The Gifts of the Parasympathetic Nervous System During PTSD Recovery

Somatic therapy modalities are increasing in popularity and for good reason; the prognosis of long-term healing for clients who receive nervous system-based intervention is higher than those who don’t.

Over the past few decades, medical and mental health professionals have integrated their research, knowledge, and patient case studies to conclude that the body really does “keep the score”. Pioneers in Somatic based modalities, notably, Bessell Van Der Kolk and Peter Levine have changed the course of trauma treatment. Their research, methodologies, and training provide a blueprint for effectively treating trauma-related disorders.

Traditionally, trauma and anxiety-related symptomatology were treated from a cognitive perspective, discussing and then describing the traumatic events in detail; resulting in what was assumed to be healing. However, patient experiences tell us that while their “mind” often understands that the trauma is over, the body does not. This is due to the fact that the natural nervous system discharge process is interrupted by the advanced development of the human’s frontal cortex or “thinking brain” (what sets us apart from other mammals). When an event occurs, we personalize the traumatic experience and start trying to understand the “why” of it.

Throughout decades of research, Peter Levine concluded that wild mammals do not present with PTSD symptoms nor do they try to “think” their way into understanding why a predator is chasing them, they simply respond from a fight, flight, freeze state.

In other words, the sympathetic nervous system responds appropriately, and when safe from the predator, the parasympathetic branch follows; bringing the prey to a state of regulation. When exploring the development of trauma-related disorders in humans, researchers have concluded that PTSD is not solely caused by the ‘event or experience’ itself but the inability of the nervous system to ‘discharge’ the activation of the experience.

The autonomic nervous system (ANS) is responsible for several vital functions including, heartbeat, breathing, and digestion. It is also involved in the acute stress response where it works with other bodily systems to prepare the body for flight or fight. The two distinct branches of the ANS; the sympathetic and parasympathetic, are responsible for reaction/response to a threat and then regulation after the threat is over. The sympathetic branch is the ‘alert’ system, it allows for pupil and muscle dilation, increased heart rate, stimulates digestion, and other symptoms are activation. The parasympathetic is the branch that brings regulation to a deregulated system; it is responsible for ‘rest and digest’, slows down heart rate, inhibits muscle movement and digestion, and constricts other bodily functions.

In individuals who have experienced chronic stress, anxiety, and trauma, the functions of the ANS are often mistuned with external stimuli. They may live in a consistent state of hyper-arousal or sympathetic activation or, oppositely, individuals may experience sharp declines in their functioning, driven by the overactive parasympathetic; the client finds themselves depressed, dissociated, and completely shut down. This volatile dance between the two branches of the traumatized nervous system often results in the client living outside their “window of tolerance”. The term “window of tolerance” can be defined as, “Being able to coexist with both thoughts and feelings; what one feels and how they react are “appropriate” for the situation”. In other terms, the branches of the ANS function “as they should”.

Many clients come to therapy in a highly sympathetic aroused state; they report symptoms such as being overwhelmed, anxious, impulsive, and reactive, unknowingly describing symptoms related to a history of trauma or a chronically distressed state of being. My goal as the therapist is to gain an understanding of the ‘health’ of their nervous system, how easily do they regulate after experiencing activation? Do they drop down into a shut-off state or are they able to remain in their window of tolerance during the ‘recovery’ period from stress? Remaining curious about the client’s nervous system allows for consistent ‘check-ins’ on the stability of their nervous system and the functioning capacity of both the sympathetic and parasympathetic branches.

It is important to mindfully address nervous system activation within your clients. Stimulating the parasympathetic nervous system encourages a decrease in acute stress response and distressing symptoms. Introducing daily activities such as mild-moderate exercise, spending time in nature, meditation, cold therapy, breathing exercises, playing with animals or children, or getting a massage can all bring regulation to an overly activated sympathetic nervous system.