1. Strategies to calm people down

Dr. Porges explains how to use the social engagement system to
calm patients who are hypervigilant.

The social engagement system is the link between the control of the striated muscles in the face and head and the vagal regulation of the heart.

Once we start to articulate what those muscles do in the face and head, we start seeing all the strategies that people do to calm down.

One strategy is ingestion (not digestion), which utilizes the muscles of ingestion in the face.

The second place to look for cues for social engagement is in the upper part of the face, especially where the orbicularis oculi is located.

The third one would be the muscles of the middle ear, where we listen to prosodic features and trigger the neural regulation of those middle-ear muscles. When we do that, we start to turn off our priorities for detecting low-frequency sounds which are predators.

If you talk to trauma victims, they don’t want to go into noisy places because the low-frequency sounds scare them or make them feel uncomfortable.

That’s because the neural regulation of the striated muscles in the face and head got turned off. But they were turned off for a functional reason – if you turn them off, you become hypervigilant for a predator.

Here’s the important clinical information: when you deal with trauma victims and they start describing hypersensitivities to sounds and feeling vibrations that no one else seems to feel – not wanting to go into crowded places – they’re telling you that their nervous system is tuned to detect a predator.

Their nervous system is a neuroceptive state that has great advantages in detecting a predator, but is totally compromised in being social.

That means the new mammalian social engagement system with the myelinated vagus is turned off, and when it’s turned off, what are you left with? You’re left with underlying defensive strategies: either to fight or flee, or to disappear and shut down. (p. 9 in the Part 1 Transcript)

2. How to explain the body’s reactions to trauma

Explaining to people how their body reacts to trauma can help them make sense of physical reactions that don’t always seem logical. This can facilitate better understanding and possibly make it easier for them to change those reactions.

We have to realize that our body – our nervous system – is making decisions, and it’s not allowing us to the table to argue our point.

The issue is our nervous system – we’re not making voluntary decisions.

If you talk to clients who have been traumatized and they are extraordinarily defensive about creating relationships – they don’t trust people – and you say to them, “You should trust people. You should go to places with other people,” how effective is that? It’s not effective at all.

But if you tell them, “Your nervous system is functionally like a TSA agent at the airport and every person who comes close to you is literally going through one of these scans.

To your nervous system, every person is a potential terrorist. The way to get all potential terrorists off the plane or away from you is not to accept them.”

This is the neuroception of people who have been traumatized – they don’t want people to come close to them because their nervous system is making that evaluation.

Now, when you ask them on a cognitive level, they will probably say, “Look, I’d love to have good relationships. I’d love to be loved. I’d love to be able to hug, but my body is reacting this way.”

If we inform people about the features of their body’s response, which is literally these neuroception subcortical areas in our body reacting, then the higher cortical areas can interpret that and start inhibiting them at a natural level.

In other words, these defensive systems are at lower-brain structures – lower-brain levels.

When we get informed by what our body is doing without keeping ourselves in that mobilized, defensive state, but now in a more calm and relaxed state, we can actually develop a narrative that may be helpful in modulating those reactions. (p.11-13 in the Part 1 Transcript)

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