Myelination, Mobilisation and Sensorimotor Art Therapy
Chris Storm AThR, SEP and Cornelia Elbrecht AThR, SEP
In the recent decade neuroscience has significantly contributed to our comprehension of the brain-body connection. It has validated many aspects of therapies, including Sensorimotor Art Therapy, and enhanced our understanding of the need for body-focused approaches to treat traumatized clients. Stephen Porges’ development of the Polyvagal Theory (2007 Porges), and his ground-breaking explorations of the autonomic nervous system (ANS), have expanded the knowledge of how our physiology detects and processes existential danger and safety. Porges identified two motor branches of the vagus nerve, that provide both motor and sensory pathways between brainstem structures and visceral organs. Consciously working with these sensory and motor aspects is at the core of Sensorimotor Art Therapy.
Every time a client sits down in front of a Clay Field it requires a motor impulse to reach into the field. As the hands touch the material, they receive sensory feedback from this encounter. The client’s neurotransmitters, perceived as internal felt sense, will constantly scan this environment for cues of safety or danger. Most clients present with a trauma history that involved touch, be this attachment or sexual trauma, accidents, medical procedures or abuse. The haptic connection with the clay will trigger conscious or unconscious memories of these touch experiences in the past. Does the clay feel cold and unresponsive like the caregivers in the past, or is it available to satiate the client’s needs for contact and fulfillment? Will I be punished for taking lots, or shamed for what I have built? Will I get hurt or is it safe to caress the smooth surface? (Elbrecht 2021)
This sensory information is transferred back and forth through neural information highways. Some of these communicate at high speed via myelinated pathways, while the unmyelinated ones operate significantly slower. Myelin operates similar to an electrical insulator. Think of the electric cables that facilitate the transference of energy from the power point source to the bulb in the bedside lamp. The neural pathways are encased in a sheath that allows this transference to occur without interruption and at great speed. These myelinated pathways of our nervous system carry information around our body. They enable the information to travel at great speed in order to facilitate a rapid response. Unmyelinated nervous systems operate at a distinctly slower pace.
In the Clay Field the hands will respond with a variety of motor impulses according to which of the pathways have engaged, and these ANS states shift throughout the session in relation to what is being ‘touched’ and how the hands are responding to that ‘touch’.
In order to grasp this concept in greater clarity, let us look at the three core ANS states our body can mobilize in response to safe or threatening life situations. They developed over millions of years. Let’s start with the oldest one in our evolution:
If there is overwhelming threat and the fear of imminent harm or death, our ANS responds with immobilization through our Dorsal Vagus System. We shut down, dissociate and become numb; we may also call this a freeze or feign state. This circuit is the oldest. It is unmyelinated and a distinctly slow response system. We can picture it like a jellyfish, able to contract and expand, but not much more, dealing with safety and danger in a rather primitive way.
If there is perceived danger we need to mobilize an active response through our Sympathetic Nervous System such as fight or flight. Once the danger has passed, we can calm down through parasympathetic responses such as exhaling, yawning and a slowing heart rate. Both sympathetic mobilisation and parasympathetic settling are myelinated pathways that developed when evolution demanded rapid adaptive shifts in our autonomic survival responses. We share this emergency response, for example, with all mammals; dogs, horses and kangaroos react in exactly the same way.
If there is perceived safety our distinctly human Social Engagement System enables us to be relaxed and present through our myelinated Ventral Vagus System. Here we can communicate with others and our environment. We are able to connect through facial expression, eye contact and our voice has tonus and modulation. (Porges 2007)
For those suffering from complex trauma issues a combination of all three states may become their dominant physiological state. We may have parts of ourselves online in a relaxed way, while there is an underlying hum of activation, which makes us easily triggered into alerted states, while other, deeper trauma memories are buried and shut down.
As human beings we embody these evolutionary emergency responses. Myelination, the formation of the myelin sheaths in the human brain, is a continuous process beginning in utero, developing quite prominently from the 24th week of gestation. (Porges 2011) The myelination process continues and completes at about 2 years of age. Its progression is predictable and correlates with developmental milestones such as learning to walk. At this stage, motor and sensory systems have matured and the myelination of the cerebral hemispheres is largely complete. There are, however, some processes which myelinate later in life. Some will be mature at about 5 - 7 years of age; and myelination of intracortical connections continues into our 20s and 30s. (Sachis, Armstrong, Becker, Bryan 1982)
Polyvagal Theory provides a framework for understanding this development from a sensory and motor perspective. The hands touch the clay, and the sensory feedback signals safety or danger to the brain, which in return responds with a motor impulse. The ANS mobilises, immobilises or socially engages depending on the perceived threat or safety in the setting. This is the job of our neurons.
Clay Field Therapy provides the opportunity to repair those myelination processes that were thwarted or ruptured due to trauma, in particular developmental trauma that occurred at an early, non-verbal age. As clients engage with the clay, they will gradually discover they are safe in this setting. From then on, their touch explorations are able to satisfy their once unmet needs. This is not a cognitive process, but one of experiencing safe connection. Such repair might manifest as nurturing attachment through creaming the skin with liquid clay. It might be the ability to have lots, to sink into the material, to lift it feeling really strong, or to push it away without repercussions.
Clients can re-engage ANS state regulation through new haptic information. Many react initially to old trauma patterns with heightened mobilization, executing almost panicky motor impulses. They are hitting the clay, squashing it down, displaying fast and erratic motor impulses. Some are unable to receive any sensory feedback from such acting out, because they learnt to avoid the fear of getting hurt. They are all action, but receive nothing from their frantic motor impulses and they leave with empty hands at the end of the session. Others are so shut down, they can barely move crumbs of clay, scratching aimlessly at the surface. Once sensory integration of safety has been realized, fulfilment becomes possible. Now, the movements slow right down and much time is needed for the repair of broken synaptic connections. This can be a wondrous state to witness, and clients emerge from it feeling “weird”, unfamiliar or strangely at peace. Children tend to describe it as deeply “satisfying”, experiencing profound nourishment and emotional satiation. They have not made anything, they have not performed or produced something, certainly not created an object to take home, but they have experienced a safe and fulfilling relationship with themselves, often for the first time. This becomes possible through the trauma-informed facilitation of the sensorimotor feedback loop, where the client touches the clay and is simultaneously being touched by it. The haptic connection with an other-than-me has become safe and fulfilling.
Understanding how the body processes information enables the therapist to support the reparation of trauma-induced rupture. It is literally a re-pairing of broken synaptic connections. Some clients may need encouragement to employ active solutions where the faster myelinated information highways of the sympathetic nervous system are engaged. Others benefit from slowing down in their work to enable the unmyelinated dorsal part of their ANS to process a new felt sense of safety and gently re-engage the dissociated aspects. And others again will engage the ventral vagal brake of safety and social engagement, which can enable them to improve their state regulation. In all cases the sensorimotor explorations aim to facilitate the repair of ruptured synaptic connections and a fulfilling relationship with oneself.
References
Elbrecht, C. Healing trauma in children with clay field therapy; how sensorimotor art therapy supports the embodiment of developmental milestones. Berkeley: North Atlantic Books. 2021
Morell P, Quarles RH. The Myelin Sheath. In: Siegel GJ, Agranoff BW, Albers RW, et al., editors. Basic neurochemistry: molecular, cellular and medical aspects. 6th edition. Philadelphia: Lippincott-Raven; 1999. Available from: https://www.ncbi.nlm.nih.gov/books/NBK27954/
Porges SW. The polyvagal perspective. Biological Psychology. 2007;74(2):116–43.
Porges SW, Furman SA. The early development of the autonomic nervous system provides a neural platform for social behavior: A polyvagal perspective. Infant Child Dev. 2011;20(1):106-118. doi:10.1002/icd.688
Sachis PN, Armstrong DL, Becker LE, Bryan AC. Myelination of the human vagus nerve from 24 weeks postconceptional age to adolescence. Journal of Neuropathology and Experimental Neurology. 1982;41:466–72.
AThR, SEP, ANZACATA, IEATA
AThR, SEP, M.Ed, CCPT, ACA, ANZACATA
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