Treating Trauma and Addiction with the Felt Sense Polyvagal Model: A Bottom-Up Approach

Description

In sharp contrast with the current top-down medicalized method to treating addiction, this book presents the felt sense polyvagal model (FSPM), a paradigm-shifting, bottom-up approach that considers addiction as an adaptive attempt to regulate emotional states and trauma. The felt sense polyvagal model draws from Porges' polyvagal theory, Gendelin's felt sense, and Lewis' learning model of addiction to offer a graphically illustrated and deeply embodied way of conceptualizing and treating addiction through supporting autonomic regulation. This model de-pathologizes addiction as it teaches embodied practices through tapping into the felt sense, the body’s inner wisdom. Chapters first present a theoretical framework and demonstrate the graphic model in both clinician and client versions and then teach the clinician how to use the model in practice by providing detailed treatment strategies. This text’s informed, compassionate approach to understanding and treating trauma and addiction is adaptable to any school of psychotherapy and will appeal to addiction experts, trauma specialists, and clinicians in all mental health fields. Cover Endorsements Half Title Title Page Copyright Page Dedication Contents Acknowledgements A Prologue: My Women's Group Bridgette's Mixed Memories Reference 1. Early Days: The Initiation of a Trauma Therapist Addiction as Behavioural Affect Regulation: A New Frontier Finding Interpersonal Neurobiology (IPNB) Experiential Response to Siegel's IPNB Model Discovering the Missing Links: The Polyvagal Theory Origins of the Felt Sense Polyvagal Model of Addiction (FSPM) Addictive/Adaptive Responses Often Tell a Detailed Trauma Story Finding Focusing: Back to Women's Group How Porges Updated the Traditional ANS Model The Dorsal Vagus The Ventral Vagus Sympathetic Nervous System The Felt Sense Polyvagal Model (FSPM) Play: Mobilization with Safety (yellow/red) Stillness: Immobilization with Safety (yellow/grey) Addiction: A Propeller of Dysregulated State Change (red/grey) The Current and Desperate State of Addiction The Polyvagal Paradigm Shift ... A Powerful Dance of Connection Summing Up the Journey to a More Sophisticated Model for Addiction References 2. Finding Focusing and Thinking at the Edge Focusing and the Felt Sense Focusing in Partnership: Learning to Listen Focusing: The Fundamentals Step 1: Clearing a Space Step 2: Getting a Felt Sense of the Problem Step 3: Finding a Handle The Felt Shift The Addictive Shift Step 4: Resonating Felt Sense and Handle Step 5: Asking Step 6: Receiving George's First Focusing Session Thinking at the Edge (TAE) The 14 Steps of TAE TAE as a Three-Step Process Steps 1-5: Speaking From the Felt Sense Steps 6-8: Finding Patterns From Facets (Instances) Step 9: Write Freely Steps 10-14: Building Logical Theory References 3. Thinking About Thinking About Addiction: Integrating Top-Down and Bottom-Up Top-Down Processing Brain-Disease Model Addiction According to the Diagnostic and Statistical Manual (DSM) Critiquing the DSM First-Person Experiencing of DSM A Group Vignette Critiquing the Twelve Steps: The Origins and History of AA The AA Controversy The Twelve Steps: Dancing with the Devil Cognitive Behavioural Therapy: A Top-Down Approach Embodied Processing: A Bottom-Up Approach The Marvellous Metaphor The Safe Edge: Where Bottom-Up Meets Top-Down Thinking at the Safe Edge: A Non-Pathologizing Approach to Addiction References 4. Addiction: A Very Bad Habit Neuroplasticity, The Brain's Way of Learning First Person Experiencing - The Fear of Shameful Sharing Back to the Origins of Neuroplasticity The Changing Brain: Dispelling Myths Myth #1: Brains Don't Change Myth #2: Brain Parts Perform Specific Functions Brain Regions Most Relevant to Addiction Dorsolateral PreFrontal Cortex: "The Bridge of the Ship" (, p. 45) Ventral Striatum: Motivational Engine Midbrain: Dopamine Pump Amygdala: "Emotional Spraypaint" (, p. 79) Orbitofrontal Cortex: Connector How Addiction Works in the Brain, A Case Example "Neurons That Fire Together Wire Together" Embodied Cognition Leads to an Integrated Approach to Addiction References 5. Facing the Truth About Addiction Facing the Truth, Settling Our Nervous Systems Five Faces of Oppression The Myth of the "Hook" Anslinger's Racist War on Drugs First-Person Experiencing Understanding Harry: White Body Supremacy The Female Chain Gang First-Person Experiencing ... Pause Childhood Trauma: The Underbelly of Addiction Felitti's Adverse Childhood Experiences Scale (ACES) Felitti's Aha Moment Felitti's Alternative Model of Addiction - A Psychodynamic Model The Plot Thickens with Later ACES Study Alexander: "Addiction is our teacher" Globalizing Free Market Society Creates Dislocation Sustained Dislocation Creates Addiction Skinner Box Versus Rat Park References 6. Bringing the Body to Mind: The Emerging Field of Interpersonal Neurobiology First-Person Experiencing Bringing the Interpersonal into Neurobiology Thinking at the Edge: Crossing Concepts and Finding the More Crossing Flooding/Numbing with Chaos/Rigidity The Sweet Spot The Brilliance of Consilience A Definition of Mind First-Person Experiencing Complexity Theory: A Push Toward Integration First-Person Experiencing Consilience and Crossing A Crossing: The Help Embraces the Harm Hypothesis: Self-Organization is the Same as Self-Regulation Complex Systems are Non-Linear, Challenging Twelve Steps The Harm Reduction Model Complex Systems have Emergent and Recursive Properties Eyes-Wide-Open Presence Bringing it all Together: The Triangle of Well-being and Resilience Mindsight: Seeing the Mind SNAG and SIFT Attachment Theory: Holding and Letting Go Four Classifications of Attachment Mapping Attachment Styles and the Felt Sense Polyvagal Model of Addiction Critiquing Attachment Theory: The Unclassifiable References 7. Creating a Safe Nest First-Person Experiencing Instinctively Seeking Good Energy Back in the Women's Group Vicarious Trauma, The Hot Potato Thinking at the Edge: Feeling into Thinking Attachment, Trauma, Addiction: Making Vital Connections Addiction as an "Attachment Disorder" First-Person Experiencing Thinking Systemically About Attachment: Bridging the Divide Attachment Theory: Early Days Strange Situation Procedure Thinking at the Edge of Attachment Theory: The Quantitative Shift The Wisdom of Mixed Methods A Feminist Lens on Attachment Global Attachment Trauma The Politics of Trauma References 8. Bringing Polyvagal Theory into the World of Addiction First-Person Experiencing: Resolving the Paradox, "What Helps you Hurts You" Porges' Vagal Paradox Linking Polyvagal Theory to Trauma and Addiction Our Very Elegant Survival System Thinking at the Edge with Polyvagal Theory Lesson 1. Safety First: None of Us Is Safe Unless All of Us Are Safe Creating a Safe Nest What is Enough Safety? Chronic States of Dysregulation First-Person Experiencing What is Essential for Safety? Lesson 2. Interoception: Honour Your Mind/Body Connection First-Person Experiencing Lesson 3. Neuroception: Our Body's Wisdom is Designed to Seek Safety Crossing Felt Shift and Neuroception Neuroception and Triggers: A Retuning/Reframing Process First-Person Experiencing Lesson 4. Social Engagement System: We need each other to survive and thrive Social Engagement and Addiction: No Thanks! First-Person Experiencing: Feeling into Our Heart, Throat, Face Connection Lesson 5. Co-regulation: Body/Environments are Alive and Co-regulate Self Regulation and Addiction: Whatever Gets You Through the Night First-Person Experiencing References 9. Experiential Psychotherapy and Gendlin's Felt Sense: The Whole of a Situation First-Person Experiencing: Meeting Mary Armstrong Meeting Eugene Gendlin Gendlin's Safe Space: Do What is Right for You The Dream: Lotte's Holocaust Story Gendlin's Holocaust Story Gendin the Philosopher The Primacy of Human Presence Three Ways of Knowing Gendlin's View of Neurobiology Experiential Psychotherapy: The Birth of Gendlin's Felt Sense and Felt Shift Gendlin's Felt Shift as a "Motor of Personality Change" The Experiencing Scale: Tracking the Felt Sense A Process Model: Gendlin's Major Philosophical Work Body/Environment is One Interaction First First-Person Experiencing: Implicit Intricacy - We Are More Than We Can Say Implicit intricacy and Words Implying and Carrying Forward First-Person Experiencing: A Dreamy Carrying Forward Addiction as Process Skipping References 10. Bringing the Model to Life: Going Deep and Thinking Big The Paradigm Shift - From a Medical Model to an Embodied Emotion Regulation Model First-Person Experiencing: Moments of Liberation The Embodied Emotion Regulation Paradigm: A Bigger Picture The Trauma of Addiction: The Bidirectional Link Two Different Versions of Joe Where Do We Start? Safe and Secret: The Hidden Faces of Addiction The Big Mistake: Never Engage in a Power Struggle With the Addict Part First-Person Experiencing The Importance of Asking The Trauma of Addiction Needs to be Named Three Process Movements: The Three D's References 11. Nuts and Bolts: Embodied Assessment and Treatment Tool (EATT) and Focusing Oriented Therapy Strategies Using EATT: Allowing the Story to Unfold The Felt Sense Polyvagal Model The Experiencing Scale (EXP) The Felt Sense Polyvagal Dialogue The Three Circles The Inner Circle: Fixate The Middle Circle: Fight/Flight, Fold The Outer Circle: Flow, Flock, Fun The Trauma Egg and The Background Wallpaper The Nine Domains of Integration Integration of Consciousness: Does this person have an inner observing compassionate voice? Can they stand beside their experiencing? Vertical Integration: How connected is this person with their bodily-felt knowing? Bilateral Integration. Can this person think logically (using their left hemisphere)? Can they describe their felt-sense embodied knowing (right hemisphere)? How well can they move back and forth between both hemispheres? Memory Integration: Is this person able to connect with the memory part of the felt sense experience in a coherent way? Implicit and explicit memory Divided Attention: Dissociation Narrative Integration: Can this person make sense of their life? State Integration: How well integrated are all the parts of this person? Interpersonal Integration: Can this person feel close to others and hold on to self in relationship? Temporal Integration: Can this person accept life's uncertainty and impermanence? Transpirational Integration: Does this person feel deeply interconnected with a wider sense of self, including the natural world? The Privilege Wheel Specific Concerns Focusing-Oriented Psychotherapy Strategies Orienting to the FSPM Resourcing: Evoking Felt Sense Experiences of Grounding and Good Energy Finding the Right Distance from the Felt Sense Clearing Space Forward and Backward Grounded Aware Presence Engaging the Relational Felt Sense The Revolutionary Pause The Focusing Attitude: Welcoming the Uncomfortable Working With Parts Working With Dreams Focusing Partnerships, Experiential Listening Summary References 12. An Embodied Experiential Assessment: The Margaritas Orienting to the Felt Sense Polyvagal Model (FSPM) The Three D's Privilege Wheel The Emergence of Parts Deepening and Developing the Process Margarita Orients to the Model Tracking the Six Steps of Focusing and the Shift The Three Circles Trauma Egg and Body Cards The Final Stage The High Flyers References 13. Hailstorms and Turtles: The Felt Sense Polyvagal Dialogue Meeting Harville and Helen First-Person Experiencing Some Imago Therapy Concepts and Points of Consilience The Primacy of Safety Imago: The Latin Word for Image Imago Felt Shift : Creating Moments of Couple Liberation First-Person Experiencing The Felt Sense Polyvagal Dialogue: The Model The Addictive Imago, An Exit Extraordinaire The Felt Sense Polyvagal Dialogue in Six Steps Behaviour Change Requests Dialoguing with Triggers in Five Steps References 14. Lily and Lucas The Call Introducing FSPD The Three Circles Mirroring, Validating, Empathizing Developing Lily's Imago Story Lily's Imago Shift Lucas' Imago Story A Couple Imago Felt Shift Reference Epilogue My Hopeful Space: Focusing on Borden In Conclusion: A Call to Action Next Steps for Therapists Reference Index