Stephen Porges: "Survivors are blamed for not fighting" | Society



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Stephen Porges is a professor of psychiatry at the University of North Carolina and a "distinguished researcher" at the University of Indiana, where he created the Traumatic Stress Research Consortium. He is best known for developing the polyvagal theory, which describes how visceral experiences affect the nervous system and our behavior. On Monday, June 10, he will give a lecture at Love vs Trauma, the one-day symposium of the Body & Soul charity in London, which aims to tackle issues related to childhood difficulties and traumas. . Peter Fonagy and Lemn Sissay are among the other participants.

Can you explain polyvagal theory in layman's terms?
The polyvagal theory articulates three different branches of the autonomic nervous system that have pbaded from very primitive vertebrates to mammals. And it's pretty interesting to see how the sequence has evolved. First, you have a really old system of pretending death or immobilization. Then there is a combat or robbery system, a mobilization system. Finally, for mammals, you have what I call a social engagement system, able to detect security features and communicate them to another. When you trigger a sense of security, the autonomic nervous system can help restore health. When it comes to dealing with a vital threat, you are probably entering into this state of feigned, dissociative death.

We hear a lot about to fight or to flee instincts but less on immobilization. But is this the most common answer to traumatic experiences?
Yes, immobilization is the critical point in the experience of life-threatening trauma. Trauma therapists once considered stress to be a flight reaction. But that's not what survivors of trauma have described. They described this inability to move, the numbness of the body and their functional disappearance. And that's what the polyvagal theory describes. So when I started talking in the trauma world, the theory was hugely enthusiastic because the trauma survivors said, "That's what I went through." why did not you fight? "

Society praises wrestling, accepts flight, but tends to attach shame to immobilization. Is it fair to say?
The most important word is "shame". Survivors are ashamed and blamed because they have not mobilized, fought and made no effort. It's a misunderstanding. This is an uninformed explanation because the body enters this state and can not move. The theory was traction because it gave the survivors a feeling of validation. Survival was really an expression of the heroic nature of our body trying to save us. Sometimes it goes into a state where we can not move, but the goal is to increase our pain thresholds and make ourselves less viable for the predator. In the legal system, there are many problems when a person has not fought a predator. And I think this is misinformed about how bodies react.

What is the long-term impact of adverse experiences of childhood (Athese)?
Aces are a ladder that accumulates exposure to adverse experiences, such as abuse, neglect, and family dysfunction. The Aces scale is derived from Dr. Vincent Felitti's observations as a doctor in the United States. While learning more about the experiences of his patients early in life, he began to see relationships between early experiences of abuse and long-term health. Research has confirmed that higher Ace scores (exposure to more adverse effects) are related to longevity and virtually all major medical conditions, including heart disease, stroke, Alzheimer's, cancer and diabetes. More recent badessments have linked badets to an increased risk of suicide, addiction and psychiatric disorders ranging from attention deficit disorder to psychosis.

So it is these undesirable events that determine the loss of well-being?
We need to reframe the question and ask questions not about the event, but about the individual response or response. Much of our society defines trauma as an event when the reaction of the individual is the real problem. By not accepting that, we end up saying, "If I can survive well, why not you?" Then we start blaming the survivors again. What you have to understand, is that when a person reacts or reacts to trauma, the body interprets the traumatic event as a threat to life. The functioning of the nervous system, its regulation of the underlying physiological systems that influence social behavior, psychological experiences and physical outcomes are considerably readjusted.

Is the incidence of Aces therefore a bad way to address the issue of social outcomes?
No, it's a very important initial recognition of what's going on in the lives of so many people. But the recognition of that is only the beginning. Because we have to understand that people respond differently to the same physical challenges. And by simply looking at aces, there are many missing individuals who have adverse reactions to events that we might think relatively minor. For example, we see the overlap between medical procedures that are not welcome, such as an emergency surgery, and the consequences of a rape. You are dealing with similar parts of the body and the body can see both cases as an undesirable intrusion. At present, the Aces model would not have to undergo the operation, but Aces remains a very important and powerful first step.

You emphasize the importance of space safety for the traumatized. How can they be applied?
Whether it is medical treatment or psychiatric models, the context in which the treatment is administered becomes important because it triggers signals into the nervous system, making it either defensive or available to the patient. treatment. The first thing to do is to understand how bodies react to the context. A frightened individual does not bring on the field a nervous system that will cooperate and collaborate with medical procedures. We are not machines detached from our thoughts and feelings. In veterinary medicine, animals like cats often fall dead at the vet because of fear and uncertainty. So we are working on ways to give safety cues.

The polyvagal theory has taken a step forward in medical and psychotherapeutic treatment, but how should it inform the way people treat each other?
When we become a multi-language informed society, we are functionally capable of listening to and witnessing the experiences of others, we do not evaluate them. Listening is part of co-regulation: we are connected to others and that's what I call our biological imperative. So when you become polyvagic informed, you better understand your evolving heritage as a mammal. We become aware of how our physiological state manifests itself in people's voices, their facial expression, their posture and their basic muscle tone. If the exuberance comes from the upper part of a person's face and his voice has a modulation of intonation or what is called prosody, we are attracted to the person. We like to talk to them – it's part of our co-regulation.

Thus, when we become informed in polyvagal, we begin to understand not only the response of the other person, but also our responsibility to smile and to have an inflection in the voice, to help the person we are talking to do so that his body feels safe.

Love vs. Trauma: Bordering the Healing of Childhood Injuries – A symposium will be held at the Barbican Center, London EC2, on Monday, June 10th. Tickets range from £ 187.14 to £ 229.78 and are available from Eventbrite

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