Ask the Faculty
CASPARI, Monica / SALVESON, Michael / EASON, Libby / ROSSI, Cornelia / KEEN, Lael Katharine / AGNEESSENS, Carol / BERG, Valerie / SCHEWE, John
Publication: Structural Integration / Language: English
Date: 12-2009 / Volume: 37 / Issue #: 4 / Page: 2-6
Abstract: Question: I have noticed that some of my clients seem to have a primary pattern involving an over-activated nervous system. Their problem seems to be systemic rather than local. There is a high level of tone throughout the body, with all their muscles tight and holding. We have lots of techniques for releasing restricted fascia and joints, but what is the best approach to help relax an amped-up nervous system?
Answer: There are different reasons for people expressing an activation of the sympathetic nervous system: either their nature is more inclined to that, or they are going through some kind of a temporary, challenging situation, or they are suffering from post-traumatic stress syndrome. The way you treat the over-activated nervous system in each of these situations may vary, and here I will write about how to deal with the first two conditions, as the way you treat the third one is better learned in a specific training.
The best approach to help any condition, from an amped-up nervous system to a depressive state, starts in the therapist’s attitude. As a therapist, I want to evoke both a new expressivity and a new receptivity from my client; that is, a new way of perceiving and of relating to the world, to things, and to others. This means that I want to evoke a new possibility of expression for my client. But for this I need to help him connect in a different way with things and others. And to do this means that I need to learn to first receive my client and to truly listen to him at all possible levels: the “animal,” the cognitive, and the affective in me. But to listen properly means that I need to empty myself, so that I can really meet another. Otherwise, if I am so sure of myself, I will be listening only to myself and will feel what I already feel. If I don’t empty myself, I don’t make room for the new to happen. How many times has someone barely started telling us his problems, and we already have a ready answer? Or how many times do we start “preaching” about what the client should do even before he is done expressing himself? For me, this reveals our own anxiety, and then it becomes harder to help the client to calm down. So step number one is to quietly listen, with an open attitude, without missing the opportunity to say nothing, at least at this point.
Together with the attitude of emptying myself in order to listen to the other comes the attitude of receiving the client’s being in my own being. This means receiving the client’s “shape.” How does his shape feel in my own body? How does my own kinesphere change as I do this? How, then, can I integrate the client in my own space?
To receive the client also means to be empty of preconceived ideas, or else I will not be truly receiving him, and will be only perceiving myself. And, when I meet the client, I want to look at him, and in the context he is in, and where he comes from. I learned a lot about this during the multinational Rolfing Structural Integration trainings – what is of value in one culture is sometimes considered inadequate in another culture, or the meaning/value that I attribute to something may be totally different than someone else’s. Just like the mosquito for the frog and the man – for the frog it means food, for the man it means a nuisance.
What about the issue of boundaries? Hubert Godard said it well: “Boundary is not a wall question. It is a center question.” To understand this we must realize that the newborn is not thinking about core stabilization but about expressing and receiving impressions. This is what initiates “the Line.” That means that the Line is about expansion, about reaching, about space. And for the core to expand, I need a periphery. I need skin that reaches to the other and to things, through space. But we see the space according to what we think we can do with it or within it. Another way of expressing this is that we do not see space the way it is but the way we expect it to be. So, the “space” between me and the other is a representation that is connected to my way of seeing. But perception (seeing, hearing, touching, smelling, tasting) depends on orientation. We then conclude that my boundaries depend on my orientation, not so much on the thickness of the wall.
The question then becomes “How can I orient myself through touch in a way that I can integrate the other person’s body in my own body? This is a serious question because the way we have been touched is the way that we will allow the client to touch us. Which means that the way we have been touched when in an over-activated nervous system will be the way we will touch a client in that same state – unless I do personal work, and learn to touch the client while relating through my lumbricals and the interosseus muscles in my hands and feet.
However, if I am not present in my own back with its potential for full extension, or if I don’t even have such a back, I can’t really include the other. Hubert Godard coined the word “backing” to refer to this way of being in/with your back. Backing, then, is a huge issue for me, and in relation to the other, especially in emotional/psychological terms. It is my backing that gives support for my front, through which I express myself. When I have my backing, my spine is free to move; I do not lock my spine, and between me and the other there is no a “wall.”
Thus, the conclusion is that for you to “relax an amped-up nervous system” you must first be in your backing, find in yourself the state you want to evoke in the other, and then touch the client from the intrinsics in your hands while touching the ground from the intrinsics in your feet. This evokes your core. There will be no wall and there will be no confusion either.
Then I proceed to help the client feel the support that the table offers and to invite his body to surrender its weight into the table, and then to invite his spine to let go of its weight towards the table. And only then do I start to talk about breathing in and out, opening to space and surrendering to the support. And every now and then during the session I go back to that, reminding the client to let go of his weight into the table, etc. And because I see many amped-up people, I always remind them that life pulsates in expansion and contraction and that resting is part of the art of working.
A: It is very difficult to answer this question briefly, as it concerns some fundamental and complicated aspects of good Rolfing Structural Integration. So, I won’t be brief.
Techniques for releasing restricted fascia are truly integrative only if they are accompanied by an ability to touch our clients in a way that connects to the expressiveness of their bodies or, we could say, their inner somatic experience. “A primary pattern involving an over-activated nervous system” is a specific example of the body’s expressiveness, communicating something about the inner state of the client. Always, when we touch, we touch in a way that connects us to the client’s “inner state.” Working with an “over-activated nervous system” will involve specific pacing, depth, duration and intensity of touch in such a way that we can perceive and respond to this expressive quality of the body of our client.
At the heart of the “over-activated nervous system” is an inability to discharge. This phenomenon of discharge is, I believe, one of the most important and least understood of the physiological events we see in our clients. Wilhelm Reich wrote extensively about this in his book The Function of the Orgasm. While he may have slightly mythologized the energetic basis of his metaphors, he was the first in the West to discuss discharge and the role it played in the psychological economy of his patients. I believe we are dealing with a similar phenomenon. Peter Levine takes a slightly more concrete, neurological approach in his book Waking the Tiger. He connects inappropriate “charge” and incapacity to discharge with the consequences of trauma, which has been an immensely useful insight. However, inappropriate charge is not always the result of trauma. The classic “Type A” personality (who resembles the client you describe) has a high level of charge and tends to have trouble “letting go,” but there is often no trauma. In fact, these people are often high achievers. The result, of course, is excessive output from certain endocrine organs and accumulated fatigue, which is overridden by effort and will.
So, how to induce discharge, which is necessary to come down from the overcharged endocrine and nervous system? First is the need of the practitioner to configure him or herself in such a way that his/her own nervous system is alert, responsive and quiescent. The important issue here is matching the client. It is crucial to be able to perceive the client accurately and then match him/her in such a way that the practitioner’s input literally responds to the client’s response, as the practitioner’s input is occurring. This is often referred to as “tuning,” and it is at the heart of all hypnosis. By “tuning” to the client we create conditions that induce trust and confidence on the client’s part that he/she will be treated appropriately, and this reduces guarding, which is, of course, mostly subliminal. It is the practitioner’s state that sets the stage for the client’s response. This effect is so powerful that I often see my clients falling asleep or in a deep trance state while I am working – in many instances quite deeply – in their tissue. How is it that my client seems to be in a state of deep relaxation while I am working deeply in tissue that one would expect to be painful? We should explore this question in depth (so to speak).
On a practical level, we modulate our touch to induce conditions in our client that are conducive to discharge or, more commonly stated, letting go. The classical teaching here is to modulate depth, duration, speed, intensity and frequency of touch according to the client’s state and ability to respond. I find that it is also crucial to be working in the right place, meaning in the place where there is access to deeper responses in the client. This may not always be the “structurally obvious” place. I will often start a session with a “charged” client by simply holding the sacrum and tuning to the inherent motion of the craniosacral pulse. This often drops the client right in and I can then go to work. We say in the advanced Rolfing training that issues regarding the nervous system override structural concerns. You cannot proceed on your structural course ignoring the fact that the client’s response to your input is not conducive to “letting go.”
Finally, it is very much about “letting go” to the inherent, spontaneous expressive and organizing forces at work in us, which is why the capacity to discharge is important. Most of the time, it is a problem of “over-control” and an inability to open to what is emerging in oneself. Standing up straight, or being “balanced in gravity,” is part of what we are working to achieve in our clients, but it is not everything. We seek to get to balance in gravity by opening, by letting go of restrictions, preoccupations and inhibitions such that we are expanded in the gravity field and free to orient to our environment in ways that serve our expressive nature.
A: In my practice, as well, I have observed that a lot of people show up with apparent sympathetic nervous system activation. I liken it to having the idle of a car set too high – when sitting still, the car’s motor is still running as though it were traveling at a speed of fifty miles per hour. This is the way that I (over)simplify it for my clients. It seems to help take the potential charge out of the situation, as some people can easily feel like they are doing something “wrong” if you call attention to this.
I always spend an hour with a new client in consultation. I take a complete history, show them anatomy-book pictures of fascia, and give a general overview of how the sessions of the Ten Series work together, cumulatively, to effect whole-body balance. Usually by the end of that time, a good relationship has been established, and the client is more comfortable coming the next time for the first session. I also approach slowly, and listen carefully, for autonomic response. Many people have had some kind of trauma and are easily triggered into that response in uncertain situations. And no one knows what to expect from Rolfing Structural Integration until he has had the experience.
I also watch for signs of activation throughout each session. I explain to the client that it is like dropping a pebble in a pond. The ripple goes out, and eventually quiets. If we don’t drop too many rocks too fast, each wave has time to complete its transit, and the system can return to calm. This engages the client in the process, treats it neutrally, and allows the person to observe and participate. I believe this is more empowering to the client, as he then may notice when the activation is occurring, and take similar measures to come back to quiet.
That said, as Antonio Damasio has pointed out, the intellect can move much faster than the emotional system. What happens in a culture of visual, intellectual, auditory and kinesthetic stimulation is an increasing inability to keep up with what one feels. It is impossible to ground without feeling one’s own sensation, and allowing its normal transit through the system. This is something our work contributes, not only to individual clients, but also to the culture as a whole: it is a call to center, ground, and notice what one is actually doing.
A: The client with a high sympathetic tone in his nervous system presents a specific and often delicate challenge to the Rolfer. In the first place, many clients who have “amped up” nervous systems are quite attached to experiencing themselves in this way. They may gravitate towards high-stress jobs and delight in intensity. Although the muscle tension that these clients feel may be a bother to them, they may be so identified with themselves in high gear that they will not be very available to a proposal that will cause them to “let down.” So the first step is to converse with the client, to discover if he really is interested in “de-amping” his nervous system. If the answer is yes, then there are some windows of availability for lowering overall nervous system tonus that the body customarily presents in the course of a Rolfing process. They will be mentioned below.
Stimulating the parasympathetic nervous system is one answer, but often it is not enough. When the parasympathetics come online, the client tends to go to sleep and then, at the end of the session, he flips the “on” switch and goes his merry way. In my experience, the way to begin to stimulate a longer-term change is to help the client make a conscious bridge into a more relaxed functioning.
Thus, any time that you see a “release” breath – that long spontaneous sigh that the client gives when something lets go – you may want to stop and allow the client a long moment to feel that sense of letting go and letting down that has just occurred. Ask him what it feels like; ask him where he feels it in his body. Help him to begin to develop a language and an awareness of what it is like to relax in small ways.
Pay attention to the signs that the body may be discharging – trembling, shaking, sighing, yawning, and twitching, to name just a few. When you see signs of discharge, take your hands off the body and allow time for the wave of discharge to complete itself, for the body to settle and reorganize. Often, if you pay attention to the discharge and allow it time to finish its work, the client’s body will spontaneously readjust and reorganize and you will see the goals of your Rolfing session fall into place without you having to do nearly as much work.
As Rolfers, we often overload our clients’ nervous systems with our input. Information overload on top of a high sympathetic tone tends to increase sympathetic tone. Feeling into the sighs and moments of repose and giving the body organic time to respond to your touch will tend to lower the tone.
These seem like little cues, but taken over time they can add up. For further information I would recommend reading Peter Levine’s book Waking the Tiger.
Lael Katharine Keen
A: I have found the best approach to address an “amped up” nervous system to be craniosacral work. I know this is not Rolfing Structural Integration, but it is still the best way I have found to let a client’s nervous system discharge and wind down. I do at least ten minutes of craniosacral work at the end of every structural integration session. The gentle techniques “stimulate” the cranial and sacral nerves that are responsible for innervation of the parasympathetic nervous system (the so-called “relaxation response”). New Rolfers are now guided to take at least three hours of craniosacral training as part of their continuing education before advanced Rolfing training. Fortunately, craniosacral workshops abound around the country and the world.
A: When I notice a hypertonic client, the approach starts at the interview where I ask questions about his/her daily life. Usually the hypertonic client speaks firmly and fast, to which I respond with a softer voice and less speedy delivery, which induces the client to another rhythm. During the session I like to tune myself to the hypertonicity with receiving and listening hands and proceed with firm but slow and longer strokes, being very attentive to my breathing and my personal tonus. I make sure to leave enough time so that the client can have those natural deep breaths (sighs). The pelvic lift should be firm and slow, assuring a soft rest for the sacrum. Prior to doing the back work, I insure that the sacrum is in a resting position and that the spine has a soft and easy connection between the legs and head.
A: An individual with an over-active nervous system has a predominance of sympathetic tone. Learn to sense the expressed quality of the nervous system. This pattern is systemic; consequently, you want to “hold” all of the client in your perceptual field. Direct manipulation will only drive the activation deeper. This pattern necessitates perceptually oriented and biodynamic approaches. Remember, the nervous system is not just deep within the body. It is contacted at the surface of the skin as well as in the space around the body known as the peri-personal space or kinesphere. The body and its autonomic tone resonate beyond the boundary of the skin.
The manner in which a practitioner comes into relationship and maintains a quality of contact and presence throughout the session sets the tone for the session. In working with this client, a practitioner needs to maintain an awareness of his own body weight, as well as an awareness of ground and back support. This systemic pattern also requires a slower tempo from the practitioner. If you are hurried in your approach, it will only “amp-up” an already activated system. The rhythm in which you work needs to be slower and more patient, as you maintain a wider perceptual field. Remember the mantra of “low, slow and wide.”
In working with these individuals it is important for you as the practitioner to cultivate the felt experience of your own calming presence as you wait for your client’s system to begin to settle. Your system creates the resonant field for the session. Client-practitioner resonance is part of the therapeutic relationship.
Just to review, the sympathetic branch of the autonomic nervous system (ANS) functions in fight, flight and freeze mode. It evolved later, providing the mobility needed to run from predatory threat. When this action is thwarted, the prey reverts to a freeze state, either feigning death, secreting substances that anesthetize pain, or dissociating as a survival action. The more primitive nervous system, the parasympathetic branch, has everything to do with vegetative, digestive, meditative states. Ideally, we are looking for balance between the two. You might imagine the sympathetic nervous system to be the gas pedal and the parasympathetic nervous system to be the brake. You need both to drive your car.
In application, it is imperative that the practitioner maintain a sense of presence within himself. To repeat: in order to establish a therapeutic shift with this individual it is imperative that the practitioner continually sense himself throughout the session. The practitioner’s orientation can be through the feeling sense of his own weight, perception of “backing,” sense of ground, or sense of field. If you match the client’s vigilance, it will be difficult to “drop in” and create a field that supports any intervention. Remember, over time you are literally helping the client’s nervous system reset and rebalance.
I pose these questions at the beginning of a session: Can you sense your back on the table? Do you have the experience of your back sinking into the table, resting on top of the table, or hovering (holding) above it? Usually an individual with an over-active nervous system either cannot feel his back, cannot sense the support of the table, or notices a familiar sensation of hovering above the support of the table. Clarifying a client’s experience at this basic level gives a baseline for later comparison. Individuals who have a keen orientation to the space around them tend toward hypervigilance, and more often than not are missing the perception of weight in their kinesthetic vocabulary.
I work with these clients to cultivating a sense of weight through the movement of yield. Yield is the first developmental movement and is often lost in our movement vocabulary because push carries a more direct experience. However, the movement of push is based on the prior movement of yield and the kinesthetic way this motion sequences through the body. Yield is not passive. It is an aware and active coming-into-contact. I might use my hands beneath the client’s back and take over the holding of a particularly tight and lifted area of the body (for example, the back of the respiratory diaphragm). Yield engenders a sense of weight but not of “dead weight.” There is a dynamic and relational experience with yield whether it is in relationship to ground, the support of my hands, or a sense of dropping into the table. In order to come into a state of rest, the state where the parasympathetic nervous system can emerge, you have to cultivate the felt experience of yield and weight.
Facilitate the client’s experiential discovery of his back and back-space. This perceptual space includes not only the anatomical musculature, but also the experienced support of his kinesphere and the field around, behind, and beyond him. With this “backing,” the viscera (which is full of nervous-system webbing) can release. This will serve all future sessions that you do. If you happen to be more sympathetically tuned, notice when you lose your own sense of ground and weight, or the sense of yourself in relation to your client.
Transitioning from lying to sitting to standing provides an abundance of information about how your client organizes his system in order to move. It is not the gross movement but the pre-movement that provides the information. This foundational strategy informs all the client’s patterns. It can be a key to uncovering how he “sets” his nervous system for daily living. Perhaps he initiates movement by grabbing his jaw or lifting away from his sense of back support, or raising his rib cage/diaphragm, etc.
While the client is sitting you can key him into the weight of his body dropping into his pelvis and being supported by the triangle of the pelvic bones, legs and feet, and the core support moving through the pelvic diaphragm. Or, perhaps, help him notice a sense of opening behind the respiratory diaphragm or the weight of the back of his head. These take time to explore. They also provide a felt experience that your client can revisit through the week. As you move to standing, reinforce the sensory-based education with attention to contact with the floor and the weight of the body supported by his legs and feet and space around him.
We are educating people to the possibility of dynamic embodiment, cultivating an individual’s experience of aliveness through the flesh. An orientation to both the flow of ground as well as the palpable sense of support and connection to the spacious field around the body becomes a daily meditation. Attention to sensation ignites the neural connections of body, brain and mind. Sensation is worth a thousand pictures and, as Rosemary Feitis so beautifully says, “what you feel you can keep.”
A: What you are calling an “amped up” nervous system is becoming more and more common, I believe, in our culture. Many times it has been there from early in life, and for some it has become a way of “being” later in life.
In our work, education and bringing a person’s awareness to patterns of holding, restrictions, or “inhibitions” (as Hubert Godard calls them) are always in the forefront of the session. I would still do the fascial work and the Ten Series, and I would bring awareness to the client’s anticipatory response, which is most likely there on the table as well as standing before you. By that I mean that if you ask for a movement, most likely the client responds quickly and with large muscles and quick contractions. His system lives in a state of “readiness.” Most people aren’t even aware that they do that.
Peter Levine’s Somatic Experiencing work is a great training to understand how to work with an activated sympathetic or parasympathetic system. Keeping the person present to body sensations is key. It is important to slow down the work in terms of the movements you ask for, the movement of your own hands, and the client’s responses. For example, if you ask an over-activated client to “let the knee bend,” he usually pops it up at 100 miles per hour! Back up; break the movement down and have him do it very slowly, piece by piece, so he can actually “feel” what is happening in the body rather than making an automated response to a request.
I see our work as being much like putting a wedge between the person’s automatic patterns of response and a new option with awareness and choice. If the person’s system is so amped up that your touch sends him jumping and flying, then again you must slow down. Have him first notice his weight on the table, where he has contact and good support. This gets the client out of his head and into the body’s sensations. You can even announce that you are going to move very slowly so he can keep tracking and noticing his responses. Sometimes just putting both hands on the area to be worked and waiting as you sink in is profound – letting his nervous system feel the lack of pressure to respond or “do” anything. Hypervigilance in our bodies doesn’t allow much “being.”
I do not avoid the important fascial layer work, but as always it is done at the layer that has significance and can be integrated for that person. Slow your own system down so the client can mirror it, and create a non-expecting “allowing” space with your hands and your words. That, in itself, is probably helping to create a huge change in the person’s life.