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The nervous system and behaviours of concern
Susan Fowler16th August 2019
Functions of behaviour
EscapeSensory seeking
Pain
TangibleSocial interaction
http://www.google.com.au/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&docid=9G--KFbCCz4WuM&tbnid=XYLXD1g1OtbpbM:&ved=0CAcQjRw&url=http://www.thegloss.com/2011/02/24/culture/when-did-you-have-your-first-drink/&ei=RmcWVIbPBMql8AWyt4HoBQ&bvm=bv.75097201,d.dGc&psig=AFQjCNGEwRZ7NeuctYsQCA4GAQHPyk4qGg&ust=1410840768072920http://www.google.com.au/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&docid=w3ieR23ukWqguM&tbnid=u3d1WfS7RAh_nM:&ved=0CAcQjRw&url=http://www.clipartbest.com/picture-people-talking&ei=bmcWVOerB4qA8QXQuoHQAg&bvm=bv.75097201,d.dGc&psig=AFQjCNEg9pxO6yYXT2OoOcIhmNGAs5puWg&ust=1410840804810952http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&docid=1tgAtxjiUrOdPM&tbnid=TLlPJp3n7hhxYM:&ved=0CAcQjRw&url=http://www.christart.com/clipart/image/hanging-upside-down_000&ei=O2gWVNmoIsj98AW26oHYCw&bvm=bv.75097201,d.dGc&psig=AFQjCNF_wZ54Zj5l_JtYBNSqT68RYK0O9w&ust=1410840959923729
3
“When our nervous system fails us, we use behaviour”
(Porges, 2017)
Dr Buczynski talking with Stephen Porges − 2017 Webinar
Frontiers in the treatment of trauma
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Neurological underpinnings of behaviours of concern
Sensory Systems
Vestibular/Movement
Balance, Gravity Hear
Smell
Touch See
TasteProprioception/Muscles
7 senses
Sensory thresholds
Notice easily
Need intensity
Some – high pain thresholds
cope with lots of pain
Others – low pain thresholds
feel pain easily
This is the same for all the senses.
Sensory Thresholds
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Misperception of danger –interpret cues as a threat in the absence of clear danger Preprogramed for fear – Prime directive – survival (Perry, 1999)
Need to be aware of danger to survive (light touch, movement in peripheral vision)
Uncomfortable but not life threatening if didn’t find food
Negative – Velcro, Positive – Teflon (Hanson, 2019)
Develop social engagement system to calm the nervous system and build trust and reassurance
Danger in the modern world – anxiety about being different, embarrassed, part of group to survive, interpreting everyday sounds as threatening
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Calming the nervous system –sensory activities Carrying heavy boxes
Moving tables
Woodwork
Digging in the garden
Pushing against hard surfaces, ie chair push ups, pushing trolley
Washing windows
Carry back pack
Deep pressure
Heavy work for the jaw – chewing, sucking (especially thick shakes, curly straws, trail mix, gum, jubes), blowing
8th sensory systemInteroception
The Interoception Curriculum
Interoception 101 education.sa.gov.auEmma Goodall
http://brainsciencepodcast.comInteroception with Dr AD(Bud) Craig
https://www.kelly-mahler.com
http://brainsciencepodcast.com/
Interoception - signals from the body
Vagus
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Interoception – assigning meaning to signals
Hunger Tired
Happy Anxious Angry
Hot
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InteroceptionNeed good interoceptive awareness for good emotional regulation
(Mahler, 2019)
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Poor interoceptive awareness – poor emotional regulation Can be under responsive – apparent 0-100
Can be over responsive – easily upset
Teach the language
Experiment
Explain the feelings
Do body checks
Teach what to do
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Use external cues
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Teaching Coping SkillsSelf Regulation
Body Signals
Assign meaning
Interoception
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Zones of regulation
Zones of regulation − PCD of zones
Used to help explain different levels of arousal
Include body signals (what this looks and feels like)
Action – what to do for person and support staff
(Kuypers, 2011)
Red Crisis
Yellow Beginning to become upset or losing focus –put in place strategies learnt in green
Green Calm and alert – time to challenge and learn new skills
Blue Shut Down
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Flip your lid – over arousal
Cognitive activities to put lid back down(Siegel, 2019)
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Stephen Porges, 1995
Polyvagal TheoryThe importance of relationships
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Polyvagal theoryStephen Porges Poly − Many
Vagus – Vagus Nerve
How we react when we are afraid
Our nervous system can have an impact on others
Co-regulation
How am I responding ?
Need good self regulation to co regulate
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Behaviours don’t happen in a vacuum What physical messages are you
sending out?
What does this say to another person?
If you are good at regulating your emotions (you feel calm and good about yourself) you will give out lots of cues about safety and that you are ok to be with. You will then be able to support another person to regulate their own emotions
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Social engagement system
Danger
Flop and drop/Feigned Death
Polyvagal theory
Fight or flight
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Importance of social interaction and relationshipsSocial engagement is the vagal brake on fight/flight
Tony Attwood and Michelle Garnett say:
“If someone approaches me for a conversation and they are full of worry, fear or anger, I find myself suddenly in the same state of emotion” (Empathic Attunement)
(Attwood & Garnett, 2016)
Importance of relationships− Polyvagal theory
© Australian Childhood Foundation 2011 (Dykema, R, 2006)
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Neurobiology of safety Neuroception – perceived sense of safety, not within conscious
control (Porges, 2017, 2019)
We give out cues of safety (mediator and client)
Too overbearing or too collapsed – doesn’t show safety
Set up feeling of safety so can turn off defensive strategies
Think of how you react to aggression – shut down and withdraw? If feel unsafe doesn’t support you to engage and build emotional capacity of others
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Creating safe social environments Co regulation – use yourself to decrease arousal Stay calm on the outside Facial expression and posture Keep voice low (not too low) and slow Slow movements Positioning and proximity Keep in front (movement in peripheral vision highly alerting) Empathise – “I’m here with you” – hold in the emotion (NVC) Breathing patterns Know what is happening Know how a person communicates
Attwood, T and Garnett, M (2016) Exploring Depression, and Beating the Blues: A CBT Self-Help Guide to Understanding and Coping with Depression in Asperger’s Syndrome [ASD-Level 1]. Jessica Kingsley Publishers
Australian Childhood Foundation (2011) Discussion Paper 18, Polyvagal Theory and its implications for Traumatised Students. Retrieved from https://professionals.childhood.org.au/app/uploads/2018/08/SMART-Discussion-Paper-18.pdf
Craig, A D (2002) How Do You Feel? Interoception: The Sense of the Physiological Condition of the Body. Nature reviews.. Neuroscience 3, 655-66. 10.1038/nrn894
Dunn, W (2009) Living Sensationally; Understanding Your Senses, Jessica Kingsley Publishers
References
Dykema, R (2006) “Don't talk to me now, I'm scanning for danger” How your nervous system sabotages your ability to relate An interview with Stephen Porges about his polyvagal theory, Nexus, 30-35.
Hanson, R (2019) Overcoming the negativity bias. Retrieved from https://www.rickhanson.net/overcoming-negativity-bias/
Kuypers, L (2011) The Zones of Regulation: A curriculum designed to foster self-regulation and emotional control. San Jose: Social Thinking Publishing
Mahler, K (2015) Interoception: The Eighth Sensory System
Mahler, K (2019) The Interoception Curriculum: A Step-by-Step Guide to Developing Mindful Self-Regulation
References
https://www.rickhanson.net/overcoming-negativity-bias/
Perry, B (1999) Memories of Fear How the Brain Stores and Retrieves Physiologic States, Feelings, Behaviors and Thoughts from Traumatic Events. Retrieved from https://childtrauma.org/wp-content/uploads/2014/12/Memories_of_Fear_Perry.pdf
Porges, S W (2017) Beyond the Brain: How the Vagal System Holds the Secret to Treating Trauma. Retrieved from http://stephenporges.com/index.php/articles-and-interviews
Porges, S W (2017) The Pocket Guide to the Polyvagal Theory; The Transformative Power of Feeling Safe. W W Norton and Company
Porges, S W (2019) Polyvagal Theory in Action - The Science and Practice of Body Regulation With Dr Stephen Porges. Therapist Uncensored Podcast
References
https://childtrauma.org/wp-content/uploads/2014/12/Memories_of_Fear_Perry.pdfhttp://stephenporges.com/index.php/articles-and-interviews
Susan FowlerOccupational Therapist [email protected]
Contact Details
mailto:[email protected]
The nervous system and behaviours of concernFunctions of behaviour�“When our nervous system fails us, we use behaviour”Neurological underpinnings �of behaviours of concernSlide Number 5�� Sensory thresholdsSensory ThresholdsSlide Number 8Misperception of danger – interpret cues as a threat in the absence of clear danger Calming the nervous system – sensory activities8th sensory system�Interoception�Interoception - signals from the bodyInteroception – assigning meaning to signalsInteroceptionPoor interoceptive awareness – poor emotional regulation Use external cuesSlide Number 17Zones of regulationFlip your lid – over arousal�Slide Number 20Polyvagal theory�Stephen PorgesBehaviours don’t happen in a vacuum Social engagement systemImportance of social �interaction and relationshipsImportance of relationships�− Polyvagal theory �Neurobiology of safetyCreating safe social environmentsReferencesReferencesReferencesContact Details