​​The reason regular "talk therapy" doesn't always work and/or takes a long time for the changes to become evident is because it is what's called top-down. The brain evolved from the brain stem, then the limbic system, then the prefrontal cortex (PFC). So when top-down modalities are used, they engage the PFC to change emotional states (limbic system) and even physiological states (brain stem).

 

Whereas bottom-up means we will leverage the brain stem and the limbic system to change thoughts. Deb Dana a brillant therapist who uses this knowledge has a phrase that I like to repeat:

"Story Follows State"

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This means that our physiological state influences the narrative that is happening in our mind. The story in our head is a result of the nervous system state our body is in. So that if we are in a sympathetic flight/fight response (e.g., anxious or angry), then our thoughts will be more aligned with the world being inhospitable, and/or everyone out to get me, etc. If we use a somatic or a body-based approach and bring mindful attention to our breath, we can shape out breath. Shaping our breath using therapeutic yogic breathing techniques can down-regulate our nervous system back into a safe and socially connected, parasympathetic state. In this state, our thoughts are more likely to reflect a world that is supportive, people who are considerate, and relationships filled with compassion. The ability to change our breath influences our ability to emotionally regulate.

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I use this bottom-up approach by using both Hakomi, mindful somatic psychotherapy, trauma-informed yoga, and Internal Family Systems (IFS) [Blogs on each].

 

I also leverage the power of the vagus nerve and applied Polyvagal Theory (PVT). PVT simply states that the vagus nerve, which is responsible for changing our nervous system state from sympathetic to parasympathetic, has 2 pathways that it can follow out of the brain. It can go up to the face where soft eyes and smile, prosodic voice, and relaxed jaw all indicate signs of safety...the ventral vagal complex (social engagement system). The vagus nerve can also traverse the more primitive survival route of dorsal vagal where we feign death (numbing out). What's in between these 2 states is the sympathetic flight or fight.

 

The vagus nerve is bi-directional, meaning it can take messages from the brain to the body and vice versa. The thing is that 80% of those fibers take messages from the body to the brain and only 20% from the brain to the body. So essentially, top=down talk therapy is using that 20% capacity, whereas bottom-up somatic therapy is using the 80% capacity. We need both top-down and bottom-up...it's just that conventional therapy is not yet fully on-board with bringing the body into the conversation, missing out on that 80% directionality.

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