Using the nervous system to heal

Every one has the same basic outline of the autonomic nervous system (ANS), with sympathetic and parasympathetic, that helps us respond to danger or threats; unfortunately the ANS can be overstimulated from traumatic events or experiences, creating a lasting pattern of over responding to innocuous situations. Ever hear of the book The Body Keeps the Score by Bessel van der Kolk? (if you haven’t, i highly recommend reading it!) There are other researchers and books that have studied the impact of lived experiences on our ANS responses such as Stephen Porges with Polyvagal Theory, and Francine Shapiro with EMDR.

I’m not an expert in all those models, nor am I a neuroscientist. But I do know is this; without retraining our responses, we can stay in a state of over activation causing a hurtful impact to our mental, emotional, and physical wellness.

Basics of the ANS

THe ANS is divided into two sections; the sympathetic and parasympathetic. The sympathetic system controls our heart rate, breathing, muscle activation. This system is triggered when there is a imminent danger or stressful event. This is that fight or flight response. People often describe feeling their heart pounding, maybe get a little sweaty, their breathing becomes faster and more shallow. People may experience some fidgetiness or restlessness. All these is the body’s way of preparing for action to respond to the danger or stress.

The parasympathetic system is linked to a state or stillness, often referred to freeze or called rest and digest. If the sympathetic system is the upper torso (heart and lungs) then the parasympathetic system is the lower torso (diaphragm and digestion). People describe feelings of heaviness, low energy, stiffness or inability to move quickly. These two systems work hand in hand to help us respond to danger or stress.

Rewire your ANS

In order to find some relief from over activation of the ANS, one must become familiar with their unique cues and triggering factors. Working with a therapist, the individual will uncover some of the past and/or current experiences and triggering moments that elicit an ANS response that may be unnecessary or exaggerated. This exercise can take weeks to uncover and requires patience from the client and the therapist. There are many ways to go about uncovering these cues and triggers; traditional talk therapy, hypnosis, brain scans to name a few.

The goal is to find a way to rewire the brain and ANS to these moments, allowing the connection between the body and the mind to be reconfigured. Not quite rewriting the history, but rewiring or retraining the body to respond in a way that is more aligned with core experiences of safety and connectedness. Techniques such as polyvagal theory, EMDR, brain-spotting, are highly successful in providing client with new ways to respond to past experience and future life events.

Be Well.

Choosing a Therapist: Red + Green Flags

As a therapist it is easy for me to share with you how to select the right therapist for your needs. However, when i went through the process myself, i was able to experience the process from a client’s perspective. I firmly believe that every therapist needs their own therapist. Regardless of who you are, the supportive people in your life, it’s so rewarding to have a truly objective person in your corner. If you have a current therapist, are looking for one, or helping someone else with finding one, read on for some tips in choosing a therapist.

Just as you would watch for red flags and green flags in a relationship, friendship or business partner, you can look for signs in a therapist. The flags listed below may not apply to everyone, so take what you need.

Red Flags

1. Unreliable. A therapist that is unreliable can make it difficult for you to find appointments consistently. The unreliability may also lead to poor follow up of services.

2. Insincere or Judgmental. One of the reasons you want to see an objective person is to avoid judgments from others. Being able to freely voice what you are thinking and feeling is essential to building rapport and feelings of safety within the therapeutic process.

3. Talks about themselves too much. A therapist may occasionally share some minor details about their lives with you during a session. But the rule of thumb is that it mustn’t derail the focus from the client to the therapist. Too much self disclosure means that they are either shifting their relationship to you from professional to personal, or they have poor boundaries.

4. Other red flags include: makes you feel uncomfortable or unsafe; engages in unethical behaviors; shares information about other clients with you; overly focused on billing/financials; imposing their values onto you; telling you what to do (therapy is not advice giving). If any one of these red flags show up, and you feel safe and comfortable to do so, bring it up to the therapist. Ask to speak to their supervisor. File a complaint with their licensing board. Do not feel obligated to return to therapy if you feel unsafe working with them.

Green Flags

1. Attentive and Attuned. A therapist’s role is to pay attention and listen; a.k.a. be an active listener. Listening to the words, the tone, the timber, the body language, the emotion expressed. All these are ways that the therapist should be engaging with you. You should feel ‘heard’ and safe in the sessions. Sometimes though a therapist may be distracted; it happens because we are human too. If your therapist reflects on something incorrectly, speak up and correct it.

2. Have skills that meet your needs. There are three kinds of therapists. The kind that niche down into working with clients on a specific need (e.g., sex therapy), the kind that are generalists and work briefly with all need areas, and the kind that say they are experts in everything. A great therapist is the first two kinds. You don’t necessarily need a specialized therapist for your needs. But if they are accessible to you, you may want to check them out as an option. Steer clear of the “expert in all” kinds of therapist.

3. Use evidence based techniques. Every therapist has learned in school a variety of interventions and modalities to help their clients. Some common ones include CBT, EFT, EMDR, Solution focused. If this is your first foray into therapy, you may want to read up on the techniques and see which feels right for you; talk to friends about their experiences. If you are more experienced in therapy, using a keyword of what is effective for you, say CBT, can help when searching.

More Green Flags

Other green flags to look for include: they want therapy to end because you have worked through the initial concern, not because they want to keep their caseload flush; they work with you on goals because they want what’s best for you; they are a strong communicator; they educate themselves continuously; they earn your trust; and they challenge you- respectfully- so that you begin to see a change in yourself.

When looking for a therapist, personal preference is important. Know what you are looking for, do some research. The biggest practice in town may not be your best ally for your needs; small solo practices are very powerful. Always ask for a free consultation; this is your chance to interview the therapist and make sure you like them. Ask questions, be clear that their values or mission statement aligns with your goals and values. Take the time to find the right one at the start, and you’’ll find your best match.

Be Well.

3 Tips to Creating Behavioral Change

People enter therapy for a variety of reasons but at the core of it is that they want something to change. Change a response, change a behavior, change their goals, change their symptoms. Change is hard and change is not linear. Identifying the specific behavior, response, or emotional state that you want to change is only a part of the process. Once that’s identified, you must identify the new behavior, skills, or response that you wish to develop. This is called goal setting.

There have been a multitude of studies on the success rates of those that set goals (look up the Harvard study on goals). Sometimes though, even having a goal isn’t enough to create the change you desire. One key factor that is essential to the process is motivation.

Motivating Change

Motivation is defined as the need or desire to achieve a goal. It has as many faces as there are goals and people. It is the internal process or condition that moves us towards something different. It may be a feeling or physical sensation that we wish to experience differently. The source of motivation is internal, not external. We may want to display the accomplishments of our motivation externally (e.g. looking great for our high school reunion) yet the internal processes that create that desire are based in receiving affirmations or praise from others.

Stages of Change

Back in 1983, researchers James Prochaska and Carlo DiClemente were studying participants in changing behavior, specifically smoking cessation. During this study they developed what are known today as the Stages of Change; a part of their Transtheoretical Model of Behavioral Change. Originally used to assist people create change from addictions, it has since been applied a plethora of behaviors. The stages follow the individual from the “I don’t have a problem” to the “I will skills to sustain my self improvement.” Check out this article for more detail.

1. Pre-Contemplation

2. Contemplation

3. Preparation

4. Action

5. Maintenance

Implementing Change

Once we can see change occurring within the therapeutic process, it’s rewarding! It’s like seeing that you can fit in that smaller dress size just in time for the high school reunion. The hardest part, though, is in consistently implementing the change. This is the process of creating new routines or habits, and developing new neural pathways. This is why I say change is not linear. We will have lapses or relapses. There will be setbacks. And you can restore your change behavior and move forward. Some tips to creating sustainable behavioral change.

1. Be clear on the internal motivation for creating change. When we try to fool ourselves into thinking that it’s something different, like trying to please someone else, we will not be as likely to maintain success.

2. Be consistent. Creating new behaviors, or change, requires time and effort. Once you have clarity on the internal motivation, you can find ways to remind yourself. Post notes on your mirror. Make a vision board. Set measured timelines to achieve mini goals. Practice daily.

3. Be compassionate. It’s nearly impossible to be 100% on point to your goal every single time. As we learn something new, we need to learn to fail as much as experience the success. It’s within the failures that we learn to adapt.

Change is hard and change isn’t linear. But change is possible.

Be Well.

Intimate Partner Betrayal

Betrayal is the violation of a presumptive contract, trust, or confidence. It is a conflict that can be experienced within any type of relationship; familial, romantic, friendship, and collegial. It can leave the individuals broken, angry, and searching for answers, much like in times of grief and loss. Betrayal is not solely sexual in nature either. It can take the form of financial, emotional, spiritual, or physical violations of trust. The type of relationship and trust that is betrayed doesn’t lessen its impact however. The most commonly discussed type of betrayal is that within an intimate relationship.

What is Intimate Partner Betrayal?

Intimate partner betrayal is when one partner uses deception, lies, and manipulation to violate the boundaries within the relationship. Just as there are multiple layers of contract or trust with an intimate partner, there are as many layers of betrayal. Intimate partner betrayal is not so much about the sexual act itself. Rather it’s about the moral infringement within the relationship. Values within an intimate partnership include trust, honesty, loyalty, sense of security, belonging, and love. When one of those is broken by one partner acting out sexually, it creates a chasm and requires care and attention. Betrayal trauma can be deep rooted for some partners especially if they have past traumatic experiences related to moral infringements.

Discovery

According to a small survey from 2021, 46% of people admit to infidelity (aka cheating), with kissing another person as the most frequent type of infidelity. This same survey also found that guilt was the most common reason for disclosure. But disclosure usually comes in what is called “trickle truths.” Little bits of truth of behavior in an attempt to either keep the behavior going, or to avoid the response and hurt the full truth will inflict on their partner. During this time, the partner has encountered suspicious behavior and deception. They have learned to doubt themselves and the truth about what they see. They can justify or normalize behaviors of the addict. Discovery day (“d-day”) is the day when the betrayed partner uncovers some, more, or all of the addicts behaviors. Discovery days look different for each relationship. Then the catalyst of crisis is uncovered.

At this time of crisis, the partner is in emotional turmoil. Intense information seeking occurs, confrontation, ultimatums and seeking help are usual responses. The addict however is offering “trickle truths” about their behaviors. Most fear that the full truth will hurt the partner more than maintaining the lies; others are afraid of the partners responses.

Recovery

Many of the signs and symptoms experienced by the betrayed partner meet much of the diagnostic criteria for PTSD. Intrusive or obsessive thinking, difficulty concentrating, blaming, loss of libido are all signs consistent with betrayal and post traumatic responses. Recovery and healing has three parts; treatment and recovery for the addict, healing and self discovery for the partner, and, if the partners want to remain together, joint therapy to begin to establish boundaries and rebuild trust within the relationship. Much like grieving, the recovery process from betrayal is not linear nor is it standardized in duration. It is a fluid process.

Recovery for the addict is about uncovering the addiction cycle and behaviors that contributed to their betrayal, and creating emotional restitution.

Recovery for the partner is about building empowerment, resourcing for self care, empathy and education.

Recovery is possible. Healing is possible. Restoration is possible. It all takes time, effort, commitment and trust. In the end, discovery day can turn into decision day about the future for each partner and the relationship as a whole.

Be Well.