Polyvagal theory and Trauma formation. How unresolved emotion can cause the freeze response

Am currently finalising my presentation for the Chrysalis Effect Practitioner Forum on Monday evening; my presentation is on Trauma formation and the Freeze Response (based on the work of Peter Levine) which I see as key to why people get stuck with conditions such as chronic pain and fatigue, CFS, ME, etc. I will be outlining:

*Role of the subconscious (limbic system) in dictating behaviour. The evolutionary triune brain.

*Trauma and unresolved emotion as 'landscapers' of the brain via the limbic system

*Beyond fight and flight; Polyvagal theory and the freeze response*

*Solutions to unlocking the freeze response; the psychosensory therapies; EFT, EMDR and havening

*POTS – Postural Tachycardia Syndrome - a red herring?

The event will be recorded so will be available on my website www.alchemytherapies.co.uk as soon as I have it. I will be sending out a newsletter with the link to my mailing list - subscribe now for my free e-book while you wait!
And if you want to know what you can do about this then see my other blogs on EMDR http://patriciaworby.blogspot.com/2013/11/emdr.html
and EFT.

A letter to Jenni Murray (BBC presenter of Woman's Hour)

Dear Jenni

I read in the Daily Mail that you have decided to have a gastric band fitted to combat the weight gain you have incurred over many years and which now threatens your health. Notwithstanding all the vitriol that you have received for this decision (motivated in part by fear of other women that if you can't manage it without surgery what hope for them?) But I was just saddened. That you have been forced down this road by well-meaning doctors and surgeons who claim it will cut your risk of diabetes, heart disease and the like. Well, in the short term that maybe true but no-one knows the long term risks of these procedures.. The surgery is going to have major implications for your health as you will no longer be able to absorb nutrients like you used to. This could increase your risk for cancer and other immune problems.

But the point of my letter is not to pour scorn on your decision but to tell you that there is another way that you haven't considered (at least not from your article anyway). You talked about having tried all the diets out there and they haven't worked. Of course not. Very few people manage to keep the weight off that way and in any case it requires constant vigilance and willpower. Wouldn't it be great if you could 'eat normally' and still lose weight? Well if you approach the psychological drivers of weight gain and treat them, you would be able to. Most people don't appreciate the huge part that subconscious processes play in our behaviour as they are, well, so unconscious. We eat to assuage a deep longing/need - for comfort, for protection, for freedom from boredom or because it's a quick fix that makes us feel temporarily better.  Our psyche tell us we are 'not right/good enough/loveable and we eat to contain that uncomfortable feeling. What I am talking about here is the role of emotions in unconscious eating. We all suffer from this to some degree but, depending on your background, and experiences when growing up, some of us have a more faulty self-image which no amount of diets or surgery is ever going to cure.

So, if the problem isn't 'physical' then why should the solution be? You need to look at using one of the new techniques that are just being developed under the term 'energy psychology'. In fact what they are is using electrical stimulation to change the neural programming in the emotional brain (limbic system). The one I would particularly recommend for eating problems is EFT or Emotional Freedom Technique. A book I would suggest to get you started would be 'Tapping for Weight loss' by Jessica Ortner who has used the technique herself to rid over 3 stone - without diets or restriction. and the benefits go beyond weight loss - they affect every part of your self-image so increasing your self-esteem and healing many old wounds and erroneous beliefs about yourself.

I don't know your story Jenni, but I know most of us have childhood trauma of one sort or another. Although we think we have 'dealt with it' we find that in fact it exists as a deeply embedded memory and belief structure that continues to affect us today. With a skilled therapist to augment the book you may be able to uncover these and deal with them but even without paying more than the cost of the book you can get great results. And it will certainly be cheaper and less dangerous than the surgery you are contemplating. I know that this is the best method I've ever come across - second only to hypnotherapy which also deals with subconscious process -  check out the hypno gastric band - that's another potential solution where you make your body self-limit it's own intake with feelings of fullness but without the surgery.. This is a subconscious problem and it needs a subconscious solution.

One day medicine will be unified- it will stop seeing things in terms of physical vs. mental and realise we are mind and body and one affects the other in profound ways. We will stop looking for the magic bullet of chemical medicine and look to supporting the body's innate healing powers instead. I hope that this new medicine will use some of the advances in modern medicine but doing so in a more intelligent, integrated way with knowledge from psychology and spirituality. These aren't flaky ideas. They are being proven  time and time again in myriad ways in labs and therapy clinics across the world. Don't be persuaded to give up your body to the knife until you've explored this. If I could intervene for you I would, but perhaps that's best left to you. I have learnt through hard experience that trying to persuade someone before they are ready is pointless. I just hope I'm not too late.

Best wishes
Patricia Worby

p.s orginal Daily Mail article is here http://www.dailymail.co.uk/femail/article-2736130/Why-I-m-getting-gastric-band-JENNI-MURRAY-years-battling-weight-s-taken-momentous-decision.html

POTS (postural orthostatic tachycardia syndrome).

I see the Daily Mail ran a story recently saying that POTS could be the 'cause' for 1 in 3 people with CFS. Having heard the woman who heads the research team at Newcastle university talk a couple of years ago I remember thinking at the time she is never going to work out the neurology of this because she's too narrow in her focus. She spent the first 20 mins of the talk (to University Researchers) justifying that CFS is a real disease and not just malingering (presumably the medics that she normally lectures to have that belief). Then when she got to the heart of her presentation and described how they put people on a 'tilt' table to measure their responses (this apparently is how they diagnose it). sounded barbaric and very unpleasant! However, my main bone of contention and one that has been repeated by the Daily Mail is that this is somehow the 'cause' of CFS when clearly it is just another result of autonomic dysregulation (mediated by the limbic system). A client of mine has pointed me to a training programme called DNRS (Dynamic Neural Retraining System) which she uses - I noted they had an article on POTS too. http://www.dnrsystem.com/POTS.html. They say;

Symptoms can include but are not limited to:

• Increase in heart rate, dizziness, fainting, headache, sweating, shakiness, nausea -  mostly worse with standing
• Poor concentration and memory
• Discoloured hands and feet
• Sense of anxiety
• Chest pains
• Nerve pain
• Hyperacusis (sensitivity to noise)
• Photophobia (pain/relapse on exposure to light)
• Changes in taste and smell

I can remember having most of these symptoms when I was ill 15 years ago - however, no-one seemed to be able to link all of these symptoms - they were all treated separately. The first thing I was given was tablets for the dizziness which made no difference at all. However, had I been diagnosed with CFS or POTS for that matter it wouldn't have helped as it is still a descriptive diagnosis of exclusion (i.e we don't know what it is but it's not something neurological/structural, it's characterised by these things so we'll call it CFS/POTS, etc). So, given a diagnosis like that people are left to manage the symptoms with no idea that the limbic system controls all of these things and that ongoing subconscious stress is triggering the limbic system into sympathetic dominance or vagal freeze. Without understanding what is behind it all people are left powerless and controlled by a medical system that then feeds them expensive drugs and surgery as the answer. It would be quite criminal if it wasn't legal...

Polyvagal Theory and the origins of Chronic Fatigue

My recent reading has led me to discover a theory first identified by Stephen Porges on Polyvagal theory of development. This states that there are three levels of the autonomic nervous system which relate to which era of our evolutionary development they originated in.

1. The unmyelinated vagus nerve which developed 500 million years ago in the fish. Myelin is the covering or sheath around nerve fibres which makes them insulated and able to transfer nerve impulses very fast so without it the messages are necessarily slower. 
2. The sympathetic nervous system (or fight' and flight' system as many know it) which is based on basal ganglia from the spinal cord - this comes from our mammalian past.
3. The myelenated vagus belonging to the parasympathetic system which is the opposite to fight and flight in that it is responsible for calming us down and giving us time to relax and enjoy interaction with others (the social bonding system).

If this is down-regulated as it often is with chronic stress we will be forced into the level below (i.e. sympathetic dominance) where we are ready to 'fight the tiger', our heart rate will be high, and our gut unable to function as blood is diverted away from it - hence churning and IBS symptoms. If our systems are even more exhausted (as they are with years of chronic pain in for instance chronic fatigue syndrome) then the other two levels are hijacked and we operate in the 'freeze' mode of the unmyelinated vagal system (freeze state) whereby nothing works. Our energy levels are so low we cannot function, even the most moderate tasks exhaust us. Our mitochondria are getting the signal to 'go slow'.. It down-regulates all metabolic activity. We are operating at the level of a reptile.

The next question is why and this is where my researches and experience working with people suffering from chronic fatigue shows me that subconscious trauma (perhaps more accurately termed unresolved emotion) seems to be the key here. If, in early life, the person suffers a traumatic experience and interprets that they are worthless or dangerous, then any subsequent event which plays into this subconscious belief system will trigger the body to go into a meltdown freeze state. The earlier the traumatic event in the person's life the more likely this is. Women also seem to be more biologically prone to this as men are more likely to go into fight and flight.

There may be periods of remission where the person has a reasonable ability to function but the next event which triggers these subconscious beliefs they will go downhill again. Thus it explains both the metabolic fatigue and the relapse and remission cycle common to all fatigue syndromes (ME, CFS, Fibromyalgia). Remember these events are recorded in the emotional brain or limbic system with the sensations and emotions that they first caused. They are processed differently from normal memories and may get 'stuck' in the emotional brain/limbic system where they continue to dictate behaviour and  symptoms.

I want to present this theory to the chronic fatigue community - including other clinical professionals at a webinar specifically set up so that we can understand why tinkering at the top level i.e. with diet and pacing can seldom work, if it doesn't approach the real underlying causes of the subconscious neural processing. Thus in summary, we are emotional beings with three increasingly sophisticated nervous systems overlaid on top of eachother (note also this occurs in the brain as well - see the Triune brain theory) - the final one belonging to a reptilian past. If, due to life circumstances this one becomes dominant as the others are suppressed, then our life becomes severely and devastatingly limited. In the next blog I'll be talking about how we can reverse this suppression with various tools from energy psychology.

With thanks to the writing of Peter Levine for these insights and my clients for their practical application.

August musings on mindbody medicine and trauma

August the month of holidays... someone said on the radio today that August is the 'Sunday' of the months and I agree. It feels like a last-ditch effort to enjoy the sun and note how the nights are drawing in. And yet it's just part of the cycle of life really.

Interesting how in having 'down-time' the mind will remember other times you had that response. I had a client in recently who was about to go on holiday but was having very mixed feelings as she has lost her father recently and she was about to return to his former home in Italy. This manifested though as odd sensations and aches in her back and down her legs. Now, you will know if you have read anything I've written before that I am very much a believer in the mindbody connection. I told her it was very likely that these odd pains were linked to her imminent departure but that she should get checked at the doctors just in case. The doctor gave her a clean bill of health so we were left to work on the symptoms from a mindbody perspective.

According to my experience and the work of Dr. John Sarno, it seems that the mind will create aches and pains to distract you from the more painful and serious emotional pain that you are trying to avoid confronting. I know if you haven't come across this idea before it may sound strange but time and time again I have proved this. Anyhow, it seemed a classic case to me as these pains had come on suddenly a few days before her intended departure.. In our therapy session we started with EFT (emotional freedom technique or tapping) which allows you to both own the symptom but also release it. As we worked together I saw a wave of emotion appear to come from her stomach (where she had located the current pain) and wash over her face - tears soon followed. There was a tremendous amount of grief pent up in this person, which she hadn't really dealt with.

Leaving to go away was both pleasurable (it was a holiday after all) and painful as it was the place she had last seen her father AND in order to go she had to leave her elderly cat who was also very dear to her and who is on borrowed time already. This is a classic case of internal conflict; you both want to do something and you don't want to. The guilt and conflicted feelings come out with back-ache or sciatica or whatever. How can you tell if what you have is a true pathology (i.e structural problem) or a mind-body issue? Chase the pain. What I mean by this is use the EFT protocol (detailed and described in detail on my website www.alchemytherapies.co.uk/eft.htm) to apply the tapping protocol and see if the pain moves. it usually changes in some fundamental way pretty quickly.

For my client, I had instructed her to do this the night before she came to see me as it would give me a strong clue as to whether to treat the pain with physical or mindbody therapy. She reported that it went from her legs to her stomach. So, I had a pretty good idea we were dealing with a mindbody problem. In the therapy we did together the pain moved again from a tightness in the stomach to a constriction in the throat (interesting as this often reflects something unspoken). As we continued this developed into a full blown panic attack so I asked her to move to the table and we worked on calming the autonomic nervous system with belly breathing (which helps to break the shallow breathing- oxygen deprivation cycle triggering panic in the brain) and then I helped her speak her pain and then we shook her limbs to release the pent up emotion  (this last approach has been detailed in Peter Levine's work - Waking the Tiger and Healing Trauma). I find it helps people to experience their emotion through their body which is where it resides. There is much theory around how the mind and subconscious process interact. Again, see the information on my website.

Suffice to say I was successful in this treatment and my client left -shaken obviously but no longer having the trauma in her body. Her pain disappeared immediately and she has recently sent me a text from holiday saying how much she is enjoying herself. (though it's worth noting for accuracy that she did experience another panic attack at a subsequent time - one session is not going to undo 40/50 years of trauma!).

If any of this sounds interesting or you have anything to add please contact me through my website or facebook pages.

The unspeakable Speakmans

Someone in the clinic where I worked asked me if I'd seen this TV show 'The Speakman's' yet.. I hadn't even heard of it (I don't watch live TV- takes up too much time) but am always interested in catching something that's been recommended. I was told 'they do amazing things like cure phobias' - really fast!' I was intrigued.

I watched the show on itvplayer - with my mouth open most of the time. The programme is very much in the shlock reality TV mould with frequent add breaks and reminders after of what you've just viewed (in case you've forgotten!). My first reaction, I'll admit was one of horror. These people look like your worst idea of celebrity chasers. He (the husband of the man and woman duo) looks like a middle aged man trying to look young - hideous haircut, and his wife is the blond bimbette type. They have a 'fabulous' house in Rochdale, several ridiculously expensive cars, surrounded by the obvious trappings of wealth, but with no taste. Never mind. I got that bit out the way and then I tried to concentrate on their methods...

Hard to decipher as in fact, the TV format doesn't really go into detail - they have a conversation, they isolate the causative event in the persons life and then they do basic NLP manoeuvres on those memories. They also aren't afraid to humiliate the client if that is what it takes. They call it 'schema reconditioning'. So, they use eye movements, sometimes body movements, freeze framing and running the story backwards, etc to break the link between the memory and the disabling beliefs that surround it.. Fascinating. Now, it's difficult to know exactly how much of what you see is edited out from what actually happened but, on the surface at least, it gets results.

And, in time I must admit I began to think well they're onto something here. So, then I began to think about how I run the 'fast phobia cure' which is an established hypnotherapy technique - it's not dissimilar. What, works for them I think is the expectation ('therapists to the stars!' is how they're billed). As we know, in treatment setting up a positive expectation is 3/4 of treatment. But as for the rest, I don't quite  know how to explain their success. He, certainly seems to know his stuff, she is probably the bubbly, bright eye candy component but you can't fail after a while to start to like them in all their exuberant awfulness. They LOVE their life as they keep telling you and want to spread their joy around. As Nik Speakman says - you're only born with 2 phobias naturally - fear of confined spaces and fear of loud noises (he's not quite right there there's a couple more) - everything else is learned behaviour and can therefore be unlearned.

So, that, my friends and followers concurs with my attitude to life. We deserve more than to be stuck. We deserve to live life in joy and health. I can't quite agree with his saying 'what do you want qualifications or results?' - because  ideally you'd have both. You'd want your therapist to be accredited, to really know their stuff, and to be effective. That's my aim anyhow. Go Speakmans!

The downward spiral

I went to visit an elderly friend in hospital this week and was aghast to see how several weeks in hospital has rendered her. This once independent, feisty woman is reduced to as shadow of herself - literally and metaphorically. the most noticeable difference is the amount of weight she has lost. Now down to less than 5 stone. The cause of this? she broke her hip 3 months ago in a fall at home. She was admitted to hospital and has had numerous operations to try to mend it but she is now so weak she cannot stand. now hospital is obviously the place to be when you have a broken bone, and particularly when you are 95 and live alone. But I really take issue with the type of care she has received. The nursing staff for the most part are lovely, but the problem seems to be with they system.

This elderly lady has been moved 11 times in her 3 months stay - both to another hospital and to different wards within the same hospital. She has also been given food she cannot eat, over cooked meat ('which all tastes the same') and ends up bringing it all back up again so she has simply stopped eating it. Nutrition is so key with someone like this. The elderly have very weak digestion and need lots of fluid and dilute protein - so vegetable/ meat broths would be ideal. Her friends have noticed and try to bring things in for her. But all she gets is cake which she doesn't want and won't help her body heal.

I know, she's 95, what can you expect. But if only as much attention and money were paid to the diet of the ill and convalescing as is spent on expensive surgery then people might get better a lot quicker and we'd have less of a crisis in our health system.