Friday, October 1, 2021

Choiceless Awareness for Emotion Processing in Polyvagal Resilience Therapy

Reading Dr. Deb Dana's 2018 book, The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation -- and encountering the following on page 42 after more than a decade studying the "dieseling" dysfunction of the General Adaptation Syndrome in the autonomic nervous system -- I was suddenly aware of why it is that the 10 StEPs component of Choiceless Awareness for Emotion Processing and other schemes in the general rubric of "mindfulness" are so effective in "heading that dieseling off before it gets to the pass," as well as making it possible to return to a state of comfort even if one slipped back into the muckmire for a while.

We'll get to that in a moment. First, however, Dr. Dana:

"Autonomic response is always happening. Our autonomic nervous system listens in a continual evaluation of risk and responds in service of our survival. Beneath awareness, we are swept along in the flow of [subconscious] neuroception.

"Bringing [conscious] awareness to autonomic response adds the influence of perception. With the addition of awareness, we move from a state of "being in" to "being with" and bring observer energy to interrupt ingrained response pathways. Without this interruption, the pull of old patterns keeps us moving down the autonomic hierarchy [into phylogenetically more primitive. "lizard brain" responses] and away from the neuroception of safety. As we experience the influence of awareness, we can make an intentional turn toward [self-acceptance, non-condemnation, appreciation, empathy and] self-compassion."

The afore-mentioned 10 StEPs of Emotion Processing is a mechanism for getting out of the state of "being in" and into the state of "being with" the autonomic response via Interoception rather than Introspection (see Craig) in the terminology of such modern-day, non-church, no-woo, pragmatic Buddhists as Batchelor, Epstein, Fronsdal, Kramer, Krishnamurti and Mishra. Where "neuroception" is subconscious, interoception is metaconscious or aware of awareness and whatever awareness is aware of... in the body. Including the...

a) dorsal vagal immobilized / collapsed / depressed / helpless / interpersonally disconnected, 

b) sympathetic autonomic mobilized / fight or flight or freeze / dis- or inappropriately connected, and 

c) ventral vagal safe / secure / comfortably interpersonally connected  

...states, all of which have easily identifiable sensations.  

Which is a 2,500-hundred-year-old Yogic Hindu and Buddhist skill that was evidently rediscovered by neuroscientists, psychiatrists and psychotherapists in about the late 1970s. (See Deikman, Kabat-Zinn, and Tart in the References below.) But those who stumbled upon the use of interoception to cure psychiatric ills were far from fully aware of the work of such as Selye, Benson and Wolpe back then. And people like Dana, Levine, Lupien, McEwen, Ogden, Porges, Sapolsky, Schore and Siegel had not yet emerged.

My only attempt at further contribution here is to connect the dots from Dana & Porges back through all the aforementioned to such as Batchelor, Block & Block, Epstein, Kelly, Mishra and other modern interpreters of Asian healing practices... and to offer Choiceless Awareness for Emotion (or "affect") Processing as one of several means of getting those dots to connect so that one who is temporarily stuck in the dorsal vagal or sympathetic autonomic states can -- simply by using those 10 StEPs and feeling what is there to be felt -- release the energy therein and move effortlessly back to the ventral vagal state. 

References

Batchelor, S.: Buddhism without Beliefs: A Contemporary Guide to Awakening, New York: Penguin / Berkeley / Riverhead, 1997.

Benson, H.: The Relaxation Response, New York: Morrow, 1975.

Block, S.; Block, C.: Come to Your Senses: Demystifying the Mind-Body Connection, New York: Atria Books / Beyond Words (Simon & Schuster), 2005, 2007.

Craig, A. D.: How do you feel? Interoception: the sense of the physiological condition of the body, in National Review of Neuroscience, Vol. 3, No. 8, August 2002.

Dana, D.: The Polyvagal Theory in Therapy, Engaging the Rhythm of Regulation, New York: W. W. Norton, 2018.

Deikman, A.: Deautomatization and the Mystical Experience, in Psychiatry, Vol. 29, 1966.

Deikman, A.: Personal Freedom: On Finding Your Way to the Real World, New York: Bantam, 1976.

Deikman, A.: The Observing Self: Mysticism and Psychotherapy, Boston: Beacon Press, 1982.

Epstein, M.: Thoughts without a Thinker: Psychotherapy from a Buddhist Perspective, New York: Basic Books, 1995, (updated 2005 & 2013).

Epstein, M.: Open to Desire: The Truth about What the Buddha Taught, New York: Gotham Books, 2005.

Fronsdal, G.: The Buddha Before Buddhism: Wisdom from the Early Teachings, Boulder, CO: Shambala, 2016.

Kabat-Zinn, J.: Mindfulness Meditation: Health benefits of an ancient Buddhist practice, in Goleman, D.; Gurin, J., editors: Mind/Body Medicine, New York: Consumer Reports Books, 1993.

Kabat-Zinn, J.: Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life: New York: Hyperion, 2004.

Kabat-Zinn, J.: Coming to Our Senses, Healing Ourselves and the World Through Mindfulness, New York: Hyperion, 2005.

Kabat-Zinn, J.: Full Catastophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness, Revised & Updated; New York: Bantam Books, 2013. (First edition published 1990.)

Kelly, L.: Shift into Freedom: The Science & Practice of Open-Hearted Awareness, Boulder Co: Sounds True, 2015.

Kramer, J.; Alstad, D.: The Passionate Mind Revisited: Expanding Personal and Social Awareness, Berkeley: North Atlantic Books, 2009.

Krishnamurti, J.: The list is so long as to be beyond appropriate space for this bibliography, so I will refer the reader to this page and call out his Choiceless Awareness (Ojai, CA: Krishnamurti Foundation if America, 2001) as a likely place to begin.

Levine, P.: In An Unspoken Voice: How the Body Releases Trauma and Restores Goodness, Berkeley, CA: North Atlantic Books, 2010.

Lupien, S., Gaudreau, S., Tchiteya, B., Maheu, F., Sharma, S., Nair, N., et al: Stress-Induced Declarative Memory Impairment in Healthy Elderly Subjects: Relationship to Cortisol Reactivity, in Journal of Clinical Endocrinology & Metabolism, Vol. 82, No. 7, 1997.

Lupien, S.; Evans, A.; et al: Hippocampal Volume is as Variable in Young as in Older Adults: Implications for the Notion of Hippocampal Atrophy in Humans, in Neuroimage, Vol. 34, No. 2, 2007.

Lupien, S.; Maheu, F.; et al: The Effects of Stress and Stress Hormones on Human Cognition: Implications for the Field of Brain and Cognition, in Brain & Cognition, Vol. 65, No. 3, 2007.

Lupien, S.: Brains Under Stress, in Canadian Journal of Psychiatry / Revue Canadienne De Psychiatrie, Vol. 54, No. 1, 2009.

Lupien, S.; McEwen, B.; Gunnar, M.; Heim, C.: Effects of stress throughout the lifespan on the brain, behaviour and cognition, in Nature Reviews - Neurosciences, April 29, 2009.

Lupien, S.: Cortisol level reveals burnout, in Trac-Trends in Analytical Chemistry, Vol. 30, No. 4, 2011.

McEwen, B.; Seeman, T.: Protective and damaging effects of mediators of stress: Elaborating and testing the concepts of allostasis and allostatic load, in Annals of the New York Academy of Sciences, Vol. 896, 1999.

McEwen, B: Mood Disorders and Allostatic Load, in Journal of Biological Psychiatry, Vol. 54, 2003.

McEwen, B.; Lasley, E. N.: The End of Stress as We Know It, Washington, DC: The Dana Press, 2003.

Mishra, P.: An End to Suffering: The Buddha in the World, New York: Farrar, Strauss & Giroux - Picador, 2004.

Ogden, P.; Minton, K.: Sensorimotor Psychotherapy: One Method for Processing Traumatic Memory, in Traumatology, Vol. 6, Issue 3, October 2000.

Ogden, P.; Minton, K.: Trauma and the Body: A Sensorimotor Approach to Psychotherapy, New York: W. W. Norton, 2006.

Ogden, P.; Fisher, J.: Sensorimotor Psychotherapy: Interventions for Trauma and Attachment, New York: W. W. Norton, 2015.

Porges, S.: The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system, in Cleveland Clinical Medical Journal, No. 76, April 2009.

Porges, S.: The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe (Norton Series on Interpersonal Neurobiology), New York: W. W. Norton, 2015.

Sapolsky, R.: Why Zebras Don't Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases and Coping, 3rd Ed., New York: Holt, 2004.

Sapolsky, R.: Behave: The Biology of Humans at Our Best and Worst, New York: Penguin, 2017.

Sarno, J.; The Divided Mind: The Epidemic of Mindbody Disorders, New York: Harper, 2006.

Schore, A.: Affect Dysregulation and Disorders of the Self, New York: W. W. Norton & Company, 2003.

Selye, H.: Stress Without Distress, Philadelphia: J. B. Lippencott, 1974.

Selye, H.: The Stress of Life, New York: McGraw-Hill, 1978.

Siegel, D.: Reflections on the Mindful Brain, in Mind Your Brain, Los Angeles: Lifespan Learning Institute, 2007.

Siegel, D.: The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration, New York: W. W. Norton & Company, 2010.

Siegel, D.: Mindsight: The New Science of Personal Transformation, New York: Bantam, 2010.

Siegel, R.: The Mindfulness Solution: Everyday Practices for Everyday Problems, New York: The Guildford Press, 2010.

Tart, C.: Waking Up: Overcoming the Obstacles to Human Potential, New York: New Science Library, 1987.

Tart, C.: Living the Mindful Life: a handbook for living in the present moment, Boston: Shambala, 1994.

Tart, C.: Mind Science: Meditation Training for Practical People, Napa, CA: Fearless Books, 2013.

Wolpe, J.: Psychotherapy by Reciprocal Inhibition, Palo Alto, CA: Stanford University Press, 1958. treating autonomic stress

Wolpe, J.; Wolpe, D.: Life Without Fear: Anxiety and Its Cure, Boston: Houghton Mifflin, 1981, and Oakland, CA: New Harbinger, 1987.

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