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  • Sam Tetzlaff, MS, LPC-IT

Learning to Regulate the Nervous System: When Talk Therapy May Not Be Enough

In recent psychology, the mind-body connection has become a popular topic, so this likely isn't an entirely new concept to many of you that have found your way to a blog dedicated to mental health. Still, I don't think it's well-known how strong this link truly is, and in some cases—that we may need to heal our bodies in order to heal our minds. In other words, when simply talking about what's wrong (in psych terms, a strictly cognitive, behavioral, or emotion-focused approach) just isn't enough.

Over the past year-and-a-half-ish, I've been learning a lot more about body-based approaches to therapy, both personally and professionally. This has come up especially when reading about different ways to treat trauma or chronic stress. Now, I want to take a moment to talk about this NOT because I don't believe in talk therapy—I wouldn't have chosen this as a profession if I didn't, and it does work—but because sometimes a client's symptoms will keep reappearing (even with applying all the skills etc.), or it's clear that the problem has been "all talked out," or, in other cases still, with people who have complex or repeated trauma, talking about it isn't enough. What I'm learning is that this comes down to, very basically, a need to regulate the nervous system.

First, a crash course on the autonomic nervous system (I'm going to refer to this as ANS because that's a lot for me to type out and for you to read). Our ANS has 2 main divisions, the sympathetic and the parasympathetic. You can think about how these divisions function like this: the sympathetic works to turn the light switch on, the parasympathetic works to turn the light switch off. Based on the information our body receives from our external environment, the ANS signals to our internal body processes whether they need to turn on or off. The ANS controls the following internal body processes:

  • Blood pressure

  • Heart and breathing rates

  • Body temperature

  • Digestion

  • Metabolism (thus affecting body weight)

  • The balance of water and electrolytes (such as sodium and calcium)

  • The production of body fluids (saliva, sweat, and tears)

  • Urination

  • Defecation

  • Sexual response

Putting that all together, an example might be when we're startled by a loud noise, the sympathetic division increases our blood pressure, heart rate, etc. and the parasympathetic division will eventually decrease it once we realize everything is okay. Overall, the two divisions work together to ensure that the body responds appropriately to different situations, and that our bodies return back to homeostasis, or self-regulate. However, when you've experienced trauma or repeated stressors, your body's sympathetic and parasympathetic systems are being jerked around a lot and can get really out of whack. You've been faced with a lot of "threats," so to speak. As a result, the body has a much harder time of getting back to a normal baseline, and is more easily thrown off balance, as well.

The thing is, we can come to learn that we are safe and no longer under threat. We can talk through that, experience healthier relationships, come into more material security, etc. We can understand that we are okay on an emotional and/or intellectual level. However, that doesn't mean our body is sure of this. And because we're wired for survival, our body is going to keep doing it's best to keep us safe—it's just a little off the mark once it's undergone a lot of stress and is working on overdrive. Again, this is not to discredit cognitive or behavioral approaches—treatments like exposure therapy create empowering change for a lot of people and significantly reduce their distress. Skills like those from dialectical behavioral therapy that help tolerate distress and regulate emotions have a lot of research to back them up and I use DBT with clients all the time because it's so accessible and it does help. My point is that these approaches aren't sufficient for everyone, and understanding our physiology can inform us as to why and give us more options on how to get better.

So how do we let our bodies know that we can relax? Cue body-based therapy. Some examples of this are Somatic Experiencing, Trauma Releasing Exercises, table work/touch therapy, and trauma-sensitive yoga. I'd encourage you to read more about these approaches, as the synopsis on the ANS I gave you above is just the tip of the iceberg. At the end of the day, the ultimate goal is for us to feel like we can self-regulate, regardless of the approach to getting there, and feel more empowered to live our lives. To hope and healing,



If you are interested in scheduling an appointment with Sam, you can reach her via email:

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[This article does not create a client-counselor relationship. This article is general counseling information and is not to be considered legal or medical advice. Please consult with your mental health professional before you rely on this information.]

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