Loss of Agency
According to Bessel van der Kolk, author of the tremendous The Body Keeps the Score, we have two distinct forms of self-awareness: our autobiographical self that assembles our experiences into a coherent narrative thru language and our moment-to-moment self (primarily in the medial prefrontal cortex – MPFC) that is based in the physical realm and is more difficult to describe. It is the MPFC that has robust connections to the emotional limbic brain (amygdala, insula) and gives us the feeling of agency — that we are in charge of our own life.
With trauma or any sufficient stress to an individual [though not necessarily something that would be traumatic or stressful to someone else because n=1 baby], the medial prefrontal cortex (MPFC) begins to show reduced activity while the limbic brain is amplified. An imbalance between the rational brain and the emotional brain drives rigid, reflexive behaviors and a loss of self-awareness. The emotional brain is running the show, seemingly without our control. This is often why people under chronic duress/pain are unable to even accurately describe their symptoms because they don’t have access to them. Many of my chronic pain clients feel as if they are not in control of their lives, bouncing from symptom to symptom and physician to physician. It’s my opinion, and research is backing this, that so many people are hypervigilant, rigid, and unaware of how they’re moving thru and perceiving the world.
If you aren’t aware of something, can you really change it?
Awareness and Change
“Knowing what we feel is the first step to knowing why we feel that way”
Bessel van der Kolk
The ability to know what you know and feel what you feel without collapsing into a reactive, rigid caricature is the essence of self-regulation and, ultimately it’s what the great movement and behavioral therapists teach their clients. Helping a client to understand why they feel that way (and I do NOT mean pathoanatomic labeling) is a crucial step in establishing a recognition of behavior that is otherwise inaccessible. Opening the window of tolerance to threats and stressors from a place of consistency and security starts with awareness which accesses the MPFC and allows us to monitor our internal state. The MPFC helps to control and balance the limbic brain as if a rider on a horse – the horse is still very much alive but you’re in control of it.
Now just because we understand the “why” doesn’t automatically change the “how” . But it’s the first step. Triplanar movement and training capacity (especially aerobic), rhythms and breathing, making better predictions, and integrating perceptions all help change the “how”. And that’s what we’re doing in treatment and training – restoring and reinforcing a robust sense of self thru awareness and behavior modification.