest Dr. Tony Madrid. Tony Madrid, Ph.D. is the director of the Russian River Counselors in Sonoma County, California. He has been a psychologist for 35 years, starting as a child psychologist for Sonoma County Mental Health. He was the director of The Erickson Institute in Santa Rosa California. He directed the Inpatient Program at Pocket Ranch Institute in Geyserville, California, which was an alternative program to traditional hospitalization and he has been on the faculty of The University of San Francisco for 25 years. He was a Member of California's Board of Psychology and he is a Fellow of the International Society for the Study of Dissociation. His area of research is maternal-infant bonding and childhood asthma, for which he received the American Society of Clinical Hypnosis Hilgard Award for scientific excellence in writing on pediatric/adolescent use of hypnosis.
Now here's the interview:
Dr. Tony Madrid, welcome to Wise Counsel.
Dr. Tony Madrid: Thank you.
David: Yeah, it's great to have you here. I recently interviewed you on my other Podcast, ShrinkRapRadio, and was one of the more popular podcasts that we've done in quite a while, so I was really jealous to be able to share with listeners of Wise Counsel, the interview with you. So, we're doing a fresh interview today, and also listeners to this series will recall that I recently interviewed Dr. Francine Shapiro on EMDR and I know that's played into your work as well.
Tony: It sure has. She has revolutionized the work with trauma patients. Her technique of the EMDR is just incredible; we require it of everybody who works at the clinic where I work. It's such a powerful tool to quickly resolve traumatic problems.
David: Well maybe we'll talk about EMDR some more as we go along. There are a number of things I wanted to focus on in our conversation; maternal bonding, hypnosis, EMDR, which we were just discussing, and then finally your recent work on the treatment of asthma.
So let's start off with maternal bonding. First of all, tell us what that is and why it's important, and how you got involved with it.
Tony: Maternal-infant bonding is a term that was coined by two pediatricians at Case Western, Marshall Klaus, and John Kennell. In 1976 they wrote a book with that name, 'Maternal-infant bonding' in which they talk about the connection between a mother and her baby as being a love connection where the mother instinctively knows what the child needs and they have a biological, emotional, spiritual dance; an interplay that exists between them. They were amazed that children that they cared for in the intensive care nursery who had difficult beginnings, often returned to the emergency room abused, and they couldn't figure out why this was the case since there seemed to be so much focused attention on the children. They hypothesized that perhaps it had something to do with the mother not being in immediate contact with their babies when they were born because the child was whipped off to the intensive care nursery.
They pointed to a number of animal studies that showed if a mother is separated from her young right after birth, she will reject the youngster. Through a number of different species it was a well-known fact, and they said maybe the same thing holds for humans. They did a number of studies that indicated that this was the case. If the mother was separated from her baby right after birth, she showed a lot of behaviors that mimicked rejection in animals.
David: That's interesting and I think this has come into some degree of popular awareness because I think when people have babies now, there's kind of an awareness that it's a good idea to bring the baby into the mother as soon as possible and for that baby to be with the mother for a while.
Tony: Exactly, and that's the result of Klaus and Kennells' work. They revolutionized the birthing in America.
David: Wow, I didn't realize that. It's something that I think we sort of take for granted now.
Tony: We do, and the usual method of birthing before Klaus and Kennells' work was, you had the baby, the baby was shown to you, you saw what sex it was and then it was whipped off to a nursery and stayed there for a period of time and stayed there until the baby came back to feed and then it went back to the nursery. And they did a bunch of studies that showed that if you keep the mother and the baby together, the mother will lactate longer, breastfeed longer, there was lower incidence of abuse and failure to thrive, and in a number of different variables the children show up as being stronger and more independent, and less 'at' their mothers.
When you see a mother who didn't bond, one of the complaints that she frequently has is that her child is always 'at' her, trying to get something from her, is difficult to comfort, impossible to nurture, is less affectionate, is more antsy. Some mothers will even say that they love their baby, but they don't like it.
David: My own mother passed away some years back so I can't interview her on this topic, but it's long enough ago that I suspect I'm in that. I was born in that time when mothers didn't get a lot of contact, so that's my excuse for all my shortcomings.
Tony: [laughs] I think we all were. Mothers were put into a twilight sleep, given a little bit of anesthesia.
David: That's right.
Tony: Well this became very interesting to me when I had a child show up at the office who had a bad case of asthma. And her mother brought her in. She was seven years old. And the child had frequent emergency room visits, was on all kinds of medications, had several courses of steroids, and was a sick little girl. And I tried the standard protocols for working with children with asthma, and none of it worked. None of it paid off. The little girl could get better for a short time, but it didn't last.
So, I continued treatment with the mother for about four months. She was always talking about how her daughter was real sick and she had to spend the night up with the daughter because she couldn't breathe, and so forth. And one day, she says, "You know, I don't even love my daughter. I wish I did, but I don't have any feelings for her."
And I had just read Klaus and Kennel's book, and I said, "Well, what happened at the birth?" And she said, "They took the baby away from me because the baby was jaundiced, and didn't give it back for a long time. And then I was sent home, and the baby stayed in the hospital. And I came back and got the baby, and I looked at the baby, and I said, "Are you sure you gave me the right baby? I don't have any feelings?" And they said, "Yeah, this is the right baby." She said, "I remember thinking, maybe you should keep the baby, because it doesn't feel like my baby."
And then she said a couple of other things that were quite interesting, and they were that her husband had just left her before the baby was born, and she was plummeted into poverty. Klaus and Kennel point to physical separation as being one of the causes that keeps a mother from bonding.
And they also say that the mother could be emotionally separated. In other words, she could be having some competing emotion, some emotion that was so strong that there wasn't room for bonding--such as grief, someone died, her husband just left, incredible fear. Or maybe she didn't want to be pregnant.
So, here we have a woman who was physically separated and emotionally separated: her husband had just left. And so I thought, "What the heck? Why don't I hypnotize her and see if we can make some corrections?" And so I hypnotized her and asked her to clean out all the trauma from the birth, which she quickly did. And then I said, "Now, let's imagine the way that it should have been." And she did that. And this whole thing took about 15 minutes.
David: Now, what made you think something like that was going to work? I mean, to many listeners that might sound pretty far out, I think.
Tony: I didn't think it was going to work.
Tony: I just threw it up there and saw if anybody would salute it.
Tony: And she continued therapy for about three months, and then she left therapy. And on our last day of therapy, she said, "Remember that time we did the hospital thing?" And I hadn't remembered what she meant. And she said, "Remember, we pictured a new birth?" And I said, "Oh, yeah." She says, "Well, from that day on, I fell in love with my daughter." She says, "I know what it feels like to be a mother now. I love her to pieces."
She says, "And what's also quite interesting is that her asthma went away." And I said, "What do you mean her asthma went away?" And she says, "No more wheezing at night. No more difficulty playing. In fact, she doesn't even need her medication. She hasn't taken her medication in three months." So we were real surprised by this.
David: Yeah, that's very dramatic.
Tony: Yeah. It was just amazing. So we started shaking the bushes and seeing what other asthmatics looked like. And we did three dissertations on the incidence of non-bonding within an asthma population, and all three dissertations showed that about between 70 and 80 percent of children in our Sonoma County sample had histories that were compatible with non-bonding. That meant that if a kid out in this area has asthma, you can bet the farm that he didn't bond with his mother.
And the kinds of things that showed up, David, were: separation at birth, difficult pregnancies and difficult births, emotional traumas that the mother went through, and the combination of those two things, in most people.
David: It's interesting that that would result in asthma. And I'm wondering, is that the only symptom, or are there other ways in which that kind of broken or unformed maternal-infant bond might express itself?
Tony: I think that it leads to a lot of problems. There is a physician in Boulder who has linked bonding to childhood diabetes. I think that it has a lot to do with hyperactivity in children. But I'm not sure about those things because I've just only studied intensively the connection with asthma.
David: OK. OK. Just for the benefit of our listeners, I think I should add that you might have sounded a little bit flip in your reply that, well, you didn't even think hypnosis was going to work. But actually, you'd been studying hypnosis for a number of years. You'd gone to visit Milton Erickson. You were very interested in an Ericksonian approach to hypnosis.
Tony: I went to visit Dr. David Van Nuys as well.
David: Yes, that's true. [laughs]
Tony: And you taught me the rudiments of hypnosis, back in the late '70s.
Tony: I spent a considerable amount of time with you, learning how to bring hypnosis into my psychology practice.
David: And you had already been doing that before you got into this work on maternal-infant bonding. Isn't that right?
Tony: That's right.
Tony: In fact, I had hypnotized this woman several times before this one session. And she was real familiar with going into a hypnotic state and doing something when she was there, so it was easy once I tried the approach with her.
David: OK. I think that's important background for us to have. What about, in the mothers that you see who've not bonded, what kinds of symptoms do they display?
Tony: I was always interested in and surprised by mothers who said that they were having a difficult time with a particular child and that this child had been trouble from the day he was born. And they wouldn't say this about their other children. They'd have perfectly normal relationships with the other children, but this one in particular had given her trouble from the beginning.
And they say, "I don't know. There was something different about this child. This child has been a thorn in my side. I have to watch over this child a lot more closely." And when we look at what went on at the birth, invariably there would be a disruption in bonding.
Tony: And what's interesting is that psychologists, for years, have talked about the psychological variables of mothers and their asthmatic children. And they have blamed the mothers for the asthma. They've called these mothers "asthmatogenic mothers." And they blamed them in the following fashion. They've said that these mothers are distant, they are demanding, they are angry, they're not giving, and they're over-controlling.
Now, these same mothers will not have these kinds of attributes with their other children.
David: That's interesting. Yeah.
Tony: Yeah. And with this particular child, they'll have these problems. In fact, there was a group at the Children's Asthma Research Institute in Denver, and now it's called the National Jewish Center for Allergies and Respiratory Problems. And this group followed mothers and children for 20 years, and they found that mothers of asthmatics had difficult times parenting their child. And it was almost predictive.
And the surprising thing was that this team found, years ago, that if they took a child away from home and brought it into their hospital in Boulder, or Denver, the asthma disappeared. And they did a lot of studies about this. They brought the children into the hospital--even with the paraphernalia from home, even with the dander from the blankets and their bedding--and the children's asthma disappeared. Until they returned home, at which case the asthma returned. And so they thought that it had something to do with the relationship with the parents.
Well, the latest study that they did showed that, if a child has asthma, there were three things that contributed to it: parenting difficulties that they noted at three weeks of age. And parenting difficulties is what happens when you don't bond with your child. Also, high immunoglobulin E, which is a marker for allergies and ear infections. And the marker for allergies is also a marker for stress. And what greater stress than being with a mother that doesn't love you?
Tony: The end result of it is, according to this team, that, once again, the mothers were blamed, when, according to us, the problems that arise between a mother and a child that somehow develops into asthma, those problems are the result of an accident--an accident at birth, an accident before birth, some type of thing that's really out of the mother's control. And over here in California, we don't believe in accidents too much, you know?
David: Yeah, [laughs] right.
Tony: Accidents do occur. And when that occurs at birth, the mother and the child, they pay for it.
David: It's interesting and unfortunate that mothers tend to get blamed. They've been blamed too often in the history of psychology, as you know. I think we went through a period where they talked about the "schizophrenogenic mother." I think also, in the case of autism, for a while, the mother was being kind of blamed. And I think both of those theories have pretty much withered on the vine as well.
Tony: They have withered, yeah.
David: Yeah. So, I don't know how much opportunity you've had to present or to publish about your work. I'm wondering how it's been received by other professionals, to the extent that word has gotten out.
Tony: We've published through a couple of different journals. The "Journal of the Association of Pre and Perinatal Psychology and Health" published about four articles on this, and the "American Journal of Clinical Hypnosis." And Dr. Shapiro and I published an article in "Clinical Series."
The word is out there, but it's not accepted too much. In fact, in the many, many years that I've been doing this work, I haven't received one referral from a doctor. I get a lot of referrals from nurses, and I get referrals from other patients. But it's somewhat inconceivable, number one, that asthma might be related to bonding problems, and furthermore, really inconceivable that it could be cleared up in a short period of time.
We've done some research on it. We have two pieces of research that were done in the last five years, and we have a new piece of research that's starting next year. And in this research, what we're going to try to do is show that immunoglobulin E is affected by the treatment--that we measure it before a child goes into treatment, and then we measure it afterwards.
And actually, the child doesn't get the treatment. We never have to see the child. We just work entirely with the mother. And the younger the child, the more effective it is. If a child is 16 years old and has asthma, we haven't had much success, David. But if it's a little baby, if it's an infant, then we have a lot of success. The dividing lines seem to be somewhere around nine or 10, when a child is looking for his or her own independence.
David: Yes. Now, you have mentioned hypnosis as a way of intervening with the mother, and then that has some good effect on the relationship with the child. And we started off talking about Francine Shapiro's EMDR, or Eye Movement Desensitization and Reprocessing. Say a little bit about that.
Tony: EMDR is a technique that we use in this treatment when we're having a hard time hypnotizing the patient. And EMDR will work like gangbusters. EMDR is a process where you have a person think about something traumatic while he moves his eyes back and forth across the field of vision. And somehow--and we don't know why--it seems to process the traumatic event in a cognitive or neurological way and discharge the energy behind it.
I had heard about EMDR when I was listening to a tape, and on the tape was a railroad engineer who said that he had some EMDR done with him and he wanted to testify about it. He said that his train had run over a family that was on the tracks and he never could get over it. He said he tried everything, tried medication, tried psychotherapy, he even tried hypnosis, but nothing could get over it. He says in one session with EMDR, he got over it and it doesn't bother him anymore.
That was pretty impressive and so I took a course in EMDR.
David: Yeah, yeah, that's very dramatic. Well I know you shared with me a manuscript of a book that you've written, or that you're still working on, and I sure hope it gets out there because it really sounds like you're onto something that deserves wider exposure, and more research to support it.
Tony: That was nice to hear. The book is called "The Mother and Child Reunion". It has been sent out to a number of publishers and we haven't gotten any tapes yet. I talk about Maternal Infant Bonding and how it's useful with a lot of different things besides asthma. We have a number of cases where a mother will phone and say, "I've heard that you do something about mothers who have a hard time with their child, and I'm one of those mothers."
Let me give you an example. A lady phoned and said that her aunt took a course from me at the University of San Francisco, and in the course had learnt about bonding. She said, "I am one of those mothers who didn't bond", she said, "I have a four-year old kid, just a beautiful kid. Everybody loves the kid but me." She said, "I take care of this little boy, I take care of him as well as I can, but there's no feelings involved."
So I said, "Well why don't you have your aunt teach you how to go into hypnosis, and when you're real comfortable with it, give me a ring." So she came in, fully able to be hypnotized, and we went and took care of the trauma and we didn't have any time to do the second part of it, which is imagining a new birth. She came back the next week and she said, "Well, I don't think I need the second part." She said, "On my way home, I missed my son." She said, "For the first time in my life, I missed him. I knew what it felt like, and when I walked into the front room, he ran across the room and jumped into my arms." She said, "That's the first time that's ever happened."
David: Somehow the kid picks up on this shift in the mother, in some kind of very unconscious way.
Tony: Isn't that remarkable?
Tony: It's almost like it's out there on the airwaves. As a matter of fact, I was teaching a course on hypnosis at the University of San Francisco and one of the students said, "I'm one of those gals who didn't bond." She said, "I'm sure of it." This gal was bout 40 years old. She said, "My mother and I, we've got to become friends in later life, but boy we just hated one another growing up." She said, "And I know why." She said, "My father was in the Second World War during my mother's pregnancy and she was worried sick that he wasn't going to come home."
So we worked on her to imagine what it was like being carried inside the mother who was joyful and happy, and processed it through pregnancy and then delivery and soon afterwards and brought it up to the present day, knowing what it's like to be loved by your mother.
Well she came back the next week, David, and said, "My mother phoned me, and she hardly ever phones me. She said, 'Hi honey', and she never says honey. And she said, 'What have you been doing out there?' She said, 'I've been walking around the house thinking about your birth and fingering the bracelet that they gave you in the hospital when you were born, almost like they were rosary beads.' She said, 'What's going on?'"
So the airwaves are real long!
David: Yeah, that's amazing. Well as we wind down here, I want to mention that you have an organization called Asthma Busters. How can people find that?
Tony: Thanks. The website is www.asthma-busters.org. What we're trying to do is get centers around the country who can work with children who have asthma in this way without the increase of medication and other kinds of things that are difficult for children.
David: Well that sounds like an excellent ambition. Dr. Tony Madrid, thanks very much for being my guest today on Wise Counsel.
Tony: It was a pleasure. Dr. Van Nuys, thank you.
David: I hope you found this interview with Dr. Tony Madrid both informative and thought-provoking. As you heard in the interview, Dr. Madrid and I had contact years ago when he first sought me out to give him training in hypnosis. I'm pleased to report that he was an extremely gifted student as you may surmise from the interview. The work that he has gone on to do is most impressive. I encourage you to visit his website at www.asthma-busters.org for additional information on this important work.
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Until next time, this is Dr. David Van Nuys, and you've been listening to Wise Counsel.