porges - polyvagal - autism - hakomi conference presentation - brain behavior handout
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Talks about Polyvagal theory, autism, and viewing life though the lense of the ANSTRANSCRIPT
Social Behavior: An Emergent property of the
phylogeny of the autonomic nervoussystem
Stephen W. Porges, Ph.D.Brain-Body Center
University of Illinois at [email protected]
Acknowledgments! Special thanks to:
» Olga Bazhenova, Ph.D.» John Denver» Keri Heilman» Jane Sorokin» Elgiz Bal
! Funding provided by:» NIMH Grant MH-60625» NLMF Family Foundation» Unicorn Children’s Foundation» Cure Autism Now
Overview: The Polyvagal Theory• Evolution provides an organizing principle to understand
neural regulation of the human autonomic nervoussystem.
• Three neural circuits form a phylogenetically-orderedresponse hierarchy that regulate behavioral andphysiological adaptation to safe, dangerous, and lifethreatening environments.
• “Neuroception” of danger or safety or life threat triggerthese adaptive neural circuits.
• New models relating neural regulation to health, learning,and social behavior may be reversed- engineered intotreatments.
The metaphor of safety: A basic principleof our nervous system
Environmentoutside the bodyinside the body
Nervous System
Safety Danger
Neuroception
Spontaneously engages otherseye contact, facial expression, prosody supports visceral homeostasis
Defensive strategies fight/flight behaviors (mobilization)
Life threat
Defensive strategies death feigning/shutdown (immobilization)
Evolution
X-X+X+X-X+Mammals
X+X+X-X+Reptiles
X+X-X+Amphibians
X+X-X+Teleosts
X-X+Elasmobranchs
X+Cyclostomes
NAAD/mSNSDMXCHMNeural Regulation of the Heart in Vertebrates
Polyvagal Theory:Emergent “Emotion” Subsystems
VVC SNS DVCheart ratebronchigastrointestinalvasoconstrictionsweatadrenal medullatearsvocalizationfacial muscles
+ / -+ / -
+ / -+ / -+ / -
+ +
+ + +
-
- -+
eyelidsmiddle ear muscles
+ / -+ / -
Polyvagal Theory: PhylogeneticStages of Neural Control
Dorsal motornucleus of thevagus
Immobilization (deathfeigning, passiveavoidance)
Unmeyelinatedvagus(DVC – dorsal vagalcomplex)
I
Spinal cordMobilization (activeavoidance)
Sympathetic-adrenal system(SNS – sympatheticnervous system)
II
Nucleus ambiguusSocial communication,self-soothing andcalming, inhibitsympathetic-adrenalinfluences
Myelinated vagus(VVC – ventral vagalcomplex)
III
Lower motorneurons
Behavioral FunctionANS ComponentStage
VVC SNS DMX
Communication
Mobilization
Immobilization
+
+
+
FunctionStructure
Head
Limbs
Viscera
Polyvagal Theory: A PhylogeneticHierarchy of Response Strategies
Phylogenetic Organization ofthe ANS: The Polyvagal Theory
head
visceralimbs
trunk
Phylogenetic Organization ofthe ANS: The Polyvagal Theory
head
visceralimbs
trunk
“old” vagus
Vasovagal SyncopeVasovagal Syncope
Apnea/BradycardiaApnea/Bradycardia
Phylogenetic Organization ofthe ANS: The Polyvagal Theory
head
visceralimbs
trunk
Phylogenetic Organization ofthe ANS: The Polyvagal Theory
head
visceralimbs
trunk
Sympathetic NervousSystem
Corticospinal Pathways
Mobilization: Flight Behaviors
Mobilization: Fight Behaviors
Mobilization:Fight/Flight Behaviors
Phylogenetic Organization ofthe ANS: The Polyvagal Theory
head
visceralimbs
trunk
Phylogenetic Organization ofthe ANS: The Polyvagal Theory
head
visceralimbs
trunk
“new” vagusCorticobulbar pathways
© Jeff Hunter/ The Image Bank
Social Engagement
The “Smart” Vagus andSocial Engagement System
Cranial NervesV,VII,IX,X,XI
Muscles ofMastication
Middle EarMuscles
FacialMuscles
Larynx Heart
Head Turning
Bronchi
Pharynx
cortex
brainstem
environment
Social Engagement System:Emergent Behaviors at Birth
Social Engagement System:Self Regulation
RESP
HP
(ms)
1200
1100
1000
900
800
SECONDS
0 30 60 90 120
0.10 RSA
HPV
60 BPM
Heart Rate Rhythms: A measure of the “new” vagus
Looking and Listening: CommonNeurophysiological Mechanisms
Middle Ear Muscles: Role in Extracting Human Voice
Borg & Counter, 1989Scientific American
t
Social Engagement
Social Engagement and Otis Media?
The Face: A Critical Componentof a Social Engagement System
• At birth the mammalian nervous system needs a“caregiver” to survive and signals the caregiver viathe muscles of the face and head.
• At term the corticobulbar pathways that regulate thestriated muscles of the face are myelinated.
• The face is “hardwired” to the neural regulation ofvisceral state via a mammalian “neural circuit.”
• Metabolic demands, stress, trauma and illnessretract the “mammalian” neural circuit with theresultant symptoms of a face that does not work andsocial engagement behaviors are absent.
Fantz, 1963
The Social Human Infant
The Social Human Infant
Neonates can discriminate between directand averted eye gaze and look longer andmore frequently at faces with direct eyegaze
Farroni, Csibra, Simion, & Johnson (2002). Eyecontact detection n humans from birth. Proceedingsof the National Academy of Sciences, 99, 9602-9605.
My Child’s Face Does Not Work!
Gabriel Metzu, The Sick Child
When Other Faces Do Not Work!
Beauty is a journey that starts with a
choice… Learn about your
Choices
Beauty is a journey that starts with a
choice… Learn about your
Choices
When the nervous system fails use Botox!
Autism
People Need People:A Biological Basis for Social Behavior
Regulators of physiology are“embedded” in relationships
M. HoferNew York State Psychiatric Institute
How are the adaptive defensivesystems (flight, fight, and freeze),which are mediated by the amygdalaand other limbic structures, inhibitedto promote the positive spontaneoussocial behavior associated with theSocial Engagement System?
Amygdala (central nucleus)
NeuroceptionLife Threat
ventrolateral
Periaqueductal Gray
Inhibitory pathwaysExcitatory pathways
Freeze(pyramidal tracks)
Autonomic State(dorsal vagal regulation)
Amygdala (central nucleus)
NeuroceptionDanger
dorsolateral and lateral
Periaqueductal GrayRostral Caudal
Inhibitory pathwaysExcitatory pathways
Fight (pyramidal tracks)
Autonomic State(sympathetic)
Flight (pyramidal tracks)
The Trustworthiness of Faces
R. Adolphs, 2002
NeuroceptionSafe
FFA/STS
Amygdala (central nucleus)
Inhibitory pathwaysExcitatory pathways
Motor Cortex
Medulla (source nuclei V,VII,IX,X,XI)
Social Engagement System
Somatomotor(muscles of face & head)
Visceromotor(heart, bronchi)
Social Engagement System:Observable Deficits in Several Psychiatric and
Behavioral Disorders
• Prosody
• Gaze
• Facial expressivity
• Mood and affect
• Posture during social engagement
The Polyvagal Theory:Insights into the selection of outcome measures
Stephen W. Porges, Ph.D.Brain-Body Center
University of Illinois at [email protected]
Acknowledgments Special thanks to:
• Olga Bazhenova, Ph.D.• John Denver, Ph.D.• Keri Heilman, M.A.• Jane Sorokin, M.A.• Elgiz Bal
Funding provided by:• NIMH Grant MH-60625• NLMF Family Foundation• Unicorn Children’s Foundation• Cure Autism Now
Overview: The Polyvagal Theory• Evolution provides an organizing principle to understand
neural regulation of the human autonomic nervoussystem.
• Three neural circuits form a phylogenetically-orderedresponse hierarchy that regulate behavioral andphysiological adaptation to safe, dangerous, and lifethreatening environments.
• “Neuroception” of danger or safety or life threat triggerthese adaptive neural circuits.
• New models relating neural regulation to health, learning,and social behavior may be reversed- engineered intotreatments.
Polyvagal Theory:Risk Assessment
Environmentoutside the bodyinside the body
Nervous System
Safety Danger
Neuroception
Spontaneously engages otherseye contact, facial expression, prosody supports visceral homeostasis
Defensive strategies fight/flight behaviors (mobilization)
Life threat
Defensive strategies death feigning/shutdown (immobilization)
Social Engagement System Observable Deficits in Several Psychiatric and
Behavioral Disorders
• Prosody
• Gaze
• Facial expressivity
• Mood and affect
• Posture during social engagement
FXSA compromised social engagement system?
http://www.fragilex.org
Behavioral Features of FXS• Hyperarousal, distractible, impulsive• Hypoarousal• Difficulties in listening• Sensory defensiveness
• sound sensitivities• oral motor defensiveness• Tactile defensiveness/hypersensitivity
• Poor eye contact and difficulties in social communication• Speech-language delays (males)• Anxiety
• Hypervigilance• Affect regulation (e.g., tantrums)• Shyness
• Low cardiac vagal tonehttp://www.fragilex.org
Phylogenetic Organization ofthe ANS: The Polyvagal Theory
head
visceralimbs
trunk
“old” vagus
Vasovagal SyncopeVasovagal Syncope
Phylogenetic Organization ofthe ANS: The Polyvagal Theory
head
visceralimbs
trunk
Sympathetic NervousSystem
Corticospinal Pathways
Mobilization: Flight Behaviors
Mobilization: Fight Behaviors
Phylogenetic Organization ofthe ANS: The Polyvagal Theory
head
visceralimbs
trunk
“new” vagusCorticobulbar pathways
© Jeff Hunter/ The Image Bank
Social Engagement
VVC SNS DMX
Communication
Mobilization
Immobilization
+
+
+
FunctionStructure
Head
Limbs
Viscera
Polyvagal Theory: A PhylogeneticHierarchy of Response Strategies
Social Engagement System Observable Deficits in Several Psychiatric and
Behavioral Disorders
• Prosody
• Gaze
• Facial expressivity
• Mood and affect
• Posture during social engagement
Social Engagement SystemAnatomical basis
Cranial NervesV,VII,IX,X,XI
Muscles ofMastication
Middle EarMuscles
FacialMuscles
Larynx Heart
Head Turning
Bronchi
Pharynx
cortex
brainstem
environment
RESP
HP
(ms)
1200
1100
1000
900
800
SECONDS
0 30 60 90 120
0.10 RSA
HPV
60 BPM
Heart Rate Rhythms: An autonomic component of social engagement
My Child’s Face Does Not Work!
Gabriel Metzu, The Sick Child
Looking and ListeningCommon Neurophysiological Mechanisms
Middle Ear Muscles: Role in Extracting Human Voice
Borg & Counter, 1989Scientific American
t
How are the adaptive defensivesystems (flight, fight, and freeze),which are mediated by the amygdalaand other limbic structures, inhibitedto promote the positive spontaneoussocial behavior associated with theSocial Engagement System?
Amygdala (central nucleus)
NeuroceptionLife Threat
ventrolateral
Periaqueductal Gray
Inhibitory pathwaysExcitatory pathways
Freeze(pyramidal tracks)
Autonomic State(dorsal vagal regulation)
Amygdala (central nucleus)
NeuroceptionDanger
dorsolateral and lateral
Periaqueductal GrayRostral Caudal
Inhibitory pathwaysExcitatory pathways
Fight (pyramidal tracks)
Autonomic State(sympathetic)
Flight (pyramidal tracks)
The Trustworthiness of Faces
R. Adolphs, 2002
NeuroceptionSafe
FFA/STS
Amygdala (central nucleus)
Inhibitory pathwaysExcitatory pathways
Motor Cortex
Medulla (source nuclei V,VII,IX,X,XI)
Social Engagement System
Somatomotor(muscles of face & head)
Visceromotor(heart, bronchi)
Social Engagement System:Observable Deficits in Several Psychiatric and
Behavioral Disorders
• Prosody
• Gaze
• Facial expressivity
• Mood and affect
• Posture during social engagement
eye trackingGaze
acoustic properties ofvocalizations, language
Laryngeal/pharyngealmuscles
facial EMG, thermography,video coding of faces
Facial muscles
impedancewords from noise
Middle ear muscles
heart rate, vagal tone(RSA), respiration
Autonomic
ERP, EEG, EOP, fMRICortex
Social Engagement System Where to look? What to measure?
106COFF % EYE % MOUTH %
32.6 57.18 10.22
Control: 12 year old male
Eye 57%
111AOFF % EYE % MOUTH %
39.31 1.15 59.54
Before Intervention: Autism 10 year old male
Eye 1%
119BOFF % EYE % MOUTH %
26.15 71.38 2.47
After Intervention: Autism 10 year old male
Eye 71%
0102030405060708090
PrePost
Fixation Duration Percent
t(19) = -7.343, p <.0001
0
10
20
30
40
50
60
70
OFF EYE MOUTH
ControlPrePost
Fixation Duration Percent
Control/Pre F(1,38) = 39.005***, 69.207***, .219 nsControl/Post F(1,38) = 21.371***, 14.551***, .030 ns
0
2
4
6
8
10
12
SCAN FW SCAN CW
ControlPrePost
SCAN Test
Control/Pre F(1,39) = 187.272***, 27.400***Control/Post F(1,39) = 6.290**, 0.108 ns
Respiratory Sinus Arrhythmia(ln msec2)
3
4
5
6
7
8
Control/Pre F(1,38) = 16.067***Control/Post F(1,38) = 3.805 nsPre/Post F(1,38) = 16.427***
* Control * Pre * Post
What Needs to be Done?•New Populations: Apply the Listing Project interventions toindividuals with language delays and older and more severeautistic individuals
•Repeated interventions: Change protocol to evaluate theeffect of repeated interventions on the trajectory of individualsin existing treatment programs.
•Describe the autistic nervous system: Validate neuralmechanisms mediating vulnerabilities in social engagementand the behavioral changes following intervention (fMRI, NIRS,ANS, facial EMG & IR thermography)
•Expand intervention strategies: Incorporate visual stimuli totrigger multisensory neurons that facilitate language and socialcommunication.
Potential Applications of the Polyvagal Theoryin Psychiatry, Psychology, and Education
! Aspects of several physical and psychiatric diseases can beexplained as emergent properties of the neural regulation of theautonomic nervous system (feedback, evolution, development)
! New diagnostic methods and new treatments can emphasizemeasurement and manipulation of the neural regulation of theautonomic nervous system.
! Environments can be designed to support the functions of thenervous system with positive impact on social behavior andemotion regulation
– Computers that modulate neural regulation of the ANS– Quiet environments– Nervous system “friendly” classrooms– Improved social behavior: People need people – a biological basis
Summary• “Neuroception” of safety or danger mediates the
beneficial consequences of social behavior.• Autonomic reactions to challenges are organized in a
phylogenetically-determined hierarchy.• Various atypical behaviors are adaptive for short
periods.• Several psychopathologies are expressed as deficits
in the Social Engagement System.• Biologically-based behavioral interventions can
trigger neural circuits that mediate positive socialbehavior.