When Dear Abby Is Not Enough


Welcome to PsychTalk for Spencer Psychology! We are so glad you are here. Like so many other clinicians in the community, we are concerned about the lack of access many have to good mental health care. We are all reading about the radical increase in anxiety and depression in college students, and we are all seeing increases in our caseloads for clients of all ages. Some of this is because mental health care is no longer stigmatized in the way it was for our parents’ generation, and people feel more comfortable seeking help. Which is great. However, some of it is also due to the increasingly complex world we all live in.

It’s stressful out there.

We decided to start a blog in an effort to help you sort through what works, and what doesn’t, and to answer some questions along the way. We’ll provide information and research on the latest in mental health, and give you self-help suggestions that we have tried ourselves.

Spencer Psychology specializes in trauma and stress (though we’ve seen about everything else over the years too). Treatment techniques have evolved over recent years, and there are some really excellent ways to help people get well faster and more completely than before. Trauma treatment has always included the cognitive realm, with Cognitive Behavioral Therapy (CBT) strategies and CBT even has a subspecialty specifically for “trauma focused” (TF-CBT). This is where most clinicians were trained. However, as we are learning more about trauma and stress, we are also learning that the body is intimately involved as well. Polyvagal theory can easily be incorporated into traditional CBT treatment, and polyvagal theory provides some understanding of the nervous system response for new modalities like EMDR (Eye Movement Desensitization Reprocessing) and Somatic Experiencing.

Polyvagal Theory: Gut-Punched and Broken-Hearted

Vagus nerve shown in yellow

You know when you feel gut-punched, or broken hearted, or have a lump in your throat when something bad happens? Your body is responding to the distress. We have a bundle of nerves that connects the limbic center of the brain with the center of our bodies into our internal organs. These nerves are collectively called the vagus nerve. When our bodies detect a threat to our physical or emotional well-being, this nerve activates and sends messages throughout our body to fight or flee. When the system is overwhelmed, it will then freeze. It is part of our biological survival system, and is useful when there is an actual threat.

However, in the modern world, there just aren’t that many bears trying to eat us.

Instead we have threats from job loss, or difficult colleagues, financial stress, or marital struggles. Our nervous system may respond in the same way to these emotional threats as it does to a physical one. And sometimes, we have significant unresolved traumatic events in our past. This can create a constant low-level activation of your vagus nerve, where it’s always “on” a little. Sometimes long-term anxiety or depression issues are related to this. And for some people, the vagus nerve is activated a whole lot by a past event, and you can get trauma diagnoses, like PTSD.

A great book on the topic is: The Body Keeps the Score by Bessel van der Kolk (it’s meaty, but worth the effort).

What many people don’t realize is that they don’t have to live with this chronic activation. For clinicians who are trained in trauma and stress responses, treatment now involves resolving these current and past traumas and stressors, so that the nervous system is able to finally relax. And we could all use a little more of that.