Neuro-Regulation Theory 3

Neuro-regulation 3

Just In: Dr. Mohahmed Looti from the University of Kerbala in Iraq recently published a 32-page online review and comprehensive analysis of The Neurovisceral Integration Model. I refer you to this which is much better than my brief comments.

In the mid 1990’s Julian Thayer of Ohio State University studied heart rate variability (HRV) in many ways including associations with and the effects on emotional health and well-being. He knows this area inside and out, probably more than anyone else. He has over 500 journal articles on the subject. Whereas the polyvagal theory had focused entirely on the neuro-regulation of heart from the basic level of the brainstem, Dr. Thayer and Dr. Richard Lane of the University of Arizona. looked as well at higher levels of the brain like the amygdala, anterior cingulate gyrus, the insula and others in their role in HRV and neuro-regulation of the heart. They were also interested, as Dr. Porges also was, in how this regulation connected to a perception of safety and threat. Also, like Porges, they were interested in how HRV was associated with complex human behavior. They developed what they referred to as the central autonomic network developed the Neuro-visceral integration model which included the brain stem as well as cortical structures. This expanded Porges’s ideas but they also looked at the coordination of multiple brain areas. So, I have already indicated that as clinicians, we don’t really need to know or understand where in the brain, why am I bringing it up? Because the neuro-visceral integration model answered a question that had been bugging me.

One thing had puzzled me and my colleagues and confused us was the lack of clarity about the freeze reaction. Is it the “deer in the headlights” response? Is it collapse and dissociation? Is it immobility without dissociation? What about “high activation freeze?” Different therapists as well as those providing supervision for me, had different answers for me and none of them were fully coherent, When a number of smart people can’t grasp a concept it is usually not the smart people that are wrong, it is the concept which is in error. The neurovisceral integration model provides the answer for us.

In the neuro-visceral integration model we don’t have a fight/flight – freeze response the way we are used to talking about it. It is more complex. When a prey animal perceives a threat (predator), there is sympathetic activation which causes a very brief immobility. This is the moment when the animal unconsciously decides to flee or be quiet and stay put. The decision is based on the proximity of the predator. If far enough away the animal will flee. If too close, the animal remains still as predators track movement.

After the brief immobility, the animal stays put or runs. As humans we are both prey and predator so we also have the unconscious fight option available. If the prey animal is unable to get away it falls to the ground in collapse. But on collapse, the animal’s muscle initially remain tense, taut, and ready to mobilize immediately if there is any chance of escape arises. This what I refer to as the 2^nd “freeze” but actually is termed tonic- immobility. If there is no chance of escape the animal prepares for death. The animal’s muscles go flaccid, the heart rate slows to almost nothing, and the animal goes into an anesthetic trance (dissociation). This 3^rd “freeze” is called the flaccid immobility response. This complex threat reaction tells us why it is so hard to understand what “freeze” means in the fight/flight-freeze model.

What we see then is the polyvagal theory is not completely accurate but it is easier for us and our patients to understand. The neurovisceral integration model is less useful when we are assessing where our patients are in the session from an autonomic standpoint or when we are teaching our patients.g