Up Close & Personal with the Autonomic Nervous System: Fostering Resilience in the Patient-Practitioner Relationship

• Many chronic, poorly understood physical and psychological conditions contain elements of the body’s responses to trauma. This seminar explores the connection between chronic physical conditions and fixed nervous system patterns formed by exposure to traumatic stress. Rogers offers an approach to the autonomic dysregulation of common syndromal disorders (i.e. IBS, migraine, whiplash, chronic pain, chronic fatigue, autoimmune disorders, fibromyalgia and traumatic brain injury) based on new understanding of the autonomic nervous system.

People who experience trauma while in a state of helplessness (i.e. falls, motor vehicle accidents, early developmental trauma and neglect, physical abuse and medical or surgical treatments) suffer an autonomic freeze state which impairs the body’s ability to regulate its state, often leading to a loss of resilience and reduced capacity to face further threats. Research in neuroscience over two decades makes it clear that addressing chronic disruptions in the physical and psychological well-being of patients necessitates changes in the nervous system.

To be clinically resonant with individuals who seek care, a self-aware practitioner fosters relationships that, over time, stimulate new neural connections in their patients. A practitioner’s essential contribution to promoting a patient’s pathways to new behavior and to adherence to treatment plans is through fostering a state shift during the visit. A therapeutic state shift is an embodied experience of change from deregulated autonomic states, either hyper-arousal or collapse, toward a zone of resilience.

By gaining skill in right-brain communication (i.e. empathy, embodied awareness, attunement) the clinician’s personal therapeutic focus is potentiated by interactions that resonate with the patient. Repeated attunement to and co-regulation with a patient through the parasympathetic social engagement system (i.e. eye contact, facial expression, tone of voice and presence) and transient exposure to mild stressors that stimulate brain plasticity, builds neural networks to foster the patient’s more flexible, resourceful and embodied self-regulation.

The practitioner’s present-moment attunement biases a patient’s brain toward conscious, explicit learning states rather than conditioned fear states that tap into traumatic learning and memory. Over time the practitioner’s face-to-face rhythms of mindful caring and reliable support lead the patient to enhanced learning and improved emotional regulation.

In this seminar practitioners learn to strengthen their therapeutic alliance with patients by increasing sensitivity to relational styles and felt autonomic states. A felt connection between the partners in a therapeutic relationship is an agency of healing, a move toward restoring a safe emotional bond and a healing partnership. It requires practitioner self-awareness and attunement to the patient as a whole person. This authentic connection, spoken or unspoken, which is full of challenges and uncertainties, is a vital foundation for a rewarding practice. It creates a resonant space within which patients can become active in making use of what practitioners offer in order to implement their own paths to well-being.

Rogers offers a fresh, vital approach to understanding the autonomic dysregulation of chronic disorders. The seminar employs a variety of teaching tools including lecture, clinical examples, discussion of cases participants bring, and guidelines for referral for additional support. Dr Rogers will demonstrate qualities of attunement through role-play and facilitate body-based exercises.

Upon completion of the seminar you will be able to:

• Explain the interpersonal neurobiological principle that past and present relationships, the physical brain and processes of the mind interact to shape who we are.
• Describe how relational styles and traumatic experience affect mental and physical health risk.
• Explain how frozen, complex trauma leads to poor health and prevents healing.
• List three types of integration in the nervous system that help to promote resilience.
• Practice techniques to attune with a patient in order to move the autonomic system toward resilience.
• Identify patients for whom referral for ongoing psychotherapy is indicated.

Course Notes: Class will be held at Bastyr’s Kenmore campus, room 286.
Bastyr University is housed in an older facility with fluctuating interior temperatures; it is advisable to wear layers. Also, Bastyr is a “fragrance-free” campus.
One hour lunch break – Bring a sack lunch or eat in Bastyr’s vegetarian cafeteria.

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