MHM Magazine

Issue 3 | 2021 | MENTALHEALTHMATTERS | 45 MHM regulation, according to Polyvagal Theory results in human beings reaching a state of homeostasis - the ability to maintain a relatively stable internal state that persists despite changes in the world outside. So, without social connectedness comes the opposite of homeostasis – imbalance and instability. In a recent article, Porges calls for a “one nervous system model” where the Central Nervous System (CNS) is interrelated with the Autonomic Nervous System (ANS). An understanding of Polyvagal Theory for us as clinicians and for our clients can help us understand how COVID-19 and its threatening nature, has shifted many people into an altered autonomic state. “Reverse evolution” or regression takes place during an altered autonomic state. Initially this altered state calls for intense mobilisation and activation of the CNS toward safety. However, the prolonged nature of a global pandemic has meant that mobilisation for many people has not led to safety. A lack of social engagement, prolonged threat and fear, loss, and disempowerment, leads one to a fight, flight or freeze state. This plays out in areas such as heightened aggression, anxiety, substance use and abuse, depression, shut down, dissociation, and suicidal ideation or death by suicide. Without connection with trusted people, it becomes unlikely that a person will downregulate their response to threat. This places us at risk of mental and physical ill-health. HOW CAN WE LESSEN SOME OF THE EFFECT OF COVID-19 ON OUR NERVOUS SYSTEM? • Safe connection with others whom we can co-regulate with • Exercise • Sufficient, quality sleep • Spending time in sunlight • Meditation • Creative activities • Safety and grounding rituals A SIMPLE THREE-MINUTE FULL BODY SCAN FOR PRACTITIONERS AND CLIENTS – A CASE EXAMPLE An adolescent client recently came for therapy after a traumatic few months of managing the stresses of COVID-19, schooling during a pandemic, physical illness, anxiety and depression. She arrived for the session dysregulated and unable to verbalise what she was feeling or what she needed. I used the following three- minute full body scan which is an adaptation of one designed by the Mindful Awareness Research Center. The co-regulation as well as grounding this exercise provides, moved my client “up the ladder” to a space where she felt less anxious and threatened, more associated with her surroundings, and better able to begin verbalising her experience of the last few months. You can use this script in practice for patients/clients. “Sit comfortably in your chair in a position where both your feet are touching the floor, your arms are relaxed, and your hands are soft. Begin by bringing your attention into your body. You can close your eyes if that’s comfortable for you. You can notice your body seated wherever you’re seated, feeling the weight of your body on the chair. Take a few deep breaths. Breath in through your nose and out through your mouth (purse your lips as you breathe out) and do this three times. Notice any sounds that you can hear. Just notice them. You can notice: • Your feet on the floor • The sensations of your feet touching the floor • Your legs against the chair, pressure, pulsing, heaviness, lightness. • Gently roll your ankles one at a time and move your toes in your shoes. Now relax. • Notice your back against the chair. • Bring your attention into your stomach area. If your stomach is tense or tight, let it soften. • Take a deep breath in through your nose and out through your mouth (purse your lips). • Notice your hands. Are your hands tense or tight? See if you can allow them to soften. Roll your wrists gently. Clench your fists and let them go (do this three times). Now relax. • Notice your arms. Feel any sensation in your arms. Let your shoulders be soft. • Notice your neck and throat. Let them be soft. Relax. • Soften your jaw. Let your face and facial muscles be soft. • Then notice your whole-body present. Take one more deep breath. Breathe in through your nose and out through your mouth (purse your lips as you breathe out) and do this three times. Be aware of your whole body as best you can. And then when you’re ready, you can open your eyes.” References available upon request