Next Level Practitioner

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1 Next Level Practitioner - Fear Week 119, Day 6 - Focus on Application - Transcript - pg. 1 Next Level Practitioner Week 119: How to Help Clients Identify and Cope with Their Fear Triggers Day 6: Focus on Application with Joan Borysenko, PhD; Rick Hanson, PhD; and Ruth Buczynski, PhD

2 Next Level Practitioner - Fear Week 119, Day 6 - Focus on Application - Transcript - pg. 2 Week 119, Day 6: Joan Borysenko, PhD and Rick Hanson, PhD Focus on Application Table of Contents (click to go to a page) Why Acceptance and Safety Are Key to Helping a Client Cope with Fear... 3 How to Understand the Body s History with Fear... 5 Research on the Soothing Effects of Touch... 6 Why Being Present Can Help Clients Calm Their Fears... 8 When Fear is Connected to a Forlorn Inner-Child... 9

3 Next Level Practitioner - Fear Week 119, Day 6 - Focus on Application - Transcript - pg. 3 Week 119, Day 6: Joan Borysenko, PhD and Rick Hanson, PhD Focus on Application Dr. Buczynski: Hello everyone. We re back. This is the part of the week where we re going to focus on clinical application: applying all the ideas from this week to your work with your patients. I m joined by Rick Hanson and Joan Borysenko, and we re going to start off by talking about what stood out to them this week. Why Acceptance and Safety Are Key to Helping a Client Cope with Fear What stood out for me are the uses and misuses of deconstruction, or disentangling, or sorting things into parts. Dr. Hanson: What stood out for me and I m really reflecting on this are the uses and misuses of deconstruction, or disentangling, or sorting things into parts. On the one hand, so many strategies that the experts were talking about that had to do with fear would be to decompose the experience of fear, which can feel so knotted and brick-like, into different strands: These are the sensations; these are the emotions; these are the thoughts; these are the desires; this is the/these are the somatic markers, and all the rest of it. That s a really great strategy. On the other hand, as Richard Schwartz was talking about, sometimes the psyche can feel so deconstructed, sort of more like an archipelago than a continent, that it can feel dissociated for people, or they re fragmented and they re not integrated. So I ve just been reflecting on when is that kind of analytic strategy of teasing things apart useful, and when is it not so useful? And what makes it useful? One of the keys that popped out was and it runs through all the Whether you re disentangling the knotted experience of fear or grappling with the partselves that are flying around in the inner chaos of the zoo of the psyche, it s important to really accept each piece. threads whether you re disentangling the knotted experience of

4 Next Level Practitioner - Fear Week 119, Day 6 - Focus on Application - Transcript - pg. 4 fear or grappling with the part-selves that are flying around in the inner chaos of the zoo of the psyche, it s important to really accept each piece. Can you accept the feelings that you ve disentangled/the path you ve deconstructed? Can you accept the part-selves, the voices, the alters, even, as really meaningful parts of yourself? Then this deconstructive strategy is effective. Dr. Buczynski: Thanks. How about you, Joan? Dr. Borysenko: Especially in listening to Peter Levine and listening to him talk about, What do you do when fear comes up? How do you work with that so that the person doesn t go over the edge, and stays safe? I thought, physical feelings of fear and physical feelings of safety are all very important. Implicitly, a therapist sometimes works with what feelings of safety are. But it just brought up that important part of mind-body training that is useful for people. If you just have somebody go inside, scan their body, and say, Find the place of greatest tension and you could do it with fear too but Find the place of the greatest tension and really notice everything about it. Then, go and find the place of the greatest comfort, the greatest ease, the greatest safety. You can talk about it in whatever way is appropriate. That sense of ease and safety is very important when we work with somebody who has fear, just because of That sense of ease and safety is very important when we work with somebody who has fear. the physical sensations that we re talking about. I would have people just do a little experiment, like, What happens if you take the sense of safety and you simply move it over into the place where there s tension? What happens if you take the safety and move it into the place where there s fear? As you work with people s sensing, just remember the safety part that actually really works very nicely, to round out the bit about sensation.

5 Next Level Practitioner - Fear Week 119, Day 6 - Focus on Application - Transcript - pg. 5 How to Understand the Body s History with Fear Dr. Buczynski: Let s stay with Peter Levine a little bit. He talked about helping people identify the feelings in their body that they label as fear, so that they could feel the fear shift as those bodily sensations shift. Can you talk a little bit about the body s connection to fear? Dr. Hanson: The body is so fundamentally involved with fear, and this has been a particular interest of mine, including really appreciating the evolutionary machinery that s involved with the fear response, in relating the fear to other primal emotions of disgust and anger. In terms of the neurological machinery for emotions I m pointing to my own brain stem here emotions began to really evolve probably around 500 million years ago, maybe 400 million years ago or 100 million years after the nervous system arose, roughly. Probably the very earliest ones were disgust, because that has to do with very primary, gustatory responses. That was long before hearing and seeing developed. It was very primal molecules landing on the mouth, and those early sea creatures or little worms needed to spit out what was poisonous and bad for them. Fairly soon after probably came the neurological basis for panic and fear, and then also anger, probably in that kind of sequence. So, it s kind of remarkable to think about the primacy and the potency of this disgust response; that, then, layered on top of the fear and then anger, really preceded many other of the basic emotions. When people really get the embodied nature of fear, that s quite helpful as a corrective. It s really useful for people to appreciate how bizarre modern life is in terms of our biological template as hunter-gatherers, and that being in the chronic state of sympathetic nervous system activation (mild to moderate action, enthusiasm, stimulation, novelty) again, and again, and again that we re now habituated to is completely normal. What it does is it primes us for fear, because once that sympathetic nervous system is chronically activated, it s a very short hop to the fight/flight response, the fear response. Countering that, then, it s really useful these days, more than ever, to train the body in calm strength. It s interesting how many deep spiritual traditions emphasize the It s really useful to train the body in calm strength. Not a numbing or a suppressing, but an unshakeable core of calm strength inside.

6 Next Level Practitioner - Fear Week 119, Day 6 - Focus on Application - Transcript - pg. 6 development of tranquility. Not a numbing or a suppressing, but I call it an unshakable core an unshakable core of calm strength inside. People can train; there are a variety of ways to do that whether it s HeartMath apps for your smartphone, or other ways of training in the relaxation response. Joan s really an expert on this, with Herbert Benson and others. That is a really important path for many, many people. If someone with a messed-up knee were to walk into the office of a physical therapist, they would say, You ve just got to do a course of rehab. For a lot of people walking into our offices who are anxious, they really would be served by doing 10 minutes a day, for four weeks in a row minimally, of fundamental training, in the visceral sense, of calm and strength insight. This would counter our cultural tendencies in general as well as deal specifically with their own fears. Research on the Soothing Effects of Touch Dr. Buczynski: Stan Tatkin said that when fear is triggered, touch is powerful as a way to soothe it because touch calms the HPA axis. Can you share some research that would support that idea? And how has the soothing effect of touch been studied? Dr. Borysenko: First of all, let me say we re primates. I just came back from a safari in Africa, in Botswana, and it was fun to watch the troops of baboons and how they would sit there and groom each other. That is the most fundamental primate activity. I was thinking, Ah, they re picking out every last mite and tick and everything else, but you can see watch the body language: profound attention on one part, profound relaxation and trust one another. I remember in the old days of psychosomatic medicine, it was one of the very early findings that if you separated rat pups from their mom and then half of them got touched, like with a paintbrush or something like that, stroked, those rats would grow up to be much less anxious, they d have better immune function. Whatever you looked at in terms of well-being was better with the stroked rats. Then of course we have all of the data on premature infants in incubators and they do about 50 percent better and grow 50 percent faster, which is huge, just if they can have 15 minutes, three 15-minute sessions of touch daily. That s why they re always looking for volunteers to hold premature babies and why some of

7 Next Level Practitioner - Fear Week 119, Day 6 - Focus on Application - Transcript - pg. 7 the newer wards in hospitals attach mothers rooms to the actual baby room with the incubator in it, to increase the amount of touch that the baby has. A great resource for people on touch is Dacher Keltner who is a professor of psychology at Berkeley and the founding director of the Greater Good Science Center. He s got several very lively and great presentations on his own work on touch and compassion, and the work of others. In one piece of work that I noticed on his website (I can t remember who did it but it was very interesting just cross-culturally) the experimenter watched friends having a conversation in different countries. In the UK, in an hour s conversation, the friends didn t touch each other at all. In the United States, on average, the friends touched each other twice. But in Porto Rico, the friends touched each other something like 180 times. A huge cultural difference with regards to touch. I remember an old study that he reminded me of. It was one of these great psychological setups: people went to the library, and if the librarian casually brushed their hand like by mistake when they took the library card, when they were asked later what their experience of the library was, they liked it significantly better if they d had the touch, even though they weren t consciously aware even that they were touched. Touching stimulates activity in the vagus nerve so that people feed soothed. What touching does is it really stimulates activity in the vagus nerve so that people feel soothed. It s one of the primary mechanisms of soothing. Ritchie Davidson and his team did a study like this: people were getting white noise and they were in an fmri scanner in terms of anticipating the nasty white noise. If a romantic partner touched them and soothed them, all of their fear response simply dissipated and they weren t worried about the white noise. But there s a very robust body of research that looks at everything from prenatal massage to inadvertent touch, and it goes back to the fact we re primates, and touch is the most soothing thing for us. It s really a shame that we re not allowed to touch people as psychologists. A friend of mine who s actually a massage therapist and a trauma specialist says, I have a license to touch people and it helps my trauma work tremendously. Why is it that, as a society, we can t even professionally make a distinction between good touch and bad touch? That is very sad. It goes back to the fact we re primates, and touch is the most soothing thing for us.

8 Next Level Practitioner - Fear Week 119, Day 6 - Focus on Application - Transcript - pg. 8 Why Being Present Can Help Clients Calm Their Fears Dr. Buczynski: Stan Tatkin said that talking or chattiness is one way that people tamp down fear, since talking uses many resources from the high-left area of the brain, and that that blocks some of the noise from the right hemisphere. But when it s time to be quiet, like bedtime, then, he said, the fear comes back. What approaches do you use to soothe fear that might come back during quiet time? Dr. Hanson: It s important as I know Stan knows to appreciate as well that a lot of verbal activity is at the heart of anxious rumination. A lot of verbal activity is at the heart of anxious rumination. Verbal activity itself is not necessarily calming and soothing, and oftentimes it s when the chatter quiets that people can drop more into the felt sense of calm strength. That said, certainly when things do get quieter and we become more vulnerable and ego control/executive control of mental processes, verbal or nonverbal, starts falling away, then things that have been pushed to the background through whatever mechanism can start coming forward again. Also, as we fall asleep, we re profoundly vulnerable. Think about how vulnerable we are in the wild when we close our eyes, especially if we re not touching others next to us in our cave or burrow. What do we do, then? I find that one of the most powerful things that It s when the chatter quiets that people can drop more into the felt sense of calm strength. actually works for people is to observe the fact, when it s true and it s usually true that you re actually basically all right, right now. The structure of fear is anticipatory, as Joan was saying earlier; it s about a future. Understandably, in the future, you may not be basically all right. Sometimes things go wrong, and that s an existential issue that we and other experts in this series have talked about. One of the most powerful things that actually works for people is to observe that it s not a perfect moment, but you re still breathing. You re all right, right now. But in the moment, now, in most cases, when people look directly, they re basically all right. It s not a perfect moment, it s not a million-dollar moment; around the edges and this is important to include for people there may be some anxiety. There may be physical pain; there may be

9 Next Level Practitioner - Fear Week 119, Day 6 - Focus on Application - Transcript - pg. 9 unhappiness of one kind or another, but in now, and now, and now, you re still breathing. There s enough air to breathe. Our very visceral core of the body is basically all right, right now. The heart is still beating, the organs are still working, no shark is chewing on your leg in this moment. In some future moment, you may not be all right, but now, and now, and now radically, you can observe directly. It s not because someone s preaching at you or trying to persuade you. You look very directly that you re basically all right. That s a very profoundly powerful practice, and it draws on the fact that most of the information entering the brain comes from inside the body. The body is continually telling the brain its state, especially in terms of subcortical elements like the hypothalamus, a very ancient part of the brain that s receiving these signals of fundamental status of the body. Those signals most of the time for most people are like the calls of the night watchman: All is well. All is well. But we habituate to them and we tune them out. In this practice, people can tune back in to what the body is telling the brain again, and again, and again: most nows of most lives, You re basically all right, right now. I ve seen so many people really benefit from that practice. When Fear is Connected to a Forlorn Inner-Child Dr. Buczynski: Dick Schwartz talked about panic as an exile that gets triggered and needs care and attention. What are some strategies that you ve used to help someone take care of themselves when they re in a panic place? Dr. Borysenko: Dick Schwartz is really cool; I love the inner systems/inner family systems work. In the past, I used to use with clients a lot of the work of Roberto Assagioli with his subpersonalities, which is somewhat similar to that. Frequently, in the case of somebody who is tearful and panicked about something, you would find some little child self in there who was all forlorn. In the case of somebody who is tearful and panicked about something, you would find some little child self in there who was all forlorn.

10 Next Level Practitioner - Fear Week 119, Day 6 - Focus on Application - Transcript - pg. 10 What we would do is really inner-child work with that part that was panicked, and that was scared, and that feels very young, and very powerless, and very helpless somehow. These days, other than Dick s work, there doesn t seem to be that much interest in that kind of inner-child work, and it s very valuable and very useful. While I didn t call it an exile part, I can see exactly what that is, and really working to become compassionate to that part, a kind of little, left-behind, frightened piece is very useful. Dr. Buczynski: Thank you. That s it for us for this week. Now we d like to hear from you: how are you going to use these ideas in your work with your clients this week? Please share your thoughts below, and while you re there, go up and read what other people have said, and comment on their comments as well. That will bring our whole community together. Now, not only is that it for us for this week, but that s it for this question, so next week we re going to have a week off. You can use that time to catch up on anything that you missed; you can take the continuing-ed quiz if you signed up for continuing-education credits, or you can just take the week off. We ll be back the following week with a brand-new question: How do you work with clients who see/who frame their problem as Someone else needs to change? I bet you ve had those kind of clients. We re going to get into that with all the experts, one after another expert giving their ideas on how they approach that kind of a situation with that kind of a client. Take good care, everyone. We ll see you in two weeks.