THE NERVOUS SYSTEM AND RESILIENCE Jan. 2015 By Laurie Leitch, Director, Threshold GlobalWorks
“Mental Health:” an outdated term:
A criticism that used to be common about mental health professionals is that we are one of the few clinical disciplines that doesn’t ever actually see the very organ we target our interventions at. Today, in part because of the amazing advances in neuroimaging, we can see pictures of how electrical impulses travel in the brain and what parts of the brain light up when we think, feel, or do certain things. We know how clever the brain is at learning to compensate for damage. We know that no matter how old we get our brains are able to learn (thank goodness!)… creating new neuronal pathways. As the saying goes, “the neurons that fire together wire together.” This can be good news and bad news. The good news is that people can be helped to have greater resiliency by practicing skills that reinforce healthier pathways in the brain. The bad news is that remaining stuck in disabling beliefs, negative emotions, and hurtful practices wires dysregulation into the brain.
In fact, the term “mental health” is outmoded. We know that the mind and body are a system, inseparably connected; so we really need a term that reflects interventions that explicitly work with both. Candace Pert has called this “bodymind,” others refer to “holistic” or “integrative” models. The fact that there is not a term that is universally used and understood reflects the fact that this is a relatively new frontier for psychotherapists and other clinicians and practitioners. Regardless of the term that eventually is used, SRM is a model that works to connect and heal the bodymind system…from the inside-out.
The goal in this essay is to provide current neuroscience information that is relevant for work with others and for practitioner self-care. There is a vast and growing body of information about the human nervous system .The goal in this essay is to provide the information that helps you understand why it is so important to work with the nervous system and how SRM skills can amplify stability and resilience across stress-spectrum disorders as well as for self-care.
Neurobiology: Used to Design and Implement Interventions:
Understanding some key neurobiological reasons why we think, feel, and act as we do can decrease the tendency to pathologize symptoms as character flaws or weakness. I have intentionally presented the material in this essay in a way that is
accessible for lay people. Neuroeducation is one way to depathologize symptoms as well as to motivate people to use the skills and it is a key ingredient of a SRM session. This essay is not intended to be a comprehensive presentation of the complexity of the nervous system. Rather, material has been selected that provides a rationale for the skills and the therapeutic choice-points and which helps clients understand their capacity for building their own resilience.
After completing this essay, you will know:
1. How to explain the role of the nervous system in dealing with stress, distress and trauma as well as in building resilience;
2. How the nervous system is organized for survival;
3. How energy is directed to automatic defensive responses under perceived
4. How to explain the functions of the key parts of the nervous system and how
they can be enlisted in healing trauma.
5. How to describe the reciprocal relationship of the two branches of the
Autonomic Nervous System.
6. Why some interventions contribute to resilience and others can contribute to
further dysregulation and re-traumatization.
Nervous System Regulation:
A question I often hear is “Why does the Social Resilience Model focus on nervous system regulation?” Most clinical models target cognitions (e.g., problem solving, positive and negative beliefs) and emotions. Although SRM includes attention to emotions and cognitions, they are secondary to the primary focus which is on the nervous system, specifically, the Autonomic Nervous System (ANS) ~ ways of assessing it, stabilizing it, and deepening its capacity for resilience. The focus on sensation (the “language” of the nervous system) enables us to work with what lies below the level of consciousness. When you can intervene at the sensation level to create stability and resilience, thoughts and feelings change for the better as well. That is why we call SRM a “bottom-up” model.
The nervous system plays a key role in shaping who we are. Understanding the parts of the nervous system and how each works becomes a guiding framework for the choice-points we encounter in creating change with clients. This knowledge helps in the design of and rationale for our interventions.
￼￼Primary Focus of SRM- Biology vs. Pathology
Responses to stress-spectrum events have a major effect on the nervous system. SRM uses attention to and knowledge of neurobiological patterns in the body.The nervous system lens changes an individual’s appraisal from threat to challenge
Greater awareness of the non- traumatic sensations in the body helps people live embodied lives.
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The nervous system is one of our body’s main information processors. As the picture above shows, it is divided into two major parts: the Central Nervous System (CNS) and the Peripheral Nervous System (PNS). The CNS, made up of the brain and spinal cord, is considered the control center of the body. The CNS does not come in direct contact with the external environment. It is completely enclosed. It is the Peripheral Nervous System, with its sensory and motor divisions, that interacts directly with the outside world and it feeds information to the CNS. Amazingly, our brain receives more information from our environment in just one day than the largest computer does in one year. And all of this sensory information comes into brain as electrical impulses along sensory pathways. That helps explain why working with sensation, as SRM does, is an essential tool for harnessing our natural resilience. Not all of our senses are equally important in learning. Sight, hearing, and touch seem to contribute the most.
Within the PNS, the sensory division carries impulses from the sense organs to the CNS and the motor division carries impulses from the CNS to the muscles or glands. The motor division is divided into: the Somatic Nervous System (which regulates all activities that are under our conscious control) and the Autonomic Nervous System (which regulates all body activities that are not under conscious control). The Autonomic Nervous System (ANS)~ the focus of SRM~ has two branches that work in balance with each other: The Parasympathetic and Sympathetic branches. One way we understand what is happening in the ANS is by monitoring and intervening through directed attention to internal sensations. The chart below shows how the two ANS branches fill opposite functions. What one branch accelerates the other branch decelerates.
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The Language of Sensation
Imagine that you are gazing at the cutest little puppy you’ve ever seen. Take in all the details…her squirmy, chubby body, wagging tail, cute, little button nose, those yummy puppy smells. What do you notice inside your body as you sense into this image? Perhaps a sensation of warmth, or the feeling of delight that is expressed by sensations of tingles in your chest. Maybe your breathing gets deeper as you enjoy
￼￼￼￼Sympathetic (SNS) Activates
The SNS controls the body during activity & stress
Breathing rate Heart rate Pupils Dilate Blood Pressure Sweating Stress Hormones
Parasympathetic (PSNS) Inhibits
The PSNS controls organs during times of rest & calm
Breathing rate Heart rate Pupils Dilate Blood Pressure Sweating Stress Hormones
Autonomic Nervous System
the sweetness of the image. The words in italics are sensation words. SRM uses the language of sensation (rather than of thought or feeling) because that is the language of the nervous system. Learning to pay attention to and track sensation in the body is the way we assess arousal in the ANS and intervene to promote stabilization, resilience, and embodiment both in our clients and ourselves. The sensations you noticed as you brought to mind the wriggling puppy are primarily from the Parasympathetic branch of the ANS. That is the branch that helps calm us (think of a parachute drifting gently down to earth).
Now, imagine that you have just come home from a day of errands. You reach into your pocket to put your wallet on the bureau only to find it is not there. You search everywhere, becoming increasingly worried that you left it somewhere. Who has it? Will they use your identification? Your credit cards? Just take a minute to sense into this scene. What do you notice inside? Maybe your heart is beating faster. Maybe your breathing is shallower. Maybe your muscles are becoming tense. These are sensations of activation and they come from the Sympathetic branch of the ANS. The Sympathetic branch is like the accelerator on a car…it revs us up for action.
The chart above from Wikopedia shows the impact of each of the two ANS branches on organs in the body. It highlights one of the main reasons that stress, distress, and trauma can generate physical symptoms like asthma, bedwetting, and cardiovascular disease. Learning skills which help manage and recover from life’s stressors before they take a toxic toll on the mindbody system promotes mastery and better health.
SRM teaches people to direct their attention to the sensation level so that they become more and more adept at paying attention to the states of activation and calming in their bodies. This sensation-level self-awareness is the key to living an embodied life, being grounded in the present moment, and being able to restore nervous system regulation by using the SRM skills.
Although many of us have a good emotional vocabulary few people have much of a sensory vocabulary. One way to build a sensory vocabulary is to practice using one: I had, for example, a bowl in my office that had a variety of objects of varying textures (rough, velvety, lumpy), shapes (pointy, curved, etc), smells (lavender, peppermint, licorice). Individuals could handle the objects and describe the sensations associated with each. It is also fine for clients to make up their own sensation words. Children are particularly good at this…describing excitement in the stomach, for example, as having a “fluffly tummy.” Smells are also a useful way to introduce the language of sensation. Most of us have certain smells that evoke sensory responses in the body. The point is to learn to pay attention to sensation and then how to direct attention in ways that bring balance. We call this “Intentional Neuroplasticity.”As individuals become better able to pay attention to, track and manage sensations in their bodies they become better able to self- regulate using the SRM skills. And, practice “wires-in” the stability.
We all have experienced the natural world’s many cycles: the phases of the moon, the tides, day following night, the seasons, to name a few. As creatures of nature our bodies have cycles as well, including sleeping and waking, appetite cycles, menstrual cycles. The cycle that we focus on in SRM is in the ANS…the shifts between activation (Sympathetic branch of the ANS) and calming (Parasympathetic branch). When the two branches are working in harmony with each other we are in what we call in SRM “The Resilient Zone”. When you are in the Resilient Zone you are capable of integrated functioning…meaning that there is
a fit between thinking, feeling, and sensing…and you can respond to situations rather than being reactive to them. When they are in The Resilient Zone people are better able to work in collaboration with others, exhibit principled behavior, and think creatively. The chart below illustrates The Resilient Zone.
￼￼The Resilient Zone: Individual Level
In the “Resilient Zone” we have the best capacity for flexibilty and adaptability in mind, body and spirit and for integrative functioning.
￼￼￼SRM skills can help deepen the Resilient Zone
￼Graphic adapted from D. Sigel
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As in any system, the systems in our bodies have rhythms and cycles that are searching for balance. This means that if an event bounces you out of your Resilient Zone your nervous system will attempt to find balance. The “balance” can sometimes, unfortunately, be a balance of extremes where you swing from hyperarousal to hypoarousal. This can be diagnosed as bipolar disorder when it isn’t or as ADHD when it isn’t.
People can become stuck in cycles of dysregulation. And, sometimes, as clinicians and caregivers we unintentionally reinforce dysregulation in our clients by, for example, overloading people with too many questions during intakes and in asking
about the “trauma narrative” in ways that spike activation levels outside of the Resilient Zone.
It isn’t unusual for people to present for medical treatment with physical symptoms that are actually trauma symptoms and not the result of a medical problem. For some people a physical problem has less stigma associated with it than an emotional problem and so they are willing to seek help for it. We find that physical problems may be the first way that a trauma survivor presents for treatment. We have found this to be especially true in cultures and in populations that do not have an orientation to mental health or who believe “emotional problems” mean they’re weak or even crazy.
The graphic above shows how the nervous system can be bumped out of the Resilient Zone, leading to a cascade of symptoms as well as reactivity. Not everyone has the same depth of Resilient Zone based on genetics, early
￼￼￼Traumatic or Distressing Event or
￼￼￼￼￼￼￼￼￼￼Depression Disconnection Exhaustion/Fatigue Numbness