Friday, November 30, 2012

Discovering a Paradigm Shift in Mental Health?

Prof, Stephen Porges - "The Polyvagal Theory"

Understanding the Face-Heart connection, and hidden vitality affects, in human health?

The paradigm shifting discovery of a “polyvagal” control of the heart, explains just how, those of us suffering from unresolved trauma experience, become locked out of the social system of group survival, in our inability to self-regulate unconscious survival reflexes,
ie, freeze/flight/fight?

The theory shows just how “unconscious, spontaneous, social reflexes,” are inhibited in those of us struggling to cope with unresolved traumatic experience, so often diagnosed as a mental illness. In a computer analogy, its like having two distinctly different operating systems, (1) survival, (2) social. If our unconscious spontaneous social reflex functioning is “turned off,” by unresolved trauma experience, we cannot form the kind of healthy human relationships, so vital for our physical/emotional/mental health. See; The Polyvagal Theory Stephen W. Porges, PhD. Brain-Body Center, Department of Psychiatry, University of Illinois at Chicago.

Polyvagal Theory: Why This Changes Everything

How to use heart rate variability as a portal to self-regulation
The key missing ingredient in the fight/flight theory
How polyvagal theory clarifies the role of fear in unresolved trauma
Why vagal regulation affects our interactions with others
How music cues vagal regulation and why this could help your trauma patients
Polyvagal theory and working with children
How to increase psychological safety in hospital settings
Stephen Porges, PhD Author of The Polyvagal Theory, Professor at University of Illinois at Chicago

From: National Institute for the Clinical Application of Behavioral Medicine.

IMO. It comes down to understanding and accepting that physiological processes are primary, and our thoughts are a secondary process? This new discovery changes everything, because it explains the very roots of “spontaneous” human behaviors, like never before in our history. Healthy, spontaneous, physiological function lies at the “heart” of human vitality and health, and Porges shows the hidden plumbing, (so to speak) which stimulates what others have called “flow,” or being in the moment. No matter our individual thoughts and experience, we all have the same human heart and the same brain/nervous system control of its “unconscious, autonomic” functioning, beneath our individual differences?

Trauma involves a desire for “escape,” where there is no physical escape, and so we escape into the mind, into the brain, beyond the body’s pain receptors, in a totally unconscious reaction. Understanding this critical point about “escaping” into the brain and therefore the mind, is vital in accepting that primary processes of unconscious communication, must come first in the recovery of emotional equilibrium, for those us with a history of mental illness. Indeed, a new appreciation of the traumatic conditioning of the autonomic nervous system, is beginning to ask very serious question’s about the re-traumatizing effects of the West’s medical model view of mental illness? For further explanation of an unconscious process Stephen Porges calls “neuroception ,“ and its implications for mental health, see; Neuroception: A Subconscious System for Detecting Threats and Safety

It seems that we need to accept that its the body that comes first, and not the mind, in our Western cultural concept’s of being human, or we will continue to exacerbate the problems of emotional-mental distress, in our “mind oriented” Western culture. The eminent neurologist Jaak Panksepp, suggests that Descartes iconic statement of modernity, “I think therefore I am,” now needs re-framing to “I feel therefore I am.“ Furthermore, there is a wealth of solid science and therapeutic knowledge, curiously unreported in the mainstream media, with its predominately negative view of emotional-mental distress. An example, is Allan N Schore’s (described as the Einstein of neurobiology) contribution at brilliant programs like Yellow Brick;

PARADIGM SHIFT: SECONDARY PROCESS COGNITION TO PRIMARY PROCESS COMMUNICATION. The relational trend in the field shifts primary process from intra-psychic cognition to inter-subjective communication. In an important article on “primary process communication” Dorpat (2001) argues, “The primary and secondary process may be conceptualized as two parallel and relatively independent systems for the reception, analysis, processing, storing, and communication of information.” He asserts that affective and object relational information are transmitted predominantly by primary process communication, and that secondary process communication has a highly complex and powerful logical syntax but lacks adequate semantics in the field of relationships. Echoing a description of right brain attachment communications, he concludes such nonverbal communication contains “both body movements (kinesics), posture, gesture, facial expression, voice inflection, and the sequence, rhythm, and pitch of the spoken words.” Integrating this and other research and clinical studies I have argued that therapy is not the “talking” but the “communicating cure.” A PARADIGM SHIFT:

Consider a recent report in the Sydney Morning Herald, dated November 27, 2012; “Mental health report card 'confronting' Australia's inaugural "report card" on mental health services has been described by the chair of the National Mental Health Commission as "confronting" after it found services need a major overhaul. Professor Allan Fels said Australia had failed in its delivery of mental health services and the situation needed urgent attention.

"The statistics related to physical illness and early death among people with a mental health difficulty are appalling," he said.

"Their health is worse than the general community on just about every measure. People with a severe mental illness have their life expectancy reduced by 25 years on average due to the increased likelihood of heart related conditions, diabetes and obesity. There are many contributing factors and there are no simple answers, but this demands immediate action." Read more>>

After stumbling upon Allan N Schore’s “Affect Dysregulation & Disorders of The Self,” in 2007, self-education has transformed my previous “medical model” understanding of my Bipolar Type 1 disorder, and allowed me to remain completely medication free (including the sleeping pills, I once used to manage mania) and find increasing good health and spontaneous vitality in my daily life. Using new insightful knowledge and Peter Levine’s methods of trauma release, (a mind-less meditation routine based on our felt-senses) has set me free from what so many believe , is condition requiring lifelong medications and their “side-effects” cost to health.

Prior to 2007, I trusted a belief in the "diseased brain" view of bipolar disorder, "its just like having cancer or diabetes," I was so often told (even by the head of psychiatry ay a major Sydney hospital). Yet undertaking a degree in counseling, I was introduced to alternative views which expressed a belief in emotional development issues, including "relational trauma." In 2013 the DSM-5 is due for release, along with a proposed new definition of childhood trauma, in order to further clarify the issue of post traumatic stress disorders. Please read a recent paper for this proposal;

Understanding Interpersonal Trauma in Children:
Why We Need a Developmentally Appropriate Trauma Diagnosis

"Childhood exposure to victimization is prevalent and has been shown to contribute to significant immediate and long-term psychological distress and functional impairment. Children exposed to interpersonal victimization often meet criteria for psychiatric disorders other than posttraumatic stress disorder (PTSD).

Therefore, this article summarizes research that suggests directions for broadening current diagnostic conceptualizations for victimized children, focusing on findings regarding victimization, the prevalence of a variety of psychiatric symptoms related to affect and behavior dysregulation, disturbances of consciousness and cognition, alterations in attribution and schema, and interpersonal impairment. A wide range of symptoms is common in victimized children.

As a result, in the current psychiatric nosology, multiple comorbid diagnoses are necessary—but not necessarily accurate—to describe many victimized children, potentially leading to both undertreatment and overtreatment. Related findings regarding biological correlates of childhood victimization and the treatment outcome literature are also reviewed. Recommendations for future research aimed at enhancing diagnosis and treatment of victimized children are provided." From: The Trauma Center

* * *

Please watch, Trauma Treatment - Part 1: Mistakes Made, Lessons Learned

In part one of Trauma Treatment: Psychotherapy for the 21st Century, join the world's preeminent trauma experts as they share not only their knowledge and clinical acumen, but their most regrettable (and remarkably similar) clinical mistakes. Although difficult for both client and clinician, those mistakes have provided fundamental lessons for nearly everyone working in the field of psychotherapy. In fact, those mistakes have laid the groundwork for the current best practices for treating clients affected by trauma and its sequelae. With warmth and grace, the experts share the successes and failures that have shaped the current trauma paradigm- including new demands for awareness, attention to the body, visceral safety and mindfulness.

It seems there truly is a paradigm shift happening in mental health knowledge and understanding, beyond our everyday mainstream awareness? What do YOU think?

Porges, S, 2010, "The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation," Norton Books, USA.
Panksepp, J, 1998, “Affective Neuroscience - THE FOUNDATIONS OF HUMAN AND ANIMAL EMOTIONS,” Oxford University Press, USA.
Levine, P, A, “IN AN Unspoken Voice - How the Body Releases Trauma and Restores Goodness,” North Atlantic Books, USA.