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

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“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 Scopesfowler@scopeaust.org.au0407351328

Contact Details

mailto:sfowler@scopeaust.org.au

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