Social connection is an essential part of what it means to be human; to survive and to thrive.
Our safety was rooted in tribes and extended families as we cared for and kept each other safe. That need for connection is hardwired into our bodies and our cells. Our very survival might depend on connections that we are able to forge with complete strangers. (Lieberman, 2013)
Deep social connections alter the way that DNA is expressed within our cells, affecting our health and well-being. These connections increase our resilience, health, productivity, happiness, and even our longevity. The most important aspect of mental health is the ability to feel safe with other people and have healthy relationships. Safe connections are essential for a meaningful life. (Fredrickson, 2013)
For people struggling with trauma and anxiety however, the mere presence of another human being may be threatening. (DSM-IV, APA 1994) Children and adults who struggle socially have sensitized nervous systems that detect, magnify, and misread nuances invisible to other people. It is nearly impossible to build social and emotional learning and resilience in a person so threatened by human contact that the very ‘milk of human kindness’ is not accessible to them.
CalmConnect provides the benefits of human connection without the threat of a live person. Ranging in age from 2 to 100, each person onscreen looks at the user(s) with the same compassionate, caring, nonjudgmental, expressive features of emotion – every single time. CalmConnect supports neurological recovery and resiliency, and one of the main components is found in the kind and consistent faces contained in each sequence.
The Polyvagal Theory
Dr. Stephen Porges is a behavioral neuroscientist whose development of the Polyvagal Theory is changing the way we look at social and emotional behavior, particularly trauma and anxiety. (Porges, 2011) (Polyvagal refers to multiple branches of the vagus nerve, which connects the brains, lungs, heart, stomach, and gut.)
Dr. Porges’ theory emphasizes the biology of safety and danger, as it examines the interaction between our body’s internal states and the faces and voices of the people around us. Are we with people who make us feel safe? Understanding Porges’ work gives us a set of tools to begin to understand and adjust the nervous system’s responses and finally our resulting behaviors.
The theory emphasizes that our nervous system has more than one defense strategy, and that our defensive response is completely involuntary, beyond our control. Our nervous system constantly evaluates risk in the environment, making judgments and setting up priorities for adaptive behaviors that are beyond our conscious control, keeping us safe in the face of danger. One of the most interesting things about the Polyvagal Theory is the way it moves beyond ‘fight or flight” to examine the important role that social relationships play in understanding safety, danger, and trauma. It is a primary mechanism for neurological recovery and behavior modification.
The vagus nerve starts in the brainstem, just behind the ears, and has two branches; one branch is myelinated, one branch is not. This bundle of nerve fibers travels down each side of the neck, across the chest and down through the abdomen, connecting the brain, heart, and gut, lungs, spleen, intestines, liver, kidneys, and a range of other nerves involved in speech, eye contact, facial expressions and the ability to tune in to other people’s voices.
‘Vagus’ is Latin for ‘vagabond’ or ‘wanderer.’ The longest of the cranial nerves, it is made up of hundreds of nerve fibers with both sensory and motor functions (afferent and efferent) and is a major part of the PNS. 80 percent of the nerve fibers are afferent, reporting sensory information from the organs back to the brain. The vagus nerve operates far below the level of our conscious minds and is crucial for maintaining good mental and physical health.
Scientists can measure the activity of the vagus nerve by tracking heart rate in conjunction with breathing rate. The strength of the vagus response is called vagal tone and can be determined by using an electrocardiogram to measure heart rate variability (HRV). HRV is one of many things regulated by the vagus nerve, which is active when you breathe out but suppressed when you breathe in. The bigger the difference in HRV when breathing in and out, the higher the vagal tone. Generally, a higher vagal tone indicates that your body is better able to regulate the internal systems important to good health; cardiovascular, glucose and immune responses.
Measured at rest, vagal tone tends to be very stable over time. People with higher vagal tone are more flexible across physical, mental, and social domains. Physically, they regulate internal body processes more efficiently, like inflammation and glucose usage. Mentally, they’re better able to regulate attention, emotions, and behavior. Socially, they’re more skillful at navigating interpersonal interactions and forging positive connections with others. The agility of the conduit between their hearts and brains allows them to be agile, attuned and flexible as they navigate their way through the world. There is much more rapid amygdala recovery, releasing people from constant anger and chronic stress.
If you feel lonely and isolated from others, your circulating levels of cortisol (stress hormone) will rise. Increased cortisol levels will signal the immune system to alter the way your genes are expressed in your next-generation white blood cells, specifically making them less sensitive to cortisol. Your inflammatory response becomes more chronic and less sensitive to cues that a crisis situation has subsided. This is how, over time, chronic feelings of loneliness can weaken people’s immune systems and open the door to inflammation-based chronic illnesses, like cardiovascular disease and arthritis.
Ideally, the Autonomic Nervous System automatically reads the environment and responds by activating the myelinated ventral vagal complex (VVC) when you are safe, the sympathetic nervous system (SNS) when you are in danger, and the non-myelinated dorsal vagal complex (DVC) when your life is being threatened.
When the myelinated vagus isn’t working well you’re less able to accurately interpret other people’s intentions. You can’t see or hear others as well and you risk misunderstanding their expressions. You don’t make eye contact as easily, and your own facial expressions become flatter, which increase the likelihood that you’ll be seen as hostile or uncaring. Others may perceive you as closed off or angry.
Components of the Polyvagal Theory
Positive Social Engagement
If your nervous system perceives you are safe, the polyvagal system triggers the most sophisticated adaptive response to stress, using the social engagement system. This connects the ‘social’ muscles of the face (eyes, mouth, middle ear, larynx, sinus) with the heart. This activates the ventral vagal complex (VVC), which is regulated by a myelinated branch of the vagus nerve; and is the most evolved strategy for keeping us safe.
The myelinated vagus uses signals from kind/happy/safe facial expressions to modulate stress to make us calm. When you get input from other people’s faces and voices signaling safety, the myelinated vagus sends a message inhibiting the sympathetic nervous system. “I’m with friends and everything is going to be okay. You don’t need to fight, flee or freeze right now.” That’s why we feel less stress when we’re around people we trust.
The myelinated vagus activates your muscles to do the motor work essential for engaging with others around you. Your face becomes more open, lifting your eyelids and eyebrows. You’re able to listen and distinguish human voice from other sounds through the contraction of the inner ear. You look directly into the eyes of the person you’re talking to. Your expression is animated, accurately reflecting your emotional response to the situation.
If there is a problem, you can call for help, support, or comfort. This level of communication is the one we use to beg for forgiveness, negotiate a solution, and straighten out misunderstandings. It activates our facial expressions, eye contact, speech and vocal prosody, as we gesture communicatively to bargain, persuade, model and implore.
The myelinated vagus works to sustain social relationships, sending and receiving emotional information that brings you closer to others and helps you to feel calmer. You feel safe because you are affiliated with, accepted by, and connected to others.
Mobilization through The Fight or Flight Response
If the myelinated vagus feels that others are unsafe, it automatically shuts down. It stops sending inhibitory messages to the SNS, allowing it to respond with a stress response. Stress responses are useful if you’re actually in danger, but if you’re around safe people your nervous system has misread as unsafe, the faulty system elicits feelings of stress with elevated heart rate, sweaty palms, dry mouth and fuzzy brain. You might start an argument or perform the social equivalent of ‘fight or flight’ by zoning out in a conversation.
Immobilization through the Freeze Response
When we sense life threatening danger and social engagement and ‘fight or flight’ systems won’t work, our bodies can go into “freeze” or an immobility response as a final attempt at self-preservation. The nervous system activates the dorsal vagal complex, shutting down the system and expending as little energy as possible by reducing metabolism. At this point our gut stops working, our heart rate drops, and we have difficulty breathing.
Humans and most mammals instinctively use this when there is no escape. As a survival strategy of last resort it’s frequently dangerous in itself, although it can help us to survive. During severe injury, it turns off our registration of pain, and shuts down body systems as much as possible. With repeated trauma, the nervous system can grow habituated to using a ‘freeze’ response, which can trigger shutdown and dissociation to any perceived threat.
Safety and affiliation are paramount; without them we are lost. The children and adults that we work with are frequently isolated from other people because of trauma. Many of them are simply trying to survive.
The Impact of Early Childhood
The human nervous system develops from birth. A baby’s life is full of routine stressors including hunger, wet diapers, and sudden noises. These stressors signal discomfort or danger, stimulating the SNS. Ideally, when a baby cries in distress, caregivers will respond appropriately and lovingly.
The myelinated vagus (VVC) is closely linked to the increased social complexity and interdependence of mammals, particularly the infant’s dependence on others for growth and development. An infant needs food and water, but s/he also needs cuddling, cooing, and other stimulating contact with adults in order to grow and to thrive.
Infants are born with reflexes that instinctively reach out to others since they are unable to survive on their own. The Rooting reflex keeps an infant’s neck and mouth turned up toward the mother, searching for the breast for food and comfort. The Moro reflex causes an infant’s arms to reach out as if in a hug when the baby is being put down.
Attuned adult-child relationships are critical for healthy neural development. Attuned relationships cause the baby’s brain to release neurochemicals (serotonin and endogenous opioids) that lessen the feeling of threat. The soothed baby learns to associate the caregiver with safety and comfort, and the experience helps her myelinated vagus to become better connected with the parts of her brain that recognize safe faces, safe smells, safe noises, etc. The multiple senses associated with healthy relationships begin to encode into the baby’s nervous system.
Human connection can now modulate the baby’s stress responses. The SNS can be soothed when the baby is in the presence of caring family and friends. The baby will grow up able to accurately distinguish between safety and danger and have the desire to seek out healthy human relationships. Research indicates that children with more secure attachments to their mothers exhibited greater empathic responsiveness, less social inhibition, and higher vagal tone, again highlighting the vagus nerve’s regulatory effect on emotional and social function.
When the VVC develops within a chaotic environment, and frightening, disconnected circumstances, the infant is repeatedly exposed to stress. The SNS is constantly stimulated, and the baby is exposed to incongruent relationships, never associating human connection with comfort and safety. While infancy is the most significant time for brain development, the myelinated vagus of an older child or adult will suffer in a chronically dangerous environment as well. If in constant danger, the brain’s rational response is to stay on high alert. Poor vagal tone not only makes it harder to successfully navigate social situations, but results in a much greater risk of heart disease, insomnia, depression, anxiety, alcoholism, and early death.
The process of strengthening the polyvagal system continues into adulthood. Every time you receive comfort, the myelinated vagus becomes faster and more efficient at sending chemical signals. We can modulate the stress response by connecting safely with others.
We received this email from an occupational therapist at a Level One Trauma Center in the Midwest:
“We have been using CalmConnect for about a year at the hospital, on our inpatient behavioral health floors. We have 5 floors with 20 adult patients each. The floor I work on is a high security floor that includes two jail cells. Most of the patients on the floor have been in jail one or more times for anything from writing bad checks, to robbery, selling drugs, assault, terroristic threats and very occasionally, 2nd degree murder. Most are diagnosed with anti- social personality disorder, among other diagnoses. Most are unemployed, have chemical dependency problems and many are homeless. Most have had terrible childhoods and lots of trauma, as you might guess. The patients on this floor are a highly multicultural group and the varied ethnicity on the DVD was affirming and part of the reason they like it so well, I think.
The most recent time we did CalmConnect, just over a week ago: A patient in his 40’s, “J”, was homeless, had schizoaffective disorder, suicidal with very disorganized thinking, needed to be hand coached to eat. He is also illiterate. He had been in the hospital over 60 days and was ready to leave. He was unable to remember the 3-syllable name of the group home he was going to and told everyone the wrong place instead. I had been coaching him for about 3 days, syllable by syllable, on the name of his new home so he could tell people. He would say it very dysfluently, pronouncing syllables and sounds poorly, halting during the word. Halfway through CalmConnect, he suddenly called out “ ______ House!” and pronounced the name absolutely perfectly and fluently! He was super excited and proud of himself. He totally remembered it after that, all the way until discharge, saying it perfectly, telling everyone he saw.
“L” a patient in his 30’s came in and was diagnosed with catatonic schizophrenia. He was mute and unresponsive at first and then was very bland in affect, low energy, little eye contact, usually stared at the floor or put his head on the table while we exercised or made minimal efforts for 30 seconds or so if we prodded a bit. Really, nothing we tried, humor, reinforcement, asking him to choose or lead an exercise, etc., had motivated him. When CalmConnect came on, he smiled spontaneously, exercised spontaneously, moved through full range in the movements and kept his focus on CalmConnect.”
CalmConnect connects users to the salient aspects of human connection, emotion, and positive social engagement (facial expressions and eye contact, musical prosody in higher frequencies shared by the female voice and simple, rhythmically attuned movements – gestures) without the threat of a live, human being.