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Porges - Polyvagal - Autism - Hakomi  Conference  Presentation - Brain  Behavior handout
 

Porges - Polyvagal - Autism - Hakomi Conference Presentation - Brain Behavior handout

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Talks about Polyvagal theory, autism, and viewing life though the lense of the ANS

Talks about Polyvagal theory, autism, and viewing life though the lense of the ANS

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    Porges - Polyvagal - Autism - Hakomi  Conference  Presentation - Brain  Behavior handout Porges - Polyvagal - Autism - Hakomi Conference Presentation - Brain Behavior handout Document Transcript

    • Social Behavior: An Emergent property of the phylogeny of the autonomic nervous system Stephen W. Porges, Ph.D. Brain-Body Center University of Illinois at Chicago sporges@uic.edu Acknowledgments ! Special thanks to: Olga Bazhenova, Ph.D. » » John Denver » Keri Heilman » Jane Sorokin » Elgiz Bal ! Funding provided by: » NIMH Grant MH-60625 » NLMF Family Foundation » Unicorn Children’s Foundation » Cure Autism Now Overview: The Polyvagal Theory • Evolution provides an organizing principle to understand neural regulation of the human autonomic nervous system. • Three neural circuits form a phylogenetically-ordered response hierarchy that regulate behavioral and physiological adaptation to safe, dangerous, and life threatening environments. • “Neuroception” of danger or safety or life threat trigger these adaptive neural circuits. • New models relating neural regulation to health, learning, and social behavior may be reversed- engineered into treatments.
    • The metaphor of safety: A basic principle of our nervous system Environment outside the body inside the body Nervous System Neuroception Safety Danger Life threat Spontaneously engages others Defensive strategies eye contact, facial expression, prosody death feigning/shutdown (immobilization) supports visceral homeostasis Defensive strategies fight/flight behaviors (mobilization) Evolution Neural Regulation of the Heart in Vertebrates CHM DMX SNS AD/m NA X+ Cyclostomes Elasmobranchs X+ X- X+ X- X+ Teleosts X+ X- X+ Amphibians X+ X- X+ X+ Reptiles X+ X- X+ X+ X- Mammals Polyvagal Theory: Emergent “Emotion” Subsystems VVC SNS DVC heart rate +/- + - bronchi +/- + - gastrointestinal - + vasoconstriction + sweat + adrenal medulla + tears +/- vocalization +/- facial muscles +/- eyelids +/- middle ear muscles +/-
    • Polyvagal Theory: Phylogenetic Stages of Neural Control Stage ANS Component Behavioral Function Lower motor neurons Myelinated vagus Social communication, Nucleus ambiguus III self-soothing and (VVC – ventral vagal complex) calming, inhibit sympathetic-adrenal influences Sympathetic- Mobilization (active Spinal cord II adrenal system avoidance) (SNS – sympathetic nervous system) Unmeyelinated Immobilization (death Dorsal motor I vagus feigning, passive nucleus of the avoidance) vagus (DVC – dorsal vagal complex) Polyvagal Theory: A Phylogenetic Hierarchy of Response Strategies Structure Function VVC SNS DMX Head Communication + Limbs + Mobilization + Viscera Immobilization Phylogenetic Organization of the ANS: The Polyvagal Theory head viscera limbs trunk
    • Phylogenetic Organization of the ANS: The Polyvagal Theory head “old” vagus viscera limbs trunk Vasovagal Syncope Apnea/Bradycardia
    • Phylogenetic Organization of the ANS: The Polyvagal Theory head viscera limbs trunk Phylogenetic Organization of the ANS: The Polyvagal Theory Corticospinal Pathways head Sympathetic Nervous System viscera limbs trunk Mobilization: Flight Behaviors
    • Mobilization: Fight Behaviors Mobilization: Fight/Flight Behaviors Phylogenetic Organization of the ANS: The Polyvagal Theory head viscera limbs trunk
    • Phylogenetic Organization of the ANS: The Polyvagal Theory head Corticobulbar pathways “new” vagus viscera limbs trunk Social Engagement © Jeff Hunter/ The Image Bank The “Smart” Vagus and Social Engagement System cortex brainstem Muscles of Head Turning Cranial Nerves Mastication V,VII,IX,X,XI Middle Ear Bronchi Muscles Facial Larynx Pharynx Heart Muscles environment
    • Social Engagement System: Emergent Behaviors at Birth Social Engagement System: Self Regulation Heart Rate Rhythms: A measure of the “new” vagus RESP 800 RSA HP (ms) 0.10 900 60 BPM 1000 HPV 1100 1200 0 30 60 90 120 SECONDS
    • Looking and Listening: Common Neurophysiological Mechanisms Middle Ear Muscles: Role in Extracting Human Voice Borg & Counter, 1989 t Scientific American Social Engagement
    • Social Engagement and Otis Media? The Face: A Critical Component of a Social Engagement System • At birth the mammalian nervous system needs a “caregiver” to survive and signals the caregiver via the muscles of the face and head. • At term the corticobulbar pathways that regulate the striated muscles of the face are myelinated. • The face is “hardwired” to the neural regulation of visceral state via a mammalian “neural circuit.” • Metabolic demands, stress, trauma and illness retract the “mammalian” neural circuit with the resultant symptoms of a face that does not work and social engagement behaviors are absent. The Social Human Infant Fantz, 1963
    • The Social Human Infant Neonates can discriminate between direct and averted eye gaze and look longer and more frequently at faces with direct eye gaze Farroni, Csibra, Simion, & Johnson (2002). Eye contact detection n humans from birth. Proceedings of the National Academy of Sciences, 99, 9602- 9605. My Child’s Face Does Not Work! Gabriel Metzu, The Sick Child When Other Faces Do Not Work!
    • When the nervous system fails use Botox! Beauty is a journey that starts with a choice… Learn about your Choices Autism People Need People: A Biological Basis for Social Behavior Regulators of physiology are “embedded” in relationships M. Hofer New York State Psychiatric Institute
    • How are the adaptive defensive systems (flight, fight, and freeze), which are mediated by the amygdala and other limbic structures, inhibited to promote the positive spontaneous social behavior associated with the Social Engagement System? Neuroception Life Threat Amygdala (central nucleus) ventrolateral Periaqueductal Gray Freeze Autonomic State (pyramidal tracks) (dorsal vagal regulation) Inhibitory pathways Excitatory pathways Neuroception Danger Amygdala (central nucleus) dorsolateral and lateral Periaqueductal Gray Rostral Caudal Fight Flight (pyramidal tracks) (pyramidal tracks) Autonomic State (sympathetic) Inhibitory pathways Excitatory pathways
    • The Trustworthiness of Faces R. Adolphs, 2002 Neuroception Safe FFA/STS Motor Cortex Amygdala Medulla (central nucleus) (source nuclei V,VII,IX,X,XI) Social Engagement System Somatomotor Visceromotor (muscles of face & head) (heart, bronchi) Inhibitory pathways Excitatory pathways Social Engagement System: Observable Deficits in Several Psychiatric and Behavioral Disorders • Prosody • Gaze • Facial expressivity • Mood and affect • Posture during social engagement
    • The Polyvagal Theory: Insights into the selection of outcome measures Stephen W. Porges, Ph.D. Brain-Body Center University of Illinois at Chicago sporges@uic.edu Acknowledgments Special thanks to: • Olga Bazhenova, Ph.D. • John Denver, Ph.D. • Keri Heilman, M.A. • Jane Sorokin, M.A. • Elgiz Bal Funding provided by: • NIMH Grant MH-60625 • NLMF Family Foundation • Unicorn Children’s Foundation • Cure Autism Now Overview: The Polyvagal Theory • Evolution provides an organizing principle to understand neural regulation of the human autonomic nervous system. • Three neural circuits form a phylogenetically-ordered response hierarchy that regulate behavioral and physiological adaptation to safe, dangerous, and life threatening environments. • “Neuroception” of danger or safety or life threat trigger these adaptive neural circuits. • New models relating neural regulation to health, learning, and social behavior may be reversed- engineered into treatments.
    • Polyvagal Theory: Risk Assessment Environment outside the body inside the body Nervous System Neuroception Safety Danger Life threat Spontaneously engages others Defensive strategies eye contact, facial expression, prosody death feigning/shutdown (immobilization) supports visceral homeostasis Defensive strategies fight/flight behaviors (mobilization) Social Engagement System Observable Deficits in Several Psychiatric and Behavioral Disorders • Prosody • Gaze • Facial expressivity • Mood and affect • Posture during social engagement FXS A compromised social engagement system? http://www.fragilex.org
    • Behavioral Features of FXS • Hyperarousal, distractible, impulsive • Hypoarousal • Difficulties in listening • Sensory defensiveness • sound sensitivities • oral motor defensiveness • Tactile defensiveness/hypersensitivity • Poor eye contact and difficulties in social communication • Speech-language delays (males) • Anxiety • Hypervigilance • Affect regulation (e.g., tantrums) • Shyness • Low cardiac vagal tone http://www.fragilex.org Phylogenetic Organization of the ANS: The Polyvagal Theory head “old” vagus viscera limbs trunk Vasovagal Syncope
    • Phylogenetic Organization of the ANS: The Polyvagal Theory Corticospinal Pathways head Sympathetic Nervous System viscera limbs trunk Mobilization: Flight Behaviors Mobilization: Fight Behaviors
    • Phylogenetic Organization of the ANS: The Polyvagal Theory head Corticobulbar pathways “new” vagus viscera limbs trunk Social Engagement © Jeff Hunter/ The Image Bank Polyvagal Theory: A Phylogenetic Hierarchy of Response Strategies Structure Function VVC SNS DMX Head Communication + Limbs + Mobilization + Viscera Immobilization
    • Social Engagement System Observable Deficits in Several Psychiatric and Behavioral Disorders • Prosody • Gaze • Facial expressivity • Mood and affect • Posture during social engagement Social Engagement System Anatomical basis cortex brainstem Muscles of Head Turning Cranial Nerves Mastication V,VII,IX,X,XI Middle Ear Bronchi Muscles Facial Larynx Pharynx Heart Muscles environment Heart Rate Rhythms: An autonomic component of social engagement RESP 800 RSA HP (ms) 0.10 900 60 BPM 1000 HPV 1100 1200 0 30 60 90 120 SECONDS
    • My Child’s Face Does Not Work! Gabriel Metzu, The Sick Child Looking and Listening Common Neurophysiological Mechanisms Middle Ear Muscles: Role in Extracting Human Voice Borg & Counter, 1989 t Scientific American
    • How are the adaptive defensive systems (flight, fight, and freeze), which are mediated by the amygdala and other limbic structures, inhibited to promote the positive spontaneous social behavior associated with the Social Engagement System? Neuroception Life Threat Amygdala (central nucleus) ventrolateral Periaqueductal Gray Freeze Autonomic State (pyramidal tracks) (dorsal vagal regulation) Inhibitory pathways Excitatory pathways Neuroception Danger Amygdala (central nucleus) dorsolateral and lateral Periaqueductal Gray Rostral Caudal Fight Flight (pyramidal tracks) (pyramidal tracks) Autonomic State (sympathetic) Inhibitory pathways Excitatory pathways
    • The Trustworthiness of Faces R. Adolphs, 2002 Neuroception Safe FFA/STS Motor Cortex Amygdala Medulla (central nucleus) (source nuclei V,VII,IX,X,XI) Social Engagement System Somatomotor Visceromotor (muscles of face & head) (heart, bronchi) Inhibitory pathways Excitatory pathways Social Engagement System: Observable Deficits in Several Psychiatric and Behavioral Disorders • Prosody • Gaze • Facial expressivity • Mood and affect • Posture during social engagement
    • Social Engagement System Where to look? What to measure? Cortex ERP, EEG, EOP, fMRI Autonomic heart rate, vagal tone (RSA), respiration Middle ear muscles impedance words from noise Facial muscles facial EMG, thermography, video coding of faces Laryngeal/pharyngeal acoustic properties of muscles vocalizations, language Gaze eye tracking Control: 12 year old male Eye 57% 106C OFF % EYE % MOUTH % 32.6 57.18 10.22
    • Before Intervention: Autism 10 year old male Eye 1% 111A OFF % EYE % MOUTH % 39.31 1.15 59.54 After Intervention: Autism 10 year old male Eye 71% 119B OFF % EYE % MOUTH % 26.15 71.38 2.47 Fixation Duration Percent 90 80 70 60 50 Pre 40 Post 30 20 10 0 t(19) = -7.343, p <.0001
    • Fixation Duration Percent 70 60 50 Control 40 Pre 30 Post 20 10 0 OFF EYE MOUTH Control/Pre F(1,38) = 39.005***, 69.207***, .219 ns Control/Post F(1,38) = 21.371***, 14.551***, .030 ns SCAN Test 12 10 8 Control 6 Pre Post 4 2 0 SCAN FW SCAN CW Control/Pre F(1,39) = 187.272***, 27.400*** Control/Post F(1,39) = 6.290**, 0.108 ns Respiratory Sinus Arrhythmia (ln msec2) 8 * Control * Pre * Post 7 6 5 4 3 Control/Pre F(1,38) = 16.067*** Control/Post F(1,38) = 3.805 ns Pre/Post F(1,38) = 16.427***
    • What Needs to be Done? •New Populations: Apply the Listing Project interventions to individuals with language delays and older and more severe autistic individuals •Repeated interventions: Change protocol to evaluate the effect of repeated interventions on the trajectory of individuals in existing treatment programs. •Describe the autistic nervous system: Validate neural mechanisms mediating vulnerabilities in social engagement and the behavioral changes following intervention (fMRI, NIRS, ANS, facial EMG & IR thermography) •Expand intervention strategies: Incorporate visual stimuli to trigger multisensory neurons that facilitate language and social communication. Potential Applications of the Polyvagal Theory in Psychiatry, Psychology, and Education ! Aspects of several physical and psychiatric diseases can be explained as emergent properties of the neural regulation of the autonomic nervous system (feedback, evolution, development) ! New diagnostic methods and new treatments can emphasize measurement and manipulation of the neural regulation of the autonomic nervous system. ! Environments can be designed to support the functions of the nervous system with positive impact on social behavior and emotion regulation – Computers that modulate neural regulation of the ANS – Quiet environments – Nervous system “friendly” classrooms – Improved social behavior: People need people – a biological basis Summary • “Neuroception” of safety or danger mediates the beneficial consequences of social behavior. • Autonomic reactions to challenges are organized in a phylogenetically-determined hierarchy. • Various atypical behaviors are adaptive for short periods. • Several psychopathologies are expressed as deficits in the Social Engagement System. • Biologically-based behavioral interventions can trigger neural circuits that mediate positive social behavior.