Healing Heartache

Healing Heartache

I learned recently that neural cells around the heart are activated when we long to connect with another, “making sense of the subjective experience of heartache and having a broken heart” when that yearning to connect is not met. [See books and websites below.]

This month’s newsletter explores some of the neurobiology of heartache and offers tools from a meditative tradition and from relational psychology to heal an aching heart by giving and receiving love well. May you find these reflections and resources useful in healing the wounds of your own heart and the hearts of people you care deeply about.

Reflections Healing Heartache

I had my own personal revelation about heartache this month and want to share it with folks who can probably resonate with the experience.

For several years I have noticed that whenever I open my heart to great joy and eagerness about life and love, very soon after I can feel inexplicable waves of loss, grief, shame well up from my torso through my throat.  I feel compelled to bend over and sob.  At first this experience was a bit disturbing, for there are no memories, no images, nothing whatsoever to hang this wave onto. But it’s deep and “real.”  I’ve long assumed some deep grief over growing up with a depressed mom and a dismissing dad and my own longings for connection not being seen nor met.

Then, two weeks ago, preparing for a training I was giving on the Neuroscience of Attachment, I read the following about dismissive attachment in Being A Brain-Wise Therapist, a book I recommend below in books and websites.

“The child makes a bid for connection, triggering the parent’s fear of connection.  In response, the parent sends a signal telling the child to move away.  Gradually the child learns that expressing this need leads to pain.  Thus, a tragic recursive pattern becomes encased in neural cement.

“Interestingly, the longing for connection appears to be embedded in neural cells in the chest around the heart, making sense of the subjective experience of heartache and having a broken heart.”

Aha!  There is an ancient embodied cause to the waves of sobbing, buried in implicit memory.  The upwelling of shame, grief, loss in response to my natural exuberance for life and connection makes sense.  Very helpful.  I can offer compassion for the layer of self that experienced this “known but unremembered” wounding while not taking it so personally now, that there’s something weird about me.  A great relief, even a gentle wonderment at the capacities of our psyches for healing.

As an experienced psychotherapist and a dedicated practitioner of mindfulness meditation, I am passionate about finding ways we can break out of our “tragic recursive patterns encased in neural cement.” How we can take in the goodness of feeling loved and cherished in our lives now to heal those early heartaches and re-wire the neurons of our brains and hearts around the deeply wholesome longing to connect with others. How giving love and compassion can crack open those tragic patterns as well.

One of the most exciting discoveries of modern neurobiology for me has been the role of oxytocin, the hormone released through warmth, touch, and movement, in generating feelings of deep connection and well-being. Known as the hormone of bonding and attachment, oxytocin generates the sensations of motherly love, oceanic feelings of devotion, and contented bliss.

Neuroscientists are now studying the capacities of the physical heart to not only receive information from the brain but to send information to the brain via the vagus nerve and generate its own hormones – including oxytocin – and release them into the body. Oxytocin is what spurs us to “tend and befriend” rather than fight, flee or freeze when we’re stressed. This chemical flood occurs whenever we engage in affectionate contact with someone we care for. A full-body 20 second hug is enough to release oxytocin in both men and women, putting them on the same loving hormonal wavelength for the time being. Sue Carter of the Chicago Psychiatric Institute writes, “a single exposure to oxytocin can make a lifelong change in the brain.”

Researchers are now learning that even thinking of someone who loves us unconditionally can release oxytocin in our brains. [See Stories to Learn From below.] It is this capacity of our brains to evoke and use a hormone that actually changes the responses of the brain around stress and the longing to connect that we explore in the tools offered below.

1. Relational Psychology

Not all of us need therapy; most of us don’t need it all the time, forever. But when we experience the deep heartache of our earliest longings for connection not being met, and suffer the pains of the less-than-loving stories we carry around about ourselves after that, an empathic therapeutic relationship can be the most powerful and most accelerated way to re-wire those “tragic recursive patterns encased in neural cement.” A skillful and unconditionally accepting therapist becomes the resonant secure attachment figure we never had, patiently re-parenting us into the inner self-empathy, self-acceptance, self-love that is the foundation of all well-being and resilience.

Therapy can re-program our minds and hearts in this way because:

a) when old afflictive experiences are brought to consciousness, even old implicit body memories held outside of awareness like the body memory of grief I carried in my heart from such an early age, and the felt sense of those experiences are seen, heard, understood and unconditionally accepted by an engaged, empathic therapist, these early memories are paired, neurologically, with the new more positive experience of “feeling felt” and loved. The new pairing re-wires the neural connections carrying the memory of the original experience. The new experience – old pain held in new genuine acceptance – is re-stored in memory as the new neural message. The new experiences modify our old sense of self in relationship and over time, with enough repetition and reinforcement, can even completely transform it.

b) researchers have discovered that oxytocin can be released in the brain from all kinds of social interactions, psychological states and mental imagery, including therapeutic relationships. (See The Neuroscience of Human Relationships in books and websites.) Oxytocin, sometimes referred to as the neuropeptide of trust, can evoke an inner sense of well-being that facilitates flexibility and openness to change. Through our own resonance circuits we can internalize an image of a therapist as a caring other, a True Other to our True Self, and evoke the release of oxytocin in our brains by remembering them.

We are coming to understand the neurobiology of: “All this talk therapy is just an excuse to hang out long enough to let the relationship do the healing.” SEPI conference on Attachment and Relationships, 2002

[See books and websites for resources on finding such a therapist.]

2. Compassion Practice

Oxytocin floods through our brains when we deeply know we are deeply loved and cherished, or when we deeply love and cherish others. Daniel Goleman writes in Social Intelligence: The New Science of Human Relationships [ See books and websites.] “Oxytocin generates a sense of satisfying relaxation…for a toddler, parents and family offer this savory security; playmates and, later in life, friendships and romantic intimacy activate the same circuits. The systems that secrete these chemicals of nurturing love provide some of the neural cement for the loving bond. These brain chemicals evoke the inner sense that everything is all right, possibly the biochemical basis for what Erik Erickson called a basic sense of trust in the world.”

In the Buddhist tradition, wisdom and compassion are considered the two wings of the dharma – the teachings and practices that lead to full healing and awakening of heart and mind. Marc Ian Barasch writes in Field Notes on the Compassionate Life: A Search for the Soul of Kindness [see books and websites] that in some traditions, the feelings we have for family, friends and lovers are all aspects of divine love. The narrowest affection [fueled by the oceanic feelings of devotion generated by oxytocin] can lead to compassion for all, even to the universal mystery called the Beloved.

Neuroscientists are now exploring the role of oxytocin in compassion practice. Whether ocytocin – the “molecule of motherly love” that generates a sustaining “oceanic feeling of devotion” in new mothers and in ongoing caregiving, might be, by extension, the actual “milk of human kindness” that nourishes our love of humanity and all sentient beings. Neuroscientists, monitoring brain activity of Tibetan monks adept in compassion practice, are discovering we are all pre-wired for compassion, the circuitry of deep caring for our own suffering and the suffering of others without an agenda, and that, in dedicated practitioners, it can become second nature, an unhesitating reaction to virtually every situation.

[See Exercises to Practice for an exercise to cultivate compassion.]

3. Speaking Circles

Oxytocin acts as a down-regulator of our body’s responses to stress. When oxytocin is released, blood pressure lowers, cortisol levels plummet. The body reverses the arousal of the sympathetic nervous system (fight-flight) as activation of the parasympathetic nervous system relaxes us; our metabolism shifts from ready-to-run to a gentler storing of nutrients for growth and healing. Our pain threshold rises so we are less sensitive to discomfort. Even wounds heal faster. [See Stories to Learn From]

A very creative if indirect use of oxytocin to down-regulate stress is in the Speaking Circles workshops developed by Lee Glickstein to help people overcome the stress of speaking in public. The relationship-based approach encourages both speakers and listeners to cultivate relational presence and unconditional support and acceptance.
Speakers feel genuinely received and heard, with far less anxiety and judgment of everything that is happening in this moment, just as it is, and thus develop their capacities to speak clearly and passionately with their own authentic voices from the ground of their own being.

Poetry and Quotes to Inspire

“Oxytocin has a short half-life in the brain – it’s gone in just a matter of minutes. But close, positive long-term relationships may offer us a relatively steady source of oxytocin release; every hug, friendly touch, and affectionate moment may prime this neurochemical balm a bit.

“The benefits of oxytocin seem to emerge in a variety of pleasant social interactions – especially caregiving in all its forms. Where people exchange emotional energy, they can actually prime in each other the good feelings that this molecule bestows. When oxytocin releases again and again – as happens when we spend a good deal of time with people who love us – we seem to reap the long-term health benefits of human affection. “Repeated exposures to the people with whom we feel the closest social bonds can condition the release of oxytocin, so that merely being in their presence, or even just thinking about them, may trigger in us a pleasant dose. Small wonder that cubicles in even the most soulless of offices are papered with photos of loved ones.”
– Daniel Goleman, Social Intelligence

* * * * *

At the Corner Store (excerpt)

It was a new old man behind the counter,
skinny, brown and eager.
He greeted me like a long lost daughter,
as if we both came from the same world,
someplace warmer and more gracious than this cold city.

I was thirsty and alone. Sick at heart, grief-soiled
and his face lit up as if I were his prodigal daughter

coming back to the freezer bins in front of the register
which were still and always filled
with the same old Cable Car ice-cream sandwiches and
cheap frozen greens.
Back to the knobs of beef and package of hotdogs,
these familiar shelves strung with potato chips and corn chips,
stacked- up beer boxes and immortal Jim Beam.

I lumbered to the case and bought my precious bottled water
and he returned my change, beaming
as if I were the bright new buds on the just-bursting-open cherry trees,
as if I were everything beautiful struggling to grow,
and he was blessing me as he handed me my dime

over the dirty counter and the plastic tub of red licorice whips.

This old man who didn’t speak English
beamed out love to me in the iron week after my mother’s death
so that when I emerged from his store

My whole cockeyed life –
What a beautiful failure! –
Glowed gold like a sunset after rain.
– Alison Luterman

Stories to Learn From

In July 2003, I chose to have lasik eye surgery to correct lifelong near-sightedness and astigmatism. The operation is risky, so I went into the operation with considerable anxiety. I had asked friends to think of me on the day of the operation, at the time I was actually in surgery, so I felt resourced and not alone during the procedure. I had to remain conscious during the operation and focus my eyes on the light beam above me so the laser could track exactly where to remove the fluid in the eye which would re-shape the cornea and create the lens that would allow new 20-20 vision. So, while lying on the gurney staying as still as I could be, I thought of all my friends thinking of me, taking in the sense of love and caring I knew was being sent my way.

About 10 minutes into the operation, quite suddenly, all sense of anxiety ceased completely. I was flooded with a sense of love and belonging that was quite over-powering. There was nothing to be afraid of, nothing at all.

This serene peacefulness lasted until the surgery was finished. It lasted for the next 8 months. I was aware that, in situation after situation that would have caused anxiety in the past, I was not feeling any anxiety. Just feeling aware and moving right along.

I had a chance to ask Dan Siegel about this experience at an attachment conference at UCLA the following spring. He told me that, indeed, the pre-frontal cortex can grow neuronal axons down to the amygdala; it’s only a few cell layers away. And these neuronal fibers can carry GABA (gamma butyric acid) down to the amygdala; the GABA will extinguish the fear response.

Later, in a training on Understanding Social Intelligence, I learned more about the primary role of oxytocin, the bonding hormone I released in my brain by concentrating on feeling so loved by my friends, to activate this pro-active, regulatory response of the pre-frontal cortex.

* * * * *

Stephen Johnson tells a wonderful story about oxytocin in his book Mind Wide Open. He and his wife were living in downtown Manhattan before, during and after September 11, 2001. His wife had given birth to their son just two days before 9/11. Stephen could see debris and ash floating past the window of their apartment that morning. He was pacing the floor, half-crazed with anxiety, while his wife was calmly nursing their son in the rocking chair, completely oblivious to the chaos around her and her newborn. Oxytocin is released during childbirth and breastfeeding, generating an oceanic feeling of devotion between the mother and the newborn, and a blissful, other-worldly sense of contentment, “everything is all right.” Stephen’s wife was protected from the kind of anxiety Stephen was experiencing by the oxytocin coursing through her system and calming her down entirely.
* * * * *

In a study done in Richard Davidson’s fMRI lab at the University of Wisconsin by J.A. Coan in 2005, women volunteers were given a slight but unpleasant electrical shock on their ankles while their brain responses of anxiety and pain were monitored in an fMRI scanner.

In the control group of women holding no one’s hand during the procedure, participants registered anxiety before and pain during the shock. In the group of women holding the hand of a stranger (the lab technician) during the procedure, the reactions of anxiety and pain were reduced somewhat. But in the group of women holding their husbands’ hands, the pleasurable security of holding the hand of someone who loved them overrode both anxiety and pain. The women experienced instead peacefulness throughout the procedure.

Exercises to Practice: Giving and Receiving Love Well

Matthieu Ricard, the French geneticist and monk in the Tibetan tradition who became famous when the changes in his brain from decades of compassion practice measured off the charts in Richard Davidson’s lab, says, “Even if 50% of our character is genetic, the other 50% is plastic. You’re not just stuck with what you are. Nothing is graven in stone. [Or permanently encased in neural cement] Learning to love can radically change you.”

In this month’s exercises, we learn how to take in the love of a benefactor to cultivate the subjective sense of being deeply loved and cherished. This practice can help release the oxytocin that calms down our fear center and re-wires the neural cells around our aching hearts. And we learn a compassion practice to cultivate the deep caring for the suffering of others that cracks open our own hearts to the oxytocin-fueled sense of inter-connection with all of humanity.

Both exercises in Giving and Receiving Love Well are drawn from Awakening Through Love: Unveiling Your Deepest Goodness. [See books and websites.] And repeating what Sue Carter wrote, “A single exposure of oxytocin can make a lifelong change in the brain.”

Taking in the Love of a Benefactor

A benefactor is simply someone in your life who has blessed you with a moment of unreserved well-wishing for your own happiness and well-being. This benefactor could be a loving parent, a caring aunt, a kind teacher, a wise friend, an open-hearted partner, a beloved pet, or a store clerk as in Alice Luterman’s poem. [in Poetry and Quotes to Inspire]

Allow yourself to bring to mind a moment of kindness, of caring, from such a benefactor. Even just one moment – a kind word, a reassuring gesture, a comforting presence, a light in their eyes when you come near. Hold that moment in your mind for a moment – the quality of their presence, their words, their play and laughter with you, or their holding you in grief. Let yourself soak in this loving presence, drink up its life-giving goodness. Let the feeling of what you feel like when you’re with them linger in your heart and soul. (Remembering this feeling helps release the oxytocin in your brain.)

Continue communing for a few moments in the shared goodness of their wishing you love, happiness, joy. Open to the deep sense of goodness it meets in your own heart. REST – relax, and enter into safety and trust in this peaceful, loving benevolence.

This practice is as nourishing to your heart as your morning breakfast cereal is to your body. See if you can incorporate both into the routine of how you begin your day.

Compassion Practice to Open and Heal Our Hearts

Compassion practice begins with caring for our own suffering and heartache, caring that we suffer the pain that is inevitably part of the pain of being a human being. Keeping our hearts open in the midst of suffering, not running away, contracting in judgment, or trying to fix and move on, is the practice of compassion.

Compassion for our own suffering and heartache, and understanding the true causes of that suffering, are the platform to extend compassion to others for their inevitable suffering. We care about the suffering of our fellow beings and train ourselves to keep our hearts open in the midst of wider and wider circles of care, not running away, not contracting in judgment, not distancing through pity, not rushing in to fix and move on. Our open, compassionate heart becomes the platform for wise action, wise engagement, in whatever we can do to ease the suffering of others.

Ground yourself in your own deep sense of caring for the well-being of all beings. Then bring to mind someone dear to you now. (Eventually, with “a heart as wide as the world,” we can perceive everyone, even the most difficult people, as cherishable in their own true nature, however obscured in this lifetime.) Remember all that you love and cherish about them, all their good qualities, all their longings for happiness and love. Feel a resonant connection with them as fellow travelers on a life journey of ups and downs, so similar to your own journey.

Ask your heart to open to any suffering and heartache this person may be experiencing now. Keep your heart open as you offer traditional wishes for them:

May your suffering ease.
May your suffering cease.
May you know you are loved and cherished in the midst of your suffering.
May your faith in the larger purposes of life be steady in the midst of this suffering.

Steady your heart in the love you have practiced taking in from your benefactors, knowing this love is an expression of the deepest goodness of them, of you, of all beings. Continue to offer compassion to your dear one until your heart can remain open and steady in its caring. Insights about wise action may flow from this practice, but it is enough in this practice to train our minds and hearts to stay open in the midst of suffering.

Over time a compassion practice, offered to a wider and wider circle of beings, strengthens the capacities of the brain, and mind and heart, to stay open and flexible in the face of suffering, not contracted or collapsed. We become more resilient, a platform for becoming more skillful, in responding to heartache wherever we meet it.

Books and Websites

This month’s recommended readings:

Being a Brain-Wise Therapist: A Practical Guide to Interpersonal Neurobiology, by Bonne Badenoch. W.W. Norton, 2008.

The most accessible text yet on how our relationships develop – and change – the structures of our brains and how the neural circuitry of our brains can become both plastic enough to re-wire and evolve or rigid enough to prevent any learning or growth at all. Intended for therapists, I have found Bonnie’s comprehensive yet clear and concise descriptions of how the various parts of our brains mature (or not) and interact (or not) for our well-being and resilience (or not) the easiest to digest and incorporate into my own thinking and clinical work of any author so far. (And the source of my learning about the neural cells of heartache.)

Social Intelligence: The New Science of Human Relationships, by Daniel Goleman. Bantam Books, 2006.

Social Intelligence is the best selling sequel to Emotional Intelligence. Social Intelligence includes a lot of the neuroscience that simply wasn’t yet available when Emotional Intelligence was written ten years before. Dan describes clearly, with lots of research to back him up, what goes on in our brains when we relate to other people – the biological mechanisms – including oxytocin – of interacting skillfully with others. He delineates eight specific capacities of this social intelligence and reveals how our history of interactions with others determines whether or not the neural structure and circuits that support these capacities fully mature in our brains. Through many touching stories, Dan vividly illustrates the positive benefits of social intelligence on our lives and the disastrous impacts the lack of it has on our relationships, our health, in business and in government.

The Neuroscience of Human Relationships: Attachment and the Developing Social Brain. By Louis Cozolino, PhD. W.W. Norton, 2006.

Lou Cozolino brings the discoveries of modern brain science – including oxytocin – down home to where we live, work, play and love. He presents complex concepts of interpersonal neurobiology – how our brains are shaped by interactions with other brains – in a delightfully warm and accessible style. Intended for clinicians, his stories and explanation are very helpful to any serious student of how our brains work in relationship and how to make them – our brains and our relationships – function better.

Field Notes on the Compassionate Life: A Search for the Soul of Kindness, by Marc Ian Barasch. Rodale, 2005.

A fascinating exploration of both up-to-the-minute scientific research on the hard-wiring of compassion into our nervous systems and the timeless wisdom of the world’s major spiritual traditions on how to increase our compassion quotient, even to people who have wronged us. Full of impeccable data and heart-opening stories. A book to be savored by both mind and heart.

Awakening Through Love: Unveiling Your Deepest Goodness, by John Makransky. Wisdom Publications, 2007.

John Makransky is a respected Buddhist scholar and experienced teacher in the Dzogchen tradition of Tibetan Buddhism. Awakening Through Love offers practical guidance to readers seeking to experience their own deepest goodness – the limitless love, compassion and self-transcending wisdom that can transform themselves and, with dedicated practice and service, the world we inhabit together. Each chapter includes a mediation exercise to receive love, extend love, take difficulties into compassion, etc.

This month’s recommended websites:


The website for the Global Association for Interpersonal Neurobiology Studies (GAINS), offering timely resources for applying the discoveries of modern neuroscience to professions that address the quandaries and potential of human and social relationships and our yearnings for or failures at connection.


The therapist directory in this website is an excellent resource to find clincians throughout the U.S. and around the world who are skilled in the kind of empathically resonant psychotherapy that actually helps people heal the heartache of the lives and recover their own deepest goodness.


Resources and trainings in a relationship-based approach to public speaking that provides the supportive environment people need to cultivate their capacities to speak passionately and authentically.

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