My Approach to Nervous System Informed Care
Informed primarily by Stephen Porges' Polyvagal Theory and Dr. Daniel Siegel's Window of Tolerance
In a hyperarousal state, you may also experience buzzy, go-go-go energy, feel edgy, irritable, and restless. Brene Brown calls this overproducing. In a hypoarousal state, you may experience procastination, a lack of motivation, inertia, feeling lazy, doing little to nothing to change. Brene Brown calls this underproduction.
In sessions with a Nervous-System aware and mindful therapist, sessions will focus on increasing your Window of Tolerance over time, by pendulating (moving or swinging) between titratated (small bites at a time) amounts of processing the hurt, with, strengthening resources.
EMDR taught me to help clients navigate between altitudes of cognition/thinking, emotions, and somatic/body sensations. Meaning, that we'll explore memories from both hemispheres of your brain helping to integrate the full experience of being with the hurt, and, the resource.
I also like bringing in The Hendricks' Institute's Fear Melters as a direct somatic release that clients can practice in sessions and in their own time. Peter Levine's Somatic Experiencing offers a plethora of additional options, as does Diane Poole Heller's DARE which incorporates SE with attachment work.
When it comes to building resources, I frequently meld EMDR, IFS, DARE, and SE options together to ensure clients have a full toolbox to experiment with and lean into in moments of distress, whether causing hyperarousal or hypoarousal.
Using somatic awareness, this approach encourages a client's Inner Parts to all engage in the journey from exploring what fight-flight-freeze-faint coping strategies worked way back when towards a more socially connected life from learning safety cues within safe, secure relationships. It's a journey of naming moments when maybe the ladder feels like a slide, identifying the triggering circumstances that led to the slide, and, to practice skills and insights to climb back up the ladder into deeper connection with self and others. Daniel Siegel indirectly simplifies the polyvagal ladder in his Wholebrain Child with an image of a house in our brain. When we're young, we need our primary caregivers to help bring us back to our connected selves, able to explore the world again. When we're adults though, we are meant to have a balance of bringing ourselves back up, and, coming back up to our connected functioning within connection with safe others. I use these interchangeably at times. With clients who have a history
with stomach issues, tightness in their neck and shoulders, habit of shallow breathing, or a hyperfocus on danger possibilities followed by an instinct to withdrawal and stay isolated, we'll likely use more of the ladder metaphor. While with clients who don't notice so many of the physiological changes, but do notice a switch, then we'll likely use more of the Wholebrain house model along with his hand model of the brain.
Therapy may focus on one traumatic event and we may end our therapeutic relationship after you feel it is no longer impacting your day-to-day life. However, therapy can also be a place to process a lifetime of 'small t' traumatic events, generally relational or self-esteem related. In this case, we too can choose multiple paths. Two of which include: working efficiently and effectively to reduce the 'sting' of each of the traumas until you feel you are ready to move away from therapy. Or, may take a slower approach, giving more space for working through what is happening in life currently along the way, and giving space to really feel into the relief, the celebration following a completed processing of a memory.
The duration of treatment really depends on the current state of your nervous system, the support system you have, your goals for therapy, your trauma history, and your preference in approach. I do have my own biases, and, will always name them as such to ensure I am not influencing your decisions in a way that feels blindly led to you. We will be collaborative all the way through. After all, one of the main keys in healing childhood trauma is getting to a place where your Inner Child can truly see and trust that things are different now: that you have a voice to advocate for yourself, the means to take care of yourself, and the commitment to only let those who see you for you and respect you as you to have any influence in the way you see yourself or live your life.