Next Level Practitioner
Next Level Practitioner - Biggest Mistakes
Week 83, Day 4 - Peter Levine, PhD - Transcript - pg. 1
Next Level Practitioner Week 83: Mistakes in Treatment that Led to Professional Growth Day 4: How Empathy Can Actually Impair Treatment with Ruth Buczynski, PhD and Peter Levine, PhD
Next Level Practitioner - Biggest Mistakes
Week 83, Day 4 - Peter Levine, PhD - Transcript - pg. 2
Week 83, Day 4: Peter Levine, PhD
How Empathy Can Actually Impair Treatment Dr. Buczynski: Yesterday, Peter Levine talked about the crucial moment of connection when a client is coming out of shutdown after trauma. Now today, we’ll explore this idea a bit further. When is it best to make contact, and when might that be a mistake? Dr. Levine: First of all, one of our strengths is empathy, and that's why people are probably attracted to the helping professionals in general. However, we don't realize how the client may be perceiving that. When a person is in a state of shutdown, they will perceive everything in the environment as mortal threat. Stephen Porges talks about the treatment, the three traffic lights. The green light is social engagement; the yellow light is threat; the dark red light is life threat.
“In any situation, the nervous system must distinguish what level of safety there is or isn't in the environment.”
In any situation, the nervous system must distinguish what level of safety there is or isn't in the environment. One of the things that brought Stephen and I together was what I was observing and saying to him. But the opposite is at least as equally true.
If a person is in a state of shutdown, that is to say, their organism, their nervous system, is responding as though they're in mortal threat, then they will perceive the environment as mortal threat, no matter how safe it is. Again, that could be the compassionate face. It's not safe when you are stuck in that nervous system response. Similarly, when we are in the fight or flight response, the sympathetic arousal state, we will experience the
environment as threatening. We will, in either case, not be able to be in the here and now. It's really important for therapists to be able to track where their client is in regards to the main three basic energy and motivational systems, as outlined by Stephen Porges in his polyvagal theory.
Next Level Practitioner - Biggest Mistakes
Week 83, Day 4 - Peter Levine, PhD - Transcript - pg. 3
Their nervous system is a fight or flight response, high activation, you can make contact with them and say, "I can see there's a lot activity, a lot of sensation. Let's just stay with this together. That's it, as you notice it beginning to settle, beginning to change.” In other words, when you're in the sympathetic arousal state, it will activate, but it will rebound. There will be a linear parasympathetic response that takes it back to equilibrium. So, in a way, you have to keep the person in contact with their sensations and a little bit out of their head until the arousal cycle itself settles. That's it. “Good. Just noticing how that feels right now in your body as you become more and more settled.” You can guide the person from the hyperaroused state to the down regulated to the settled state through contact. However, when the person is in the shutdown state, you cannot use it. It only makes things worse. It only drives the person deeper inside of themselves and into isolation. I use special techniques including sounds and breath and movement to help the person come out of the shutdown state so that they can begin to feel the sensations of hyperarousal, and then shift it down to the state of relaxation and the desire to make contact. When a person starts to come down and you can see they're more settled, their eyes will want to move towards yours and/or to just look around the room, almost as though they were seeing it for the first time. That's here and now presence. You can think of trauma as a disorder of not being able to be in the here and now. I think that's a definition
that Bessel made, and I totally agree with that. When the person is able to make contact and to perceive, I'll ask, "Let's just notice two or three things that get your interest." They'll look around, and they'll say, "Oh, that's a plant. That's a plant that I water. I really like that plant." "Okay, so as you look at that plant, can you just let the image of the plant impact on you and just notice what sensations that provokes?" Dr. Buczynski: When a client is ready for contact, they can engage with the therapist and begin to feel safe. As Peter shared, though, we need to know when our contact might be a threat.
Next Level Practitioner - Biggest Mistakes
Week 83, Day 4 - Peter Levine, PhD - Transcript - pg. 4
But now I’d like to hear from you. How will you use some of these ideas today in your work with clients? Tomorrow is Friday, which as we know means it’s our Critical Insights session. I’ll be joined by Dr. Ron Siegel and Dr. Kelly McGonigal. We’ll deconstruct many of the experts’ ideas from this week and look at new ways to apply them to your practice.
Week 83, Day 4 - Peter Levine, PhD - Transcript - pg. 1
Next Level Practitioner Week 83: Mistakes in Treatment that Led to Professional Growth Day 4: How Empathy Can Actually Impair Treatment with Ruth Buczynski, PhD and Peter Levine, PhD
Next Level Practitioner - Biggest Mistakes
Week 83, Day 4 - Peter Levine, PhD - Transcript - pg. 2
Week 83, Day 4: Peter Levine, PhD
How Empathy Can Actually Impair Treatment Dr. Buczynski: Yesterday, Peter Levine talked about the crucial moment of connection when a client is coming out of shutdown after trauma. Now today, we’ll explore this idea a bit further. When is it best to make contact, and when might that be a mistake? Dr. Levine: First of all, one of our strengths is empathy, and that's why people are probably attracted to the helping professionals in general. However, we don't realize how the client may be perceiving that. When a person is in a state of shutdown, they will perceive everything in the environment as mortal threat. Stephen Porges talks about the treatment, the three traffic lights. The green light is social engagement; the yellow light is threat; the dark red light is life threat.
“In any situation, the nervous system must distinguish what level of safety there is or isn't in the environment.”
In any situation, the nervous system must distinguish what level of safety there is or isn't in the environment. One of the things that brought Stephen and I together was what I was observing and saying to him. But the opposite is at least as equally true.
If a person is in a state of shutdown, that is to say, their organism, their nervous system, is responding as though they're in mortal threat, then they will perceive the environment as mortal threat, no matter how safe it is. Again, that could be the compassionate face. It's not safe when you are stuck in that nervous system response. Similarly, when we are in the fight or flight response, the sympathetic arousal state, we will experience the
environment as threatening. We will, in either case, not be able to be in the here and now. It's really important for therapists to be able to track where their client is in regards to the main three basic energy and motivational systems, as outlined by Stephen Porges in his polyvagal theory.
Next Level Practitioner - Biggest Mistakes
Week 83, Day 4 - Peter Levine, PhD - Transcript - pg. 3
Their nervous system is a fight or flight response, high activation, you can make contact with them and say, "I can see there's a lot activity, a lot of sensation. Let's just stay with this together. That's it, as you notice it beginning to settle, beginning to change.” In other words, when you're in the sympathetic arousal state, it will activate, but it will rebound. There will be a linear parasympathetic response that takes it back to equilibrium. So, in a way, you have to keep the person in contact with their sensations and a little bit out of their head until the arousal cycle itself settles. That's it. “Good. Just noticing how that feels right now in your body as you become more and more settled.” You can guide the person from the hyperaroused state to the down regulated to the settled state through contact. However, when the person is in the shutdown state, you cannot use it. It only makes things worse. It only drives the person deeper inside of themselves and into isolation. I use special techniques including sounds and breath and movement to help the person come out of the shutdown state so that they can begin to feel the sensations of hyperarousal, and then shift it down to the state of relaxation and the desire to make contact. When a person starts to come down and you can see they're more settled, their eyes will want to move towards yours and/or to just look around the room, almost as though they were seeing it for the first time. That's here and now presence. You can think of trauma as a disorder of not being able to be in the here and now. I think that's a definition
that Bessel made, and I totally agree with that. When the person is able to make contact and to perceive, I'll ask, "Let's just notice two or three things that get your interest." They'll look around, and they'll say, "Oh, that's a plant. That's a plant that I water. I really like that plant." "Okay, so as you look at that plant, can you just let the image of the plant impact on you and just notice what sensations that provokes?" Dr. Buczynski: When a client is ready for contact, they can engage with the therapist and begin to feel safe. As Peter shared, though, we need to know when our contact might be a threat.
Next Level Practitioner - Biggest Mistakes
Week 83, Day 4 - Peter Levine, PhD - Transcript - pg. 4
But now I’d like to hear from you. How will you use some of these ideas today in your work with clients? Tomorrow is Friday, which as we know means it’s our Critical Insights session. I’ll be joined by Dr. Ron Siegel and Dr. Kelly McGonigal. We’ll deconstruct many of the experts’ ideas from this week and look at new ways to apply them to your practice.
