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1 Patricia D. Wilcox, LCSW The Traumatic Stress Institute Klingberg Family Centers New Britain, Connecticut 2020
Creating Excellent Organizations through
Brain and Body Science
Thank you The concepts and therapy worksheets in this presentation have been learned from: Dana, Deb The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation (Norton Series on Interpersonal Neurobiology) W. W. Norton & Company; 1 edition (June, 2018) Which is based on the work of Steven Porgess More ideas and exercises available in the book. 2 The Polyvagal Theory Explains Everything! 3
Explains everything? Describes our physical system of managing danger and intimacy 4 The science of safety—the science of feeling safe enough to fall in love with life and take the risks of living. What Is the Polyvagal Theory? POLY – many VAGAL – refers to the vagus nerve The Polyvagal Theory describes the multiple branches of the body’s vagus nerve and their role in maintaining our ability to stay safe and to thrive. 5 Creator Steven Porgess Key principles:
- Not voluntary or conscious
- No separation between our physical selves and our psychological selves
- Applies equally to our clients and our selves 6
Dilemma of being human
- To stay alive, it is essential to connect to others
- To stay alive, it is essential to detect danger in others and respond 10 Cooperate Protect Copulate Raise young Fight Flee Protect young Freeze How do we know which to do when? Through our neuroception which constantly scans for danger and safety monitoring: 11 Facial expression Noise Tone Movement Familiarity/newness And many other aspects of its environment. Our neuroception is influenced by our experiences. In each of our relationships, the autonomic nervous system is “learning” about the world and being toned toward habits of connection or protection. . The Vagus Nerve
- The vagus nerve is a primary component of the autonomic nervous system (ANS).
- ANS is the nervous system that you don’t control, that causes you to do things automatically, like digest your food. 12
The vagus nerve connects all the input information we gather through neuroception with all the organs that are part of our response. 13 The autonomic nervous system doesn’t make a judgment about good and bad; it simply acts to manage risk and seek safety. Through a polyvagal framework, the important question “What happened?” is explored not to document the details of an event but to learn about the autonomic response. When we use the ANS too much for defense, it has no time for its other tasks (Don’t swim after meals). Using all organs as part of defense response. Hence the association with illness (ACEs). 14 The Vagus Nerve Bi-Directional Communication
- Vagus nerve gathers information from our organs to enhance neuroception: food in stomach, progress of digestion, tension of muscles, heart rate, skin conduction, information from senses Danger: Cold, upset stomach, pain Safety: just right temperature, textures, right food
- Vagus nerve communicates instructions to organs: raise blood pressure, stop digesting, slow heart rate, tense muscles, etc. all based on safety or danger 15
In other words… To be able to use our social system (ventral vagus) to recover from fear, move from fight, flight or retreat/collapse to connection and support. 19 Humans need connection to thrive
- Humans have always needed to
determine if another person is safe
- If safe, they can connect and use each
other to co-regulate
- Survival of the fittest: the fittest is the
one who can make the most
connections
20 How does our neuroception enter our work environments?
- How safe do our staff feel in our workplace?
- What signals from the clients move staff up and down the ladder?
- What signals from other staff move staff up and down the ladder?
- What signals from supervisors and administration move staff up and down the ladder? 21
How can we help promote healthy neuroception??
- Teach theory
- Build awareness of our own ladders
- Tracking and reflecting
- Understanding the our own biological over- sensitivity
- Honoring the strategies and teaching new skills
- Techniques like breathing and meditation
- Support connections among staff
- Offer wellness meditation mindfulness programs 22 Staff states Client states
- List several ways that client actions might send staff into activated or withdrawn states.
- List several ways that staff actions might send client into activated or withdrawn states.
- List several ways that client actions might help staff stay in a safe state.
- List several ways that staff actions might help clients stay in a safe state. Exercise 23 The Polyvagal Ladder 24 Ventral Vagal Safe Social Mobilized Sympathetic Fight-Flight Dorsal Vagal Collapsed Immobilized F L O W C H A O S D A R K N E S S Glimmers Triggers Triggers
When you are in the mobilized or collapsed state, you may not even notice opportunities for connection. 28 Exercise What are three or four small, practical changes you could make in your program to increase staff sense of safety? 29 Section Two: How Can We Use This Science to Create Stronger Connections Among Staff? 30
Social Connections that Support the Work 31 The role of staff connections
- Safety
- Witness
- Humor
- Support
- Refilling energy
- What else? 32 Recent research shows that having connections at work is one of the strongest determinants of job satisfaction and longevity. The role of supervision
- A strong connection
- A safe place
- A quiet place
- A time to think 33
Community and outpatient
- Staff form strong relationships with clients while maintaining clear boundaries, and discuss boundary dilemmas with their teams
- Staff have time to connect with supervisor and team and discuss their cases 37 Choice and Voice- another source of safety and expanding the windows of tolerance 38 In what areas can employees have choice?
- Work hours
- Decorating space
- Use of treatment methods
- Including own interests (music, meditation, etc.)
- New responsibilities (training, supervise interns)
- Community involvement 39
In what areas can employees have voice?
- Agency policies and operations
- Treatment decisions
- Strategic planning
- Moral and ethical decisions
- What else….. 40 Section Three: Can We Strengthen Resilient Treaters? 41 Embedding Attention to VT 42
Bibliography 46
- Dana, Deb Series on Interpersonal Neurobiology The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation (Norton) W. W. Norton & Company; 1 edition (June, 2018)
- Dykema, Ravi “Don't talk to me now, I'm scanning for danger” How your nervous system polyvagal theory NEXUS March/April sabotages your ability to relate. An interview with Stephen 2006 Porges about his
- Levine Peter A. Ph.D.Trauma and Memory: Brain and Body in a Search for the Living Past: A Practical Guide for Understanding and Working with Traumatic Memory Atlantic Books October 27, 2015 North
- Porges, Stephen The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self Neurobiology) 1st Edition W. W. Norton & Company; 1 edition (April 25,-regulation (Norton Series on Interpersonal 2011)
- Porges, Stephen W. The Polyvagal Perspective Biol Psychol. 2007 February ; 74(2): 116–
- Porges, Stephen W., Ph.D. Trauma and the Polyvagal Theory: A commentary for Italian journal
- van der Healing of Trauma Kolk, Bessel M.D. Penguin Books; (September 8, 2015) The Body Keeps the Score: Brain, Mind, and Body in the New Book Clinical Applications of the Polyvagal Theory: The Emergence of Polyvagal-Informed Therapies (Norton Series on Interpersonal Neurobiology) by Stephen W. Porges and Deb A. Dana | Jun 12, 2018 47
