We’re finally here, to the “now what?” point of this series, where we start the discussion on how to use this information for healing. When we think about trauma impacting the four brain regions in distinct ways, and those impacts creating distinct symptoms, it can be very helpful to plan for healing region by region. Because of the hierarchical organization of the brain, if there’s dysregulation at the bottom of the brain, we need to start there, before addressing upper, more complex brain regions.
Brainstem shifts can be the hardest; since the brainstem develops first, it will have the most repetitions of doing things (or not doing things) a certain way, meaning those neural connections will be very strong. Even then, neuroplasticity still applies to our brainstem. Luckily, brainstem interventions are pretty simple and intuitive, it’s just that a lot of repetition is needed. When we look for brainstem interventions, it’s easy to think of things we would do to soothe a baby. The brainstem is the only part of the brain fully developed in a new baby, so when they are dysregulated, it’s the brainstem we’re trying to soothe. Rocking, swinging, bouncing, swaddling, singing, suckling, vibrations, and close contact/pressure are all things that mimic conditions of the womb and soothe a new baby. As older children or adults, we can do these things by sitting in rocking or bouncing chairs, swinging, weighted blankets, massage, and music, especially music at the rhythm of a heartbeat, which are all things that are regulating to us and our brainstem. Having your pet lay on you is one of my favorite ways to get that deep pressure babies would get from swaddling. I also suggest people do things that trigger our suck-swallow reflex, which babies do for comfort, such as drinking from a straw or sucking on hard candy or hard pretzels.
When exploring ways to heal our midbrain, it’s helpful to think back again to how children grow and develop this part of their brain; they spend time using their bodies to explore the world! Activities that engage both gross and fine motor, as well as proprioception (knowing where your body is in relation to itself) can help heal our midbrain. Things like walking, weight lifting, sports, and balancing activities help develop gross motor skills, whereas things like creative arts, knitting or crocheting, gardening, and drumming help develop fine motor skills, all of which help the midbrain reach regulation. While it's not always accessible, occupational therapy is an excellent tool for sensory and motor integration.
With the emotional and relationship oriented problems that are created with limbic system dysfunction, interventions that involve safe relationships are key to creating new neural networks and healing. Things that foster connection, like community service or spending time with animals, can be incredibly healing to the limbic system. Mentorship or other activities where people can practice one-on-one relationships where people are caring and safe are other great options for healing our limbic system. Therapy has its place here; even if the therapist is not specifically working to treat trauma, a strong therapeutic alliance that creates a connection and safety regulates our nervous system.
Things that engage the cortex and create repetition and use of this region of the brain are great options for managing cortex dysregulation, such as puzzles, word games, reading, writing, and learning a language. Our cortex develops with novelty, or new ideas and experiences, as well as repetition; new experiences create new neural pathways, and repetition strengthens these pathways. Traditional talk therapy that requires insight, self-reflection, and meta-cognition, such as Cognitive Behavioral Therapy (CBT), are great interventions for dysregulation in the cortex.
As a whole, few people are coming to therapy with cortex dysregulation alone. I regularly work with clients who have been through years of talk therapy, but their symptoms have not improved. If we refer back to our second post on in-the-moment reactions to stress and trauma, we can see why. If you have experienced repeated trauma in the past, enough to leave you constantly activated or shut down, your cortex is not going to have as many robust neural connections, because it hasn’t been safe to use that part of your brain. Instead, the lower areas of the brain are going to be where you’re spending most of your time for survival, which is incredibly adaptive and necessary to do during those traumatic experiences, but may create long-term over and under development in certain regions.
When we ask folks who have experienced trauma over time to do traditional talk therapy, which is really only able to get at the cortex, it doesn’t work for them because their cortex is underdeveloped and not used often. I think this point is so important, because it takes the shame and judgment out of therapy not working for people in the past; your brain is literally not able to use talk therapy to work your way out of trauma. Finding therapy, like EMDR, that gets to those deeper parts of the brain, where trauma is stored, is critical for creating healing.
