CONTINUING THE PHILOSOPHY OF REGINALD O. KAPP

9.30 Relational Heart Conference

Report of the Conference         30.7.08

John Kapp,
22, Saxon Rd, Hove BN3 4LE, East Sussex
  johnkapp@btinternet.com   Tel: 01273 417997


Held by the British Holistic Medical Association and Confer on 25-26July 2008 in London. Chairman Prof David Peters, Speakers Dr Alan Watkins, Dr John Armour, Dr Stephen Porges, Sue Staziker, Dr Fay Alberti, Dr Elya Steinberg, Elizabeth McCormick. It was attended by 120 people, mostly psychotherapists.

The purpose of the conference was to develop a deeper understanding of how the heart (emotions) and mind (intellect, intelligence) interact in disease and healing, drawing on examples of autism and post traumatic stress disorder. (PTSD)

The problem – physiology - the traffic lights of our nervous system
Whether we are patients or therapists, we want ‘performance’. However, that is only attainable if the right emotional infrastructure supports our body in a hierarchy:



outer world


determined by

performance
behaviour

(such as criminal)
(such as violent)

-----------------------------------------------------------------------------------------------------

inner world

determined by

thoughts

(such as aggressive)

 

determined by

feelings

(such as frustration)

determined by

emotions

(energy in motion, such as anger)

determined by

physiology

(such as hyper-arousal)

-----------------------------------------------------------------------------------------------------


Dr Watkins said we are mammals programmed for survival with 200,000 year old un-updated software. A perceived threat produces physiological changes within 30 milliseconds, and we are out of control, acting robotically, until we are out of danger.

Dr Porges used a metaphor of traffic lights for the different hormonal states:

Traffic light

Perceived danger

Response

Hormone reaction

Frontal lobes of brain

Green

None

Business as usual

Endorphines

Engaged

Yellow

Threat

Flight

Adrenaline

Disengaged

Yellow

Threat

Fight

Nor-adrenaline

Disengaged

Red

Life-threatening

Freeze

Acetylcholine

Traumatised



The adrenaline flight/fight responses create fast, shallow breathing, suppressed immune function and shuts down the frontal lobes of the neocortex so that we cannot think rationally. It is as if we have had a temporary lobotomy, and we revert from behaving like mammals to robotic reptiles. This explains the physiology underlying road rage, domestic violence, burnout, crime and alcoholism. These have doubled over the last decade following greater exposure to perceived threats, pushing us all towards the yellow and red, eg ‘Do not leave baggage unattended…’, and the abduction of Madeleine McCann.

Dr Watkins demonstrated this by connecting the ear lobe of a volunteer to a computer, which measured heart rate variability (HRV) He showed on the screen how stressing the subject caused chaotic HRV signals, impairing performance. This turns the traffic lights from green to yellow, preparing to fight or fly.

The solution – go green by deep breathing and meditation.
In the old days we were told that the way to stop a pub brawl or street fight was to tell the protagonists to take three deep breaths. You can control your emotions by controlling your breathing, which is linked to the ‘little brain’ of the heart by intrathoracic neurons, as described by Dr Armour. Slow, rhythmical breathing forces your nervous system back into the green. This reconnects your frontal lobes, and you can again see, hear and think rationally.

Dr Watkins described studies of Tibetan monks who were well practiced in mindfulness meditation, such as the Mindfulness Based Cognitive Therapy (MBCT) course, approved by NICE. They could remain calm in the face of stress and outperform control subjects by an order of magnitude. He showed the following slide:

RED

YELLOW

GREEN

Angry
Frustrated
Anxious

ACTIVATION
Flight     /     Fight
Adrenaline / Nor-adrenaline

passion
enthusiasm
motivated

CATABOLIC STATE
Cortisol
Negative emotion

 

ANABOLIC STATE
DHEA oxytocin
positive emotion

Apathy
Inattention
Detached

RELAXATION
faint / play dead
acetylcholine

receptivity
interested



Dr Porges showed video clips of autistic children who gained almost full engagement after 5 short weekly sessions of music therapy. However, this was not sustained if the home environment did not support them. Sue Staziker, a yoga teacher, lead the conference in meditation, and gave us the experience of the calmness of the green state. Dr Steinberg described how she got a traumatised patient out of paralysis (red) using the power of touch.

Fay Alberti showed how physicians 3 centuries ago understood these heart/mind interactions better that doctors do today. She cited the case of a slandered woman who presented with chest pains, shaking limbs and heart palpitations. The verdict was ‘bad blood and bitterness trapped like poison.’ The remedy was emetic to make her vomit, laxative to clear her bowels, and light bleeding to relieve excess hot blood and rebalance mind and body.

Conclusion Emotions affect our ability to think rationally
It is no use reasoning with anyone (eg client, patient, colleague, partner) in the adrenaline yellow or red states, because they cannot understand you. They may not even be able to hear what you say because the muscles of their inner ear may be contracted. If they have been traumatised they may revert to the dissociated paralysed state (eg addicted, burnt out).

Heart Rate Variability (HRV) is a practical means of demonstrating this effect to patients, who can retrain themselves out of an emotional state into the green by monitoring their progress. The equipment costs about £150 and is available from Dr Watkins, alan@cardiac-coherence.com

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