The Three Pathways to Safety

The Ventral Vagal Pathway

• Responds to cues of safety and supports feelings of being safely engaged and socially connected.

• Our heart rate is regulated, our breath is full, we take in the faces of friends, and we can tune in to conversations and tune out distracting noises.

• We see the “big picture” and connect to the world and the people in it.

• I might describe myself as happy, active, interested and the world as safe, fun, and peaceful.

• I am connected to my experiences and can reach out to others.

• Middle ear distinguishes human voice from background noise. When we feel safe the ear muscles relax so that we can hear human voices more clearly.

• Some of the daily living experiences of this state include being organized, following through with plans, taking care of myself, taking time to play, doing things with others, feeling productive at work, and having a general feeling of regulation and a sense of management.

• Health benefits include a healthy heart, regulated blood pressure, a healthy immune system decreasing my vulnerability to illness, good digestion, quality sleep, and an overall sense of well-being.

The Sympathetic Path

• Activates when we feel a stirring of unease—when something triggers a neuroception of danger.

• We go into action. Fight or flight

• Our heart rate speeds up, our breath is short and shallow, we scan our environment looking for danger—we are “on the move.”

370 Linwood Street, New Britain, CT 06052 | Telephone: 860.832.5562 Websites: www.traumaticstressinstitute.org| www.klingberg.org For more information, contact Patricia Wilcox at [email protected]

• I might describe myself as anxious or angry and feel the rush of adrenaline that makes it hard for me to be still.

• I am listening for sounds of danger and don’t hear the sounds of friendly voices.

• The world may feel dangerous, chaotic, and unfriendly.

• I may believe, “The world is a dangerous place and I need to protect myself from harm.”

• Lower frequency sounds remind us of predators

• When we feel unsafe we become hyper-sensitive to background noise, our hearing tightens and we cannot tune into the human voice

• Some of the daily living problems can be anxiety, panic attacks, anger, inability to focus or follow through, and distress in relationships.

• Health consequences can include heart disease; high blood pressure; high cholesterol; sleep problems; weight gain; memory impairment; headache; chronic neck, shoulder, and back tension; stomach problems; and increased vulnerability to illness

The Dorsal Vagal Path

• Our oldest pathway of response is the path of last resort.

• When all else fails, when we are trapped and action taking doesn’t work, the “primitive vagus” takes us into shutdown, collapse, and dissociation.

• Here I am alone with my despair and escape into not knowing, not feeling, almost a sense of not being.

• I might describe myself as hopeless, abandoned, foggy, too tired to think or act and the world as empty, dead, and dark.

• From this earliest place on the evolutionary timeline, where my mind and body have moved into conservation mode, I may believe, “I am lost and no one will ever find me.” Some of the daily living problems can be dissociation, problems with memory, depression, isolation, and no energy for the tasks of daily living.

• Health consequences of this state can include chronic fatigue, fibromyalgia, stomach problems, low blood pressure, type 2 diabetes, and weight gain.

Tips for Treatment Informed by the Polyvagal Theory

• Teach treaters that eye contact and social responsiveness are not voluntary, that my body responds automatically to the signals from your body, and that this sensitivity is exaggerated with multiple early exposures to danger.

• We must be deliberate in sending safety and attachment signals.

• Being aware of all parts of our interactions: body language, tone, facial expression.

• Maximize our ability to calm people through use of our bodies, by deliberately learning ways to keep ourselves calm. Remember there is a biological process in which the calm in your body when combined with attachment will help calm another person.

• Teach clients to understand and honor their body’s wisdom (self-worth).

• Use music in every way possible, as it organizes and calms brain.

• Teach treaters that traumatized people, especially those who were restrained, may associate the calm response with danger, so resist it by constant motion. We all need calm periods to regenerate and heal. Use music and other supports to help clients relax and rest.

• Help clients (and staff) learn safe ways to move into interaction when feeling overwhelmed (emotion management) instead of using retreat or aggression.

• When you notice fight, flight or shut down, gently comment, help the person become aware how that feels, while (if possible) remaining in connection.

• Familiar faces are critical to calming faulty neuroception. Maintain familiar faces as long as you can.

• Reduce turnover

• Attend to VT

• Staffing patterns

• Create safe environments, which are necessary to relate, relax, and attend to bodily functions.

• Tone of voice, facial expression and body language has more power than content of words.

• Regularity, predictability help create safety.

• Pay attention to the sound environment: lower frequency sounds remind us of predators. When we feel unsafe we become hyper-sensitive to background noise, our hearing muscles tighten and we are less able to tune into the human voice and separate it from background noise. So redesign noise environments (fire alarms).

• Remember clients have not experienced the biologically soothing power of attachment.

• Teach clients how they can take steps to increase their own sense of safety (new dimension of safety plan).

• Teach breathing techniques with longer exhalation.

• Remember the Importance of play- allows client a chance to practice relationships, be active and still connected.

Polyvagal Theory Worksheet

Do’s and Don’ts for Staff Derived from the Polyvagal Theory Adapted from Ravi Dykema

Do make eye contact with your team members when you feel safe. Do express emotions with your face. Do modulate your voice (use expression). Do listen to voices of your team members, separate them from background sounds and client chaos. Do monitor your own sense of safety. Do adjust your focus to things that will make you feel safe, e.g. feel your sensations or focus on something familiar. Do play a musical instrument. Do try move into social relationships instead of away when upset by the work, as a way to reduce mild anxiety. Don’t always isolate yourself in order to feel safer at work; try connecting with others too. Don’t push yourself harder to be social when you feel unsafe; seek safety first. Don’t ignore your gut reactions; adapt to them and learn from them and share them with team members. Don’t use fighting or fleeing from team members; instead, find a way to get to safety. Don’t adopt a flat, expressionless affect with people who you want to feel safe with you. Don’t substitute email or internet relating for face-to-face or phone contact. Don’t assume other's outbursts, melt downs or mistakes reveal their “true” attitudes or motivations. Their calmer social capacities (like empathy) are “true” too.

370 Linwood Street, New Britain, CT 06052 | Telephone: 860.832.5562 Websites: www.traumaticstressinstitute.org| www.klingberg.org For more information, contact Patricia Wilcox at [email protected]

“Don't talk to me now, I'm scanning for danger” How your nervous system sabotages your ability to relate

An interview with Stephen Porges about his polyvagal theory

By Ravi Dykema

hat if many of your troubles vagus nerve’s two different branches centered psychotherapy.) Here, various fibers in the nerve originat- could be explained by an auto- are related to the unique ways we Porges speaks about the polyvagal ed from different areas of the brain- Wmatic reaction in your body to react to situations we perceive as theory and its significance with stem. For example, the neural path- what’s happing around you? What safe or unsafe. It also outlines three Nexus publisher Ravi Dykema. ways that go through the vagus to if the cure for mental and emotional evolutionary stages that took place the lower gut come from one area of disorders ranging from autism to over millions of years in the devel- RD: Please tell me about the the brain, while the neural pathways panic attacks lay in a new under- opment of our autonomic nervous theory you have developed, that go to the heart and to the lungs standing and approach to the way system. polyvagal theory. Isn’t it an come from another area. the nervous system operates? The bulk of Porges’s work is now innovation on the theory of the Stephen Porges, Ph.D., thinks it two nervous systems? RD: Is that relatively new infor- could be so. mation? Porges, professor of psychiatry at SP: Let me clarify. Historically, the the University of Illinois, Chicago, autonomic system has been broken SP: Yes. But the theory is that the and director for that institution’s into two branches, one called the system reacts to real world chal- Brain-Body Center, has spent much sympathetic, and the other parasym- lenges in a hierarchical manner, and of his life searching for clues to the pathetic. It is an organizational not in a balanced manner. In other way the brain operates, and has model that came into place in the words, if we study the evolutionary developed what he has termed poly- late 1800s and the early 1900s. Over path of how the autonomic nervous vagal theory. It is a study of the evo- the years, this model has taken on a system unfolded in vertebrates— lution of the human nervous system life of its own, although we know from ancient, jawless fish to bony and the origins of brain structures, more now. Essentially, it linked the fish to mammals to human beings— and it assumes that more of our sympathetic system with the “fight we find that not only is there a com- social behaviors and emotional dis- or flight” response, and the plexity in the growth of the cortex, orders are biological—that is, they parasympathetic system with ordi- (the outer layer of the cerebrum, are “hard wired” into us—than we nary functioning, when one is calm which is the largest portion of the usually think. Based on the theory, and collected. brain), there’s also a change in how Porges and his colleagues have conducted in the Brain-Body Center, This model of the autonomic developed treatment techniques that a 24,000-square-foot, interdiscipli- nervous system has evolved into can help people communicate better nary research center at the various “balance theories,” because and relate better to others. University of Illinois. At the Center, most organs of the body, such as the The term “polyvagal” combines professionals in the fields of heart, the lungs and the gut, have “poly,” meaning “many,” and endocrinology, neuroanatomy, neu- both sympathetic and parasympa- “vagal,” which refers to the impor- robiology, psychiatry and psycholo- thetic innervation. tant nerve called the “vagus.” To gy work together. They study mod- Most of the parasympathetic understand the theory, let’s look at els of social behavior and develop innervation (nerve energy) comes the vagus nerve, a primary compo- treatments for disorders such as from one nerve, called the vagus, nent of the autonomic nervous sys- autism and anxiety. Porges’ polyva- which exits the brain and innervates tem. This is the nervous system that gal theory is becoming art of thet the gastrointestinal tract, respiratory you don’t control, that causes you to raining of bodyworkers, therapists tract, heart and abdominal viscera. do things automatically, like digest and educators. An example is last However, the easiest way to concep- your food. The vagus nerve exits the summer’s national Hakomi confer- tualize the neural pathways that go brain stem and has branches that ence held at Naropa University, through the vagus is to think of the regulate structures in the head and where Dr. Porges was the keynote vagus as a tube or conduit. in several organs, including the speaker. (Hakomi is both a system of Conceptualizing the vagus this way heart. The theory proposes that the bodywork and a system of body- forced the scientist to notice that Stephen Porges, Ph.D.

the autonomic nervous system state. These are common features of works. It is no longer just a sympa- several psychiatric disorders, includ- Matrixworks thetic/parasympathetic system in ing anxiety disorders, borderline per- Working with Groups As Living Systems balance. It’s actually a hierarchical sonality, bipolar, autism and hyper- system. activity. The neural system that regulates both bodily state and the mus- Discover your natural leadership qualities and become more RD: So one thing happens then cles of the face goes off-line. Thus, confident, effective and creative contributor in groups, another thing happens then people with these disorders often whether you are a member or leader. another thing? lack affect in their faces and are jittery, because their nervous system is THE 4-PART SERIES SP: Right. This influences how we not providing information to calm July 20 - 23, 2006 Optional Introductory Weekend react to the world. The hierarchy is them down. composed of three neural circuits. October 26 - 29, 2006 Inclusion November 30 - December 3, 2006 Chaos / Conflict One circuit may override another. RD: How will polyvagal theory February 8 - 11, 2007 Mutual Connection We usually react with our newest change treatment options for system, and if that doesn’t work, we people with these disorders? March 15 - 18, 2007 Integration & Completion try an older one, then the oldest. We April 19 - 22, 2007 Optional Advance Practice start with our most modern systems, SP: Once we understand the mecha- and work our way backward. nisms mediating the disorder, there So polyvagal theory considers the will be ways to treat it. For example, For More Information Call: evolution of the autonomic nervous you would no longer say “sit still” or Mukara Meredith, MSW, CHT 303-440-0148 system and its organization; but it punish a person because they can't www.martrixworks.org also emphasizes that the vagal sys- sit still. You would never say, “Why tem is not a single unit, as we have aren’t you smiling?" or “Try to listen long thought. There are actually two better” or “Look in my eyes,” when vagal systems, an old one and a new these behaviors are absent. Often one. That's where the name polyvagal comes from. The final, or newest stage, which is unique to mammals, is character- ized by a vagus having myelinated pathways. The vagus is the major nerve of the parasympathetic nervous system. There are two major branches. The most recent is myelinated and is linked to the cranial nerves that control facial expression and vocalization.

RD:Which are virtually all for the benefit of someone looking at us, right? treatment programs attempt to teach SP: Right, or for us looking at them clients to make eye contact. But or communicating or signaling--or teaching someone to make eye con- even listening. We forget that listen- tact is often virtually impossible ing is actually a “motor” act and when the individual has a disorder, involves tensing muscles in the mid- such as autism or bipolar disorder, dle ear. The middle ear muscles are because the neural system control- regulated by the facial nerve, a nerve ling spontaneous eye gaze is turned that also regulates eyelid lifting. off. This newer, social engagement When you are interested in what system can only be expressed when someone is saying, you lift your eye- the nervous system detects the envi- lids and simultaneously your middle ronment as safe. ear muscles tense. Now you are pre- The concept of safety is relative. pared to hear their voice, even in You and I are sitting in this room noisy environments. together and nothing appears to See our ad on threaten us. We feel safe here, but it RD:Very interesting. How would may not feel safe to a young woman page 4 for you apply these principals or with panic disorder. Something in information on findings in a treatment setting? this environment, which is safe for us, might trigger in her a physiologi- how to advertise in SP: Let's say you're a therapist or a cal response to mobilize and defend. parent or a teacher, and one of your clients, students or children's faces is RD: So if she gets a flat affect or flat, with no facial expression. The is fidgety and nervous in this sit- NEXUS face has no muscle tone, the eyelids uation, she may not have a droop and gaze averts. It is highly choice. It's a neurological phe- Colorado's Holistic Journal likely that individual will also have nomenon, right? auditory hypersensitivities and difficulty regulating his or her bodily Please see POLYVAGAL on page 32

© NEXUS March/April 2006 31 POLYVAGAL THEORY For them, the background noise dis- in which we no longer need to be torts the human voice. hypervigilant, and to allow us to SP: I'll address that by describing to continued from page 31 participate in the life processes that you a part of our nervous system SP: Right. It is actually an uncon- RD:What about the normal require “safe” environments. Social that is entirely focused on respond- scious or subconscious neurobiologi- neurotic, those of us who don’t engagement behaviors—making eye ing to other people, even other cal motivational system. She’s not have an identifiable or diagnos- contact, listening to people—require mammals like dogs and cats. This is doing it on purpose. It’s an adapta- able disorder, but have periods that we give up our hypervigilance. not the same part of the nervous sys- tion to a situation that her nervous where we’re stressed or anx- Back to the issue of clinical appli- tem that can put us into states of system has evaluated as dangerous. ious? How would polyvagal the- cations: when we see people with flat enlightenment or ecstasy. In a sense, The question is, how do we get her ory suggest that we be treated? affect, flat muscle tone, drooping this is a very grounded component out of feeling threatened? eyelids, people who are talking with- of our nervous system. It engages Traditional strategies would be to SP: In much the same way that we’d out intonation in their voice or hav- contact with certain levels of senses reason with her, to tell her she’s not treat someone with a more severe ing difficulty hearing what people that are not the ones that you're in a dangerous situation, to negotiate disorder. For example, when we’re are saying, people who are in states describing. It's where we are feeling with her, to reinforce her, to punish stressed, we may engage in high- that are kind of jittery and non- our bodily information from inside her if she doesn’t respond as direct- intensity exercise. But this actually relaxed, we can see how these physi- our organs. This information from ed. In other words, we try to get the creates a greater retraction of the ological states might have adaptive the body actually travels through behavior under control. But this social engagement system; it puts us functions related to protection. But nerves up through the brain stem approach doesn’t work very well in a state of analgesia, so we no these adaptive functions will not and radiates upward to our cortex. with social engagement behaviors, longer feel the stress, as opposed to mesh well with the social context in This part of the nervous system pro- because they appear to be driven by stimulating a sense of safety and which an individual is living. vides a contact with reality; it regu- the body’s visceral state. Our current security. Polyvagal theory would lates our bodily state, so we become knowledge based on the polyvagal suggest strategies to create that sense RD:You mean they think it's an alert and engaged. That does not theory leads us to a better approach. of safety, like retreating to a quiet unsafe world? include all of human experience, but Thus, to make people calmer, we talk environment, playing musical instru- it does include most of what we call to them softly, modulate our voices ments, singing, talking softly, or even SP: It's not related to a cognitive social interactions. We can say that and tones to trigger listening behav- listening to music. process. It's a physiological reaction the social interactions are a very iors, and ensure that the individual Think about what we do when that involves the nervous system. It's important component of our psycho- is in a quieter environment in which we’re stressed; we take ourselves out not a conscious reaction; most people logical experience as human beings. there are no loud background noises. of interpersonal relationships, as who feel that way would rather not And this system, the social engage- opposed to moving into them. But feel that way. They just can't turn it ment system, is what determines the RD: Because it's hard for them it’s natural for human beings to use off. We have to understand that these quality of those interactions—the to hear a human voice with other people to help regulate our feelings are physiological events, features that we show other people, background noises? own mental and emotional states. So triggered by specific neural circuits, when you ask, “How can we use this and we need to figure out how to SP: That’s right, because those sys- knowledge,” the answer is that we recruit the neural circuits that pro- tems aren’t working and because have to re-understand what it is to mote social behavior. That's the loud background noises will trigger be a human being. important part of the research--we physiological states and defensive Part of being a human is to be can actually recruit these neural cir- behaviors. dependent upon another human. cuits through a variety of techniques: Not all the time, of course. Similar to intonation, reducing the amount of RD: So if someone’s in a severe most mammals, we come into the stimulation in the environment, lis- reactive state, he or she may world with great dependence on our tening, and presenting familiar faces not able to pick up a human caregivers, and that need to connect and familiar people. voice against background noise? and be connected to others remains What we often do when we're stressed or anxious is to distract our- SP: Exactly. People in these states selves or create novelty. We'll say, are often brought in for hearing tests, “Let's go to the park! Let's do some- and they test perfectly in a sound- thing different!” But what we need proof room. People whose nervous to understand is that the nervous systems function properly have cer- system is really requesting familiari- the facial expression, the intonation tain neural mechanisms for hearing ty and predictability, which is a of our voice, the head nods, even the beyond background noise. Those metaphor for safety. hand movements, are part of this. mechanisms attenuate low-frequency And if I turn my head away while background sounds, which enables RD. It might explain why some I'm talking to you, if I talk in a mon- them to hear human voices more New Yorkers wouldn't leave otone without any intonation, or if I clearly even in environments with Manhattan after 9/11. drop my eyes, will you have a vis- noisy background sounds. ceral response? How do you feel These mechanisms aren’t avail- SP: Right. It's familiar. It's home. when I do that? able to people with certain disorders. And "home" is a powerful metaphor For example, a young boy with for safety. RD: It feels like you're not very autism will have difficulty differenti- present, like you're withdrawing ating voices from background noise; throughout our lives. As we mature, RD: I've heard the human mind or you're disconnected. human voices will wax and wane we need to find safe environments so described as a paranoid instru- based upon the background sound. that we can sleep, eat, defecate and ment.The premise is that when SP: Disconnected, which may be The voice will start “disappearing.” reproduce. We create the safe envi- we are living in our senses, in interpreted by the other person as That’s why people with autism and ronments by building walls to create the here and now, we usually evaluative, not liking, not being several psychiatric disorders general- boundaries and privacy. Or, we may feel safe, but our thinking mind motivated to engage, condescending ly don’t want to go to shopping get a dog, which will guard us, so often throws scary impressions or suspicious. So these facial ges- malls, or don’t want to be where we can sleep. The point of these in front of us, as if it's anticipat- tures, which for some people are there are loud ventilation systems. strategies is to create an environment ing some threat. purely physiological responses, are

32 © NEXUS March/April 2006 now interpreted with a moral or, at ing. When they were born, they least, a motivational overlay. This were not able to take care of them- may or may not be true. Social selves. Unlike reptiles that hatch and engagement is a unique and very scamper off to the water, mammals powerful component of our interac- need to be suckled. So with this tions. POLYVAGAL THEORY physiological evolution, there also Now, how valuable is this knowl- evolved social cueing—facial expres- edge? Let's take three different types By Ravi Dykema sivity, crying, vocalizations, sucking of clinical populations. One, fussy or movements; all these types of colicky babies who cry excessively. behaviors of the neural regulation of Two, kids with attention deficit dis- Events trigger you to react. If your first reaction doesn’t the face provide poignant cues and order. Three, individuals along the make you feel safe, you revert to the second, then the third: are part of the mammal's repertoire spectrum of autism. How do the for behavioral and state regulation. parents of these three types of chil- We still use the same “cueing” dren feel? Do they feel that their The part of your communication system to test social children love them? Is it easy for Evolved nervous system used interactions. The neural regulation and what it helps them to love their children? Or, do in Feels like: of the facial muscles provides a way humans: you accomplish: they feel duped and disliked by to reduce psychological distance their kids? How do they feel? before we deal with the inherent risk With the fussy baby, parents often of moving physically closer. This First Recently Safety Myelinated vagus nerve feel that their overtures of love and social engagement system enables reaction Social engagement caring are being rejected. With the people to touch each other. We don't hyperactive kid, they feel their over- just walk up and touch someone; tures of engagement are being reject- there's a whole interaction between ed. They feel the same way with the Long the face, vocalizations, other bodily Ago autistic kids. So they are responding Second Moderate to Sympathetic cues, to see if we feel safe with each nervous system to a common feature expressed in reaction extreme danger other. Then we can touch. Thus, these three types of children, and Mobilization: fighting social engagement behaviors pre- their nervous system interprets their or fleeing cede the development of social child's features as if the child is bonds. Social engagement behaviors motivated not to like them. provide an option to test interac- Where's the power of knowledge tions in “psychological space” with and science in helping these fami- Third very low risk, prior to the test in lies? Where and how can this reaction “physical” proximity. Polyvagal knowledge be used? We can teach Very Long Life Threatening Nonmyelinated theory shows that as reptiles vagus nerve these parents to understand that the Ago evolved into mammals, the neural child's behaviors are not motivated Freeze, feign death regulation of the heart and lungs by or directed at them. We can teach changed. It came to be regulated by the parents that they need to help an area of the brain that also con- soothe and calm their children. trolled the facial muscles. After that, What generally happens in all emotional expressivity, ingestion of three conditions? The parents are food, listening and social interac- feeling very upset and these feelings Note: The polyvagal theory places great tions were all related to how we reg- increase the intensity of their inter- importance on social engagement as a ulated our bodies. Those compo- component of staying healthy, physically actions with the child and makes the and psychologically. nents calmed us down. Thus, social child's behavior worse. behavior could be used to calm people down and to support health, RD:They can't help but reveal growth and restoration. their anxiety about the child's Everyone knows that social sup- behavior? to modulated sounds. you're back on target and you forget port is good. But what are the fea- This system of intervention about the fact that I turned away. tures of social support and why SP: Yes, and that anxiety gives more works very well, and very rapid- The same thing happens with par- does it work? Generally, it operates cues to the child, and often is trans- ly—within a few hours. As many as ents of autistic kids. Once the child through the mechanisms that we're lated to the child as anger. The par- 60 to 80 percent of the children is engaged, they forget the child talking about; it triggers the social ent may feel justified, because they treated demonstrate changes in eye ever had a problem on those levels. engagement system, which is linked think that the child does not love gaze, heart rate activity, visceral Our nervous system expects this to the myelinated vagus that calms him or her. It's tragic. state and ability to process lan- facial expressivity and dialogue. us and turns off our stress respons- guage. The changing of eye gaze When that expectation isn't met, we es. It’s self-soothing and calming, RD: Have you used these princi- and facial expressivity of a child feel bad. When it comes back into and makes us much more metaboli- ples to treat autism? who is autistic changes the whole play, it's natural. cally efficient. The theory involves interaction with the parent. It's the complex linking of systems: how SP: Yes, but I have approached it at quite amazing. What's perhaps the RD: Can you talk about polyva- the nerves that regulate the heart a very different level. I've actually most interesting is that many par- gal theory as it relates to our and lungs are linked to the nerves tried to trigger the neural mecha- ents don't even know it's happen- need for safety and our reac- that regulate the striate muscles of nisms in the autistic child that ing, because it's such a natural tion when we don't think it's the face and head and how the corti- enable him or her to make better eye process. there? cal regulation of brain stem areas contact and facial cues. I went If I am looking at you, and our that do this regulation enable us to through the portal of how they lis- contact feels safe and appropriate, SP: If we start thinking in terms of turn off defensive strategies. ten to acoustic information, and and your nervous system is in tune, what happened through the stages actually created an intervention pro- you'll feel uncomfortable if I turn of evolution, when mammals Please see POLYVAGAL on page 34 gram that stimulates active listening away. But then, if I turn back, evolved they required lots of nurtur-

© NEXUS March/April 2006 33 POLYVAGAL THEORY mammals have this mechanism. In a So the theory states that our voluntary behaviors. What does that sense, it's a beautiful strategy; if physiological responses are hierar- mean? It means that if I'm in this continued from page 33 you're going to die, raise your pain chically organized in the way we state of activation and arousal, when Here's one thing I didn’t discuss: thresholds and just say goodbye. react to challenge, and the hierarchy my nervous system detects that I am how do we distinguish between There's another kind of immobiliza- of reactions follows the sequence in in danger, I can use voluntary friend or foe? There’s an area in the tion, an immobilization without fear which the systems evolved. behavior—I'll move myself into a brain that picks up biological move- that is positive and enjoyable. Often Additionally, the linkage between quiet room or go to what I perceive ment and intentions. That area immobilization without fear is the nerves that regulate the face and as a safe environment. detects familiar faces, familiar voices required to enjoy sex. This state of the nerves that regulate the heart Some people believe that you and familiar movements. So hand immobilization without fear is com- and lungs implies that we can use don't have that option; if you have a gestures, facial expressions and mon for female mammals. Actually, the facial muscles to calm us down. job, you have to perform even at vocalizations that appear “safe” turn men may immobilize after sexual Think about it: when we're stressed times when your nervous system off the brain stem and the limbic activity as well. There is an impor- or anxious, we use our facial mus- wants out. For example, you have to areas that include fight, flight and tant link between immobilization cles, which include the ears. We eat freeze responses. without fear and being in a safe or drink, we listen to music, and we environment. What's the saying? If talk to people to calm down. RD:The sympathetic nervous you want to steal something from a system? RD: So we could use dramatic facial expressions to calm SP: It's actually even more than down? that. The limbic system "grabs" the sympathetic nervous system (as well SP: Absolutely. Think about how as what's called the hypothalamic- pranayama (a yogic breathing tech- pituitary-adrenal-axis) to turn on nique) works. When you do these defense systems including the fight- breathing exercises, you're actually or-flight mobilization system and “exercising” both the sensory and the freeze immobilize system. motor nerves regulating the facial muscles; you are controlling breath RD:Where's the "freeze" and maneuvering the oral motor response in all this? cavity. It's a very efficient way of working on the system. A lot of peo- SP: Fight and flight are actually pro- ple don't like to teach pranayama grammed in different areas in the because they think it's too powerful. lecture, teach or see clients. You can't brain. Even though they generate Polyvagal theory explains how remove yourself from the situation, the same autonomic responses, like pranayama might work and how because you have responsibilities sweaty hands and increased heart other methods of stimulating the that define you as a professional. rate, they are actually different pro- same system, including social inter- What are your alternatives? grams of movement, and they're actions, can result in similar benefits First, listen to your body. Your programmed in different areas of man, do it right after sex. They're to our health and mental state. The body is telling you that it's in an the brain. But the freeze response is just totally helpless. And to really social engagement system includes unhealthy state. Your body is not totally different; where fight and enjoy sex, women, in a sense, have the nerves regulating the face and well adapted for prolonged periods flight are mobilization, freeze is to feel safe with the man and to the myelinated vagus regulating the of stress and anxiety. And while you immobilization, and immobilization immobilize without fear. heart and bronchi. The power of the can't control all of your surround- is potentially lethal for mammals. social engagement system is amaz- ings, you can control some of them. RD: How does polyvagal theory ing both in terms of its effects on We also need to recognize and RD: It's like being scared to relate to all this? behavior and mental state, but also honor our individual differences. death? in terms of the speed with which it Just because our significant other SP: The theory has two important works. enjoys a noisy party, doesn't mean SP: Exactly. The metaphor would be parts. The first is the link between that our nervous system can handle the cat-and-mouse game. When a the nerves of the face and the nerves RD: So do humans have the it. So with this understanding, we mouse is confronted by a cat, it may that regulate the heart and the ability to consciously access our can arrange our lives so that our freeze into a death-like faint, where lungs. The second is the phylogenet- more recently developed neu- surroundings are more harmonious it will be floppy and unresponsive. ic hierarchy that describes the evolu- rological systems, instead of and peaceful, so that our neural cir- Actually, about 20 percent of the tionary sequence from a primitive, reverting automatically to our cuits aren't being triggered. small mammals who use this death- unmyelinated vagus related to con- reactive systems? If so, can we feigning strategy will die, just by servation of metabolic resources, to use them to override the vague RD: So let's say I've just arrived going into that state. It is not a vol- a sympathetic-adrenal system anxiety with which many of us at a party where I don't know untary behavior, in which they are involved in mobilization strategies, live? anybody, and I realize I'm pretending to die. It is a reflexive, to a myelinated vagus related to underdressed for the occasion. adaptive response. They're literally modulating calm bodily states and SP: Let's take a very optimistic I'm embarrassed, but it's an in a dissociative state. Their pain social engagement behaviors. The viewpoint. Let's say that some of important business function thresholds are raised. hierarchy emphasizes that the newer these behaviors—at least the shut- and I can't leave. How would I “circuits” inhibit the older ones. We ting down of social engagement to use the listening-to-my-body RD: Does this happen in use the newest circuit to promote facilitate defensive behaviors—are approach to calm myself and humans? calm states, to self-soothe and to not voluntary choices. However, feel safe? engage. When this doesn't work, we often when this occurs, it is as if the SP: Well, this may be part of the use the sympathetic-adrenal system nervous system has betrayed us. SP: I think the essence of what post-traumatic stress disorder to mobilize for fight and flight To cope with these apparent you're describing is the feeling of (PTSD) syndrome. PTSD may be behaviors. And when that doesn't betrayals, we need to recognize being trapped. You can't leave. It's about raising pain thresholds; it may work, we use a very old vagal sys- when our nervous system is failing like being in a situation where be a preparation to be killed. Many tem, the freeze or shutdown system. us and to learn to compensate with there's too much noise, it's too hot,

there's an abusive conversation that and my well-being going and, for whatever reason, you depends on my making a good can't leave. That's very difficult. But, impression, I could blow it. in general, we have to learn to navi- Do s and Don ts gate situations and find ways to ’ ’ No, because you're too smart to SP: make ourselves feel safe. go that direction. You've been in In this case, you have to do some- similar situations and know what thing; your visceral state has shifted Derived from the polyvagal theory to expect and how to regulate because of something that cognitive- through appropriate behaviors. ly is not very important--your cloth- By Ravi Dykema What we're really talking is how ing--but your body may have react- the mammalian system evolved to ed in the way that destabilizes your maximize survival. We really only ability to be social. What I'm saying DO DON’T want to be in groups with people is we have to respect that. We can't we know. But you're not consider- Do make eye contact when you Don’t combine intimate conversation minimize that because to us it feel safe. with hard exercise; you'll misread all ing your behavior from a motiva- appears to be inconsequential. the other person's cues. tional model in which your success and professional survival is RD: So staying at the party— Do express with your face. Don’t always isolate yourself in order dependent on you making connec- pushing through the situation— to feel safer; try connecting with oth- tions. This motivational model is not the solution. ers too. involves much higher brain structures that can modulate the more SP: Absolutely not. The solution is Do modulate your voice Don’t push yourself harder to be “primitive” defense strategies. in respecting and honoring the (use expression). social when you feel unsafe; seek safety first. body's responses. When this feeling RD: Maybe, but it's the people of being trapped comes up, we have Do listen to voices, separate them Don’t ignore your gut reactions; who are willing and able to go to deal with it by saying, “How can from background sounds. adapt to them and learn from them. into those threatening environ- I modulate that?” Children like ments over and over again autistic kids are feeling trapped all Don’t use fighting or fleeing with who are leading corporations the time, because their physiology is Do adjust your circumstances to feel loved ones; instead, find a way to and governments. saying, “Get the hell out of here.” safer, e.g. move to a quieter place. get to safety. And they're being forced to sit, to SP: Maybe, but those people may make eye contact, to do things that Do adjust your focus to things that Don’t adopt a flat, expressionless also have some features that would are terrifying to them. To treat them, will make you feel safe, e.g. feel affect with people who you want to not result in strong interpersonal we must first respect what their your sensations or focus on some- feel safe with you. relations. They may start veering bodies are saying. thing familiar. toward what we might call sociopa- The bottom line is that our nerv- Don’t substitute internet relating for thy. They may not discriminate Do play a musical instrument. face-to-face or phone contact. ous system is evaluating risk and among whom they like or interact safety in the environment. It's auto- with, since they are always socially Do try moving into social relation- Don’t assume other's outbursts matically doing that all the time. It's ships instead of away, as a way to reveal their “true” attitudes or moti- engaging. It is possible that these like a radar system, constantly sens- reduce slight anxiety. vations. Their calmer social capaci- people don't develop very good ing whether we're safe or not. We ties (like empathy) are “true” too. close relationships. can use many metaphors. For example, someone may say, "I don't like RD:Any closing words? the energy in this room.” Let's investigate what that means. It may SP: Yes, I think it is important to be that people are not making eye and makes eye contact with you RD: ...everyone seems to be remember that we can use our contact, they're not inviting, and and says, “Oh, I've heard so much judging me. higher cognitive processes to help there may be a lot of background about you. I get your magazine.” maintain important and positive noise. There are many features that And he says, “Can we sit down and SP: Oh, but not necessarily. You are connections with people, even dur- we can now decode. talk, because I have some ideas.” misreading their cues. ing stressing situations. When we And then you go into a quieter are in a mobilized anxious state and RD: But in the sequential place, you have a drink, and sud- RD: But that's what I'm feel- want to communicate or relate on a order, if we're feeling that the denly you feel fine. Now if someone ing. calmer personal level, we need to environment is unsafe, then doesn't engage you, and you stand put the brake on our sympathetic- social interaction could either there in the periphery, the way you SP: Absolutely, because what hap- adrenal system and recruit the neu- make us feel safe, or make us were feeling continues to radiate pens is when you're in that physio- ral circuit that promotes social feel threatened, right? and you formulate a strategy to get logical state, neutral faces appear to behaviors. We can do this by using the hell out of there as soon as you be angry, so you misread every- our facial muscles, making eye con- SP: Right. But we don't make the can. thing on a conservative level relat- tact, modulating our voice, and lis- determination. The person engaging ed to survival. In this conservative tening to others. The process of us is actually triggering our system, RD:That's exactly how I feel state, your nervous system evalu- using the muscles in our face and one way or another. So let's say you when I go into a business set- ates anything that may be neutral head to modulate our social go into this strange room. You don't ting, and I don't know anybody. as dangerous, rather than pleasant. engagement will actively change know anyone. You're hypervigilant. And then as soon as someone I But once you become calm and our physiological state by increas- Your body is saying to you, “I'm not do know arrives, everybody engaged, you see neutral as being ing vagal influences on the heart comfortable here, because I don't else seems to be friendlier. neutral, and then you engage peo- and actively blunt the sympathetic- know anyone.” There's no familiar ple and they start reacting back to adrenal system. Then we can be face, there's no familiar voice, so SP: Ah. Now you've brought up a you. more in contact with reality, more you're unable to turn off the brain very interesting feature, because alert and engaged. The social neural structures that regulate defense when you're in a state of this arous- RD: It seems counter-adaptive. circuit also supports our health. strategies. Then someone comes up al or this danger evaluation... If I go into an environment like