Hi Jazzy,
I've noted the title of that website, and I think we've made a great team in looking at the Conference together, I'm glad you're watching it too, as it's been great to hear your thoughts as well.
So, I've taken notes from today's talk (Day 6 - 26th September 2019)
Talk by Dr Peter Levine PhD entitled "Somatic Experiencing and Autonomic Dysregulation Syndrome"
Dr Peter Levine developed somatic experiencing model. He wrote "Waking the Tiger" and "Through a Child's Eyes" and many other books too.
He talks of the theme of 'revisited pain' and he was working clinically in the 1960's and 1970's at a time when there wasn't much medicine for pain or anxiety.
He mentions working with 'haunting memories' or 'flashbacks' and said there were more people with chronic pain issues.
He noted that what underlay the memories was pain. Pain was how the body remembered.
He united the idea of pain and memory.
He talked of a client he saw in 1969 called 'Nancy'
Nancy - had many very painful conditions, things he said would now be labelled as things like fibromyalgia, irritable bowel, etc etc and he said she was 'very anxious' and had chronic agoraphobia, and panic attacks. She had seen numerous specialists and had been passed on numerous times, and finally she was seeing a psychiatrist who was a friend of Dr Levine (I think he said the psychiatrist's name was Dr Jackson - but not sure). Dr Levine mentioned the lack of medication for anxiety, and that he had developed relaxation exercises for people with high blood pressure, and had found it was effective for reducing high blood pressure.
Therefore Nancy and her psychiatrist came to the appointment with Dr Levine for help.
Dr Levine used relaxation exercises with her, and her blood pressure reduced.
Dr Levine felt so relieved at first.
But, short-lived relief as her heart rate continued to drop, going from high 160's down to 55 bpm
He said this was when he discovered 'relaxation-induced panic' and dysregulation syndrome.
He had said to Nancy at this point:
"Nancy, you need to relax. Just relax."
He then thought of an image that appeared at the far wall of the consulting wall - a Tiger crouching and ready to pounce.
He said
"Nancy, there's a tiger chasing you, Run! Escape over the rocks and get away. Escape!"
Her body went through movements. Shaking and trembling.
Cycles of movements and then resting movements were noted. This went on for 45 to 50 minutes.
When her blood pressure had been very low (55 bpm) she had said "Don't let me die" Horror and terror in her eyes at that point.
But later, when she felt better, her gaze on him was 'soft' later.
She asked him "Do you want to know what happened?"
"I saw the tiger, my legs felt like lead and I couldn't run" But Dr Levine encouraged her. She could climb rocks and get away. She told him the tiger had changed to either a mask on her face, and a memory of when she was 4 years old and having a routine tonsillectomy operation, and how she had felt terrified. Immobile and terrified.
After that session - she had no further panic attacks.
Dr Levine did further sessions with her - focusing on relaxation, and her symptoms reduced further.
He noted that trauma and pain are connected.
Implicit procedural memories (body memories)
Neurophysiology was his area of study at this time. He mentioned that Donald Wilson (in a Zoology session) had talked about the tonic immobility of an animal when captured or preyed upon.
The low level heart rate - signals dorsal vagal response. Hypo-arousal.
Dr Levine said he wrote his doctoral dissertation on this area. Fear and immobility.
At a similar time, another researcher - Dr Stephen Porges had written an article on measuring the beneficial effects of Ritulin on children with ADHD.
Dr Levine sent Dr Porges his doctoral dissertation and they subsequently met up and talked for hours - sharing ideas.
Discussed para-sympathetic response that shuts down the autonomic system.
Poly-vagal theory attributed to Dr Steven Porges.
Dr Levine mentions they are co-mentors.
Spoke of high heart rate = autonomic system and Low heart rate = dorsal-vagal theory
Poly-vagal theory - landmark model helping people track and intervene in psychotherapy.
Dr Levine stresses that it is critical to understand the difference between sympathetically dominated arousal state, and shut-down, and terms shut-down as being 'life-threatening' 'realm of walking dead' and 'state of shut-down'.
MUS = medically unexplained symptoms. Dr Levine and Dr Porges said - these are NOT MUS, they have a root.
Pain - Buddha states that we will not escape this world without experiencing pain. That we will be touched by pain. He or she who is touched by pain, then retracts, but then feels second pain, which reinforces the first pain, and leads to experiencing fear and helplessness.
Dr Levine mentioned the book 'Life of Pi' by Yan Martel, and that only fear can defeat life. FEar can lock in these physical symptoms. Don't know if they're going to stop. Therefore leads to worry.
Something comes and there's danger - shoulders go up. When threat is over - shoulders go back down. Startle perceived as fear.
Veteran - shoulders may stay contracted. For years or months. Will generate pain.
If it becomes chronic, then will be diagnosed e.g. as fibromyalgia or other condition.
Autonomic nervous system - increased ++
When came down - plummeted ++ Therefore extremes.
Hyper-arousal and hypo-arousal. Need to work towards the Mid Range.
Somatic experiencing - helps with tools to track experiences. Gradually go into hyper and then into hypo - gradually. FLOW. Mid-range. 'flow' 'goodness' 'wholeness'.
Enabling people to come into mid-range.
Books 'An Unspoken Voice' and 'Trauma & Memory' - books written by Dr Levine.
Pain = symptom that can be worked with.
Images of things that happened in the past.
Patterns - Accumulate over time.
Foetal stress - no content or context.
Early bonding, attachment.
No conscious memories.
But "the body remembers"
Chronic pain - frequently attachment issues exist.
Autonomic dysregulation syndrome.
Somatic experiencing.
Stress-reduction therapy was original name. Currently 25,000 to 30,000 therapist trained.
Dr Levine mentioned meeting a 'serial entrepreneur' at a Boston conference (not sure if he mentioned his name, possibly Jay...?) who asked to talk with him after the talk. Mentioned all the people suffering in the world, and how Dr Levine said "I would like to be able to help these people who suffer from fibromyalgia" How? Online programme, measure responses and devise exercises to help them.
Suggested the entrepreneur should experience it for himself, and so he flew out to California to have sessions 'blew his mind' and became his 'biggest fan'. Developed an app - at initial testing phase. To help regulate the autonomic nervous system. Dr Levine is excited.
He said that Trauma and pain = facts of life, but don't need to be a life sentence.
Body posture: shoulders chronically tight. Dissociate from pain. What do shoulders want to do if contracted. Tense and release millimetre by millimetre. Titrate, incremental. Relief and spontaneous breathing = result. Working with trauma and pain together.
There may be a physical cause for pain - e.g. tumour and therefore must have comprehensive medical work-out prior to therapy, to rule out the possibility of medical causes or medical issues.
Somatic experience = helpful. Important to understand the underlying autonomic dysregulation.
As therapists - empathy considered important. BUT, need to know the arousal state of the client. If hyper-aroused, help bring them down. Feedback to slow heart. Reciprocity. Empathic sway. But if in shut-down, consider setting chairs at 90 degrees rather than face to face, to enable 'own space' and less threatening. Careful to respect space, or will shut-down more, as empathy can drive them more into their trauma. Empathy perceived as threat when in shut-down.
Ruth Lanios (Not sure of spelling of her name) - she studies Neurobiology of Trauma and is based in Canada - she showed people a Friendly Empathetic Face photo - if show this to people who are NON-traumatised, then their pre-frontal cortex lights up, and the amygdala reduces (on brain scans), but if show the same photo to someone with chronic trauma then the front part of the brain shuts down, and the amygdala turns up really high. Therefore if someone is in a dorsal -vagal shut-down state - must do things to help them out of this state.
Simple: get up and walk around the room together side by side. Less threatening than sitting.
More active, less passive.
Dr Levine used to walk bare-foot with clients on grass and sit by river with feet in water.
Movement.
Chronic pain - work very slowly. Movements - very slow. Engage and bring on line the frontal brain. Shut-down = regulation.
Hug and gentle squeeze to muscles.
Physical and emotional pain involve most of the same circuits.
Islands of safety - work with these.
Even bringing awareness to the pain will increase it. So VERY gradual.
Contraction and expansion. All animals - movement, universal rhythm. Flow and pain cannot co-exist.
Shame = pervasive in dorsal-vasal state.
Here and now - versus - there and then.
Orientating to more current time things.
Nancy - felt held in warm tingly ways - after her session. Flow experience.
Create, invite, and support state shifts.
Porges provides a clear framework for therapists.
Dr Levine's book 'Unspoken Voice' - how body holds pain and is also the healer if its wisdom is heard.
Regulation = important.
He mentioned a book by Porges at the end, and I must admit I didn't get the title, but I know Dr Stephen Porges is going to be talking in a couple of days time.
(I enjoyed this talk by Dr Levine, really exciting to see him talk, and I value his work. I think the entire conference is very good. Looking forward to tomorrow's talk).
Hope
