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The autonomic nervous system and the experience of safety

Anssi Leikola, Psychiatrist, therapist, author and trauma survivor

6 July 2018

New insights link the functioning of the autonomic nervous system (ANS) closely to mental health. At my practice, I am exclusively treating individuals that are severely traumatized in their childhood. This article discusses the crucial significance of the experiences of safety for the development of the ANS and mental health.

Considering an optimal childhood in which parents are able to provide care and need fulfillment for the child, the child acquires a useful model for developing lasting, secure attachments to adults. The child learns to seek soothing security from intimacy with others. The feeling of safety provided by another person, whether related to emotional or physical intimacy, will remain inside them through life as the strongest tranquilizing experience. The internalized experience of safety protects the human mind, a fact perceivable also in the functioning of the most developed part of the ANS.

In a sense, humans make contact with their environment through the nervous system. The nervous system, including the ANS, is a plastic, adaptable organ reorganized by life experience and environmental factors. Neural plasticity is most active in childhood. Through experiences, new synapses are formed in the brain; in other words, connections between neurons are reinforced by experiences. Experiences of safety are essential in developing effective cooperation between the different parts of the ANS. This cooperation constitutes a “security radar” which is necessary for a healthy adult’s ability to defend themselves. The ANS is constantly assessing the level of safety. As its name suggests, it functions autonomously and non-voluntarily. It reacts to insecurity subconsciously, activating more quickly than the consciousness is orientated. From the evolutionary point of view, this rapidity has been of apparent advantage in life-threatening situations. The learning process of the ANS is implicit by nature, thus an unconscious by-product of living, happening through experiences, similarly to the learning of mother tongue. When the childhood environment is insecure in some way and the child is repeatedly exposed to stimuli that activate the most primitive parts of the ANS, cooperation between the different parts will not develop sufficiently. In this way, affect regulation will remain inadequate. Emotionally traumatized individuals generally show two types of significant problems caused by miscalculated responses of the ANS. Either they are unable to defend themselves properly, or they may act defensively in occasions where it seems inappropriate from the present perspective. These kinds of inappropriate responses are re-exposing them to traumatization, burdening their intimate relationships and disturbing the development of secure relationships. One could say that the safety radar of these people is not functioning reliably.

The physical symptoms of an individual traumatized in childhood and carrying experiences of repeated, even life-threatening insecurity can be so powerful that, in extreme cases, the body is entirely paralyzed. One of my traumatized clients described the experience as a physiological prison. In this state, the person doesn’t have the strength or ability to move, speak or think. These are all classic symptoms of major depression, but there are also advantages in perceiving them as trauma symptoms. The symptoms can be explained by the activation of the oldest part of the ANS. This is the part that reacts to the risk of death. Its function can be called a “passive defense”, for it implies a total submission for fate, a shared response for all mammals to the risk of death. Experiences of insecurity and the resulting high sensitivity of the ANS can be seen as one important explanation for mental disorders. Because of the alertness and dysfunction of the alarm system, the child or adult is suddenly –as if by magic – taken over by a strong emotion before even realizing what they were triggered by. It may take no more than a certain expression, a word, a tone of voice or a smell. This is characteristic of a traumatic memory that is linked to the alarm system of the ANS. All of a sudden, the present situation may appear in the light of past fears, without the person themselves realizing the shift. In extreme cases, when activated, trauma memories may provoke disturbance in reality testing – that is, psychosis. More often, trauma memories are only partly activated, manifesting themselves as milder symptoms that can also be very physical. In any case, trauma symptoms carry an essential message about the person’s past. What that is, is still seldom very easy to decipher.

” In the treatment of trauma, safety is always the most important thing.”

Traumatization often originates in the experience of unsafety felt in various forms, for example as a strained atmosphere at home, a culture of silence, bullying, abuse and unfair treatment. One of the main reasons for childhood traumatization is a blurred idea of parenting, or domestic abuse. Thus, coming back to a childhood in which the parent is absorbed in fulfilling their own needs (whether it is their career progression, drugs or love affairs), the child’s inner experience of safety will remain more or less insufficient. The lack of parenting is one of the most central traumatizing childhood experiences that can also be observed at the level of the ANS. The experience can result in defenselessness and, in more unfortunate cases, in mental disorders. Many traumatized individuals are not capable of recognizing their own trauma because their lives are unconsciously controlled by the avoidance of unbearable emotions. Considering this, it is obvious why the threshold of getting help is very high for them.

The recovery of the ANS can begin whenever a feeling of safety can be reached in the “here and now” interaction. At the practice, it is all about the atmosphere that should be made as safe as possible, considering the patient’s situation and unique background. From the perspective of the present safe reality, the patient may start to comprehend their history in a new way and gain critical insights about how they are really feeling – and more essentially – who they really are. Sometimes, an indication of an acquired feeling of safety is the sudden improvement in the patient’s thinking ability, which is a very pleasant experience. This kind of development can occur in the course of psychotherapy. It reflects in a very concrete manner a gradual recovery from childhood trauma. However, it is not very easy to build a relationship that would restore the functioning of the ANS, not for the therapist either, because the unbearable emotional states of the traumatized individual are so often just behind the corner. At any time, they have the power to shift the atmosphere towards unsafety. What is most important is that the mistakes are corrected and the experience of safety restored. Yet, it is also necessary to investigate what it was that actually triggered the reaction! It might be a moment of tactlessness on the therapist’s behalf, or it might as well be the sound of an ambulance passing by. Emotional trauma is caused by unbearable emotional experiences, and the ANS is for its part very closely related to affects and emotions. One is constantly in some kind of emotional state, even when they are calm and at their most rational. Calmness is as much of an emotion as anger. Thus, it is wrong to state that a person is emotional only while having a seemingly irrational, intense emotional experience. According to present understanding, emotional states that are overriding rational thought can be seen as states linked to the individual’s defense system, that in turn are theoretically connected to traumatic memories. Effective affect regulation implies that however difficult emotions we face, they cannot override our judgment or paralyze our functioning capacity. Affect regulation is crucial for attaining an experience of safety and being able to appease other people. In the treatment of trauma, safety is always the most important thing. It can be said that when therapy is progressing appropriately and affect regulation is improving, the person will be able to face even the more difficult things in a safe way. Still, for this kind of safety to develop, we need another person who is worth our trust. In Finland, new theoretical insight on the ANS has gained rather little attention. However, it plays a significant part in helping the trauma therapist and his patient along the path of recovery.

Photograph by Anny Sprat via Unsplash

THREE SIGNALS

THREE DIFFERENT PARTS OF THE ANS ACCORDING TO THE POLYVAGAL THEORY

1. THE EXPERIENCE OF SAFETY activates the most developed part of the ANS. This is when a person is feeling calm and relaxed. This neurological structure matures and strengthens through experiences. In other words, the more experiences of safety or recovery are acquired, the stronger the inner structure develops. In this state, the person’s abilities of learning and understanding will reach their highest level. The more the experience and feeling of safety is internalized, the more the affect regulation – and mental health – will improve.

2. DANGER arouses active defense. This kind of defense involves such feelings and reactions as panic, anxiety, combat (aggression), and flight (fear). The purpose of them all is to restore the experience of safety – to eliminate the threat.

3. THE RISK OF DEATH triggers the passive defense whenever active mechanisms and patterns are not working but only making things worse – a collapse into submission and paralysis. This reaction is associated with depressive states and of the emotions, especially with shame. Shame can be understood as “disappointment in the expectation of interaction”.

Originally published in: Pelastakaa Lapset magazine 1/2016

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