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How Therapy Uses Object Relations To Quell Anxiety

Most therapies produce similar results. Maybe the common factor is relationship.

Research by Stephen Porges offers a way to understand how therapy can enhance a client's ability to self-regulate. Years ago, Porges was doing research on sinus arrhythmia: when we breathe in, the heart accelerates to transport the newly oxygenated blood. When the oxygen in the lungs has been depleted, we breathe out. The heart - with less work to do - slows down.

Porges ran into a problem. The heart changes its rate - accelerating and decelerating - quickly. He needed a way to measure the heart rate instantaneously. When he found a way to do so, he was surprised to find that the heart rate of his subjects reacted to other people present. It was understandable that the heart rate would increase when a stranger approached? But, why was the heart slowing - in some cases and not others - when others engaged the subject.

This opened up a new area of inquiry that led to what Porges now calls the Social Engagement System. When we encounter a new person, the amygdala releases stress hormones which triggers the fight or flight response. Why, then, do we not simply start a fight or run away? The fight or flight response is countered by unconscious processes. According to Porges, we unconsciously emit signals that show our intent. These signals are received and decoded unconsciously, If they indicate the person can be trusted, a signal is sent to the vagus nerve which overrides the effects of stress hormones and slows the heart rate. Porges calls this action the "vagal brake." In addition, signals unconsciously activate the parasympathetic nervous system which causes gut level calming to take place.

In the relationship between mother and child, when the child is stressed, the empathically attuned mothers' face calms the child. When this is consistently repeated, a link is established in the child's mind between the stressor and the mother's calming presence. In time, the child is calmed by the mother's psychological presence when she is not physically present. Porges's discovery appears to be the neurological basis for Object Relations. Here is an oversimplified explanation of how Object Relations may work neurologically.

Imagine two little kids. One has a unitary mom; there is only one version of her. When the child becomes upset, the mother tunes in. She merges with the child in a way that allows her to resonate with what the child is feeling. The child senses that she is sharing his experience; he is not alone. Then, shifting from oneness, she demonstrates her separate personhood. She interprets the experience; she may give it a name. She assures the child that there is light at the end of the tunnel: he is going to be OK in a couple of minutes.

The other child has a mom who presents herself in five different ways. She occasionally does what the first mom does. More often, though, she is not responsive. When overwhelmed, she lashes out at his need for her attention. When his crying bothers her, she tells him to stop crying or she will give the kid something to cry about. Sometimes, he actually gets hit.

The first child builds (in his mind) a sort of internal video of his mother's consistent response calming him, reassuring him, and giving him confidence. The second child has five different versions of his mom, and thus he has five different internal videos.

When it is time for kindergarten, the first child, if upset in kindergarten, can push the "play" button and replay a reassuring video in his imagination. The replay calms him even though his mother is not present. That's great. Having internalized the mother's consistent response, he has an ability to "self-regulate."

But when the second kid gets upset, if he pushes the "play" button, it is like Russian Roulette. He has only one chance in five of playing a video that will allow the kid to calm down, and four chances in five of feeling worse. This insecurity translates into insecure attachment.

The first child has learned that though he and his mother are individuals, they are psychologically connected. Since he has his mother's responsiveness built inside, imagine him saying, "Hey mom, if I have a meltdown at kindergarten, I'll just think of you and I'll be fine." The second child might say, "Look mom, if I have a problem at kindergarten, since I don't have you built inside me, you have to come to kindergarten and sit beside me." It is a question of psychologically inside or physically beside. The first carries his mother along psychologically. The second cannot; he continues to need her present physically.

As an adult, the second kid goes to therapy. When uncomfortable feelings arise, the therapist is attuned. He senses he is not alone. Though she is a separate person, the therapist bridges the gap of separateness and senses his distress. Sharing with his feelings, she demonstrates the mutually felt distress is bearable. She may provide a name the feeling. Her consistent emotional availability calms him. Mentally, a link is formed between the emotional challenge and her calming relatedness. This link provides automatic and unconscious regulation for that specific emotional challenge.

To regulate anxiety when flying, I teach clients to link each moment of flight to the memory of an empathically attuned face. This is done prior to flight. Then, as the flight takes place, links between each moment of flight and a calming face provide protection against anxiety.

At times, the Social Engagement System completely shuts down the fear system for reproductive purposes. To provide even more effective protection, we establish a second set of links that have a reproducdtive or romantic nature. When the signals between two lovers are just right, oxytocin is produced. Oxytocin inhibits the amygdala and prevents it from releasing the stress hormones associated with fear and anxiety. Again, the signals are sent, received, and processed unconsciously.

In the fight or flight response, if the urge to flee were not somehow regulated, we would simply run away whenever the amygdala released stress hormones. We would not be able to work together in a cooperate way. If the urge to fight were not to some degree regulated, humans would harm each other into extinction. Though the primitive fight or flight response remains in us, nature has found a way for fight or flight urges to be muted through unconscious signals. How well that muting works varies from person to person, possibly due to genetic differences, but mainly, according to neuropsychologist Allan Schore, due to differences in early relational experience.

 

 

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