"Somatic therapy is just about understanding the body, listening to the body and trying to express the charge that's contained in the nervous system."
What does anxiety or depression feel like? How can you calm your nervous system? Can you retrain your brain after experiencing trauma?
Blair O’Hara is an Australian psychotherapist with a wealth of experience in helping people heal from trauma. Through use of techniques like somatic therapy and cognitive behavioral therapy, Blair focuses on calming the nervous system and developing coping mechanisms to help the brain reframe thoughts associated with trauma.
In this episode, Blair explains how trauma and stress affect the brain, somatic and cognitive behavioral therapy models, and the importance of connecting the mind and body.
Read Blair's entire transcript below.
Blair O'Hara:
I'm a psychotherapist and I work mainly in anxiety, anger, family systems. And my primary modalities are somatic experiencing and CBT, which is cognitive behavioral therapy. So basically combining those two is working with the mind and the body. And I have a specialty in family systems, inherited trauma, developmental trauma, so how we kind of inherit the traits that we have, the patterns that we have, the emotional response that we have, whether they're kind of formed during our childhood, which is obviously quite common, but also whether they're generated through previous generations and their experiences. So quite a wide range of cases I take on, but yeah, I'm really positive about trying to help people live a happy life and with confidence that they can manage their emotions and their thoughts confidently.
Molly Casey:
Tell me about somatic therapy. It's fascinating to me and it's new as well to me. And I think it's something that a lot of people aren't fully aware of yet.
Blair O'Hara:
Yeah, it is an emerging therapy model. Somatic basically means body work. And so what we do when we're working in somatic therapy is trying to map out and understand the sensations that arise and subside when we're feeling certain things or when we're thinking certain things or when we're remembering certain things. Because the body, - I think we talked about the book, The Body Keeps the Score, quite a well-known book by Dr. Bessel van der Kerk. And the idea behind that is the body remembers traumatic incidents and events that happen to us. And even, I think it'll be relevant for our conversation today because it doesn't mean we even have to acknowledge what's going on consciously. The body is keeping track of all of the stimulus around us and it will kind of log it in the body. And so when we’re doing somatic therapy, we're trying to offer the body a chance to release things that it's never had a chance to release before because we have this tendency to suppress and bury certain emotions and certain thought patterns. So somatic therapy is just about understanding the body, listening to the body and trying to express the charge that's contained in the nervous system and helping facilitate a safe and as gentle as possible release of that energy so that person can kind of just regulate, it's all about regulating our nervous system okay so that we feel calmer more often we feel more comfortable more often we feel safer all as much of the time as possible so that's really what it's about in a nutshell.
Molly Casey:
How do you go about the process? Is it more mind-body connection? Is it through, I know CBT is the cognitive behavioral therapy, but is it all talk therapy? Kind of what goes into somatic therapy?
Blair O'Hara:
So somatic therapy is definitely an experience. Obviously we are having a conversation, we're talking through it, all the way through. But it's generally slower. So what we do when we do somatic work is we really try and slow down what we're paying attention to. And if there's a certain thought that's triggering distressing emotions, then we just pause and we go, okay, so you're having this thought, and what do you notice in your body when you're having this thought? Okay. And then all of a sudden people start paying attention to the little subtle tension points, the stress points, the heavy points that we all kind of get within our bodies, but we're not really slowing down enough to pay attention to it. And so when we do that, we get kind of a feedback from the body. And so for example, you might have a knot in the stomach when you think of a certain person or when you're remembering something, right? Or if, just give you an example, through like a painful breakup, right? Often, you know, it's in the chest that we feel a lot of tension, we feel heaviness, right? So it's like, okay, well, what's going on with this feeling in the - in the chest or in the stomach or wherever it might be. And then we - basically, what we're trying to do is just allow for the impulses that were that are being stored in there when we're feeling heavy or tight or stressed in certain parts, it means that the body’s holding kind of trapped energy, right? That really wants to get out and just release itself. So to give you an example of something that's really healthy and that we all would do. So let's just say you've heard something really funny, like you've heard a funny joke, right? So that's a trigger. So you're triggered by the joke. You laugh, you laugh, you laugh, you laugh. You can laugh for 10 seconds, you can laugh for five minutes. You know what I mean? Like you're just having that funny, great experience, right? And then, you know, it kind of subsides and you kind of slowly catch your breath again and come back to normal and then and then you're feeling just normal again. Right. So that from joke to feeling normal again is a cycle of an emotion, emotional flow. Right. But what happens when we feel something, when we're angered or when we're put in a stressful scenario, the emotion rises. You have the trigger, the emotion rises, but we put a break on it, it’s called a self protective response because we don’t want to risk us becoming overwhelmed right and so then this energy hasn't moved anywhere okay and so then it gets kind of stored in the body this is what it means and so what we try and facilitate with somatic therapy is the release of that energy just in the same way that the funny energy would move through without any resistance because there's nothing to block it this is what we’re trying to facilitate, things that have been stored up. So it doesn't matter how old it is, it could be 40, 50 years old, some trapped memory that hasn't had a chance to move. And so yeah, we're just trying to offer a safe and guided process to allow people to kind of let some of these emotions and energy go through.
Molly Casey:
Is there a specific emotion or experience, say PTSD or something of that nature, that does best with somatic treatment?
Blair O'Hara:
Yeah, so PTSD was one of the original cases that Peter Levine, kind of the developer, the founder of somatic experiencing model began with. He worked with veterans in war-based kind of traumatic scenarios and found that the approach, because it's the effectiveness of somatic therapy is that when we're avoiding overwhelm at all costs because what we don't wanna do is have anyone re-experience or become re-traumatized by remembering something painful from the past, right? And so PTSD has been, you know, one of the things that somatic therapy's found to be really useful for. It's a slow process because you have to be gentle and you have to honor what the person's gone through and just maintain their safety at all times. So that's another kind of pillar of the semantic model is rebuilding a sense of safety within someone's nervous system. And that can help offset the impact of PTSD where there's a constant feeling of threat. So the antidote to that is trying to rebuild a sense of safety. So semantic therapy is really all about bringing those foundational elements that make us feel okay again and that can dissolve a lot of the symptoms and yeah impact of PTSD.
Molly Casey:
When someone starts somatic therapy, do you have them talk through what the traumatic event was or is it just taking it bit by bit?
Blair O'Hara:
Yeah, great question. So the somatic approach is bit by bit. And often we work with things that are more of an incidental nature. You know, you're not going to go right into the core of the trauma from- in the first session, you might kind of broadly discuss it. So you've got a context of what's going on, but you don't have to. And what we're looking for is actually the thing that the person feels most comfortable exploring at that point in time. Okay, and the beauty of that model is that if you start to work with things that are more of a mild nature and you resolve them you have that energy kind of pass through the body then guess what the person actually built some capacity to deal with some more of the heavier work, So the bit-by-bit approach is part of the model that's proven to be quite effective in working with kind of severe trauma. So you never go into the trauma quickly and if you can avoid going into the deeper memories of that trauma then you would do that if you could. Sometimes it can't be helped like it's just present and the person will bring it up then you work with that but you just make sure and we're keeping track of the body the whole way through so if we get a sense - and there's things that happen our eyes dilate our body definitely starts to move if we get a sense that someone's going into an overwhelmed state, then we’ll try and resource them, bring them back out of that state. And again, just to feel comfortable, right? So we're working in comfort, we're building a baseline of comfort. And then what we're trying to do is get people to experience a bit of it, but not too much. And then we bring them back to comfort. And in that process, we call it pendulation, where you swing from comfort into exploration of the symptoms, that offers the release of whatever's being stored in the body. So yeah, the model's been fairly well defined and yeah if you follow it it's quite yeah it's really quite useful
Molly Casey:
And you also were talking about CBT, or cognitive behavioral therapy, and that's similar to somatic in some ways. Can you describe cognitive behavioral therapy?
Blair O'Hara:
Yeah, sure. So there is a lot of overlap, but the focus is more on how we manage our thoughts and how the impact of our thoughts have on the rest of the system. So when we're exploring CBT, cognitive behavioral therapy, we're looking at, well, what thoughts are you repeating in your mind and what kind of impact is that having on your emotional state, your somatic state, the way your body responds and also what you do actions and behaviors. Right. And usually what happens if there is a repetitive thought it will trigger quite a predictable emotion, a predictable set of behaviors and a predictable physiological response. Okay and what we do in CBT is and where it's effective is if you're feeling a certain way and you feel like you're stuck so you might have heard someone say I feel really stuck I'm just bogged down I can't get out of it. Well often what people are trying to do is get completely unstuck all at once and try to move this big boulder of distress all at once and that's hard to do. So the CBT model is “well, let's look at the different elements, our thoughts, our emotions, our behaviors and our physiology and what part do we have an ability to influence.” And so usually because the mind's so flexible we can come up with different thoughts and okay if we can come up with a different thought that's equally valid to the thought that you're having how might that affect your mood, how might that affect your emotion and behavior. And what we find is if we have a different set of thoughts, it will create again a new set of emotions, a new set of sensations, a new set of behaviors that are more beneficial to the person. So it's really about exploring the range of our experience and helping people feel that it's within their power to influence their cognitions, their thoughts, to create a different experience. Yeah, and so reframing thoughts is a big part of that model. And also, we often think irrationally. So if someone says hi you always do such and such like the always part that always word is not usually true like someone may do something but they don't do it all the time like like they definitely don't and we go to go through that. Well, like is that thought actually real? Is it true? It's partly true, but it's not all true. And so when we take the absoluteness out of our language and actually can soften the way we feel about it. So people say, I never and I always, and that's if we can get away from that type of thinking, it can actually help us be a little bit calmer about processing what we're thinking. Yeah, so it's really kind of looking at our thoughts more precisely and saying, what can we do with those thoughts to create a different experience?
Molly Casey:
So in a way, is it retraining the brain?
Blair O'Hara:
Yeah, it can be. Yeah, definitely. If you practice it enough and there's a lot of exercise you can do to kind of look at it as a skill, like being aware of what thoughts we're having and the ability to have some influence over them is a skill. And yeah, and you can develop a pattern of noticing what's going through your mind, readjusting, reframing. I have a lot of people do this. It doesn't take that long actually. And yeah all of a sudden they’ve gone from going down a slippery slope of you know not feeling great, thinking too much, getting them down, to okay I can reframe this and I can kind of reset and get on with my day just as I would like to. So, yeah so in some ways you could see it as retraining the brain and the brain adjusts quit e quickly once you kind of set it on the path that you'd like it to kind of follow so yeah it's kind of true.
Molly Casey:
Are there specific conditions that work best with CBT?
Blair O'Hara:
So CBT has had a lot of research done and a lot of studies. It's considered kind of the gold standard in psychotherapy purely because it's been around for a while and it's had the most efficacy tests done with that across different countries, different studies. And so it doesn't mean it's the best, but it's proven to be very reliable across a range of cases. But it's very useful for generalized conditions like anxiety. It's great for anxiety, great for depression, it’s great for kind of anger, it's great for kind of grief and loss. So a lot of the things that a typical experience have proven to be a really effective model to work with and people can understand it. It's quite simple when you kind of explain it and go through its parts and how it works and people can use it in a really practical way. So yeah, so it is useful in a range of, anytime that we're thinking, which is most of the time, it can be applied effectively. So it is a really good model to work with.
Molly Casey:
If someone were to walk in and have no idea what they were struggling with, whether it be anxiety and oppression, those words maybe don't exist to them. Would that be a type of therapy that you start with them just to maybe drill down into what might be the issues they're dealing with?
Blair O'Hara:
Yeah, for sure. Yeah, you would look at trying to get a history of what's happened to them the way they typically feel. So you're going to go through, you know, their mood, you know, some of the thoughts that it might be repeating in their minds, you know, look at their life situation, what's happened, what are the events that have shaped their experience. And, you know, it's more kind of psychiatrists and, you know, psychologists that would give a kind of a rigid diagnosis for and that kind of helps set a framework for therapy. And so, yeah, so most people have a fair sense of what's going on and then usually if you explore all those elements, thoughts, behaviors, the past history and moods and things like that, you can kind of work out what's going on pretty quickly.
Molly Casey:
Do you ever use somatic and CBT at the same time?
Blair O'Hara:
Ummmm… good question.
Molly Casey:
Or do they go hand in hand at all?
Blair O'Hara:
They do. I was drawn to somatic work because there's a lot of information that the body's providing that we have a hard time processing. So thoughts are actually quite easy to process because we can articulate them, we can write them down, we can explore them, we can adjust them again with the mind. But the body's kind of giving a lot of feedback as well, but it's subtle it's harder to define it's not as obvious so what I found is actually you know working with the mind first and then coming into the body second unless there's like a really obvious physical symptom going on. But yeah they do go hand-in-hand and but if I'm working with someone and had like a couple of hours to spend I'd probably start with them the mind first get it to know what's going on, get the past history, and then work in with the body, because sometimes people are disassociated from the body because we're so logically, rationally processed that the body work can be a little bit foreign to some people. So we have to kind of start more slowly with that sometimes.
Molly Casey:
Can you describe how the body maybe shows or feels emotion, maybe what physical symptoms somebody may experience?
Blair O'Hara:
Oh, there's so many, Molly. So, I mean, start with the top of the head, I mean, and go down like we can get headaches, we can get tired behind the eyes, we can cry, we can feel tightness in the jaw, we can get locked in around the mouth, we can feel lumps in the throat, we can feel pain in the back of the head, we can feel the weight of the world on our shoulders, right? We can feel definitely in the chest, there's a lot of activity in the chest, like when we're happy or sad, we feel it in the chest. Upper belly is usually a blow to to kind of power power discrepancies how much energy you have to kind of push towards certain things and then you're going all the way down and basically the entire body is feedback. So, an exercise that I do with people is get them to stand up normally you might like to try this if you're watching you stand up and then you just just stand up normal and then you just check in with the feet and see in which in which way your feet are leaning like your body weight like some people, it’s very rare for someone to be perfectly even. So, some people are at more forward in their toes, some people are in their heels, some people lean left and right, some people kind of rock actually front and back, and some people are squared in the middle, but even in that little exercise you can tell what's going on in the mind by checking with how the feet are aligned and what's going on there. So, there's so much information coming through the body that it does take some time to unpack it and to get to know the person and what they've been through, what's going on, to fully understand it and help them.
Molly Casey:
What do the feet tell you about the mind? Now I'm interested.
Blair O'Hara:
Well, it's a generalization. It's not necessarily a hard and fast fact, but generally speaking, I found anxious people to be leaning more forward. People that are more low moods or depression are more in their heels. And then people that are really uncertain with their life path can be kind of rocking. It's almost like they don't know where to go. So it's really subtle. Like it's not that drastic. And, but yeah, that's generally true, but not always.
Molly Casey:
Interesting. And you were talking about how a lot of times you can't start the somatic work yet because individuals are disassociated from their body and it's just too much to start going through. It took me a very long time to understand what disassociation meant. Can you explain what disassociation is?
Blair O'Hara:
Yes, so dissociation when usually the body becomes so overwhelmed with sensation that it can't process it anymore. And so that the body basically goes into a form of shutdown or isolation to the to the mind and that it just doesn't want to have. It's kind of like an invisible protective mechanism that stops the body from feeling things that are just they're uncomfortable. It stops you from feeling, which is a good thing if you're feeling too much, but it stops you from feeling much of anything, which is obviously not healthy because you're disconnected from life and healthy dynamics as well.
Molly Casey:
When you start trying to help someone understand disassociation, how long does it usually take for you to kind of work through enough of the mind work to get to them being able to recognize feelings in their body?
Blair O'Hara:
Quite quickly, so you could, usually within the first one or two sessions, you would have an idea of the level of disassociation if it's present. And simply because we check in with the body and we're trying to correlate thoughts and emotions with the sensation and if there's no sensation present or being offered, so it's kind of numb or it's just there's not much of anything, then there's a sign that there's some disassociation happening. It does mean its the entire body either sometimes it's isolated to one part of the body so it might be that we don't feel much in the chest or in the stomach but we definitely feel it in the legs or in the arms right so it's not necessarily the entire body that's dissociated but it just can feel like that because the nervous system runs up and down obviously the spine and that's usually the core of what people can experience and feel. So they're the kind of the center points for dissociation, but we can find connection in other parts of the body, we can reconnect to the body by finding parts of the body that feel good, right? But generally speaking, we wanna try and get to know the reason why over time, what’s happened to the body to react like that because the body is usually reacting quite naturally and from things that have happened and so we want to kind of get understanding of what were the things that may have induced all this overwhelm for the body to kind of turn off that sensitivity and and for it to be kind of stuck in like a free free state. Yeah so that's how we kind of start to dig into that.
Molly Casey:
Are there any specific conditions that are more associated with disassociation?
Blair O'Hara:
Definitely PTSD can be. Eating disorders can also be, yeah, grief and loss. We can disassociate through, you know, extreme grief. We can become disassociated when we're very angry or when we're very upset. The body can kind of, we can feel emotional, but we don't have much connection to that emotion. It's very much taken us over. So, they’re some of the main causes that I would deal with.
Molly Casey:
You were talking earlier about protecting the body from the mind. W hat else does maybe our mind do to protect it from itself when it's in that state of overwhelm?
Blair O'Hara:
Great question. So, well, the mind can do lots of things and this is where some of the cognitive part comes into it because it will come up with a solution to wanting to feel too much and not wanting to re-experience it too much. So the mind will come up with reasons for things to, for it to be this way and for it to be okay. Alright, so this is working with the ego and what the ego is going to do to protect the system, protect the entire system from death, right, and whether that can come in various forms, not just a physical death, but I won't go into that. So the mind can serve us to stop us from feeling or stop us from getting into situations where this may happen again. And that becomes part of the problem when we try to unwind it because the mind told the system that it's unsafe to change anything. The mind is unsafe to want to feel things again. And so the mind can be our friend, it can be not our friend when we're dealing with trying to resolve trauma or to dissolve these undesirable symptoms.
Molly Casey:
In the way of how the brain kind of does this, you know, almost, in my mind, it's almost like boxing of things to create that system of keeping us from doing things that are unsafe. How does something like trauma affect the brain?
Blair O'Hara:
That's a great question. So the trauma affects the brain in a couple of ways, and there's three main parts of the brain that we can talk about. First is there's the cognitive part of the brain, our prefrontal parts of the brain. Then we've got our midbrain section, which contains our mygdala, our hippocampus, and some of the kind of fine tuning of the brain function. And then we've got our brain stem, which runs down the back of the neck and head, and that is our instinctual, kind of reptilian brains. This is the original part of the brain which a lot of other kind of natural animals would have as well and obviously runs down the spine into the nervous system. So when someone's experiencing trauma what generally happens is that the instinctual part of the brain recognizes that significant threat and that can be, let's just have the case of it being a real threat to survival. So that's going to trigger the nervous system to an automatic response. And while the brain's doing that, and that response is like hundreds of millions of years old in evolution, right? So it's a very adaptive response to threat. And so then what happens to, because this front part of the brain, which is developed later, which is given humans kind of this superior advantage over other animals is a logical conscious processing. So generally speaking, when the brain stem is active, then a lot of the energy and processing is happening from that part and downwards and this part kind of goes offline. So if anyone's ever experienced brain fog or you're really emotional and you can't think straight or you can't get the words out, you know, it can happen in public speaking as well. Like if you're speaking in a big crowd and you're really nervous, this is a threat. This is a perceived threat. It's not, it's not a lion chasing you down or anything like that, but to some part of the body, it's a threat. And ao, again you're very activated up in the back in the midbrain and then your cognition, your cognitive part just completely switches off and then so the midbrain gets impacted with too much kind of processing because then the thinking brain is trying to fire back messages saying you know what's going on if you can pull yourself together enough to think about trying to get yourself out of this predicament and then the midbrain and the all the other parts of the brain are trying to work itself out to get back to some kind of equilibrium. But depending on what stimulus is still in the environment, that's going to continue to cause triggers to arise and for this process it's going to continue. So, so trauma, you know, can leave a really long lasting impact because if it's stored as a memory in the body, any kind of trigger that sets off that memory, even if you can't cognitively remember it, is going to create some kind of response. And this is what we're dealing with in somatic work is trying to understand and help people release from that stored response that they never knew was really there. And I think that's why Bessel's book was such a breakthrough into the mainstream about how trauma is stored in the body and its not just cognitive processing that can help us, it's we've got to work with the body to unpack the impacts of trauma.
Molly Casey:
Tell me about how it is that we can have a triggered response to something that we don't even remember and how you would end up working through that if you don't even remember what it is.
Blair O'Hara:
Yes, good question. Yeah, great question. So, you know, it's the body, it's this somatic sensation based response. And we have to work with what's present. And we look for little clues that in and of themselves don't tell us anything. But it's amazing when you bring up a conversation point and it doesn't have to be about the exact thing. It could be a color. It could be an image of something could be a tree, it could be, it really could be anything, it could be a smell, that will elicit some kind of response, right? And see what's going on in the body is when we, I was thinking about your, you know, in your role as a journalist, right? So let's say you turn up and there's a car accident, right? And you've got to go reporting on that. So you’ve got a job to do, you've got to turn up, tell people what's happened, get on camera, it's very, you know, a lot of cognitive processing, how you're gonna, what's the story, how I'm going to say this, where I'm going to set up the camera, blah, blah, blah. And so you've got a job to do cognitively consciously, right. But in the background, the body's like, there's there's an incident, right? There's, there's people being affected, there might be someone crying, there might be people screaming, there might be ambulance, so there's a lot of stimulus that your body is paying attention to that you're not because you're focused on the story, right? Not that you're not entirely, but it's, it's compartmentalized, right? And then the body's just like reading the environment all the time. And, and while you're busy doing your thing functioning, which is a blessing that, you know, we can function in traumatic moments, the body’s still taking it on. And so, if you're trying to unpack that, well then you might look at the colors associated with the cars that were there. Or you might ask a question about what happens when you hear the sound of an ambulance, right? And then the body's like, shoo, okay, I'm feeling something, right? And then we just start to unpack that, you know, bit by bit. So, and that's quite explicit about that example I was giving you. So you're basically looking for clues all the way through and just being really gentle and unpacking kind of what's going on. And so there's different ways to kind of explore it. But again, you just have to pay attention, try and slow the person down so that they're feeling it in just micro moments. We're not trying to take the whole of the car accident in again in one go. We’re looking at, well what happened before anything happened. Like how were you feeling before? You were just, you know, let's say driving along and then we go down into like the little micro moments that happened in an event if we have to and just see what happens. It's very organic, it's hard, sometimes it's really hard to predict what's gonna happen. So in my example, like in my, I've had somatic therapy done to me as well and one session was really odd because my hand started to curl in a funny way right so it was just like I was sitting in a chair and it was just quite comfortable and then we started talking my hand just curled like that just in on itself and this hand was fine and this hand just went like that and I actually prompted my therapist to say oh let's do the hand because I kind of knew what we were doing and and I said I don't know but let's explore this strange like movement right and then it actually was really profound. It can really come out of nowhere, but it's amazing work.
Molly Casey:
You talk about bringing people back down from kind of that high moment so that they can feel that safety again. What are some of the ways that you bring that person back down? Because in my own experience, especially when I was first going through PTSD treatment, it was hard to get back down. So are there any - are there specific ways that you found most useful to kind of find that safety again?
Blair O'Hara:
Yep. Well, there's lots of different ways we can explore it. The first one is, you know, just breathing, right, or just trying to take calmer breaths. Because as we know when we're panicked, *deep breath* comes right up and stays up here really high. And so usually the breath’s quite shallow. So it's like, okay, how can we get the breath just to go a little bit slower, a little bit gentler, and then just see how much movement we can get back into the lungs, right? So if you can take a deep, calm, slow belly breath and breathe out a similar way then you're not in a threat response. If the body - if you're breathing slowly and calmly the body's like “oh well we must be doing okay” because if, again, there was a lion around the corner you're not breathing like this you're only breathing like that if you're calm. Okay? That's one way and it's I find I think it’s working with really gentle breathing is really simple and really effective. It's, you don't have to do any fancy techniques to benefit from breath work. You can just breathe just slowly and gently and it creates a nice effect and brings back that sense of safety. Also, you know, just again, feeling your body in the space around you. So if I'm sitting on the chair, I just wanna put my feet just even on the ground. I wanna get some symmetry in my body so it feels nice and even. And if I do that it feels kind of stable and it feels like I've got a foundation underneath me and that sense of foundation, even though it's just a normal everyday floor, if I pay attention to it it can make me feel a bit more stable and then safe again I'm not having to rush anywhere I'm calm and peaceful and there's a lot of exercise that we can do you know you know just turning the head left and right just really gently can stimulate the vagus nerve that kind of runs down both sides of the neck. Very subtle exercise, but it helps us kind of just slow down again, and then just stimulate those nerves to say to the body that we're okay. So what we're trying to do is actually communicate to the body, consciously through some action, that it's safe, like you're re-informing the body that actually right now in this comfortable space, I'm okay, right? And the body's like, oh, okay, you know, I get you, right? there's no there's no threat anymore okay that's good and then the body will start to adjust. So anytime anything you can do that reminds the body that you're in a safe, comfortable, pleasant space will alleviate the effects of PTSD or traumatic responses
Molly Casey:
You've actually studied the polyvagal nerve and how that all ties into your responses. Can you explain one, what that is, and two, how it all ties together?
Blair O'Hara:
Yeah, so the vagus nerve runs basically along the entire length of the nervous system. So it runs all the way down through down into our lower back. And basically there's multiple parts to the vagal system. And basically there's one part called the ventral vagal system, which is all about trying to reconnect to things that are safe and make us feel good. So social engagement is one thing that all humans benefit from. And again, it's kind of the idea we go back to primal concepts is that, you know, if you're in a tribe and you've got people around you and near you, it feels safer than if I'm on my own, I'm isolated. I have to sort any potential threat response out by myself is more scary. So being around people is healthy. So that part of the vagus nerve is about trying to find that sense of energy and vitality that we can get in the body in certain circumstances. And you know the other systems, I won't get too technical, but it's called the dorsal system. So this actually is good in some ways because it can help us relax and calm down but if it becomes too activated, we can actually collapse and go into a freeze state. And then we've got two sides of the nervous system operating. We've got a parasympathetic, a sympathetic, which is kind of like, again, the sympathetic part lets us get up, take action, move, swim, run, jump, do all those things, work. And then the parasympathetic is the part that wants to, again, help us rest, restore, rejuvenate. they're always on, both of them are on all the time. And it's this flexibility that we're looking for in therapy to try and help people back to flexibility in the nervous system. So we can engage all parts of the vagal system and all parts of the nervous system all the time. That's okay. And we want that flexibility back, right? The problem that we get is, you know, say trauma, it creates a really strong freeze response and we’re stuck there or in a really overactivated dorsal response where you know people have become very lethargic and they just can't move and this is where depression comes from. We just don't want to stay stuck for any length of time we want to create this movement of energy through the system right which is healthy. Yeah so that's kind of my debrief but it's quite complex I've given my simple description of it but yeah the polyvagal theory is relatively new but it's become very widely used and accepted in therapy as a guiding principle of how we're reacting to things and how our body's responding.
Molly Casey:
You mentioned flight and fight, and there's freeze, which I had no idea was a thing until I started therapy on my own. Can you kind of talk about what those different reactions are and why they come up?
Blair O'Hara:
So again this is a primal response. These are primal responses to threat and risk. Okay, so depending on the perception of threat it will activate the core functions of the nervous system which is to protect ourselves. Okay, and whether we are typical responses to fight or flight is predisposed to us. So we have a tendency to fight or flight just depending on the makeup of our body, our genetics. It's just an organic response. And then the freeze response is another level of activation, right? Because the fight and flight response lets us expend energy. We're either fighting or we’re running. But if we cant do either we’re trapped for example and we're overwhelmed well then we can't fight and we can't run so then what well then we have to play like play dead right or freeze, yeah? And so that's another level of nervous system response that actually tries to keep us safe so we'll stay quiet we won't say anything we'll just stay still and hope that the threat goes away by itself and then if the threat doesn’t go away, that’s even that’s even more complex. That's where kind of the programming to deal with stuff becomes more embedded in the person's psychology and psyche and it can be yeah it takes a lot of time to unwind that but that's kind of the the nature of those primal responses in the nervous system.
Molly Casey:
I had no idea freeze was like the second level that it was, you know, fight or flight was like level one and freeze was level two. I did not know that.
Blair O'Hara:
Well, it just depends on whether you have a chance to action the response. So, yeah, that's kind of how to look at it.
Molly Casey:
So when you are looking at kind of the broad spectrum of different types of therapy that are offered, you mentioned that CBT is the gold level and it sounds like somatic is, kind of as you said, hand in hand with that. Are there any specific conditions that really benefit from either one of those most or they fairly across the board can be used types of treatment?
Blair O'Hara:
Yeah, I think somatic work is more focused on, it can be more focused on, helping people process the impact of trauma. If there's a very strong physiological or disassociated state, that would probably be more effective, for example, than CBT. CBT is really effective in more kind of generalized scenarios where it's not any kind of severe mental health and helps us function and kind of regain our functioning in day-to-day life. So if you're overwhelmed and burnt out or overly stressed or again anxious, depressed, you've got irritation, anger, grief, loss, you know, that's a great, CBT is great for kind of all of those and then the somatic work can complement all of that as well. But, yeah, it can be at its best use when you're dealing with kind of things that are, you know, trapped in the body like emotions that are stuck. Again grief and loss is another one which would benefit from both. You know trying to get over, you know painful endings of relationships would be both, you know. Because a lot of our common languages, you know, we're heartbroken, you know, that that there's some level of truth to that right or, you know, you have a gut instinct or you feel a gut doesn't feel right about this decision, well that's the body, you know, that's probably like really really old phrases that we still use today that basically is the body giving us the message about what's best or what's going on. So they do compliment well but is there any that you wouldn't take on? I think anything that's really, you know, severe mental health like schizophrenia, bipolar, those kind of disorders are more probably suited for that therapy but supported by probably some medical pharmaceutical intervention to help kind of offset the symptoms that someone might be experiencing.
Molly Casey:
You talk about mindfulness a lot in your work and kind of creating balance and also breath work. I think a lot of people look at mindfulness and they think, oh, it's just meditation or, oh, it's just repeating a mantra to help me calm down or things of that nature. But in your view with being a somatic therapist, how would you describe mindfulness?
Blair O'Hara:
So mindfulness to me is very practical and it's just to help us manage our thoughts and emotions with some level of awareness about what's going on just for our own experience. So mindfulness to me is what's going on for me right here and right now and is this the kind of experience I want? Is it something that I have the influence in kind of changing or is something I can create for myself? Can I be proactive in what my experience is going to be for myself. So mindfulness is just about being aware of what's going on, you know? And I think it's just really helpful to have that because with awareness you can start to navigate your experience a little bit easier or with some confidence, you know? When thoughts and emotions take us over and we're unconscious about it, they're living life through us. We're not really driving the car of life anymore. They’re driving us and some usually it's in a direction we don't want to be going in right? So, mindfulness is for me is really about just helping us slow down pay attention to what's going on and just again being mindful of “well, is this what I want my experience to be like? And having some level of influence to help us have you know a slightly different experience or a better experience. So yeah I like to talk about mindfulness because - and I like reflecting with in terms of nature, natural things because everything kind of we see that in nature reflects our experience as well and so if it's already happening all around us and it must apply to us as well and so this is where mindfulness can kind of help take the edges off some of those cognitive irrationalities that we can actually get stuck on and cause us to feel you know bogged down in an emotion. We can get really angry all the time, for example, if we're thinking something. But mindfulness helps to kind of soften the edges of those thoughts which again can help us dissolve those kind of unwanted emotions so, it just, again it probably another way look at it is it just helps you enjoy your life experience a little bit more because you're kind of in the moment and you're feeling the things that the little things that actually add to your life, you know? I wrote a post the other day about sparkles you know being the little innocuous moments that happen in a day that we often just ignore and I use example of like the first sip of a coffee like a nice coffee you know that first sip is just you know it's really nice right but we do it every day so we just pass the up, we love like the lovely little moments and if we pay attention to those they can kind of become like the breadcrumbs of our life instead of like the hard stuff that we have to kind of put up with. It's just a nicer kind of vibe to be kind of living through I guess and mindfulness just helps you shape the lens that you process it through. So yeah I like to work with those concepts as much as I can.
Molly Casey:
And then can you just talk a little bit about why it is that mental health really shouldn't have a stigma around it and why getting help isn't being weak?
Blair O'Hara:
I'm starting to think this is changing and well it's definitely changing and for the better because we live through our thoughts and our emotions. This is our full-time activity going on within us and it's like we're refusing to do any work on it. It just doesn’t make sense It's like to be focused on how we're living our experience. Like can we do things to make our, to feel, you know, more vibrant or clearer in the mind? Like who wouldn't want those things, right? And so it doesn't make sense. And I think there is a lot of comparisons to physical fitness now. Whereas like that's our physical body that we have to look after and no one seems to dispute that's important. But what about all the things that are going on inside? Like that are equality important in shaping our experience. So I see kind of therapy as an advantage. You know, you'll learn so much. It's empowering working on mental thoughts and emotions, understanding yourself a little bit better. It's liberating, right? So there's a lot of really positive things that come out of therapy. And I work with a lot of young kids as well. And some of them just don't wanna be there. They think there's something wrong with them. But I say to them, like, this is huge. This is a great opportunity for you to learn stuff that people later in life just they wish- we - you know, a lot of us didn't have any idea of this until we were much older. So, you're you know 10 or 11 years old and having this base of knowledge is just setting you up for like, you know really healthy experience. So I just look at is “what- what are the things that create a healthy experience?” Yes our physical health is really important but mental health is important, our emotional health is important and - and we know this, like if you feel good, it's good, right? So why not work on feeling good, right? So this is what my colleagues and I try and do. So it's not about weakness at all. I see it's empowering, it's liberating, it's freeing, it's exciting, you know. So there's no reason not to kind of work on it, I feel. And you know, use the sports analogy as well like all the great athletes of all time have all had coaches and everything like that and you know the executives in the world all have their coaches and you know and we've got to we've got to find a way to feeling better and working on that more mainstream and you don't have to have anything wrong with you to seek out kind of a therapist. You can do it for all kinds of healthy reasons, right? Yeah, it just gives you tools and techniques to help manage your thoughts and emotions and they're happening all the time so why not get some help learning how to do that?
Molly Casey:
And that I think fits perfectly with the reporting space, with the journalism space, because we're often made to feel if we do choose to find help that we're weak. But in the end, we come across trauma so frequently, and also we're just humans, and having that that coach really does end up making a massive difference.
Blair O'Hara:
Oh for sure, yeah absolutely. Yeah, no question about it Molly. Yeah, I hope the stigma around it being a weakness changes into something that strengthens you and yeah, again, just gives you more ability to create your life, right? Or have an impact on your life in a positive way. So we all have goals and aspirations but we can't escape our thoughts and emotions. Like, We can't, so if we can help understand them better, get to know ourselves better, like some of the ancients, like the Stoics and things, part of their whole philosophy is if you know thyself, like get to know yourself, is basically one of the goals in life. And I find it actually gives you a lot of purpose for your life journey, because there's life after career as well, and then what? Yeah just getting to know yourself is just so healthy and it gives you a purpose all the way through your life. Yeah so I hope that that changes that perception I think it will in time but and then you know definitely the younger generation are getting across this more and more so I think this will become a thing of empowerment in the years ahead rather than perceived as you know, a weakness.
Molly Casey:
Thank you so much for sharing your time with me today. We've just hit the hour mark, which is amazing, I feel like we've been talking for five minutes.
Blair O'Hara:
Thanks, Molly. Yeah, it's great to chat.
Blair O’Hara:
Blair O’Hara, Reporting Live on Mental Health