I was reminded of this by an occupational therapist friend, and to some degree it is available in my room all of the time to my clients without my even being aware of it, but proprioceptive stimulation can be calming for clients both during and after the SSP. “Proprioception is the sense of position of parts of the body and strength of effort needed in movement.” (from the Sensory Connection Program, Andrea Auch and Melanie Anonuevo). Some calming forms of proprioceptive input that I use include:
Joint compressions
Slow, rhythmic movements
Heavy, sustained resistance
Chair push ups
Body Sock
Bean Bag Chair with Pillows
Deep vibration
Squishing between two soft pillows
There are so many other great proprioceptive ideas out there if you search deep pressure, and I’m sure the occupational therapists in our group have wonderful ideas that go far beyond what I have here.
When it comes to the somatic side of things, I employ a number of different approaches based on the needs of my clients.
For direct ventral vagal interventions, I draw on a number of different sources, including:
· This has been discussed before in this group, but I recommend and utilize Stanley Rosenberg’s Self-Help Exercises from Accessing the Healing Power of the Vagus Nerve: Self-Help Exercises for Anxiety, Depression, Trauma and Autism frequently with my clients and parents. I find that the exercises are generally fairly easy to teach and learn. I probably use the first two, The Basic Exercise and Neuro-Fascial Release Technique for Social Engagement the most.
· Deb Dana’s Book The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation is packed with techniques that can be incorporated into any practice (I know I do so with mine). I’m always grateful to have it as a resource, as it reminds me that there are so many ways to help to tone the autonomic nervous system. She has suggestions in the areas of breathing, sound, touch, movement, experimenting with elements of the social engagement system
· Deb Dana did a webinar that I completed that was also awesome and she taught these two simple techniques that I teach to my clients and families that they find to be so beneficial (Dana, Bringing a Polyvagal Perspective into Therapy: How to Safely Navigate Emotional Storms, 2018):
3 Sighs
Sighing resets physiology and psychology
Rule of Three—Repeat 3 times
First time the brain views this as chance
The second time it is viewed as coincidence
The third time, the brain starts to see a pattern
If the system is heading toward dorsal vagal:
Stretch
Touch
Breath—extend exhale to bring more ventral vagal online
Laugh
· Breathing Techniques (Phillips, 2018)
There are any number of breathing techniques out there. Three that I have found beneficial are:
““Just One Breath”: Ask the client to take one breath without changing anything. What is different?”
“Porges: Out breath twice as long as the inhalation, dropping the diaphragm: Count in: 1-2; out: 3-4-5-6-[7-8]. Start with what is easy and then expand. If it helps, place hands on your diaphragm and press down gently”
“Calming breath: Breathe in: “Safe and secure;” breathe out: “relaxed and ready””
I also find this beneficial for a number of my clients: Finding the Breath (Pollak, 2014)
“Start by sitting comfortably, assuming a posture of dignity with your back straight, your spine relaxed but not rigid, eyes either softly open or closed.”
“Find your breath. We are often so busy that we often don’t realize that we are breathing. Simply notice your breath.”
“See where you feel your breath most strongly. It may be at the nostrils, at the chest, or in the belly. Allow yourself to feel the sensations of each inhalation and exhalation.”
“If your mind wanders, no problem. Give yourself permission to begin again.“
“Gently, kindly bring yourself back. Let the breath become your anchor, your friend. Rest in your breath.”
“Don’t be too ambitious; take it slow. We all have the ability to feel one breath completely.”
“When you are ready, stretch, wiggle fingers and toes, and open the eyes if they have been closed. Try to extend focused attention into your next activity.”
· Laughter: “Laughter is the best medicine. This can actually be true in the case of increased vagus nerve activity as laughter has been shown to increase heart rate variability in a study comparing (the) laughter (of) yoga participants. Laughter has also been found to be beneficial for cognitive function and protects against heart disease. It increases beta endorphins, nitric oxide levels and benefits the vascular system. It has also been shown that people put in humorous situations show a lower cortisol stress level overall.” (Habib, 2018)
· Exercise: “Mild exercise has been shown to stimulate gut flow and gastric motility (peristalsis) which is mediated by the vagus nerve. This in turn means that mild low-level exercise can stimulate the vagus nerve” (Habib, 2018)
I find that some individuals have a difficult time integrating these new sensations that they are having during and after the SSP. There are some simple and easy integrating practices that I do with some clients:
· 3-4 Steps Forwards and Backwards—repeat as necessary; this repetitive motion backwards and forwards requires that the individual focuses on the here and now to complete
Walking forwards and backwards has influences on aspects of our memory (specifically walking backwards can influence memory for information) (Aksentijevic, Brandt, Tsakanikos, & Thorpe, 2019). Interestingly, in the some of the studies reviewed in this article participants didn’t even need to physically move backwards to get the benefits. They received the benefits from mentally imagining the backward motion.
Walking backwards can improve our attention, particularly for those who demonstrate difficulties with attention like individuals with ADHD. (Viggiano, Travaglio, Cacciola, & Di Costanzo, 2015)
Walking backwards appears to improve cognitive control (“[B]ackward locomotion appears to be a powerful trigger to mobilize cognitive resources. Thus, whenever you encounter a difficult situation, stepping backward may boost your capability to deal with it effectively”) (Mercola, 2018)
· PACE (from Brain Gym) (Dennison, Dennison, & Teplitz, 2000) (Dennison & Dennison, 1989)
o Drink Water
Drinking water is essential for nerve function. It increases the electrical across cell membranes, thereby making them ready to work.
All of the electrical and chemical actions of the brain and central nervous are dependent on water for conductivity.
o Brain Buttons
Rest one hand over your navel.
With the thumb and fingers of the other hand, feel for the two hollow areas under the collarbone about one inch out from the center of the chest, where the collarbone meets the sternum.
Rub these areas vigorously for 30 seconds to one minute, as you look left to right and right to left.
o Cross Crawls
Move one arm and its opposite leg to meet at the midline, then the other to its opposite leg, similar to marching in place with the elbows or hands to opposite knees as they rise.
Cross Crawl around 30-60 seconds.
Cross Crawl activates both brain hemispheres simultaneously. It engages the brain for coor­dinating visual, auditory, and kinesthetic abili­ties, thus improving such skills as listening, reading, writing, and memory.
o Hook-Ups
Stand with your feet flat on the floor.
Cross your left ankle over your right ankle.
Next, extend your arms with the backs of your hands facing each other and cross the left wrist over the right so that your palms touch.
Interlace your fingers and swing your hands down and then up onto your chest.
On inhalation, place your tongue flat against the roof of your mouth, approximately one quarter inch behind your front teeth; lower it on exhalation.
Repeat the tongue placements, relaxing in this position during the course of four to eight complete breaths.
Uncross your legs, placing your feet flat on the floor.
Lightly join the fingertips of both hands together, as though enclosing a ball.
Close your eyes as you continue to lift your tongue on inhalation and lower it on exhalation, relaxing in this position during the course of four to eight complete breaths.
· Emotional Stress Release Points (Mahoney, 1989)
Technique:
Lightly touch the emotional stress release point with your fingertips (or whole hand). Wait until you feel or sense a light vibration or pulse.
Focus on the event or problem.
See the details. (Be aware of the colours, sounds, shapes, smells and feelings involved.)
Make it real. (You may notice shallow breathing, flickering of your eyes or tearfulness.)
Continue to lightly hold the ESR point, breathe and relax. These signs of stress will pass.
Now play the day (or event) as you would like it to happen. Fantasy is OK here.
When your mind starts to wander you know the event is cleared of immediate stress.
Reassess how you feel (or your emotional energy towards your ’day’) on a scale of 0 – 10.
Repeat the process as different aspects of the stress comes to mind. It is okay to do it often.
“Frontal Eminences: Approximately three finger widths above each eyebrow directly above the eyes.”
“Hands: Thenar eminence, on the meaty part of the palm near the thumb, adjacent to the crease of the wrist. Mythical Lung 9 1/3.”
“Tibia: Approximately two finger widths below top of tibia on the flat inside surface.”
“Foot: Sole of the foot approximately one finger width lateral of Kidney 1, at the junction of the contact surfaces of the ball and side of the foot.”
· Interpersonal Neurobiology Integration Exercises and Principles
There are tons of things herefrom Daniel Siegel that I use when helping a client and or family.
A number of my clients benefit from his many acronyms in the process; I find it helps them to better place meaning to some of the information. One some like is FACES:
Flexible
Adaptive
Coherent
Energetic
Stable
His Wheel of Awareness is also an exceptional tool
I also have training in aspects of manual therapy and integrate that training into my work. Deb Dana talks about the importance of touch in her book The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation, and undeniably to me the manual work that I do provides this touch in a graded, safe fashion that allows the clients that I work with who need this work an avenue for the facilitation of awareness, integration, and toning of the autonomic nervous system when dysfunction in a particular system may be impacting on it. There are so many different areas and techniques that can be chosen:
· One that I really like comes from an author whose classes I took over two decades ago by the name of Sharon Weiselfish-Giammatteo. Sharon’s book is: Integrative Manual Therapy for the Autonomic Nervous System and Related Disorders. The whole book is worth it though. This book covers techniques that impact on autonomically innervated muscular tissue, including arteries, veins, organs, lymph, and discs. Some of the techniques that I use frequently include:
Advanced Strain Counterstrain for Auditory Function—Tympanic 1: I find this benefits a number of the clients who indicate that they are having ear discomfort/pain during, or after, the SSP. They often report that the discomfort/pain subsides, and they are better able to tolerate longer sessions.
Advanced Strain Counterstrain for Vision—The Ocular Muscles: Atlee (2016) discusses how “Parasympathetic function can also be influenced through the parasympathetic component of the oculomotor nerve (Cr III) by applying a very soft gentle contact to the eyeballs.” (Attlee, 2016). This systematic approach often, I find, will decrease headaches during and following the SSP.
Advanced Strain Counterstrain for the Diaphragms—Sharon highlights 4 diaphragms, pelvic diaphragm, respiratory diaphragm, thoracic inlet diaphragm, and cranial diaphragm. I am often amazed at the change in autonomic state just by focusing on these four diaphragms.
There are also a series of gastrointestinal, cardiac, and cranial releases that can be beneficial depending upon the client.
· I also have training in cranial, gastrointestinal (visceral mobilization), respiratory, and lymphatic techniques. There are so many beneficial ones, and I think many manual therapists probably could recommend even more than I could. But one that I find beneficial is:
Hyoid release—the hyoid release is so beneficial for so many individuals during the SSP and following the SSP. I’ve found some people are fairly rigid in this area, and this can contribute to some of the somatic complaints that they have. This is a fairly simple technique.
· Neurofascial Processing: “NFP signifies: N for neural, F for fascial and P for process. The neural or nervous system transmits signals through the body. The fascial system is a thin layer of connective tissue that covers every organ, vessel and nerve in the body, like a body suit. NFP integrates the nervous system and the fascial system with sensory information and emotional health.” (Burnham, 2018) The book Body Wisdom has a more detailed look at these.
“NFP involves placing your hands (no need to press) over specific parts of your body, called Process Centers (PC) for extended periods of time, and simply “being with” what comes to consciousness while doing so.” (Burnham, 2018)
Key process centers for Executive Functioning and Cognition: (Burnham, 2018)
Frontals (forehead): Thought, Judgement, Behavior, Attention Deficit Disorder
Limbic System (at the bridge of nose or frontonasal and eyes): the center for survival and has to do with rage responses
Parietals (top of the Head): home of the sensory and motor cortex and associated with feelings and sensations (sight, sound, taste, smell, touch) as well as action and movement
Mental Body (2 to 3 inches above Left eye at the hairline, ½ an inch off the body): Thoughts, Perseveration
Thanks for sticking with this long rambly set of ideas. Hopefully there was something beneficial in here for someone.

Bibliography

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