Figure 6.5d
A Note on Feedback and Core Regulation
In 1932 Sir Charles Sherrington received the Nobel Prize in Physiology or Medicine for showing that the nervous system is made up of a combination of excitatory and inhibitory nerve cells. It is the balance of these two neural systems that allows us to move our limbs in a smooth, coordinated, accurate way. Without inhibition, our movements would be wildly spastic and uncoordinated. While Sherrington’s work was primarily on the sensory/motor system (at the level of the spinal cord), the balancing of excitatory systems by inhibitory ones occurs throughout the nervous system and is considered a fundamental principle of it. This organization is the basic architecture of self-regulation. Let us look at an analogy from ordinary life:
In its simplest form (mechano-electric) regulation is what allows our house temperature to be kept in a comfortable range, regardless of the outside temperature. So let us say that on a winter’s day we would like to keep the indoor temperature at a comfortable 70 degrees. To do this, we would set the thermostat at the desired temperature. This turns on the furnace. However, the furnace is not turned on all the time. If it were, the temperature would continue to rise, and we would have to open windows to bring the temperature down. But then, as the temperature dropped, we would have to close the window. The reason that we don’t have to do all of this is that the temperature is controlled by a negative feedback loop. Like Sherrington’s inhibitory system, the temperature rises, say to 72 degrees, and the furnace shuts off until the temperature drops to 68 degrees, at which time the furnace turns on again. This brings the temperature back to 72 degrees, giving us an average temperature of 70 degrees. With the aid of a light cotton sweater, a relatively comfortable environment is reached. If, on the other hand, the furnace were to turn up as the temperature rose, we would have rather quite an uncomfortable situation. Not only would we have to take our pullover off, but we would soon be going around the house stark naked. In the first example we have a smoothly regulated temperature mediated by a negative feedback system (with positive consequences). In the second situation, we have a positive feedback loop with negative consequences; our house becomes a sauna and sweat lodge.
In distress and trauma, I believe that a positive feedback loop, with extremely negative consequences, is set up. Indeed, most of us recognize that primal negative emotions readily turn into self-reinforcing, runaway positive feedback loops. Fear and anger can readily explode into terror and rage. Here trauma is the ouroboros, the serpent swallowing its own tail, eternally re-creating itself.
In the reciprocal enervation discovered by Sherrington, the nervous system operates primarily as a negative feedback system much like—but infinitely more complicated than—a house thermostat. Self-regulation of the complex nervous system exhibits what are called emergent properties, which are often somewhat unpredictable and rich in nuance. They frequently lead to finding new and creative solutions and are cherished when they happen in life and in psychotherapy. So while the nervous system operates under the principle of self-regulation, the psyche operates under the emergent properties of creative self-regulation. We might say that as the nervous system self-regulates, the psyche engages with these emergent properties: that is, to creative self-regulation. The relationship between the viscera and the brain is a complex self-regulating system. The richness of creative emergent properties allows these “sounding” and breathing techniques (like the “voo” sound) to initiate change throughout the nervous system. In a situation of inescapable and mortal threat, the brain stem, or reptilian brain, sends intense signals to the viscera, causing some of them to go into hyperdrive (as with the gastrointestinal system) and others to constrict and close down, as with the bronchioles of the lungs or the beating of the heart. In the first instance (hyperdrive), we get symptoms like butterflies, knots in the gut or rumbling, uncontrollable diarrhea. With the lungs, we have feelings of tightness and suffocation, which, when chronic, can lead to the symptoms of asthma. Likewise, the effect of the primitive vagus on the heart is to decrease the beat to a level so low that it can actually lead to (voodoo) death.80 Because these sensations feel so dreadful, they themselves become the source of threat. So rather than coming from outside, the threat now emanates from deep within one’s bowels, lungs, heart and other organs and can cause the exact same effect upon the viscera that the original threat evoked. This situation is the unfortunate setup for a positive feedback loop with disastrous negative consequences. In addition, because traumatized individuals are experiencing (intense) threat signals, they project this inner turmoil outward and thus perceive the world as being responsible for their inner distress—and so remove themselves from both the real source of the problem and its potential solution. This dynamic also wreaks havoc not only on the body but also on relationships.
The “voo” sound—by, first of all, focusing awareness upon the inner locus of the real problem—allows one to begin to change one’s experience from dreadful to pleasant and thus moves the situation from being a positive feedback loop (with negative consequences) to being a negative feedback loop, which helps restore homeostatic balance, equilibrium and, hence, feelings of goodness. This shift, even if only brief, opens an opportunity for the client to experience the warmth of the supportive therapeutic relationship, which, in turn, also provides a buffer against the rush of (sympathetic) hyperarousal soon to follow. Then the self-regulatory system (negative feedback loop) brings down arousal, allowing for much deeper, more stable and enduring sensations of goodness, as well as a more resilient nervous system and psyche.
* Merriam-Webster’s definition of organism is “a complex structure of interdependent and subordinate elements whose relations and properties are largely determined by their function in the whole.” Organism describes a wholeness, which derives not from the sum of its individual parts (i.e., bones, chemicals, muscles, nerves, organs, etc.); rather, it emerges from their dynamic, complex interrelation. Body and mind, primitive instincts, emotions, intellect, and spirituality all need to be considered together in studying the organism.
† Namely, in the cartilaginous and even jawless fish, in which it regulates metabolic energy conservation.
‡ Any situation that can increase one’s sense of safety has the potential of enlisting the evolutionarily more advanced neural circuits that support the behaviors of the social engagement system.
§ For a thorough discussion of the structure and complexities of dissociation, the reader is referred to the following comprehensive article: van der Hart, O., Nijenhuis, E., Steele, K., & Brown, D. (2004). Trauma-Related Dissociation: Conceptual Clarity Lost and Found. Australian and New Zealand Journal of Psychiatry, 38, 906–914. These authors define dissociation, contextually, thus: “Dissociation in trauma entails a division of an individual’s personality, that is, of the dynamic, biopsychosocial system as a whole that determines his or her characteristic mental and behavioral actions. This division of personality constitutes a core feature of trauma. It evolves when the individual lacks the capacity to integrate adverse experiences in part or in full, can support adaptation in this context, but commonly also implies adaptive limitations. The division involves two or more insufficiently integrated dynamic but excessively stable subsystems.”
‖ Jacksonian dissolution is, essentially, the precursor of Paul McLean’s triune brain theory. See McLean’s The Triune Brain in Evolution: Role in Paleocerebral Functions (New York: Springer, 1990).
a It is most probable that sensory afferents, both from the external senses (e.g., sight and sound) and from the interior of the body (from muscles, viscera and joints), converge in the thalamus at the uppermost portion of the brain stem and, from there, proceed to the insula and cingulate cortex.
b While brain maps are useful, these are somewhat artificial situations, as fMRIs are more like static snapshots of dynamic brain circuitries.
c Remember that because fMRIs are fixed images, they would not be able to pick up such dynamic chang
es.
d To make matters more complex, one often observes indications of concurrent combinations of sympathetic arousal and parasympathetic (vagal immobility) activation. This occurs particularly at high-stress and transition points. Concomitant indicators include low heart rate (vagal/parasympathetic) along with cold hands (sympathetic).
e It can also be evoked by intense and unremitting stress.
f The social engagement system controls the voice, ear and facial muscles, which are all used together in nuanced communication.
g Screenwriter William Broyles Jr. actually spent a full week marooned on a desert island, and many aspects of the 2000 film were informed by his firsthand experiences.
h The power of simple contours representative of the human face may trace back to an innate pattern recognition that is already functioning just after birth. A number of clever experiments have been devised, all showing that the newborn is drawn preferentially to simple (curving) contours and not attracted, for example, to angular shapes.
i Indeed, the brain stem’s immobilization system is the “root” of the default hierarchy.
j These same brain regions (in the medial temporal lobe) that process memory and emotion, when malfunctioning, contribute to delusions of identity. To people with injury here, their mother looks and sounds exactly as she should, but they have lost the sensation of her presence; she seems somehow unreal.
k Along with the vestibular system, this is how we know where we are in gravity space.
l These figures are taken from Healing Trauma: A Pioneering Program for Restoring the Wisdom of Your Body written by Peter Levine and published by Sounds True. Used with permission from Sounds True, www.soundstrue.com.
m This diffuse brain lines the entire alimental canal (almost 30 feet from the esophagus to the anus).
n It should be noted that excess levels of serotonin in the gut also lead to problematic states.
o Motor neurons that act on the viscera are called viscero-motor neurons.
p In addition, there are multiple and bidirectional “neuropeptide” systems studied by Candice Pert and others. See Pert et al.’s Molecules of Emotion: The Science behind Mind-Body Medicine (New York: Simon and Schuster, 1999).
q It is interesting that many autistic children have GI abnormalities. See Hadhazy, A. (2010). Think Twice: How the Gut’s “Second Brain” Influences Mood and Well-Being. Scientific American, February 12.
r As previously mentioned, many people experience a combination of sympathetic and vagal hyperactivity—a fact that makes the symptom profile more complex. For example, in the case of patients diagnosed with irritable bowel syndrome (IBS) or “spastic colon,” there is often a vacillation between constipation and diarrhea.
s Therapists may be taken aback when certain clients perceive them as a threat or as either a hero or a villain.
t Many medical texts still teach that no sensations or feelings arise from the guts. The only thing we feel in our guts, they say, is pain—and then only when the pain is referred to areas like the lower back.
u I recommend the wonderful Swedish film As It Is in Heaven (2004).
v See the next section for a more detailed explanation of how feedback influences core regulation.
w Jin Shin Jyutsu®, an ancient healing system for “harmonizing the life energy in the body,” has been passed down from generation to generation by apprenticeship. The art fell into obscurity until the early 1900s when it was dramatically revived by Master Jiro Murai in Japan and then brought to the United States by Mary Burmeister. In 1979, I had the privilege of meeting this vital octogenarian in Scottsdale, Arizona, where she continued to practice and teach well into her eighties.
CHAPTER 7
Mapping the Body, Mending the Mind
SIBAM
The Body is the Map of the Mind.
—J. D. Landis, Solitude
The Body as Instrument of the Self
Physical sensations are the very foundation of human consciousness. As the biological creatures that we are, our bodies are designed to respond in an ever-changing, challenging and often dangerous world. A new baby must gradually learn to discern the meaning of the sensations that his or her body is experiencing. Babies learn about their body/mind self through action and interaction with their parents and with the environment that surrounds them. Infants live within a sea of sensations. Fortunately most parents catch on fairly quickly to their newborn’s code. They know when she is signaling the various and unmistakable sensations of hunger, pain, anger and tiredness because babies instinctively communicate those internal states, inducing their caregivers to provide relief. It is a matter of survival. Later, however, this evolutionary brilliance serves more than a life-or-death function. Sensations actually form the bedrock for a child’s gradual maturation toward authentic autonomy and independence.
As you grow, you are defined by how your body interacts with your environment. What you do physically—whether experiencing pleasure or pain, success or failure—is registered by your body and recorded in your mind. Your knowing about the world, as you interact with it, comes from the totality of your sensations, both external and internal. Sir Charles Sherrington, winner of the 1932 Nobel Prize in Physiology or Medicine, said that “the motor act is the cradle of the mind.” Fifty years later another such laureate, Roger Sperry, elaborated on Sherrington’s iconic premise:
In so far as an organism perceives a given object, it is prepared to respond with reference to it … The presence or absence of adaptive reaction potentialities, ready to discharge into motor patterns, makes the difference between perceiving and not perceiving.81
In a series of astonishing experiments stimulated by the “Sperry Principle,” Richard Held and Alan Hein had adult subjects wear special prism goggles that made everything appear to be upside down.82 After some time (usually a week or two), the brains of the subjects who were free to move about actively, touching and manipulating their environment, adapted so that they actually saw the environment as right side up again. The subjects who were not allowed to move around and explore, however, did not experience visual normalization. Held also carried out experiments that illustrate the developmental significance of motor responses.83 Newborn kittens were put on a movable apparatus and placed within a circular enclosure. One group of kittens walked and pulled the apparatus around the enclosure with them, while the other kittens were pulled along passively. Both groups had exactly the same visual experiences moving around the enclosure. The kittens that were moved around passively, not actively exploring their environment, were unable later to use sight to guide their movements. They could not place their paws properly or move away from a place where they could fall. This deficit was swiftly reversed when they could actively move around, exploring their environments.
Finally, in this parade of Nobel Prize recipients, Gerald Edelman, the American biologist who won the prize in 1972 for his work on immunology, has proposed a theory of what he calls Neural Darwinism.84 This complex theory recognizes the intrinsic relation of motor activity, from our past and present explorations of the environment, as the underpinning of experience and memory. Collectively, these Nobel recipients see “mindedness” (including our complex structure of meaning making) as deriving from the fine tuning and categorization of our actions, sensations, feelings and perceptions. Turning earlier theories on their heads, we are now aware that, rather than being the hierarchical, top-dog commander in chief, our thoughts are a complex elaboration of what we do and how we feel.
Thought can indeed be said to function as an “explanation” to ourselves: a reminder of what we are doing and feeling. Thinking and symbolizing help us to make categories of events, people or locations, such as “safe” and “dangerous.” The evolution of thoughts, symbols and verbal communication, derived from sensations, gave our earliest ancestors a crucial edge, allowing them to share successes and failures and to pass them on to others. As hunters and gatherers, survival meant being fully in our bodies just l
ike the babies. Excessive mental rumination would have surely meant sudden death or slow starvation. However, over the millennia, the innate intelligence of the body was abandoned for the exclusivity of rationality, symbolization and language. Our bodies came to exist solely (as a character in a Jules Feiffer cartoon quipped) “to transport our heads from place to place … Otherwise we would have no need for them.” On the contrary, consciousness actually unfolds through the development of body awareness, of learning to understand the nuances and the meaning of our internal physical sensations, and of our emotional feelings as well.
Trauma and the Body/Mind
Under ordinary circumstances, physical sensations are signals for action: to fight or flee when threatened, to chase down a wild turkey or open the fridge and make a sandwich when hungry, to go the bathroom when the urge presses, to make love when aroused by passion, to sleep when tired, to break into song when the mood strikes or to plant your feet and raise your voice in anger and assertiveness when your boundaries are violated. In all these instances, the body initiates and the mind follows.
Having an intimate relationship with, and understanding of, your physical sensations is critical because they, in signaling action, guide you through the experiences and nuances of your life. If one has been traumatized, however, one’s sensations can become signals not for effective action but, rather, for fearful paralysis, helplessness or misdirected rage. When some of one’s bodily signals become harbingers of fear, helplessness, impotent rage and defeat, he or she is typically avoided like the plague at a dear cost mentally, emotionally and physically. While attempting to shut down distressing sensations, one pays the price of losing the capacity to appreciate the subtle physical shifts that denote comfort, satisfaction or warning of clear and present danger. Sadly, as a result, the capacity for feeling pleasure, garnering relevant meaning and accessing self-protective reflexes also shuts down. You can’t have it both ways; when feelings of dread are held at bay, so are the feelings of joy.
In an Unspoken Voice Page 15