{"id":33194,"date":"2016-10-27T06:00:46","date_gmt":"2016-10-27T13:00:46","guid":{"rendered":"http:\/\/www.goodtherapy.org\/blog\/?p=33194"},"modified":"2017-08-24T11:20:36","modified_gmt":"2017-08-24T18:20:36","slug":"the-biology-of-calm-how-downregulation-promotes-well-being","status":"publish","type":"post","link":"https:\/\/www.goodtherapy.org\/blog\/biology-of-calm-how-downregulation-promotes-well-being-1027164","title":{"rendered":"The Biology of Calm: How Downregulation Promotes Well-Being"},"content":{"rendered":"

\"AthleticIn my therapy practice, I dedicate considerable time to helping people understand what\u2019s happening deep inside of them, in the layers of the nervous system where the conscious<\/a> mind blurs into the unconscious<\/a>. This is the part of us that some therapists call the \u201cbodymind.\u201d Understanding the communication of the bodymind creates the ability to \u201ctalk\u201d with our inner self: to understand what it is trying to tell us, and even to work with it in its own \u201clanguage.\u201d It is my experience that the bridging of this gap is ultimately what eliminates most symptoms.<\/p>\n

My previous article on self-regulation<\/a> explains that most symptoms that bring people to therapy are the result of, or strongly related to, difficulties in maintaining this biological balance. It\u2019s important to be aware of this underlying process. After all, we can\u2019t manage things if we\u2019re not aware of them!<\/p>\n

This article expands on our understanding of self-regulation. It\u2019s about developing our capacity to be calm, aware, and present, even in stressful<\/a> situations. For those who have genuinely struggled with this despite repeated and intense efforts, it\u2019s time to stop blaming yourself. As it turns out, this capacity is largely biological. And although we often forget this, biology is the platform upon which social and emotional interactions play out.<\/p>\n

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Self-regulation of the autonomic nervous system (ANS)<\/a> can essentially be broken down into two opposing functions: it goes up or it goes down!<\/p>\n

In a car, we can press the gas pedal to access more energy, or the brake pedal to slow down or stop. Similarly, the ANS has two parts, or branches: the sympathetic nervous system (SNS)<\/a>, which makes us go up into greater arousal, and the parasympathetic nervous system (PNS)<\/a>, which helps us come down into calmer, less aroused states.<\/p>\n

Upregulation<\/strong> means there\u2019s more firing of nerve cells (neurons) along a nerve pathway. So, upregulation of the SNS refers to when this \u201cgoing up\u201d branch of the nervous system is more active. This \u201cpressing of the gas pedal\u201d increases the amount of energy available in the body. This is why the SNS is often referred to as the \u201cfight-or-flight\u201d<\/a> nervous system, although it can also upregulate in pleasant situations requiring more energy.<\/p>\n

Its opposite, and the focus of this article, is downregulation<\/strong>. Sympathetic downregulation brings down the charge along the pathways of the SNS. At the same time, the PNS upregulates, which helps the SNS downregulate. (We will examine the important exception to this general rule in a future article.)<\/p>\n

Both upregulation and downregulation of the SNS are biological processes that we can feel and experience happening within us. Recently, a woman I work with in therapy was able to describe the involuntary muscular tensions, unpleasant pangs, and fluttering sensations of her anxiety<\/a> (upregulation). She also described the wonderful (downregulation) sensations of her body finally letting go into blissful sleep when she settles down in bed at night.<\/p>\n

As most of us can intuit, SNS upregulation can feel terrible when it’s a response to something stressful happening. However, SNS upregulation can also feel great when it’s in response to something fun or exciting: our team scoring a touchdown, or dancing when our favorite song comes on. In contrast, SNS downregulation almost always feels soothing, calming, or relaxing.<\/p>\n

I am focusing on SNS downregulation because it’s incompatible with states of anxiety, rage, or stress. Additionally, SNS downregulation keeps the SNS in check, so that it doesn\u2019t \u201covershoot\u201d and produce too much stress to effectively cope with a problem.<\/p>\n

So, then, how do we encourage SNS downregulation? How do we help the body settle down into a state in which it can rest, digest, and repair? For that matter, how do we know when we\u2019re in a downregulated state?<\/p>\n

Well, here\u2019s the catch. Downregulating the stress response is an acquired capacity. It\u2019s like a muscle: you have to build it over time in order for it to be strong.<\/p>\n

Although infants are born with the capacity for stress response (fussing, crying, etc.), their parasympathetic pathways, which help downregulate the SNS stress response, are not online at birth. This means babies can go up, but they can\u2019t come down on their own. (They will go into a “freeze” state if ignored long enough; this looks calm, but it really isn\u2019t.) The baby’s nervous system develops the ability to calm down through thousands and thousands of supportive, soothing interactions with caregivers. At first, the caregiver is essentially functioning as the child’s parasympathetic nervous system. The development of this \u201cbraking system\u201d continues throughout childhood, through continued positive interactions that meet the child\u2019s needs.<\/p>\n

There are many situations in which a child may not receive enough soothing in order to learn to downregulate sufficiently. These situations are not always the fault of the parents. Perhaps the child\u2019s mother had a lot of her own unmanaged anxiety, was depressed<\/a>, and\/or experienced posttraumatic stress<\/a>. Or maybe the family lived in poverty, with constant stressors impacting everyone\u2019s sense of safety. Perhaps someone in the family passed away or suffered a major illness, rendering them unavailable for care. Maybe the child grew up in wartime or, unbeknownst to their parents, was frequently bullied at school.<\/p>\n

Great things happen when we are parasympathetically dominant. Our breath is full, slow, and deep. The digestive system works well. The body can focus on repair, including reduction of inflammation, tissue repair, and hormone production. Subjectively, people feel fully present and alive. Many report feeling a pleasant softness and warmth, perhaps even throughout their bodies. <\/span><\/p>\n

It\u2019s important to point out that disconnecting from stress is not the same as resolving (downregulating) it. Alcohol and drugs<\/a>, eating disorders<\/a>, exercise<\/a> or sexual compulsion<\/a>, or even \u201czoning out\u201d on the internet may make the chronically stuck upregulation of the SNS seem to go away for a time. However, as the people I work with in the therapy room could tell you, it\u2019s not the same as sinking into a lovely, full-body sense of calm and relaxation<\/a>.<\/p>\n

Great things happen when we are parasympathetically dominant. Our breath is full, slow, and deep. The digestive system works well. The body can focus on repair, including reduction of inflammation, tissue repair, and hormone production. Subjectively, people feel fully present and alive. Many report feeling a pleasant softness and warmth, perhaps even throughout their bodies. When the SNS is on \u201cstandby\u201d and the PNS is more active, people have a \u201cbuffer\u201d for stress. They have energy to get through their day, but they can stay calm and present in challenging situations.<\/p>\n

One of my first tasks in therapy is to assess and support the person\u2019s ability to downregulate their stress responses. After they are provoked by something, how quickly and smoothly does their system deactivate? Are they still bothered by a small aversive event hours or days afterward?<\/p>\n

Here\u2019s a vital point often overlooked by therapists who haven\u2019t had sufficient training in this area: In therapy, it is essential to make sure the person has the ability to downregulate the stress response before<\/em> going into highly stressful material. In other words, you should never go into material that’s overwhelming, because overwhelming inherently means it\u2019s bigger than your capacity to deal with it. So instead of the issue resolving, more symptoms arise. The way around this is to first support the capacity for downregulation. Then, only after this \u201cbraking system\u201d is on board, take the difficult material a small bit at a time.<\/p>\n

If someone doesn\u2019t have a strong enough ability to come out of the stress response, how can they develop it?<\/p>\n