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Jane Shaw and Steve Haines

Jane Shaw and Steve Haines

Click here to listen to the interview:   Jane Shaw and Steve Haines 2015-07-09

Jane is a senior tutor on Body Intelligence Trainings, organises the Breath of Life conference, runs a busy cranial practice in Northern Ireland and is currently doing a MA/PhD in Depth Psychology.

Here she talks about creating safety in clinical practice, tips from meeting Stephen Porges at the BOL and some simple recommendations for clients to help them practice feeling safe.

Transcript of the Interview 

Steve: Hi, Jane. We’re in Dublin right now, teaching seminar nine of the cranial course. I’ve realized we’ve known each other for a long time; about 10 years.

Jane: Mm-hmm, 10 years.

Steve: Amazing. I thought I’d pick your brains. You’ve done a whole bunch of stuff that I know of, running the Breath of Life Conference. You’re studying an MA in…? 

Jane: MA PhD in Depth Psychology.

Steve: Wow. You also have a busy practice in Ireland, and you’re a tutor now in Body Intelligence courses. What are the highlights for you in your work right now?

Jane: As you say, I’ve got a clinical practice in Northern Ireland, and I also do a lot of traveling with the Psychology MA PhD in California, and teaching with BI, but my clinic in Northern Ireland is focused around working with people who have suffered trauma. That’s always been my interest since I graduated almost 10 years ago. That’s the area that I’ve focused on in my training and in my clinic.

Steve: Great. One of the big things that I’ve learned from watching you teach is a real emphasis on safety. Do you want to talk a little bit more about that, and why that’s so important for you in healing?

Jane: For me, safety is one of the fundamentals that our body can’t heal itself unless it’s safe. I have found that from my own personal experience, and of course, then working with people who have suffered bad experiences. People who have suffered bad experiences in their life, whether that be involved in a car accident, or being caught up in a bomb, or maybe raped, or something really horrible – their body tends to be on high alert in case it happens again. Their bodies are scanning for danger constantly, and while our bodies are scanning for danger, they can’t heal themselves. We have the two main parts of our nervous system, the fight or flight, and the rest and repair. Unless we’re in the rest and repair part, our bodies can’t start healing. Safety switches that on.

Steve: I know you’ve had the privilege of meeting Stephen Porges, a major theorist around how trauma works. You tell a great story about him helping you feel safe before you were talking. 

Jane: Yes. One of the things I do is I run the Breath of Life Conference, which is a big international conference in London, where we get neuroscientists, and craniosacral practitioners, and other pioneers in the field to come and speak. We’ve had Stephen Porges over a couple of times.

There was one occasion when I’d been going through all sorts of difficulties, and my nervous system was running at high alert. I was about to go on to stage to introduce Stephen, standing up in front of 300 people, and introducing this eminent neuroscientist from America. We were standing in the green room, and he of course picked up my nerves, and he said: “Jane, one of the quickest, easiest ways to reduce your activation in your nervous system is to talk slowly in long phrases.”

Why that works is because when we do that, we are breathing out, we’re exhaling, and when we exhale, we switch on what’s called our vagus nerve, which is one of the key parts of his theory, and it’s one of the keys to creating safety.

Steve: Really nice. I really like that story. We can do simple, everyday things that will change our physiology. We don’t have to have huge understandings or journeys to discover why we’re activated, it’s just there are some skills in the present moment in your body that you can do right now. That’s a very nice one, take speaking more slowly (I’m terrible at that) and taking longer breaths, and it switches on your vagus nerve. Is that correct?

Jane: Yes. I particularly like that one, because we can know the theory of exhaling with long breaths, which is one that helps us to stop being nervous, but sometimes it’s difficult to do that. To speak slowly I think is an easier construction.

Yes, you mentioned also without having to know the whole story. I think that’s key to my practice as well. People come into my treatment room, and they want to know why they’re like this. Yes, that can be interesting to know why, as a 45 year old, you can’t sleep and you can’t digest food, and you are maybe irritable of whatever it is. Actually, if we just learn how to control the physiology by becoming more embodied, knowing our body, being able to differentiate all the different parts of our body, that actually is the major step, and certainly the first step to your body becoming more regulated.

Steve: Very nice. We don’t need to understand, we don’t need to remember necessarily; what we need to do is come into our body in the present moment.

Jane: Yes.

Steve: What are some of the steps that you might do? Maybe setting up the treatment room, or those initial things that might help the process of someone feeling safe?

Jane: Someone initially comes into my treatment room, they need to feel safe in that room. Say a woman had been raped. She needs to know that she’s safe sitting there with me. Her body probably thinks the whole world is unsafe, at least that’s probably why she’s come to see me. There are all sorts of physical symptoms going on, that she maybe hasn’t necessarily connected with that experience 20 years ago. Very simple things I do is I will show her where the door is, so she knows how to get out. If she needs to get out, she can get out.

Steve: Yeah. I really like that one. I don’t sit between my clients and the door.

Jane: Yeah.

Steve: Really nice.

Jane: If there’s noise outside the room, I name it. I say: “Oh, you might hear noise, and it might be X, Y, and Z.” I live on a farm, it might be a tractor. Things like that can disturb people, and they start getting distracted, and they come out of their body, because they’re off wondering what that noise is. Is it going to be the old danger? They’re not thinking that cognitively; they’re thinking that with lower parts of their brainstem.

Steve: Excellent. It’s really a whole package of things, but you do a lot of work before you put your hands on people.

Jane: Yes, absolutely. Yes. I get people to notice their body before I put my hands on them. I create the safety in the room. The other thing, this is also come to Stephen Porges’ work, his social engagement. We didn’t name that, his work around the social engagement system. This is using all the parts of our face and our voice that create safety.

One thing I will do is I’ll speak slowly, and I’ll probably speak with a bit of intonation in my voice, and I might speak with a slightly deeper voice. If I speak very quickly in a high-pitched voice, somebody’s not going to be able to feel safe.

Steve: Yeah. Very nice. That’s been a huge learning for me, because often when I was a practitioner at the start of my career, I used to try and get people on the table straightaway. I didn’t perceive myself as a great talker, and just needed to use my skills to touch people. In a sense, I had to become an expert at chit-chat, just simple, ordinary, human interaction of welcoming people, engaging them. How did they get here today? In England, I always talk about the weather. That really helps create safety, I believe. I think Porges teaches us that we, human beings, seek safety in other human beings. If you’re the therapist, you need to be the safest thing in the room. 

There’s also some very, very small things about just being an ordinary human that I think you describe very well that start that process of: “I can trust this person, because they’re looking me in the eye, because they’re not speaking quickly, they’re not rushing me, and they’re listening to me.” Is that fair, do you think?

Jane: Yes. “Listening to me,” listening with presence, that’s huge. In fact, I think that is a large part of what I do as a practitioner. I’m embodied. I know all parts of my body as much as I can while I’m with that person, and the other person’s system starts to entrain to mine, rather than me to theirs. I will be picking up all the nuances in their body right from the start. Creating that environment where they can trust me is huge. Listening with presence is an undervalued skill, I think.

Steve: Very good. As you work, helping people feel safe in the room and environment, helping them feel safe with you, what about when you’re actually working as a craniosacral therapist, as a touch therapist, what sort of other things might you be focusing on?

Jane: Again, keeping them engaged the whole time, so that I’m not leaving them hanging. They’re not going: “I wonder what she’s about to do next?” So: “When I put my hands on, I’m going to put my hands on your…” I don’t even say: “I’m going to,” I say: “How would it be if I put my hands on your shoulders?” So that I don’t just come and put my hands on, because that would be coming from behind, and that would again, would spark all those defence responses.

I’m constantly asking them how it is in their body as I’m working. As I move my hands around the body, I’m asking them to track the changes, and to notice… Sort of to map their body, to map the picture, it’s like creating… Maybe they start with a blank canvas, we then have an outline of the body, and then we can fill in the detail of it. The flowers, and the meadow, and the greens, and the blues, or whatever language they want to use. Some people might use colours, some people might use the physiology, but I use their language. That’s very important, to use the language that the client uses, and then to maybe reframe that for them to my experience.

Steve: You’re using touch, and negotiating that touch, and really orienting people to their own experience of their body, and continually helping them develop skills to find their sense of the body.

Jane: That’s right, yes.

Steve: Wow, sounds good. There are lots of things we could talk more about, cranial skills. Maybe we’ll do that one another time. 

Any top tips that you give to your clients, the things they can do for themselves to support their experience of safety?

Jane: As I’m working with the client in the treatment room, I’ll be asking them to orient to certain parts of the body, and these skills I then suggest that they practice when they go home. Really simple tips. This is another one that came from Stephen Porges, was in a room full of people, we are scanning for danger. Especially if we’re on that high-activation path. A very simple tip is to stand with your back against the wall, because then you only have 180 degrees to scan, rather than 360, so your nervous system immediately, it takes a huge load off your nervous system. To speak in these low, long phrases, or to do breathing exercises where your exhalation is longer than your inhalation. A very easy way of doing that is to sing.

Steve: I feel stressed when you say that.

Jane: So sing in a car, where no one can hear you. Sing. Some people do chanting. Singing at football matches. The singing really helps to regulate that social engagement system.

Steve: So breath is a very powerful tool, isn’t it?

Jane: Breath is a very powerful tool. Children playing wood or brass instruments, they use their breath. That’s very good for children with ADHD or overactive syndromes.

What else do I ask people to do? I suggest that people orient to noises in the natural world. Birds. If you’re going for a walk in the park, or if you live in the country, orient to the birds and see if you can differentiate the birdsong. When we can hear birdsong as a human, there’s no threat. Because the birds would fly away if there’s a tiger around.

Steve: Nice.

Jane: If you can’t hear birds, your nervous system tends to be a bit more hypervigilant. If you can train yourself to orient to the birds, then you will reduce the activation.

The last really simple one is to get people to push their feet into the ground, and push their back into the back of the chair. Noticing mapping the body, which is switching on the vagal response.

Steve: All right. Thank you. Nice talking to you.

Jane: Thank you.

Asprey labrador

 

Above is a great audio clip on how the old parts of the brain can govern behaviour. The clip is from a talk by Dave Asprey. I am never entirely sure about many bio hacking claims, but this is a novel way of explaining the triune brain.

Note Asprey is talking about an untraumatised brain. Even without trauma, the old parts of our brain are easily distractable, prone to trigger random eating, focused on sex and biased to hardwired reflexes in response to danger. In a sensitised nervous system the reptile and mammalian elements react even quicker and limit the prefrontal cortex even more.

I like the idea of the energy economy of the body being stacked to deal with reptile brain, then mammal brain, and only then conscious processing. So, for example, if there is inflammation or toxicty in your liver (Asprey is very keen on not stressing the liver with molds) then the resources of your system will be diverted to the liver by the reptile brain. You will not be able to think clearly or maintain energy, focus and willpower.

Watching the video made be think of an old friend – Mike The Headless Chicken. Another example of how many of functions can be done without thinking. For Asprey that is scary – we need to learn how to exert control on these unconscious systems or they will control us. He likes meditation, gratitude, sleep and clean diet, all aided by bio feedback, as good starting points to influence what is happening in the old parts of your brain.

 

Mike the headless chicken

Pain Throw Amputated Leg

This is a great story of how extreme the body can be in prioritising threat.

Pain has a geography in the body. Suffering is a bigger category and existential?

This is tricky territory, hence the question mark.1

My view is that in pain there is an explicit representation that involves the body. Considering suffering as initially experienced through thoughts and emotions is a broader category that acknowledges that thoughts feel primarily psychological. Of course mental events have correlates in body physiology, they have to; there is no such thing as a pure thought or pure mind outside of body.2 However it is an achievement to be embodied. Tracking psychology, thought, or emotion in our bodies is a skill that requires practice and discipline.

It is not efficient to always track every sensation associated with a thought, in exactly the same way that it is not efficient to track every muscle we contract to pick up a glass of water. The goal of the brain is predictions and outputs that work quickly in nature. When we are suffering and in pain then retraining our brain to operate differently necessitates bringing awareness to the steps that make up our thoughts and movements. Only then can we can chose to assemble the simple building blocks of how we think and move in more optimum, non painful ways.

‘I think this is a quote from Antonio Damasio that is worth repeating: “The mind is embodied, not embrained.”
Let’s consider some of the evidence that shows how important the body is to the mind. For example, the role of emotion. We’ve talked in the past about the importance of the parts of the brain that monitor the body’s internal state. Antonio Damasio is the one that has shown that when parts of the frontal lobe that are involved with getting emotional input are damaged, a person can’t even make decisions. So we need the body’s input. That’s why separating the brain out by itself is a dangerous example of reductionism. It’s the whole person that has experiences, not the brain.’ Ginger Campbell (2009)3

Pain is a conscious experience

‘Pain is an unpleasant conscious experience that emerges from the brain when the sum of all the available information suggests that you need to protect a particular part of your body.’ Lorimer Moseley4

You cannot be in pain and not know about it. Your body can be working poorly, be inhibited, have silent tumors growing, and have metabolic disorders humming away all outside of your awareness. That is disease. Pain is something that grabs attention as the brain decides the information it is receiving is dangerous. The goal of acute pain is to change behaviour to protect.

The body has other ways of changing behaviour. Tiredness is an output that limits behaviour, it is also a conscious perception like pain. Interestingly inflammation is increasingly being understood as a protective output, in parallel to pain but led by the immune system.5 However inflammation has the difference of running outside of our awareness and is non-conscious.

A consequence of embodied awareness is that as you pay attention and learn to feel you may suffer more. What you learn to feel is your suffering. Often as people come out of dissociation what they encounter is pain. The strategy of cutting off from sensation occurred because something was too much. This is why pacing and resources and are essential when meeting the body if there has been trauma. Levine (2010)6 offers that health is the ability to hold increasingly intense sensations and not get activated.

‘Let me tell you something really, really shocking. As late as the 1970’s young infants in hospitals, having major operations, including amputations, are having them without any form of anaesthetic, let alone analgesic.’ Jonna Bourke7

In the 18th century the baby was seen as exquisitely sensitive, there was a shift in 1870’s to infants being considered not at all sensitive and this continued for another century. Small children were not perceived to experience pain in the same ways as adults, it was thought you needed to have the capacity to suffer to feel pain. Presumably babies were thought to have no self consciousness and no memory. Oh dear, a sad example of why clear understanding of pain matters.

References

1 Bourke (2014 p60-62) gives a good discussion of pain versus suffering and relates it to an historical split between mind and body:

‘Finally, astute readers will already have noticed that I am using the terms pain and suffering interchangeably. It used to be radical to question the distinction between the mind and the body. Not any more. The assumption that there is a clear distinction between the mind (characterized as disembodied, rational, computational, and male) and the body (caricatured as presocial, emotional, impetuous, and female) has been attacked from all sides. Feminists have led the assault on the representation of the mind as some kind of superior, active, unique entity, which ‘feeds’ information to a passive, universal, and inferior physiology. In more recent decades, though, anthropologists, social scientists, and cognitive scientists have enthusiastically joined in the skirmish. Historians have been relatively slow to commit themselves.

Of course, people-in-pain typically highlight one aspect of the pain-event over another (I am in physical pain because I burnt myself while making coffee; I am psychologically suffering because I have fought with my lover). The Cartesian distinction between body and spirit or soul is deeply embedded in our culture. Nevertheless, mental pain always involves physical events – neurochemical, muscular nervous, and so on – and physical pain does not exist without a mental component. My burn depresses me; my sadness weighs down my body. As physician and writer David Biro astutely argues in ‘Is There Such a Thing as Psychological Pain? And Why it Matters’ (2010), ‘psychic distress can itself be painful in a meaningful sense, that it can be phenomenologically akin to physical pain, and, therefore, should be categorized under the same rubric’. Furthermore, the Cartesian distinction made between ‘bodily pain’ and ‘psychological distress’ (often denigrated as the difference between ‘real pain’ and its ‘psychosomatic’ variety) has done a vast amount of ideological work for physicians, psychiatrists, psychologists, the pharmaceutical industry, and chronic pain patients. For researchers in the arts and humanities as well as in the sciences, however, mind/body dichotomies have been an impediment to scholarship. There are many grounds to be suspicious of them, including the vast scientific and medical scholarship that demonstrates the interconnectedness between physiological and mental processes. Bodies are actively engaged in the processes that constitute painful sensations. Mindfulness is engaged in a dialogue with physiological bodies. And culture collaborates in the creation of physiological bodies and linguistic systems. The body is mind-ful and the mind is embodied.’

2 Another very tricky bit: no pure, independent mind is the materialist view. Dualists and religions argue that mind/soul is distinct and independent from the body.

3 Campbell, G. (2009) Did My Neurons Make Me Do It? Brain Science Podcast Episode #53: Aired January 17, 2009

4 Mikkelsen S. (2014) Notes on Lorimer Moseley lecture 7 June 2014. Facebook post. https://www.facebook.com/ManuellterapeutSigurdMikkelsen?fref=ts. Accessed 17 July 2014 Manuellterapeut Sigurd Mikkelsen

5 ibid

6 Levine P. (2010) In An Unspoken Voice: How the Body Releases Trauma and Restores Goodness. Berkeley, CA: North Atlantic Books.

7 Bourke J. (2014) The Story of Pain: From Prayer to Painkillers. Oxford University Press. http://www.bbc.co.uk/programmes/b046j8z5  Interview July 2014 @10.00mins.

 

The video below is another wonderful development of how pain works. There is a revolution in how researchers are framing pain over the last few years. As teachers in the cranial community we are trying hard to catch up. We have changed our essential reading list to include Painful Yarns by Lorimer Moseley and tweaked the Body Intelligence Training manuals and teaching to reflect these new understandings.

The good news is that much of the territory we have been exploring for many years. The video below gives some great science backing up the model of using WOSI (Weight Outline Skin and Inside) as a framework of exploring how people actually perceive their body and our general goal of being embodied.

The research on two point discrimination described about half way through is fabulous. Also the left right discrimination. In fact the whole thing is just great.

Osteoarthritis pain is at least as much about the perception in your brain as it is tissue damage to the joint:

Screen Shot 2013-09-16 at 18.17.40

You can access many of the papers here   http://www.bodyinmind.org/resources/journal-articles/  A really good start is scroll down to 2008 to: Moseley,GL (2008) I can’t find it!  Distorted body image and tactile dysfunction in patients with back pain. Pain 140,1 239-43.

Self touch improves the picture of our body in the brain and reduces the experience of pain (Results from new study in Current Biology)

Below is a link to a really interesting article on how representation of the body affects the experience of pain. The is very affirming of the importance of working with dissociation to improve health.

In this study the results show the pain is reduced more if people self touch rather than them being touched. I wonder/hope that the combination of body awareness work we do in biodynamic craniosacral therapy, plus the skilful nature of biodynamic touch, would trigger the experience of ‘coherent whole’ that seems to affect pain.

“We showed that levels of acute pain depend not just on the signals sent to the brain, but also on how the brain integrates these signals into a coherent representation of the body as a whole.

Self-touch provides strong evidence to the brain about the correlation of sensory information coming from different parts of the body.

This helps to give us the experience of our body as a coherent whole.”

Click here to read the full article  http://www.bbc.co.uk/news/health-11399254

Really good interview with stephen porges………

‘Ginsberg (1974) immobilized chicks, and then allowed one group to recover spontaneously, and one to recover, but with prodding and stimuli to terminate the freeze. These groups, along with a third group of chicks that had not been immobilized, were then tested for resiliency to avoid death by drowning. The group that had not been allowed to complete recovery from immobility died first, the group not exposed to immobility next, and the group that had spontaneously recovered from the freeze survived the longest. Clearly the experience of and the spontaneous recovery from freezing carries survival benefits, whereas not being allowed to go through this recovery process seemed to reduce resiliency to life threat.’ Scaer (2001)

This is a very powerful illustration of the innate ability of animals to recover from trauma. Natural/spontaneous recovery actually enhanced the drowning survival rates over the control group. We can transcend trauma and be stronger afterwards, but only if we engage the bodies natural healing mechanisms. Not my favourite philosopher, but Friedrich Nietzsche was right: ‘That which does not kill us makes us stronger.’

The worst option is to interfere and block the natural processes of the body – in this experiment poking and prodding the chicks out of immobility. The chicks were immobilized by holding, the inescapable threat inducing the freeze response.

My experience of TRE (Tension and Trauma Releasing Exercises) has shown me that shaking is a natural part of recovery from trauma. Even though it can appear that people are falling apart when shaking, it is better to fall apart briefly, rather than hold on to a life time of chronic tension.

References

Ginsberg, H. (1974). Controlled vs noncontrolled termination of the immobility response in domestic fowl (Gallus gallus): parallels with the learned helplessness phenomenon, as quoted in Seligman, M. (1992) Helplessness: On depression, development and death, New York:W.H. Freeman

Nietzsche quote from http://www.brainyquote.com/quotes/quotes/f/friedrichn101616.html#ixzz1lKDnjPOs

Scaer R.C., (2001) The Neurophysiology of Dissociation and Chronic Disease. Published in: Applied Psychophysiology and Biofeedback, (2001), 26(1), 73-91

With thanks to Riccardo Cassiani Ingoni for the reference and image – I saw Riccardo talk about the chick experiment at a TRE Level 1 course in London.

Like the snake video, the above video captures some essential elements of hardwired trauma responses. Notice how stiff the mouse is at the start of the video. I am increasingly appreciating how stiffness is a good early sign of immobilisation. Before I was only focussed on the loss of muscle tone as a cardinal sign, in fact both can hyper and hypo myofascial tone can occur in immobilisation.

Why does the mouse attack the cat as it comes out of immobility? Two passages from Peters Levine’s excellent new book ‘In An Unspoken Voice’ give an explanation:

As They Go In, So They Come Out: The Rage Connection

‘Similarly, when a well-fed household cat catches a mouse, the latter, restrained by the cat’s paws, stops moving and becomes limp. Without resistance from the mouse, the cat becomes bored and will sometimes gently bat the inert animal, seemingly trying to revive it and restart the game anew (not unlike Jimmy Stewart slapping his swooning heroine to bring her out of her faint). With each reawakening, chasing and reactivated terror, the mouse goes deeper and longer into immobility. When it does eventually revive, it frequently darts away so quickly (and unpredictably) that it may even startle the cat. This sudden, non-directed burst of energy could just as easily cause it to run at the cat, as well as away from it. I have even seen a mouse ferociously attack the nose of an astounded cat. Such is the nature of exit from imrnobility, where induction has been repetitive and accompanied by fear and rage. Humans, in addition, reterrorize themselves out of their (misplaced) fear of their own intense sensations and emotions.

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Amazing illustration of the mobilisation and immobilisation phases of the overwhelm response. Initially aggressive and quick, but when its head is trapped and there are no options for escape the snake goes limp and plays dead.

If you ask me, playing with snakes and spitting out the venom they have managed to spit into your mouth is slightly too interesting a way of earning a living. Just saying.

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