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Why your chronic conditions are not healing. What is missing in the current medical model.

8/30/2021

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In order to heal your chronic conditions, you have to heal the overstimulation of  
                your survival stress responses in your central nervous system.  
 
There are always the latest medical buzz words floating around and the “I have received this bombshell diagnosis” statements. Lately in my clinic I have been seeing an influx of people diagnosed with mast cell activation syndrome (MCAS), an under-active vagus nerve or functional neurological disorder (FND). When they ask me do you have experience with these syndromes or disorders, can you help me? Well the answer to be honest can range from yes, yes, and no never heard off but yes. You see, the diagnosis is not really the point, great starting point but we have to get beyond the diagnosis in order to heal chronic conditions. The point is what caused your nervous system, immune or hormonal system to (over) react that has caused this overstimulation of stress responses in your body? My answer to that question: Chronic conditions are triggered and held in place by an overstimulation of the stress responses in the nervous system and a hyper sensitive and hyper reactive brain and here is the bombshell – this can lie below the level of your conscious awareness.

So yes, we may have symptoms like chronic aching bodies, painful muscles, over-acidic bodies, sleeping problems, high blood pressure, neurological problems, light/noise/food sensitivities, tinnitus, asthma, addiction, auto-immune system disorder, anxiety, depression, neurological disorders and digestive problems but
it is our nervous system and our brain that regulates our physiological changes and symptoms. This seems to be overlooked in the medical health model. It is the central nervous system that runs our internal show, sending messages from the body to the brain in a bi-directional communication loop and driving most of our symptoms on a physical, mental and emotional level. 

Let’s have a closer look in detail.
Neuroception
The number one priority our body has is our survival and secondly procreation in order to keep the species going. Neuroception means our autonomic nervous system is always scanning our external and internal environment for cue’s of safety or danger, be if physical, mental or emotional, in the drive to survive and the longing to connect. Neuroception operates below our subconscious mind, meaning it lies outside the realm of our awareness as it accesses information without involving the thinking parts of the brain. When cues are picked up as threats, a cascade of cleverly orchestrated physiological wired-in stress and survival responses occur in the body. Some stress responses we may become aware of in the form of physical symptoms, others we don’t become aware of as they remain below our level of awareness, until overload hits and the body crashes. Neuroception answers to the question: Am I safe or in danger right now?
 
Interception
Interoception means the ability to perceive sensations of the internal state of the body. Interoception helps the brain to identify how you feel both physically and emotionally, as it collects all the feelings from inside the body and uses this information to respond accordingly, this is important for self-regulation. For instance, are you hungry, is your heart beating fast, are you are hot or cold or thirsty, do you need to use the bathroom, are you in pain or are you angry? Some people do not have a clear recognition of their bodily signals or how or what they are feeling. Their interoceptive awareness – the ability to identify, understand, and respond appropriately to their internal signals is off balance and they may not be able to realise that they are anxious or angry as they don’t recognise that their muscles are tense, their breathing is shallow or that their heart is racing. Interoception answers to the question: How am I feeling?
 
Brain
Through neuroception, the brain receives signals up the chain of commands, that there is a threat. This threat can be real or just perceived as real, it can come from people, family members, work stress, pressure, overwhelm, overload, anxiety or from emotional concepts like loneliness, boredom and abandonment, as those concepts can also threaten our existence, our survival and our social connections. The brain thinks: what do I need to do to survive and responds by triggering a targeted set of defensive mechanisms in our nervous system, hormonal system or immune system to counter attack the perceived threat and ensuring our survival. The brain answers to the question: What do I need to do to survive?
 
Nervous system
In past blogs I have written about our nervous system and its 2 branches – the sympathetic (fight and flight) and the parasympathetic (rest and digest) branch. (blog) When we are in a state of stress our sympathetic branch is activated, we are in fight/flight and respond to danger. We are ready for action, wired, fearful, and we have a hard time to relax, as if we are waiting for something to happen and on alert. This can lead to an over triggering of stress response leading to an over triggering of stress hormones like cortisol and adrenaline and/or an over triggering of the immune response. 
 
On a physiological level it leads to oa:
  • Muscular tension, increased muscular aches and pain, joint pain, chronic pain
  • Sleeping problems
  • Anxiety, overwhelm, panic attacks
  • Depletion, tired, on edge and irritable. 
  • Neurological problems – headaches, migraines, twitching, pins&needles
  • Digestive problems - decreased digestive function of food– IBS, bowel problems and absorption
  • High blood pressure, faster heart rate, cardiovascular problems
  • Decreased brain function, brain fog, living in our survival brain stem – difficulty processing and absorbing information
  • Weakening of immune system – increase of colds and flu, slower wound healing, maladaptive cell response.
  • Freeze response - The body goes into survival mode as a coping system and shuts down, slowing down of metabolism, building up over overacidity and inflammation in the body, leading to illnesses like depression and chronic fatigue. 
 
Putting it all together
Our symptoms are deeply shaped and influenced by our brain and nervous system, due to acute stress, long term toxic stress or (childhood) trauma. Survival stress is held in our central nervous system, in our physiology, in our tissues and our cells as our reactions to physical, mental or emotional stress are primarily bodily ones and lie as the root cause behind chronic conditions. When the brain learns to be in long term survival mode, it will be operating on a hyper vigilant and hyper reactive level. An over reactive brain is more primed to be on the lookout for danger and in a state of hypervigilance for any physical, mental or emotional stress and the brain eventually gets stuck in that hyper mode.
 
People can have faulty neuroception, where they are no longer able to read the cues adequately in their environment and are unaware of their external and internal triggers leading to things like anxiety or depression. We often see this in trauma as trauma reshapes body and brain, as the brain and nervous system keeps triggering, even when threats are not present.
 
People can have a compromised functioning interoception, where there is a disconnect between the body’s signals and the brain’s processing of those signals. Here people are unable to read their own internal cues adequately of how their body is feeling or what their body needs ie not drinking when thirsty or sleeping when tired or relaxing when wired. This can underlie  anxiety, depression, panic attacks, addictions, post-traumatic stress disorder, obsessive compulsive disorder and attention deficit hyperactivity disorder (ADHD).
 

Feedback loop is on stuck and in a maladaptive vicious cycle
When an over triggering of responses continues, the nervous system and the brain gets stuck and wired to be in the on-mode and things become more chronic.
  1. The nervous system becomes hypersensitive and over reactive to stimuli from the external and internal environment, where there is a continuous over firing to perceived threats; 
  2. When there is an inability to calm these stress defence mechanisms then this can lead to a hyper vigilant brain, always on the lookout for danger;
  3. This hyper reactive brain will continue to easily trigger an overstimulation of our stress responses, creating symptoms;
  4. These symptoms loop back to the brain, informing the brain that there is still danger and retriggers the stress defensive responses and loops back into step 1….. 

This maladaptive vicious cycle, where the body is caught in a loop and cannot reset or switch off properly, feeds the chronic conditions. The body has upgraded itself in this new stuck position and it may even start to feel normal and part of the fabric of who we are and perhaps despite many medical interventions, we are just not able to overcome our symptoms or regulate our physiological processes.
 
Enter: Craniosacral Therapy

Craniosacral therapy (CST)
Craniosacral Therapy is a powerful physical therapy to reset your central nervous system. To work with chronic conditions, you have to work with the brain and the nervous system on a physical, mental and emotional level, as well as enhancing your neuroception and interoception. This therapy packs a punch and its subtle touch belies its power.
 

Five core reasons why Craniosacral therapy needs to be included in the treatment
      of chronic conditions – chronic pain, trauma, addiction,
                                     complex illness and diseases. 
 

CST is proven to:
  1. Decrease any sympathetic nervous system arousal, down regulating our fight and flight response and coming out of the hyper reactive stress state.  CST works with the biological stress responses of the nervous system.
  2. Increase healthy parasympathetic nervous system, bringing the body and the nervous system back into homeostasis and into a healing state. Enhancing the functioning of the dorsal parasympathetic vagus nerve, allowing the body to come out of the freeze response.
  3. Calming a hypervigilant, overactive brain by working with the individual brain parts that deal with our survival responses in the brainstem, with sensory processing in the insula and with the amygdala surveillance centre -thereby decreasing highly activated beta brain waves. 
  4. Enhancing and restoring neuroception and interoception leading to an increased awareness of the internal state of your body and an increased awareness of your unique triggers.
  5. Work with the deep inner physiology of the body, allowing the body to come into a healing state. CST is a potent medicine for your central nervous system. In the words of osteopathic physician Dr. John Upledger who coined the term and one of the main founders of Craniosacral therapy: "The craniosacral system is a functioning physiological system and has a powerful influence over the nervous, hormonal and immune system and a total body effect".
References:
  • The central nervous system and biological stress responses:  International School of Biodynamic Craniosacral Therapy 2011, Kiental, Switzerland -  Teacher F. Wolf
  • Dana, D. (2018) The Polyvagal Theory in theory.
  • Naviaux, R.K,. (2019) Cell danger response biology 
  • Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind and body in the healing of trauma. 
  • Upledger Wall Chart – The Craniosacral system
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Trauma - The Four core reasons why Craniosacral therapy, as a body-based therapy needs to be included in the treatment of trauma

8/29/2021

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​In order to heal your trauma and emotions you have to process it through the body – what is missing in the current cognitive talk therapy model.
 
A couple of times in my career, I have been vetoed by psychologists and psychiatrists, who advised their clients to work exclusively with them as they process their events, trauma and experiences, on a cognitive level and/or medicate them – dampening their disturbed physiology. Whilst I never met or spoke with their respective therapists and they possibly may not know what craniosacral therapy is, I respect their professional advice and view their advice as a gift. A gift that it is my responsibility to contribute to the education of Craniosacral Therapy for all trauma suffers – developmental, chronic toxic stress, shock trauma - and the medical world. I would like to encourage an open ongoing dialogue in how we can mutually support a Trauma client and the complementary domino effects craniosacral therapy has to talk therapy and vice versa, in a holistic and integrative healing model. I have benefited from talk therapy myself but when it comes to trauma it needs a broader approach. The current model emphasises so much on cognitive functioning without the integration with our bodily experiences.  Trauma impacts the body so strongly and the body has often not metabolised its responses, and it can get stuck, repeating the same patterns over and over again. It is through pioneers like Stephen Porges and his Polyvagal theory, Bessel van der Kolk – in the bestselling book the body keeps the score – where he recommends craniosacral therapy, and many other trauma informed practitioners, including my own craniosacral teacher, that hopefully one day the global medical world will play full catch up. Healing trauma and regulating the nervous system by including the body through: Craniosacral therapy – Yes. Trauma Yoga, Breathe work – Yes. Art/Music/ Dance Therapy – Yes. Mindfulness & Meditation – Yes, yes and well of course, yes. 


​                The body remembers what your mind forgets. (Martha Manning)
         Why body-based therapies need to be included – The 4 core reasons:
  1. Trauma is a physiological event that happens in the body. Trauma has a profound impact on the body, the nervous system and the brain. Craniosacral Therapy works with all parts – it works with the body, the brain, and the nervous system. Craniosacral addresses physical pain and the physiology, regulates the highly activated sympathetic fight and flight or freeze (dorsal vagus) response of our nervous system by coming back into the healthy-rest and digest (ventral vagus) parasympathetic nervous system. Furthermore, it downregulates brainwaves out of the highly activated Beta waves into healthy and restorative Theta brainwaves and works with and addresses the brain centres where the actual trauma is stored. 
  2. In Trauma, the arousal cycle of the nervous system is interrupted. In order to heal, we need to complete the arousal cycle (see my previous blogs). In a perfect world we move from our healthy nervous system into fight and flight maybe a little bit of freeze when appropriate as we cycle through the different events and parts of our nervous system throughout the day to meet the demand and always coming to a complete full cycle, in a balanced and relaxed state. In trauma – the nervous system gets activated, aroused to mobilise us into action but it gets curbed, disrupted, perhaps because you could not run away, or fight back, the overload and toxic stress never stopped and/or you very simply too young. This leads to an incomplete arousal cycle – as the cycle is interrupted, it does not come to full circle and you get stuck in hyper arousal (anxiety, fear, insomnia etc) or in a last ditch attempt your body goes into freeze – body crash of depression, chronic fatigue etc. In Craniosacral we address this part of the physiology, we assist the client to complete the response, to recalibrate the nervous system – discharging the hyper arousal or the freeze and allowing the body to come to full cycle, to base line functioning and regulated emotions. 
  3. Talk therapy tends to focus on verbal communication and is known as a top down  - mental, addressing thoughts - approach. Talking, listening and understanding happens in the neocortex, the prefrontal cortex part of our conscious brain. Trauma and its memories however are stored in another part of the brain, in the limbic mammalian brain, which is subconscious. You can have a rational and logic understanding of what has happened to you but if unprocessed traumatic memories and incomplete arousal cycles remain stored on a subconscious and nervous system level, your body can still be displaying many symptoms. I see this so often in my clinic when a first trauma perhaps was cognitively dealt with or not and then a second slightly similar flavoured experience happens and the house of cards start tumbling down as the first experience was not fully addressed, restored and completed on a bodily, nervous system memory level. Furthermore, talk therapy is left side brain dominated.  The left side of our brain is the logical and verbal side – the conscious mind. During a traumatic event – the brain switches from the left side of the brain to the right side of the brain and disrupts this part.  The right side of the brain is our emotional and nonverbal side and lies in the subconscious mind and is particularly implicated in development trauma as it is pre-verbal. Craniosacral therapy also known as a bottom up – addressing physiology - approach as it involves the body - bypasses the logical thinking and left side of the brain and is able to access the right side -the subconscious mind and addresses the brain centres where the trauma lies.
  4. Explicit memories and implicit memories. Explicit memories hold our memories in the form of factual information and general knowledge – the holiday you took, what you had for dinner, the dress you wore and when WW2 was. Not all memories are conscious. Implicit memories are memories that are held in the body and hold our emotional responses and body sensations. Implicit memories are being held, kept and stored by the body as they did not get encoded during the trauma – they are body oriented. They exist as a memory in our nervous system. These two types of memories access different parts of the brain and travel along different pathways. For healing to happen – they need to be integrated. In Craniosacral therapy people are able to access, with the right resources, these implicit memories – their bodily feelings – through the body. There may be no specific connection to any memory, often a thought might come up around the trigger or a long forgotten event, but the body is able to unravel, process and let it go. This is very important when it comes to our senses – a touch, a sound of footsteps in the hallway, a smell of cigarettes or perfume, a tone of voice can be triggering for trauma victims as it reminds the very subconscious primal part of the brain of what the perpetrator smelled like, the colour of their hair, the tone of their voice – this happens on a subconscious level but will leave your nervous system in overdrive and all of a sudden you feel anxious, and people can’t figure out why…..

I thank the psychologists who send their clients to me. The woman with severe pelvic pain due to sexual abuse, who was able to unfreeze and come into the healthy healing response, the woman with chronic pain, a history of trauma and many operations and prescription medications who was able to process and integrate her trauma and come off her opioid addiction and the boy with high anxiety and digestive issues: working with his digestive system on a physical level, down regulating his nervous system out of the anxious state on a physiological level, regulating his emotions that kept his system stuck in a negative feedback loop whilst his psychologist provided coping mechanisms, emotional support, identified triggers and put protective and safety measures in place.
 
The one common denominator that I hear time and time again from all my (trauma) clients is – “I thought I had processed my experiences and memory but it is not until I engaged with my body through craniosacral therapy that I realise that is not the case”. Through Craniosacral therapy, firstly clients regulate their  fight and flight nervous system, so important to address anxiety and hyper aroused brains, secondly in the right environment - clients literally come out of their biological freeze response (imperative to heal) as they process their experience and emotions on a bodily level – they often feel so cold after the treatment, bone cold and thirdly in a very safe and contained way -  memories or insights may come up that they were not aware of, as we tap into the subconscious mind, bypassing the logical thinking mind. Cranio is not a one-off miracle session, it is very much therapy.
 
Craniosacral therapy is absolutely gaining in anecdotal evidence on an ever-increasing scale, being written about in trauma, psychology and healing literature and also gaining in scientific evidence with more advanced measurement techniques made available. I would love to be wired up or for my clients to be wired up and measure their brains, track their nervous system, their heart rate variability, their muscle tone, tissues, their nerves, cortisol and adrenaline levels before and after a Craniosacral session. 
 
This week I treated a man with a severe flare up of his colitis. The client is very body aware, has a great sense of interoception and is working with a trauma therapist on his developmental trauma. The client was able to feel every change that happened in his body whilst I was working on him – he could feel the facilitated nerve in his digestive system switch off, he could feel his diaphragm open, his muscles coming out of hyper tonus, his nervous system go into total healthy parasympathetic state, lowering the inflammation response, his brainwaves enter subconscious mode and as icing on the cake,  he was able to make some important and crucial realisation why his colitis had flared up. We were so attuned. After 3 treatments and with his own ongoing work, his colitis was back in remission. We joked at the end of our session, that I wished I had a camera on my fingertips that could go through the skin of his body and project what I feel, “see” and how the body responds to the craniosacral touch. We imagined those images projected onto the wall of a classroom or trauma conference, as Craniosacral is not necessarily a spectator sport as little seems to happen on the outside but yet So much is happening on the inside, on a brain, body and nervous system level.  
 
Open to anyone who would like to fund me and these scientific measurements in the advancement of craniosacral therapy, trauma and nervous system work.
____
Below some heart felt Google reviews from my Trauma clients: Enough said.
Processing Trauma - through the BODY
I was suffering from involuntary muscle movements & cognitive short circuiting. My doctor found nothing wrong with me; sadly, not all health professionals are trauma informed.
Thankfully Dorine not only has a deep understanding of processing trauma through the body derived from her training; she also has an unconditional acceptance and care derived from her experience. This enabled me to feel safe & comfortable, even when I was highly agitated before I walked in the door. I am not usually one to post reviews. I write this for those going through a similar experience to let them know, “you have come to the right place”. Dorine’s help has been invaluable; her treatments are non-invasive yet powerful. And there is absolutely no need to feel self-conscious about your symptoms, I think she has seen it all.
My mind, body and life are back on track now, I am forever grateful.
_____
I came to see Dorine at the recommendation of my Integrative GP and I'm SO glad my GP told me about her.... I had been struggling with chronic fatigue and was having a lot of difficulty in getting my nervous system to calm down.. My experiences with Dorine have been game changing for my emotional, physical and mental health. With her grounding and nurturing support I was able to FINALLY process and move through traumatic experiences that I had blocked and stored in my body- that talk therapy just couldn't quite help me with to the same degree...Dorine has a way of making you feel so safe and so seen so you can really let go and let out what you have been storing in for years...sometimes decades. Whilst you can move through big stuff, you dont leave the session feeling worse (as you sometimes you do with certain therapies) I always find I feel 100 times better and far calmer...like I can breathe more deeply. More GP's should be recommending this kind of treatment for people with trauma and who have nervous systems that need support in learning to feel safe. 


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Tinnitus Syndrome- A New Treatment Model - The brain is not at rest

8/28/2021

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Tinnitus is an internal noise or a hyperactivity in the central auditory system normally experienced as a ringing noise in the ears, coming from within the person. In some cases it is temporary and goes away over time. Unfortunately for others the ringing noise can be constant and impact their daily life. Tinnitus can be experienced in one or both ears. It can make different sounds and can vary in intensity. Tinnitus can be brought on by many different causes including dental trauma, loud music, TMJ (jaw problems), a physical trauma, long-term work stress, trauma or anxiety. Tinnitus is much more widespread than generally known with around 25% of Americans and around 20% of Australians suffering from it.
 
Tinnitus is considered a neurological/audiological condition but has eluded medical treatment and scientific understanding so far. Initially, sufferers consult an Ear Nose and Throat (ENT) specialist, audiologist and/or a neurologist. In the majority of cases (around 80%) no known cause is found. If nothing specific is found, then sometimes medication is prescribed like Valium or Amitriptyline but thankfully more and more mindfulness meditation. Sufferers are often told by their doctors that not much can be done, to shift their focus, unscramble the picture and mask the sound. At best the brain will adapt and learn to live with it. 

However if we view Tinnitus as not just being about a "hearing/ear" problem but a nervous system problem with a whole body reaction, we might be a step closer in bringing relief to Tinnitus sufferers. I believe there is a largely untapped potential in understanding the variables, common threads and biological nervous system responses in Tinnitus sufferers and approaching it in a new light. This calls for a treatment model that not only incorporates the physical body and the Craniosacral system of the physical body but also the mental and emotional body and this is exactly the strength of Craniosacral Therapy.  
 
Craniosacral Therapy views Tinnitus oa as a signal where the adrenal flight and fight response seems to be manifested through the auditory system as noise in the ears, leaving a certain hyper vigilance, which keeps the brain active. This leaves your system so sensitive that you actually hear your own internal noises like ie: nerve impulses, structural movement and/or fluid movement, as well as the external noises. In my personal Craniosacral practice, Tinnitus clients, describe their ringing as: cicadas, kettle boiling, a high pitched dog whistle, the pinging of a microwave, humming of a fridge or as a high frequency. Often, but not always clients symptoms appeared in or around a major event in their life, or related to an echo of past difficult experiences. In these circumstances I usually find, that whatever the trigger was for the tinnitus to occur, it usually is the last overwhelm of previous layering challenges to the clients long suffering system, that breaks the "donkeys" back, like in the kids game Buckaroo. The last suitcase may have triggered Buckaroo's back to buckle but many other suitcases were loaded on top first.

Tinnitus is about our nervous system and brain as our brain continually scans our inner and outer world for threats. When any threats are detected the stress response automatically fires up. As you go through life the brain acquires expectations based on your experience and in particular negative one’s. When situations occur that are even remotely similar, the brain automatically applies its expectations to them, if it expects pain or loss or even just the treat of these, it pulses fear signals, creating hyper vigilance, keeping the brain active (Buddha's Brain-2009). Most of the time these seems to happen subconsciously as people are not aware of how their bodies respond in their day to day life, to stress or threats and how this can manifest as ringing in the brain. 

A new scientific study at the University of Illinois (July 2017) seems to validate this. Using MRI, this new study found that tinnitus is in the hearer's brain. They found that chronic tinnitus is associated with changes in certain networks in the brain. A tinnitus patients brain seems to be not truly at rest even when they are resting, as the brain stays more alert. This could also explain why sufferers also feel tired more often.

I personally view Tinnitus more as a Syndrome than a condition as the whole central nervous system is on high alert and tinnitus is just one of the many side effects of this whole body reaction with everybody's Tinnitus being different. Some clients may have a slight hearing loss but not all clients with hearing loss have tinnitus, some clients have neck and shoulder problems and then again some have TMJ issues and/or temporal bone(s)/muscular dysfunction but the common denominator seems to be (unconscious) anxious and/or unprocessed stressful times and patterns lodged in the body. Some people may be aware off of this, some totally unaware but in all cases it has not been dealt with on a bodily level. I find looking at our evolutionary biological stress pathways and the structures involved around Tinnitus very insightful. Let me break it down: (Please view My blogs on our biological Stress Pathways,  TMJ and our 3 Brains for more in-depth background information). 
  • Ears play a big role in our biological stress response, making our sensory perceptions more acute so we can pick up any danger in the fight and flight, hyper vigilant arousal. If it stays too switched on, you may start to hear your own internal noises, the noises of your nervous system. Our auditory pathways are hard wired to the limbic system which is where the emotional centre in your brain lies and in particular to the Amygdala - which is the brain's alarm system and storehouse of emotion-linked memory. The hearing apparatus of the inner ear and autonomic nervous system provide sensory input to the Amygdala, which acts like a smoke sensor every time a real or perceived threat presents itself to us, making us hyper vigilant.
  • Tinnitus impacts the neural regulation of the middle ear muscle. When we are in fight or flight mode, stressed and perceiving threat, the body is biologically primed to focus on detecting low level frequency and back ground noise, so it can be ready and hyper vigilant to detect the predator. Tinnitus and overwhelmed people find it hard to go into low frequency places like restaurants, shopping malls or bars as the low frequency sounds make them feel uncomfortable and anxious. They often get diagnosed with Hyperacusis . But what this really means is that you are hypersensitive to sounds as your nervous system is tuned on to detect a predator. 
  • The auditory vestibular nerve, known as the eighth cranial nerve, transmits sound and equilibrium through the hair cells of the inner ear to the brain. It originates in our brainstem - which is where our fight and flight lies. The nerve exits the inner skull via the internal acoustic meatus in the temporal bone.
  • People with Tinnitus often have very tight neck and shoulders. We use all of our sense organs in our head, as a basic universal motor pattern, for gathering information as we scan our environment for input. The muscles of the head and neck are intimately involved in this sensory information and brace themselves in response to any real or perceived threat and/or fight/flight survival in a muscular holding pattern and can lead to persistent Myofascial pain. 
  • The two large muscles in the neck and shoulders that contribute to Neck and Shoulder pain, are the Sternocleidomastoid (SCM) and Trapezius also known as the emotional muscle. These two muscles allow us to look up, down, sideways and turn our head. Survival depends on being able to turn the head effortlessly and these muscles are mainly responsible for it. Both muscles are innervated by Cranial Nerve XI - This spinal accessory nerve, emerges from the brainstem, where our fight and flight lies. (All other 650 + muscles in our body are innervated by the spinal nerves) and a dysfunction here can lead to sore neck and shoulder muscles.
  • People with Tinnitus also often have TMJ problems. Can TMJ be a structural cause of Tinnitus? I think it is part of the overall syndrome and is a contributing factor. Jaw clenching is a primitive reflex based on instinctual survival patterns and also a muscular bracing pattern linked to arousal. Common problems of Cranial Nerve Dysfunction are tightly clenched teeth and grinding. TMJ problems are a well-known symptom of stress  We mainly clench at night, a time where we process our experiences of the day. 
  • Some Tinnitus people have none of the above symptoms or very mildly but have conflicting inner thought processes and negative stuck thought processes acting as a pressure cooker but mainly lying below conscious awareness that causes them unduly stress, anxiety and/or inverted anger: "You cant let go of what you don't know and don't acknowledge. 
  • Some people may develop Tinnitus after a one-off trauma like a physical trauma to the head or body. I have had a client with Tinnitus after a one coward punch to the head where the temporal bones were clearly implicated but also the central nervous system, or a client whom after an operation, where many things went wrong and the body went in shutdown during the operation, woke up with Tinnitus. Again here it is dealing with the trauma, fight and flight lodged in the body as it is about resting the brain tissues and working with cranial bones and muscular restrictions.

The strength of Craniosacral Therapy is that it addresses all of the above: working structurally around the auditory tube structures i.e. temporal bones, cranial nerves, intra-oral work, TMJ - jaw, neck & shoulders, releasing any tissue and bone restrictions, resting the brain & the meninges (brain tissue). Craniosacral is known to resettle the Nervous System, so stored tensions can be released,  decreasing “the fight and flight” hyper vigilant sympathetic nervous system and increase the "rest and digest" parasympathetic system, lowering the tone of the Vagus Cranial Nerve. Craniosacral therapy sees symptoms as a signal of the body and unpacking any issues and unconscious thought processes that may have contributed to the onset off their Tinnitus can be very helpful, Having more awareness means you can make a choice. The body tends to hold tension and emotional conflict deep inside until it feels safe and is ready to process it. 

UK based Julian Cowan Hill is an ex-Tinnitus sufferer. He found his cure in Craniosacral Therapy and has since become a CS practitioner himself. He has written a book about Tinnitus “From tyrant to friend" which I recommend. It is a handy practical little book, packed with information and a Wellbeing Matrix with levels and exercises to go through. He also has You Tube videos that people find helpful. Simon Baker (an ex DJ with hearing damage) is also an ex Tinnitus sufferer and has also become a CST practitioner himself and is a Professional Tinnitus advisor with the British Tinnitus Association. A link to one of his articles: https://djmag.com/content/hearing-damage-djs-guide-preventing-tinnitus
 
Tinnitus treatments are about regular treatments rather than a one quick fix. It is a gradual process, as it is about regulating and rewiring the nervous system and brain, learning to switch off the whole central nervous system. Grooves and patterns are often hardwired and they take time to change and integrate, to build a new road. My advice would be that if you do suffer from Tinnitus, try Cranio earlier at the onset of your symptoms. Cranio is one of the best therapies around for settling the nervous system, treating TMJ, resting the brain and cranial nerves and clearing any unprocessed shock, becoming less hyperactive and if applicable uncovering any unconscious emotional conflict. My clients that develop the best results are the ones that don't expect to be just fixed but are prepared to put in the work as well by adopting a multi-disciplinary approach and new life style regimen through diet, meditation, exercise and unpacking any issues. For some clients, the ringing in the ear becomes less intrusive and they don’t focus on it anymore, some clients find the noise has backed off and even forget about it and some clients make a full recovery. As Julian Cowan Hill says: "The state of your nervous system is very changeable and reversible, as the nervous system is a fluid, constantly altering state of balance, when the right conditions come along, it changes". He should know, he cured his.
 
References: 
  • Tinnitus: From Tyrant to friend - how to let go of the ringing in your ears - Julian Cowan Hill - 2010. I want to thank Julian for being a pioneer in bringing relieve and hope to Tinnitus sufferers and being an inspiration to the Craniosacral Community and beyond.
  • Tinnitus: Ringing in the Brain | Josef Rauschecker | TEDx (online - youtube)
  • Living with Tinnitus - sbs life - online www.sbs.com.au -  the sound that comes from nowhere.
  • www.Neurosciencenews.com/tinnitus-attention-7378 (online) University of Illinois - "ringing in ears keeps brain more at attention and less at rest".
  • Buddha’s brain: the practical neuroscience of happiness, love and wisdom. Hanson, Rick 2009.

Keep up to date with news, research and my upcoming book with oa Tinnitus case studies.

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Attachment style and the impact it has on trauma treatment

8/27/2021

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When I heard Psychiatrist, Bessel van der Kolk (author of the Body keeps the score) say in his Sydney workshop – “in order to heal the trauma, you have to heal the attachment style” – a lightbulb went off in my head and all my senses tuned in.

​It was that magical feeling, where you have no idea what the person is going to say next, yet you know and feel with every cell in your body, that it is going to be gold. And it was. 

 
Our attachment style is shaped and developed in early childhood, in response to our relationships with our caregivers, as our survival and safety depends on our caregivers. As babies, for the first few years of our lives, we are entirely dependent on our caregivers, and we already start bonding in the womb and subsequently from the second we are born. We depend on our caregivers for our physical needs: touch, eye contact, soothing voice, skin to skin, for our emotional needs: love, care, cues of safety, soothing and for our physiological needs: food, safe home, safe connection, regularity and predictability. This is a crucial point in time where our brain and nervous system develops exponentially – the biological need for healthy development is that we require safe relationships for our brain and nervous system to grow coherently – through connection, co-regulation, congruence, attunement, predictability and safety.

The attachment styles we received is critical in how we relate to others, how we show up in relationships, how we respond emotionally, how we view relationships and in particular, how it affects the quality and behaviors in our relationships. Simply put - the attachment style we have, often mirrors the dynamics we had with our caregivers in childhood. Attachment injuries happen in relation to people – they all occur in relationships - children may not have experienced abuse per se, but they have learned that their needs were not be met, perhaps because caregivers were not able to attune to the child’s needs, due to stress, worry, fears, work, mental health struggles, their own attachment issues or childhood trauma and this wounding has an effect on regulating their central nervous system and on their adult relationships. 

Secure Attachment Style
In the most favourable of circumstances, where a secure and stable attachment is formed, caregivers are emotionally present and attuned to baby’s needs. The child learns that their needs are met in a safe, consistent, attuned and coherent manner. Growing up, they learn that they can rely and trust on others to have their physical and emotional needs met, that they are not alone, and they are able to build secure attachments with loved ones, as their presence equals safety. Later in life they are able to form secure, loving relationships with others, they trust, (self) love, feel close to people, have healthy boundaries, and are not afraid of true intimacy and being emotionally available. Secure people need someone to respect their individuality and to walk with them in life, neither in a dependent or co-dependent way but in a healthy symbiotic balance. 

Insecure Attachment style
On the flip side - the child may perceive that their needs are not being met, that their caregivers are emotionally unavailable or unresponsive when they seek their attention, affection, or support. This can be due to, emotional neglect, traumatic event(s) or through shameful experiences. As a result, the child is unable to form a secure bond.

There are three types of insecure attachment:
Avoidant - People with avoidant attachment style tend to have trouble getting close to others or trusting others in relationships. They have a fear of intimacy. There is a distance in their relationships and friendships and they tend to be largely emotionally unavailable with a preference of being independent and relying on themselves. They tend to avoid intimacy or in-depth communication by pursuing work, (work alcoholic) hobbies and solitude. In their early childhood, their caregivers were emotionally disconnected and dismissive of their true needs. They may have been unresponsive and distant to the child’s basic needs of trust, safety, belonging, connection, allowing them to fully show up as themselves, leading the child to develop a (limiting) belief that their needs won’t get met. They tend to push people, intimacy and emotions away, particularly when they feel emotionally threatened or when people are getting too emotionally close.  Avoidant people need space and privacy.
 
Anxious - is marked by a deep fear of abandonment and rejection. Anxiously attached people tend to be very insecure about their relationships, often worrying that their partner will leave them. Their behaviour is associated with a neediness or clinginess and they can get very anxious when their partner doesn't call or text back straight away (so prevalent in today’s society). They are insatiable for validation, do I look nice, pretty etc, constantly feeling and expressing that their partner/friend doesn't care enough about them, wanting to spend all their time with them, knowing exactly where they are, with whom and for how long. They often express that they feel neglected, not enough of this or that. Anger, tears, arguments but also manipulation are common in order to have their needs met. In early childhood, their attachment style suffered some form of neglect, being uncared for, or perhaps even asked to leave to home. Caregivers were inconsistent and unpredictable with their affections and emotional availability – sometimes involved, sometimes distant and withdrawn. All these things led the child to develop an anxious attachment style coupled with various (limiting) beliefs that often drive their behaviour from the inside: I must have done something wrong, I cannot trust people, somebody is always better than me, people will always leave me. They are always seeking for validation in order to get their needs of trust, safety/security, feeling heard and self-esteem met.  
 
The remainder of the blog will focus on the 3rd insecure attachment style: the fearful avoidant aka disorganised attachment style and the need for differentiation between disorganised attachment and trauma.
 
Fearful-Avoidant aka Disorganised Attachment style
A disorganised attachment style is often a consequence of early childhood trauma including physical, emotional, sexual abuse and/or emotional neglect. This style arises when the child has reason to feel afraid of the care giver as their source of safety (care giver) becomes a source of fear. People with a disorganised attachment style experienced a chaotic, inconsistent and unpredictable parenting style. They may have gone through a somewhat fearful upbringing where they witnessed or experienced physical abuse from one parent to the other parent or to them personally, which was then followed by some form of emotional affection, to that parent or to them, whether it was through physical affection, praise, being bought or promised something, leading to mixed messages about love, pain and punishment – so often seen in abusive relationships and addiction. 

The child does not know what to expect, experiences inconsistency and chaos. The child does not know if or when their needs will be met and learn that they cannot rely on their caregivers to have their basic needs met. All these experiences leads the child to experience a deep sense of fear for its own safety, a lack of trust, a poor understanding of boundaries and a confusion in what a healthy relationship looks like, yet desperately wanting close connections. People with fearful-avoidant attachment both crave and deeply want intimacy, love, closeness and affection but also deeply want to avoid it, distance and distract themselves. This can often operate on a deep subconscious level. This affects how they engage in intimate relationships, often chaotic, being driven by subconscious deep unmet needs, with a distinct push and pull, self-sabotaging and paradox behaviour in an attempt to keep themselves safe, as their fears run so deep.
 
They often operate on a fight/fight or flee nervous system level (see stress blog), depending on whether they feel people are getting too close, encroaching on their space, or experience overwhelm due to a fear of abandonment. They do want relationships but they are afraid to let anyone in as they have a strong fear that the people who are closest to them, will hurt them. This can often lead to a self-filling prophecy due to their incongruent behaviour. They need consistency, safety and space. Disorganised attachment style is associated with a difficulty in regulating emotions, an increased risk for physical, mental or emotional abuse in relationships, increased psychological risks and sexual behaviour, and plays a role in addiction (addiction blog).
 
Single event Trauma vs Disorganised attachment

Disorganised attachment comes from childhood trauma. The distinction between a single event trauma and disorganised attachment is important because issues resulting from disorganised attachment trauma need a different approach than problems that result from a one off traumatic experience like an attack, assault, accident or another traumatic incident. 
 
The approach for a single traumatic event that ultimately changed your life in an instant, like an accident, the death of a loved one, illness, or an attack benefits from accessing and processing the memory of that event on a cognitive level but can also benefit from processing on a bodily level. EMDR is a good tool for processing on a mind level and Craniosacral therapy for mind and body -  some of my clients do it in conjunction. 
 
The approach for accumulated series of traumatic events in a disorganised attachment needs to focus on neural regulation of the disturbances in the nervous system and the brain, it needs to focus around dissociation, relationship to self and to others, emotional regulation, making the subconscious, conscious and needs to include a bottom up approach involving the senses, movement and expression. Talk therapy alone would be limited and several methods are needed on a neurophysiological level, including processing it through the body, integrating their imprinting with bodily experiences, feeling safe in their body, emotional regulation and embodiment, this means including the body as an access point to resource and to create safety through trauma informed bodywork like craniosacral therapy. 
 
Craniosacral therapy creates safety in the in-vironment of the body, recalibrates the nervous system, allowing any processes from the past to be safely completed in present time as it is processed through the body, literally coming out of the fight, flight or freeze, changing the physiology, repair attachment, accessing and processing the right – emotional side of the brain where trauma is stored and brain centres where sensory processing happens – which cannot be accessed through talk therapy alone and so much more (please see trauma blog)
 
Bottom line – Most trauma is interpersonal trauma – it occurs in the context with people and in relationships. How trauma is processed depends on the quality of the attachment relationship we received as it has implications and consequences for how we show up in life and on any physical, mental or emotional ailments we may have. Never too late and it can be restored. Be aware and repair.
 
“Make the unconscious, conscious otherwise it will drive your behaviour, direct you life and you will call it fate” – based on C. Jung

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    Dorine Siccama - Due to change in domain name, all blogs over the previous years have been reposted in archives August and September and November 2021
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