Resources

There has been a revolution. Have you noticed?

In this section, we list a few of the extraordinary professionals who have influenced us. We also include some links for you to consider.

No one can skill you out of trauma, as no addict can be skilled out of their addiction, as no couple can be skilled into a loving relationship. Academic knowledge tends to look at one small, disconnected aspect of life, and the research is limited to what can be tested by available methods. What gets studied is heavily influenced by funder sources and preconceptions of academics’. It is not hard to see why big pharmaceutical companies and insurance forces are behind much of what has become termed “researched-based.”

In the arena of psychology, for decades the academic research has favored cognitive and behavioral studies, and therapists have gotten in line to reap insurance benefits by offering brief course of skill-training, with the often underlying attitude that if you fail to get better via this approach then you are “resistant” or unmotivated.

Consider for years that it has been common for difficult patients to be given a personality disorder diagnosis. Though it can be helpful to look at traits that are problematic, so they can be interrupted and replaced, a diagnosis can also be a suggestion that you are the problem. It can even be a sophisticated form of name-calling.

However, if you are reacting from complex trauma, you may well look personality-disordered.

Link: You Tube: Childhood Trauma, Affect Regulation, and Borderline Personality. Bessel van de Kolk.

The research that is often cited to support a treatment is far behind what seasoned practitioners know in their bones; and the outcome studies can be uniformed by recent neurobiological information.

Our approach is based on what we have learned to be true, blending new information with what our experience has shown to be effective.

We encourage you to look at the current understanding from experts who do not maintain a strict medical/pathology focus. So you can judge for yourself.

Jaak Panksepp-Affective Neuroscience

“It is all too easy to accept emotions as primitive “givens” and proceed toward a superficial understanding based on words, arbitrary definitions, and the quiddities of logic rather than biology.”

He is an American psychologist, psycho-biologist, and a neuroscientist. He is the Chair of Animal Well-Being science for the Department of Veterinary and Comparative Anatomy, Pharmacology, and Physiology at Washington State University’s College of Veterinary Medicine, and Emeritus Professor of the Department of Psychology at Bowling Green State University.

He has numerous published books:

• The Archaeology of Mind: Neuroevolutionary Origins of Human Emotion.
• A Textbook of Biological Psychiatry
• Affective Neuroscience: The Foundations of Human and Animal Emotions.
• Advances in Biological Psychiatry
• Emotions and Psychopathology
• Handbook of the Hypothalamus.

He has also authored over 200 scientific articles dealing with the physiological mechanisms that underlie motivated behavior. In addition, he currently serves as director to the Memorial Foundation for Lost Children, which helps parents and children with neuropsychiatric disorders.

Jaak Panksepp was born in Tartu, Estonia. He and his family fled to the United States when the Soviet’s began to take over his country. Perhaps this helps explain his ability to weather his position as the outsider and to continue his research despite lack of support. He has been called “the rat tickler” in the popular press because of his research on laughter in non-human animals. He has demonstrated that by studying and understanding emotions at the neural level we can understand emotions and emotional disorders in humans, a field of study known as “affective neuroscience,” a term he coined.

His research has been considered radical because, for decades, behaviorists have controlled academia and research opportunities and have reduced human beings to their behavior, conceiving of us as little more than stimulus-response machines. Young aspiring scientists have been pressured by lack of career opportunities and fear of academic ridicule into completely ignoring our emotional similarities to other animals on the planet.

But as Packseep has shown, “We are all brothers and sister under the skin.” By studying animal emotions through electrical stimulation of the brain, his data has proven scientifically (in the way that only a neurobiologist can show this to be true) that animals do feel as humans do; all mammals have the same basic emotional system (underlying neural networks that are linked to raw emotional systems). This has been considered radical only because neuroscientists still generally refuse to consider the emotional life of animals.

“Animals do have emotional systems that generate feelings, even though hardly a neuroscientist yet acknowledges this fact.”

His major contributions to the field are now widely accepted, especially by psychotherapists who are keeping up with advances in treating patients for emotional concerns such as depression.

A couple of points that have been considered revolutionary:

• He contends PLAY promotes optimal brain development. “Play is a primary process that helps achieve the pro-social programming of higher brain regions, such as the neo-cortex.” PLAY is vital for humans and other animals to establish friendships and to learn social cooperation as well as competition, while testing the boundaries of what can and cannot be done. Overall, PLAY is “what allows us to engage positively with others,” Panksepp says. “It also can be an antidote to the negative emotions. Animals who get abundant play are less susceptible to depression. PLAY promotes enthusiasm in the brain–that is, social joy.
• Another system, the SEEKING system and the PLAY system work together “as a dance.” The SEEKING-EXPECTANCY system is the same circuits that Behaviorists have attempted to reduce by calling it erroneously the “reward-pathway.”  SEEKING is not focused on reward. It “allows animals to go out in the world and enthusiastically look for the resources needed to live.” It encourages foraging, exploration, investigation, curiosity, interest and expectancy.
• The opposite of SEEKING is depression. That moping, listless, who-cares-about-anything feeling? When the SEEKING system has shut down, you are no longer feeling alive. It instinctually seems better to roll over and play dead.
• The shutting-down of SEEKING is our natural response to the violation of yet another fundamental human instinct: our built-in need for attachment. A break-up, divorce, loss of job, or death–any perception of isolation or loss of love– triggers another one of our instinctual systems, the PANIC-Grief System; this is the psychic pain that results from social loss or disenfranchisement. And once the PANIC-Grief System is set in gear, the SEEKING System can no longer function vigorously.
• A powerful way to treat depression, Panksepp has discovered, is Play.

“Perhaps the best therapy for depression, at least in its milder forms, is to coax people to play again. And also to have lots of physical activity which can invigorate many brain systems.”

The seven primary emotional circuits (he capitalizes them because they are so fundamental):

SEEKING-Generates feelings of enthusiasm and motives seeking out food and resources.
RAGE-Produces feelings anger, being pissed off. It helps animals protect their resources.
FEAR-Generates feelings of anxiety, prompts an animal to avoid danger.
LUST-Related to reproductive urges, it makes us feel horny (Panksepp’s word).
CARE-Produces feelings of tenderness, loving care and a desire to care for the young.
PANIC-Causes us to feel lonely or sad. In many animals it leads to separation cries and distress.
PLAY-Allows animals to get socialized in a positive Joyful way. It generates feelings of happiness.

Richard Schwartz-Internal Family Therapy

“It is more than a therapeutic technique. It is a conceptual framework and practice for developing love for ourselves and each other.”

Richard Schwartz, PHD, is a member of the Harvard Medical School, Psychology Department. He first became well known as coauthor of the family therapy textbook, Family Therapy Concepts and Methods; this is frequently used as the standard text in many graduate schools. The book prepares therapists in training for careers in mental health and social work by explaining systemic therapies and strategies deemed significant and important. All of these approaches were radical and cutting edge, before they became widely accepted.

However, Schwartz isn’t a man driven to standardize the counseling field, by explaining what has already been put into a text. But he has been driven. He says that part of what has led him into a more creative exploration is knowledge that he was (as the oldest boy of six) a “huge disappointment” to his father. The elder Schwartz was a well-known endocrinologist and researcher, and three of Richard’s brothers became “real doctors,” ie physicians.

Schwartz is now best recognized for his own therapy approach called Internal Family Systems. As he explains the beginnings, In an effort to help a woman with an out of control eating disorder and self-mutilation behaviors, he found the strategies he had been taught (and had been teaching others) were having no effect, in fact , in this particular case they appeared to making things worst.

When the patient arrived in his office with a large slash on her face, he surrendered his role of expert authority and listened more intimately. He connected personally. By doing so he discovered the importance of staying in an open and mindful state. From this place, he could more creatively and effectively respond. He was brave enough to leave familiar territory, encountering his client authentically, engaging in the art of therapy.

As a result of his willingness to be receptive, with his heart and soul as it were, he was able to see how much our internal living room is peopled with a squabbling group of ego-states much like a family, in fact often a very dysfunctional family. Over several years he developed a therapy that resonates with patient’s intuitively, and this therapy has been used often with trauma survivors because of its great sensitivity to people who have been terribly wounded.

Of course to go where he has had to go, he abandoned preconceived notions, and could not rigidly hold to any established therapy model. And for a time he was brutally criticized for this by both family therapists and psychodynamic clinicians because he was daring to violate their sacred doctrines. It is still common for practitioners  trying to maintain insurance reimbursements, by heralding their adherence to only standardized approaches that have been deemed “well researched” or “evidence-based”  to scoff at the notion that we have little people inside our heads. These therapists fail to explain to their clients how research is normally at least 10 or more years behind what is well known to skilled practitioners in the field.

As a result of his inspired work, Richard Schwartz is recognized as a master clinician, elaborating a therapy that is flexible and a very usable way to understand and explain the mind’s inner landscape. He has also taught us the important of staying in a receptive state (he calls this simply the Self state). For those who have been severely traumatized, he provides a language to help separate out the “parts” that have been pushed to extreme self-sabotaging roles as a person struggles between their unbearable pain and their desperate attempts to detach from it.

www.Personal-growth-programs.com

Dan Siegel–Interpersonal Neurobiology

www.drdansiegel.com

Dan Siegel, MD is a psychiatrist-scientist, clinician and attachment-researcher. He has been clinical professor of psychiatry at UCLA School of Medicine and co-director of the Mindful Awareness Research Center. He is hard to characterize because his interests cross many fields and disciplines. He has published numerous books, including The Developing Mind, Parenting from the Inside Out, Brainstorm: the Power and Purpose of the Teenage Brain, The Mindful Brain, The Mindful Therapist, Mindsight and the Neurobiology of We. He is a much sought-after lecturer.

In several books he has described his struggles in medical school and his decision to leave for time because he was criticized for wanting to connect with his patients. He had already worked on a crisis line, and had learned how much people heal through relationship, whenever another person really listens with insight and empathy (which he calls mindsight). In contrast, in Medical School “nothing seems to be available to develop empathy, compassion or self-regulation for the professional in our own training.”

One of his contributions is the “triangle of well-being.” This is a description of the 3 dimensions of each human life:

We are a Mind that can change our relationships and the brain’s own wiring, turning mind-states into persistent traits by repetitive focus.

We are an Extended Nervous System, a physical mechanism that can integrate or can deviate from integration resulting in chaos and or rigidity. An example of chaos would be rage states while an example of rigidity is experiencing paralysis or emptiness.

All of us are also in Relationships. As we connect and communicate, depending on what we are focusing on and reinforcing, we will change both our minds and our nervous system (the very wiring in our brain) toward either integrated states or unintegrated states (rigidity and/or chaos).

It is worth understanding that we are not just a brain that creates our mind and our relationships. Each of these dimensions interacts and impacts the others. This is often not well understood even by well-educated medical professionals who will talk as if we are levels of neuro-transmitters in the brain; and propose that if we are having some problem in our mind or our relationships then there must be a chemical solution.

Dan Siegel is also an advocate for mindfulness, a state of “presence” that he characterizes as being Curious, Open, Accepting and Loving. This state is a special kind of conscious awareness that allows us to make intentional choices. Even if we have been stuck in well-worn patterns, mindfulness allows us the possibility of thinking, feeling and behaving differently. He explains that what we get out of a practice of mindfulness (our outcomes) is the same that we would have gotten in a “good enough” childhood. For those of us who have experienced attachment challenges, which is the majority of us, then this is amazing news.

It is possible to develop the positive traits that we would have developed if the parents who raised us were not so preoccupied, absent or abusive.

To give one example, both mindfulness practices and a childhood with secure-attachment promotes response-flexibility. This is the ability to be still in our brain, body, mind and in our relationships until we can direct energies in a way that helps us grow (promoting integration). Response-flexibility means that we have the flexibility to act in a way that is true to our values and healthy desires.

Bessel van der Kolk, MD—Diagnostic messiness

www.besselvanderkolk.com

“As long as we live in a world in which there are no definitions and  no language for what’s wrong with people, we can’t do anything about it.”

Bessel van der Kolk has served as president of the International Society for Traumatic Stress Studies, medical director of the Trauma Center at JRI in Brookline, Massachusetts, and professor of psychiatry at Boston University School of Medicine. His published books follow :

• Treating Complex Traumatic Stress Disorders: An Evidence-Based Guide.
• Overcoming Trauma Through Yoga: Reclaiming Your Body
• Trauma and the Body: A Sensorimotor Approach to Psychotherapy
• Post-traumatic Stress Disorder: Psychological and Biological Sequelae.
• Psychological Trauma.
• Traumatic Stress: the effects of overwhelming experience on mind, body and society.
• The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma.

When Dr. van der Kolk first began working with Vietnam veterans, there was a diagnosis for PTSD, and he says that this was simple to understand, because it describes those who are doing OK, mind their own business; but suddenly they face a life threatening event that changes them. They become violent, begin to drink and drug heavily, have difficulty getting jobs etc.

But he was also seeing patients in his Boston practice who did not fit this criteria. They cut themselves, spaced out and didn’t remember things. They felt a lot of shame and self-blame, and got upset over small things. They were described as clingy, needy, impulsive, depressed, enraged, and often had physical illness such as fibromyalgia, irritable bowel syndrome, chronic pain and acid stomach. They also reported histories of childhood incest.

At the time psychiatrist believed that incest was “extremely rate”—effecting about one in every million people; incest was believed to be often “gratifying and pleasurable” and the vast majority of girls were none the worst for the experience. So the patients Dr. van der Kolk encountered were not being treated for sexual abuse. They were being treated for depression, anxiety, agoraphobia, panic, multiple personality disorder and borderline personality disorder.

In late 80’s van der Kolk began working on getting “complex PTSD” diagnosis into the DSM-IV. He began studies between 1990-1992 to determine if people who had been traumatized by long term interpersonal childhood violence looked different from people who were traumatized by one-shot traumas. The answer was a clear yes!

The DSM-IV PTSD Committee voted 19-2 in favor of accepting the diagnosis. But it was overruled at higher levels because of its “diagnostic messiness–its tendency to leak into so many other disorders.”

Another diagnostic messiness:

The National Child Traumatic Stress Network (NCTSN) congressionally mandated in 2001 ran into the same problems working with children. The vast majority of children treated in their 53 clinics and academic institutions nationwide suffered from something that went beyond PTSD, and children often collected 4-6 diagnosis, one after another, like bipolar disorder and conduct disorder.

Since DSM-IV, a massive body of neurobiological research has revealed how protracted childhood abuse and neglect cases pervasive, devastating, and lasting biological and psychological harm, including to the prefrontal cortex, corpus collosum (integrating right and left hemisphere), amygdala, temporal lobe (hearing, verbal memory. language functions), and hippocampus (memory). This research comes from the field of epidemiology—look at the ACE study—tracking the relationship between childhood maltreatment, neglect, and other family loss or dysfunction and adult mental and physical health.

Child abuse increases the risk for mental health and emotional disorders–and associated risks for alcoholism, drug abuse and smoking. Also, increases risk for heart and lung disease, diabetes, live and kidney diseases, some cancers, sexually transmitted diseases, autoimmune disease, and the increased likelihood of being arrested as a juvenile, as an adult and committing a violent crime

In 2007, the cost related to child abuse of increased mental and health care, to the criminal justice system, loss of productivity was estimated at 103 billion dollars. Van der Kolk helped organize a complex trauma task force. Between 2002-2003 they collected clinician reports of 1,700 children receiving trauma-focused treatment at 38 different centers. They found that nearly 80% of these children has been exposed to multiple and/or prolonged interpersonal trauma, and yet fewer than 25 percent met the diagnostic criteria for PTSD.

“These kids have seriously problems for affect regulation, dissociation, attention, concentration, risk-taking, aggression, impulse-control, and self-image–they hate themselves. But they don’t have PTSD.”

Dr. van der Kolk and his colleagues developed a diagnosis based on the research, called Developmental Trauma DO. The criteria follows:

Developmental Trauma Disorder
Developmental Trauma Disorder incorporates and inter-weaves threads from Reactive Attachment Disorder, Oppositional Defiant Disorder, ADHD, Post Traumatic Stress Disorder, and provides a comprehensive lens through which to view the behaviors of children who have experienced trauma during their early lives.

Risk Factors:

Multiple or chronic experience of or exposure to traumatic events such as abandonment, abuse, neglect, or violence during the early years. Changes of primary caregiver in the early years.

Symptoms:

Affective and Physiological Dysregulation

• Unable to self-regulate from strong emotional states
• Rages
• Disturbances in regulation of bodily functions (sleeping, eating, and elimination)
• Sensory over or under-reactivity
• Lack of awareness of or dissociation from sensations, emotions, and bodily states
• Lack of ability to describe emotions or bodily states

Attentional and Behavioral Dysregulation

• Hypervigilant
• Self-harming, risk-taking, and/or thrill-seeking behaviors
• Maladaptive attempts at self-soothing (e.g., rocking and other rhythmical movements, compulsive masturbation)
• Habitual (intentional or automatic) or reactive self-harm
• Inability to initiate or sustain goal-directed behavior

Self and Relational Dysregulation

• Parentified behavior
• Extreme concern over the safety and well-being of the primary caregiver
• Persistent negative sense of self
• Distrust of others
• Reactive physical or verbal aggression
• Inappropriate intimacy (physical or emotional)

Lack of empathy

Trauma Center at JRI (Dr. Bessel Van der Kolk)

DTD was rejected from DSM V.

Francine Shapiro PhD.  EMDR

It is important to understand the parallel between negative childhood experiences and that of the trauma victim. In both cases there are generally feelings of self-blame and inadequacy and a lack of control, safety, or choices. Presumably, a dysfunctional node is set in place in childhood (during developmental stages), when positive information is not assimilated into the neural network during the critical period immediately following a disturbing experience (e.g. the child may not receive comforting after an injury).               Francine Shapiro

The truth about our childhood is stored up in our body.

                                         Body, Alice Miller 

Francine Sharpiro is an American psychologist who originated and developed EMDR (‘Eye Movement Desensitization and Reprocessing‘), a form of psychotherapy for resolving the symptoms of traumatic and other disturbing life experiences.

In 1987, she made the chance observation that moving her eyes from side to side appeared to reduce the disturbance of negative thoughts and memories. This experience led her to examine this phenomenon more systematically. EMDR is now recommended as an effective treatment for trauma in numerous international practice guidelines, including those of the American Psychiatric Association and the Department of Defense.

Dr. Shapiro’s publications include:

• Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures. EMDR as an Integrative Psychotherapy Approach: Experts of Diverse Orientations Explore the Paradigm Prism.
• Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy.
• EMDR: The Breakthrough Therapy for Overcoming Anxiety, Stress and Trauma .
• Handbook of EMDR and Family Therapy Processes.
•  Short-Term Therapy for Long-Term Change.

Central to EMDR therapy is the concept of Adaptive Information Processing (AIP).

• The theory is that there is a body-based systems that integrates new experiences into already existing memory networks.
• Our perceptions (thoughts/beliefs/images/emotions/sensations) are automatically linked with associated memory networks.
• Like other animals, we process information in order to generate predictions about the environment (safe, dangerous, nutritious?) and about beings around us (trustworthy, dangerous?”) However, humans also generate predictions about ourselves (good, bad, powerless),
• Problems result when traumatic, stressful or confusing events interfere with normal memory processing. The incident is dysfunctionally stored, frozen-in-time in its own neural networks.
• Our nervous system that gets triggered when there is a threat interferes with the usual AIP process, and this leads to impaired neural linking (fragmentation of cognitive, affective, or sensory information).
• When we get triggered, the environment and those around us seem dangerous, and this leads us to beliefs (I am worthless. I am unlovable).
• EMDR stimulates the inherent neural process mechanism and helps to link the unlinked memories to more accurate Or “adaptive” information that are held in other memory networks. (“The threat is gone.” “I am safe” “I am lovable” I am capable”)
• We become more integrated.

Gabor Mate, MD

“Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience. A hurt is at the center of all addictive behaviors. It is present in the gambler, the Internet addict, the compulsive shopper and the workaholic. The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden—but it’s there. As we’ll see, the effects of early stress or adverse experiences directly shape both the psychology and the neurobiology of addiction in the brain.”

Gabor Maté is a Hungarian-born Canadian physician who specializes in the study and treatment of addiction and is also widely recognized for his perspective on Attention Deficit Disorder.

Born in Budapest, Hungary in 1944, he is a Jewish survivor of the Holocaust. His maternal grandparents were killed in Auschwitz when he was five months old,. His aunt disappeared during the war, and his father endured forced labor at the hands of the Nazis. He emigrated to Canada with his family in 1956.

His publications include:

•  Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder, (published in the United States as Scattered: How Attention Deficit Disorder Originates and What You Can Do About It).
• When the Body Says No: The Cost of Hidden Stress (published in the United States as When the Body Says No: Exploring the Stress-Disease Connection).
• Hold On to Your Kids: Why Parents Need to Matter More Than Peers, co-authored with developmental psychologist Gordon Neufeld.
• In the Realm of Hungry Ghosts: Close Encounters with Addiction.

Maté ran a private family practice in East Vancouver for over twenty years. He was also the medical co-cordinator of the Palliative Care Unit at Vancouver Hospital for seven years. Currently he is the staff physician at the Portland Hotel, a residence and resource center for the people of Vancouver’s Downtown.

Mate proposes new approaches to treating addiction (e.g. safe injection sites) based on an understanding of the biological and socio-economic roots of addiction. He also describes the significant role of “early adversity” i.e. stress, mistreatment and particularly childhood abuse, in increasing susceptibility to addiction. This happens through the impairment of neurobiological development, impairing the brain circuitry involved in addiction, motivation and incentive.

The impact of childhood adversity is also noted in When the Body Says No: Understanding the Stress-Disease Connection. He notes that early experiences have a key role in shaping a person’s perceptions of the world and of others, and affects the person’s health later on. He argues that patients should be encouraged to explore their childhoods and the impact on their adult behaviors. He has also spoken about how the rise in bullying, ADHD and other mental disorders in American children are the result of current societal conditions e.g. a disconnected society and “the loss of nurturing, non-stressed parenting.” He points out that we live in a society where, for the first time in history, children are spending most of their time away from nurturing adults. He asserts that nurturing adults are necessary for healthy brain development.

Stephen W. Porges, PhD. The Polyvagal Theory

“Neuroception is not perception. Neuroception does not require an awareness of things going on. It is detection without awareness. It is a neural circuit that evaluates risk in the environment… When confronted in certain situations, some people experience autonomic responses such as an increase in heart rate and sweating hands. These responses are involuntary. It is not like they want to do this.”

Stephen Porges, PhD.is a Professor in the Department of Psychiatry at the University of North Carolina in Chapel Hill, North Carolina. Prior to moving to North Carolina, Professor Porges directed the Brain-Body Center in the Department of Psychiatry at the University of Illinois at Chicago, where he also held appointments in the Departments of Psychology, BioEngineering, and the Program in Neurosocience.

Prior to this he was on the faculty at the University of Illinois at Chicago, serving as Chair of the Department of Human Development and Director of the Institute for Child Study. He is a former President of the Society for Psychophysiological Research and has been President of the Federation of Behavioral, Psychological and Cognitive Sciences, a consortium of societies representing approximately 20,000 biobehavioral scientists.

He was a recipient of a National Institute of Mental Health Research Scientist Development Award. He has chaired the National Institute of Child Health and Human Development, Maternal and Child Health Research Committee and was a visiting scientist in the National Institute of Child Health and Human Development Laboratory of Comparative Ethology.

In 1994 Stephen Porges proposed the Polyvagal Theory, a theory that considers the evolution of the nervous system to provide us insights into human defenses. He saw that there are two different vagus circuits that come from distinct areas of the brainstem. One developed on our planet far earlier than the newer one. The very old reptilian defense system is the circuit involved in death feigning and the shutdown behaviors often observed in response to life-threat. These more primitive neural circuits operate by “neuroception.” — which is totally involuntarily.

It is important to understand that outside the realm of our conscious awareness, our nervous system is continuously evaluating risk in the environment, making judgments, and prioritizing behaviors that are not cognitive. Flight/flight or immobilization shutdown, is not a voluntary decision. Mammals have this ancient “reptilian” nerve system and also have a newer vagus system. During evolution, a unique mammalian vagus emerged, linked to areas that regulate the muscles of the face and head.

“The important aspect is that mammals require opportunities to reciprocally interact. These reciprocal behavioral interactions serve a function in regulating each other’s physiological state. Basically, we create relationships to feel safe and to maintain our health by facilitating the regulation of our physiology.

Face-heart connections promote our “social engagement system” which turns off defenses (down-regulates) and creates opportunities to feel safe and to grow in healthy ways.

“The neural pathways of social support and social behavior share with the neural pathways that support health, growth and restoration.”

Dr. Porges has revealed how things like tone of voice, certain gestures, and even the use of music can help someone reestablish a sense of safety after a traumatic experience. His theory provides fresh understanding of how our autonomic nervous system unconsciously mediates social engagement, trust, and intimacy, and it has startling implications for the treatment of disorders, child attachment problems, intimate couple relationships.

When we are in relationship (mother/child, intimate partners/therapist/client), we are always helping to regulate or dysregulate the other person’s physiology. Our nervous system reads information in facial expression, intonation, gesture, and makes a decision whether engagement is safe or dangerous. This also suggests that we have an ongoing baseline in our nervous system of calm; when we detect a threat, we deflect away from that resting state into fight or fleeing or freezing.

As many therapists have recognized, we do not have to have a client construct a place of peace, acceptance, love, but help them return home.