Trauma & Art

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As I re-engaged with a few still available sessions from the Healing Trauma Summit (Sounds True) and further explored some theories and ideas I fumbled upon a very relevant e-book: Healing Trauma and Pain through Polyvagal Science and Its Interlocking Somatic Interventions by Maggie Phillips PhD (2015), in which the sympathetic/adrenal branch of the polyvagal system and some of its interlocking patterns with dorsal vagal shutdown and social engagement, the ventral vagal/social engagement system and the dorsal vagal system are examined with Peter Levine, Stephen Porges, and Maggie Phillips at: http://maggiephillipsphd.com

The book explores links between trauma, neuroscience, social engagement and the defensive functions of the nervous system, and the applications of polyvagal theory, Somatic Experiencing and other body focused approaches to healing and integration. Specifically, chapter two ‘explores the hierarchical patterns of the polyvagal system and how the newest system, the ventral vagal system, calms us and creates safety while the older circuits provide for defense. Porges discusses how neuroception helps us to detect safety in multiple ways that we are unaware of. One example is voice prosody that includes pitch, rhythm, high tones of intonation. Another is the muscles of the head and face that indicate a spontaneous, trustworthy smile. Porges also indicates the importance of neuropeptides, especially oxytocin and vasopressin, in the creation of safety through the ventral vagal system. The slow exhalation breathing approach is offered as a way to dampen the defense systems and increase myelinated ventral vagal activity’. Chapter three presents ‘a dynamic discussion of the dorsal vagal component of the polyvagal system and its complex interactions with the ventral vagal social engagement system and with the sympathetic/adrenal fight-flight system of defense and regulation. One of the most important principles that was emphasized multiple times in different ways is the importance of bringing in safety through ventral vagal social engagement. In the treatment of trauma and pain, this must be accomplished by steering the healing relationship through what Stephen has termed “biological rudeness” as social cues are misinterpreted, acoustical sounds are perceived as dangerous and predatorial, and both members of the relationship are triggered to withdraw. Although this is extremely challenging work, there is much hope in the strategies offered here. The gift of simple presence can help defense and shutdown shift to connection and healing. Belly breathing and “voo” sounding extends the exhalation and the soothing feeling of ventral vagal engagement. Simple movement like walking around the office can help clients who have great difficulty with social engagement through eye contact and other connection. We can help sympathetic containment by teaching vocabulary to our clients so they can stay connected to their own body experience and to us. Encouraging movement on an exercise ball or special trampoline that is safe and increases social engagement is hugely healing. Gentle rocking movements can similarly be a safe and enjoyable way to enter the ventral vagal system while beginning to move out of shutdown. Finally, tending to the acoustic environment and enhancing prosodic qualities of the therapist’s voice can also expand the ventral vagal engagement so that all 3 branches help move the organism into homeostasis and wholeness’.

The Healing Trauma Summit continued…..

‘When she began to focus on the accident and began to flood or disconnect, we immediately shifted her attention to after the accident was over when she felt out of harm’s way or safe again. This illustrates another key concept of Somatic Experiencing TM called “pendulation” or “looping”.  Looping is a technique  in  which the  therapist  helps  the  client  move  back  and  forth  between  small  pieces  of  the  traumatic material  and  one  of  the  client’s  resources. This  looping  back  and  forth  helps  discharge  the  activation  in  the nervous system that emerges as the person slowly works through the traumatic event’.  Diane Poole Heller & Laurence S. Heller, from: https://www.ibpj.org/issues/usabpj-articles/(3)_Heller__D._P.___Heller__L._S._Somatic_Experiencing._USABPJ_1.1__2002.pdf

2. Extract from an older post on Stephen Porges’ Polyvagal Theory

‘So as mentioned above, the ANS has in the past been conceptualized as consisting of two branches the sympathetic that activates fight-flight responses during threat and the parasympathetic nervous system, which refers to a calm state. However, Porges views the ANS as three hierarchically organized subsystems that determine our responses to environmental stimuli. Polyvagal theory consists of the word ‘poly’ that means many and vagal, which refers to the vagus nerve, a big cranial nerve that exits from the brainstem (information on the brainstem in the previous post) and sends information about the organs in the body to the central nervous system. The vagus nerve is part of the parasympathetic nervous system, but it can also shape the sympathetic and it regulates inner body feelings, pain thresholds, cortisol level secretion, the heart, face, lungs and abdominal viscera. Stephen Porges writes that ‘the vagus nerve directly supports the behaviours needed to engage or disengage with the environment’ (cited in Bridges, 2015) and if it is left on too long it can potentially lead to anxiety, discomfort and pain, insomnia, digestive problems, and many other health issues.

The three circuits/ subsystems of the ANS are the a) ventral parasympathetic branch of the vagus nerve (social engagement), which corresponds to optimal arousal b) the sympathetic system (mobilization), which corresponds to hyperarousal, and the c) dorsal parasympathetic branch of the vagus nerve (immobilization), which corresponds to hypoarousal. The most recent uniquely mammalian subsystem is the ventral vagus, which originates in the brainstem and determines the person’s consciousness. Porges calls this system the socialengagement system, because it provides us with the capacity to communicate more flexibly and it regulates areas in the body, like the heart and the muscles in our face and head that are used in social interaction, without mobilizing our more primitive defensive responses. Other scientists and researchers have referred to our capacity to tend and befriend, in times of stress, which elicits oxytocin release and activates the social engagement system that is embedded in our mammalian brain. This circuit has the capacity to down regulate stress responses. ‘The social engagement features, such as, prosody, facial expressivity, gesture within a quiet safe environment provide opportunities to help soothe…… and downregulate sympathetic activity, adrenal activity’ (Porges).

However, when we are threatened or stressed out and the social engagement system proves ineffective it is overridden by the sympathetic system, which activates fight-flight responses. We experience symptoms like shallow breathing, dry mouth, and our hypothalamus causes the secretion of increased levels of hormones like adrenaline and cortisol that increase arousal and facilitate mobilization. If we manage to fight or run from our predators or danger, hyperarousal may return to an optimal level once the danger has passed. But, ‘mobilization is not always possible and trauma is all about unsuccessful attempts to flea or fight’ (Stephen Porges). However, if both social engagement and fight-flight responses fail then the other branch of the parasympathetic nervous system, the dorsal branch of the vagus nerve is triggered into action by hypoxia, lack of oxygen in the body tissues, which causes immobilization, such as feigning death, behavioural shutdown and even syncope. This mode is regulated by the oldest branch of the vagus nerve, which we share with reptiles. Immobilization, bradycardia and apnoea are parts of this older reptilian defence system. For instance, in reptiles like lizards and snakes, immobilization is the primary fear defence strategy. In this state of immobilization our body becomes slower, our digestion, bladder, bowel control, sight and vision go offline, our heart rate decreases, and we feel numb and separated from our sense of self. Reduced blood flow to the brain causes dissociative features. So, ‘what we want is a state of homeostatic balance between our older sympathetic system, which gets our cardiovascular system working and ready for fight or flight, and our new social engagement system’ (S. Porges), which inhibits more primitive defensive responses and allows us to soothe our physiology and navigate ourselves out of potentially unsafe situations without shutting down and becoming immobilised’ (Tonya Alexandri, Notes on Polyvagal Theory and trauma responses / January 11th, 2016)