There is more wisdom in your body than in your deepest philosophy.
—NIETZSCHE
OVERVIEW: THE BASIC FRAMEWORK
How can you recruit the power of the autonomic nervous system not only in service of survival but also in service of healing? Using the same physiological processes that shape the system, it is possible to move out of habitually activated reactions and bring flexibility back to a system that has become rigid in patterns of protection. Following the organizing principles of Polyvagal Theory, you can help your clients reshape their systems and rewrite their stories.
The BASIC framework—Befriend, Attend, Shape, Integrate, Connect—helps your clients develop skills in autonomic regulation leading to increased flexibility of response and resilience. Repatterning the nervous system depends on bringing explicit awareness to implicit experiences, interrupting automatic response patterns, and engaging the ventral vagal safety circuit.
Befriend. Transient experiences of disconnection from the body are common in the general population and prevalent with your clients who have experienced traumatic events. The greater the awareness of body-based feelings, the more control your clients have over their lives. Befriending is learning to tune in and turn toward autonomic state and story with curiosity and self-compassion.
Attend. Attending practices create the ability to name autonomic states, track the movement between states, and develop a moment-to-moment habit of noticing large shifts and nuanced changes. Learning to attend to these autonomic experiences sets the stage for shaping the system.
Shape. Trauma interrupts the ability to regulate autonomic state and flexibly transition between states. Just as the brain has the capacity to rewire, the autonomic nervous system can also establish new patterns. Shaping the system away from habitual survival responses into patterns of connection involves bringing mindful attention to practices that increase the capacity for staying anchored in the ventral vagal system.
Integrate. Through the lens of the autonomic nervous system, resilience is the ability to return to ventral vagal regulation following a move into sympathetic mobilization or dorsal vagal shut down. Autonomic state shifts in response to the challenges of daily living are a normal and expected experience. For many people, the shifts are slight, and even in the moments of large-scale changes there is enough resilience to return to a regulated state. For others, the response is extreme and a return to regulation is unreachable. Integrating brings attention to the new autonomic patterns that are emerging and engages them to shape new, resilient pathways.
Connect. The autonomic nervous system shapes the way we connect. The way your clients experience self, create relationships, and move through the world is built through their autonomic pathways. With new abilities for regulation, creating safe connections is possible.
When the autonomic nervous system has been shaped by trauma, there is often a disconnection between physiological state, psychological story, and behavioral response. Cues of danger seem to be everywhere and the smallest reminder of a traumatic experience activates a survival response. The ability to find regulation in the ventral vagal state is compromised. This leaves your clients unable to either become quiet and calm or activated and outspoken without moving out of connection into a state of protection (Williamson, E. C. Porges, Lamb, & S. W. Porges, 2015). When the regulating influence of the ventral vagal system is missing, your clients feel as if they are locked in a state of protection, unable to either reach out or let anything in. Interrupting the automaticity of a response pattern through awareness supports the process of change (Neal, Wood, Wu, & Kurlander, 2011). Bringing perception to neuroception mobilizes higher brain structures and stimulates awareness. With awareness, your clients can see cues in present time rather than through the lens of the past.
It’s important to help your clients cultivate a ventral vagal–powered attitude of self-compassion when working with the BASIC exercises. Self-compassion can reduce sympathetic activity and bring increased ventral vagal flexibility in responding to stressful situations (Homan & Sirois, 2017; Kirby, Doty, Petrocchi, & Gilbert, 2017; Luo, Qiao & Che, 2018). Self-criticism activates ancient defense systems that take your clients out of safety into a state of protection. From a survival state, access to higher levels of thinking is impaired, reflection is replaced with reaction, and the ability to engage in the process of change is shut down. Self-compassion offers your clients a safe pathway to explore their autonomic response patterns.
HOW TO USE THE EXERCISES IN THIS SECTION
Research on the way humans make and sustain change highlights the importance of having confidence in the ability to change, having positive beginning experiences of change, and having a belief that with practice change takes less effort to sustain (Lally, Wardle, & Gardner, 2011). Following a process of making and repeating small changes brings these possibilities to life.
Chapters 4–8 offer exercises to introduce to your clients during sessions, with the intention that they will continue to work on their own between sessions. The exercises are designed to bring autonomic patterns into explicit awareness, and it is helpful for clients to use a notebook or journal as a way to track changes. Grounded in the clinical philosophy that therapists don’t ask their clients to do anything they have not already tried I encourage you to complete the exercises yourself before inviting your clients to try them. The BASIC framework is designed so the exercises in one chapter build the foundation for the next. A natural confidence emerges as your clients begin to engage new autonomic patterns that support well-being. My suggestion is that you go through the chapters with your clients in order. Sometimes, though, you may decide that a client would benefit by engaging in a specific exercise at a certain point in your work. You could choose to introduce the exercise out of sequence and then return to earlier exercises. The exercises are not meant to be a one-and-done activity. The goal is for your clients to use the exercises over time to create competence and confidence with a specific skill and then select certain ones to become ongoing autonomic practices.
Personal progress trackers for Chapters 4–8 are found in the Appendix. These are designed to track the subtle shifts that are an integral part of autonomic change. Invite your clients to use the personal progress trackers on their own and also follow your clients’ progress by periodically using the trackers to check in during your sessions. Change is not an event but rather a lifelong process and autonomic reorganization is ongoing. The personal progress trackers are a way for your clients to routinely check in with the ever-changing state of their systems.
EXPECTED OUTCOMES
The BASIC framework guides your clients into a new experience of actively engaging with their autonomic nervous systems. The exercises offer opportunities for your clients to experiment with skills to navigate differently. Over time, new skills become sustainable practices. As your clients learn to partner with the autonomic nervous system, they feel more competent and more confident, and they experience the well-being that comes from living with an integrated body-mind system. With greater capacity for staying anchored in ventral vagal regulation, clients discover they have an expanded ability to feel safe and connect to the inherent wisdom of the autonomic nervous system. For many clients this is the longed-for therapeutic outcome and once they are able to predictably regulate, they are ready to move on. For other clients, this is the platform that supports moving deeper into trauma processing. For all clients, engaging in the Befriend, Attend, Shape, Integrate, and Connect exercises builds the ability to look through the lens of the autonomic nervous system and recognize what is happening, find a toehold in ventral to be able to regulate and respond in a different way, and begin to write new stories of safety and connection.