How long does it take to heal a dysregulated nervous system?

How long is it going to take? This is a question that I get so often these days. People want a number for how long is it going to take to heal my dysregulated nervous system. Six months, two years, ten years, something they can plan around. Welcome to this episode of the Biology of Trauma Podcast. I'm your host, Dr. Amy. We are going to be looking at how do you measure that a dysregulated nervous system is healing? What are the factors that influence how long it takes? Because it is not the same answer for everyone. There are specific influences that go into how long you're looking at it, taking to shift your nervous system to a more regulated state. I will even share with you a way to measure the patterns of unresolved trauma in this episode. So be sure and listen for that. Let's jump in. What does it mean to heal a dysregulated nervous system? Well, healing is the process of change towards health. And so healing a dysregulated nervous system looks like the movement towards a more regulated nervous system. What does that mean? More regulated nervous system does not mean it is always calm, it's the new version of a flat line and always feeling safe and in parasympathetic. That is not regulation. Regulation is the health of the nervous system to be able to go in and out of the states as it was designed to do. And so healing means a healthy nervous system, a healthy nervous system. Is designed to help us grow, help us expand, help us become more embodied, help us be more present, and move towards health, emotional health, mental health, and physical health. So then we really need to answer the question, well, what is dysregulation? If we're going to try to heal it, what is it? Disregulation is a feature of the nervous system, it's a pattern of the nervous system, of how it responds to change. Let me break that down for a second, the nervous system of this body that's an amazing machine for us. The nervous system, more than any other system, is designed to keep us alive. And so it is designed to be so attuned to anything and everything that changes in our environment because then it needs to change something internally to be able to survive that change in our environment. Let me give you an example. You walk outside on a hot day pretty quickly. Your pores start to open and you start sweating to cool you down. That was your nervous system responding to a change in your environment to help you survive. For us, this happens so subconsciously that we don't even realize all the ways in which our nervous system is adapting to our environment every single second because it's not just responding to our external environment. It's responding to the changes in our internal environment. When did I last eat? What are my blood sugar levels? What is my blood pressure? What are the sodium, potassium, and chloride levels in my blood? It's responding to all of that because it has to. That's how it keeps us alive. And so we can look at how it responds to change. And we can put it into three categories. Does it respond as it should or does it overreact or does it underreact? Just with that, I'm sure that you can think of people in your life that you have seen and seen how they react to change. For example, you're in a building and a fire alarm goes off and you will see some people overreact. You will see some people react at the amount that is appropriate for this situation. And then you will see some people underreact and they just sit there. And so that is exactly what's happening with our nervous system. And so we look at the pattern of how it reacts to change in our life. And the change can happen emotionally. The change can happen physiologically. The change can happen energetically, psychologically. It can happen based on what someone says to us. That's a change in my environment. And everything that changes in my environment, my nervous system is going to react to that change. How does it react? Does it overreact? Does it underreact? Those would be called dysregulation. And so coming back to then, how are we defining is your dysregulated nervous system healing? It's, are you noticing how you react to change as becoming more healthy? We're not going to call the others bad because there is no bad reaction. There's helpful and not helpful. But we want to see that movement towards health. My nervous system is flexible. It's adaptable. It's able to move into stress. It's able to come out of stress. It's able to do all of the states that it needs to do when it is supposed to do them for my best health. And that's the key. A dysregulated nervous system will always lead to disease. A dysregulated nervous system can never create health. A regulated nervous system is what promotes health. And that is why for those with chronic illness, whether or not they have a diagnosis, just a chronic health issue that they struggle with, part of what they will want to do is the nervous system work. Because while their nervous system is in a dysregulated state, it will only promote more of the same illness because that's all that dysregulation can do. Disregulation can never promote health. We will come back to that later. But now that we understand what dysregulation is, now we can really understand that dysregulation never exists in isolation. Disregulation is a pattern of the nervous system stuck in danger mode. Meaning it sees danger even when there's not actually danger. But it sees danger as if it were real. And so we call that unresolved or stored trauma in the nervous system that it creates this ongoing survival response and states that then creates patterns. Let me walk you through this in more detail. I want to walk you through how the survival states operate in the body. And then that will explain where dysregulation comes from. Because then that will explain what all goes into healing a dysregulated nervous system that you can start to see how long is this going to take me. The five steps of the body's trauma response start with a startle. And the idea is that a startle is one where the body, the nervous system, senses a danger. And so looking at the body's trauma response, it senses a potential danger. And it has several seconds of research and science say about 15 seconds for the nervous system to assess the situation, collect more data and say, this is a real stress or no, it's not. And so as we look at what happens next, we see that it goes from there into a stress response. A stress response is the high energy survival state where I am going to be taking action because I can see that action can be taken. But the moment that my nervous system assesses the situation and says, actually, there's no longer a chance that doing anything else will make a difference. And so I'm powerless. There's nothing I can do that can make a difference. I'm trapped in this situation can't escape and I feel all alone. That's your trifecta for creating the freeze response, which is the initial shock of I can't believe this is happening. And then that is unsustainable in our physiology. and so it continues all the way down. into the second actual step of the bodies trauma response, the shutdown step. And if we know how to resolve that, then our body is able to return back to a sense of safety, and nothing gets stuck in the nervous system, meaning the nervous system doesn't get stuck in this body trauma loop that always keeps it in a survival state. But since we are not taught and most of us don't implicitly know how to actually process and resolve and experience where we have gone into freeze and shutdown, then what the nervous system does is it stays in that sense of danger where even though I logically know that that situation is over, it could happen again. And so I need to stay on guard. I'm not actually safe even though it's not happening right now. And because I need to stay on guard, then that is why my nervous system loops between the two survival states, which are the stress response and the trauma response. Very rarely is it able to ever actually land in a true sense of safety or what we would call ventral parasympathetic, because if the danger might happen again, it's not safe for me to relax, it's not safe for me to let my guard down. And so here's where disregulation comes into play. When my nervous system gets stuck in this body trauma loop, that is how we can recognize the patterns that come out of an unresolved trauma that is creating this body trauma loop. And to understand the patterns, we need to understand what are the survival strategies of that trauma response, because those survival strategies create the patterns and will create the pattern of disregulation. So let me show you that. In the trauma response, because doing something is no longer an option. And I need to surrender and shut down in order to survive. I need to people please, maybe fawn. I need to disconnect from myself in order to survive this. Then those are the survival strategies. One of the survival strategies is to dissociate. And dissociation is not always a leaving of your body, though some people experience that. It is the disconnection between my reality. It's the disconnection between what I really would want to do, because I can't do it. And so it's a disconnection between ourselves and a disconnection between our reality. And so that dissociation becomes one of the patterns of unresolved trauma. It's called the pattern of disconnection. But how also are we going to survive a trauma response? It's not only the dissociation, but it is the immobilization. We see that in the freeze response. And the freeze response is designed to be able to put on the brakes when it's no longer helpful. And we might die if we try to keep running, fighting, fleeing, whatever our strategy was in the stress response. So the freeze is the ultimate survival strategy. And the strategy is to immobilize, to put on the brakes. And by the brakes, I mean all of the brakes. That is what a immobilization freeze response is. And so as that becomes our survival strategy in the moment, because our body is going to move into this body trauma loop, that becomes a chronic pattern that we can measure to assess healing and the change in that pattern over time. Do I still see and feel myself stuck in different areas of my life and my health perhaps? I keep repeating the same behaviors. I keep doing the same things, even though I don't want to. That is immobilization that has turned chronic. So we've covered dissociation. We've covered immobilization. And now we're going to cover the energy conservation. Energy conservation is the idea that I am going to dim down my metabolism so that I can not be seen, not be heard, not be felt. If I am still panting, because I'm fighting or I'm running away, well, then the bear, the monster, whatever it is, that is the danger. Well, hear me. If I'm still warm, they might feel my presence. And so energy conservation is happening at the cellular and the system level. So thyroid helps out, might it. Condria helps out to dim down our metabolism. And we will feel that as an energy conservation. That energy conservation becomes the pattern of depletion, chronically. In the moment, it's an immediate energy conservation. And so here you have already three patterns of what become the chronic patterns of how to recognize stored trauma in the body. We have the dissociation that becomes disconnection. We have the immobilization that becomes the stuckness or disruption of forward movement. And then we have the energy conservation that becomes a pattern of depletion. I always feel low in energy. When you have those things, if you are energy depleted, if your tank is low, if you feel stuck, maybe even powerless and trapped and hopeless in certain aspects, if you feel disconnected from yourself, from reality, from your life, from others, perhaps, of course, your nervous system is going to have a disregulated response. A regulated response would come when we feel resource, when we feel like we have the energy to respond to a new problem in our life. But when we are already in a state of depletion, one new problem is too much. And so these patterns contribute to the development of a disregulated nervous system. So that is why I say disregulation never happens in isolation. Which means that we can use these other patterns as a way to measure change. We don't have to just look at disregulation and how is my nervous system reacting to change? Is it overreacting? Is it underreacting? We can also look at what is my sense of connection? What is my sense of forward movement in my life? What is my sense of energy versus my sense of depletion? Because those are feeding the disregulated responses. And so disregulation is the natural byproduct of being disconnected, feeling stuck and powerless and trapped, and feeling like you have little energy to put into new problems. Of course, your nervous system is going to be disregulated and is going to be like, wow, what do I do with this? Do I overreact because I really get triggered with this idea of change? Or do I underreact because I just, I can't care, I don't have the energy to care. And so we're not wanting to just focus on the disregulation, but we're wanting to focus on what creates the disregulation because then that's how the disregulation will shift. And so the disregulation is the fourth pattern of stored or unresolved trauma. There is a fifth pattern. And this is all covered in chapters 9 and 10 of my book The Biology of Trauma. And so in chapter 9, I cover the, the four patterns of the stored trauma. In chapter 10 is where I cover this fifth pattern, which is the pattern of disease. And so chapter 10 is when trauma becomes disease, the fifth pattern of stored trauma. I started with a quote from Dr. Vincent Filedi that says, reflecting on the, what his patients told him, what you think is the problem has been the solution to the problem. And that's how I want you to view disregulation. It has been the solution to these chronic patterns of stored trauma. We see it as the problem by itself. It has been the solution. to those challenges of this stored trauma. And so is disease. And so now think of a body that has had a nervous system that under reacts, over reacts, anything but responds to change in a healthy, flexible, adaptable way where I can stay in body, I can stay present, not disconnect. That body is going to adapt over time to develop the diseases of dysregulation. And what are the diseases of dysregulation? All of the diseases that have been associated with the adverse childhood experiences would be diseases of dysregulation. They are, the equation really is, dysregulation times time equals disease. You cannot have dysregulation in a physical body and not have it create disease 'cause the disease is the adaptation to the dysregulation. Like the quote of Dr. Vincent Fletti's patients, what you think is the problem, we think the auto-muty, we think that the digestive issues, we think that the skin issues, we think that the hormone issues are the problem. What if they are actually the decades of adapting to living with a dysregulated nervous system that over reacts or under reacts but is always sensing danger. It's never able to actually be in safety mode which is where the healing and the repair happen. So let's now come back to this question of, how would we know how long it's going to take to heal my dysregulated nervous system? Well, let me share with you some principles. One of the principles is you can measure the degree of dysregulation and the time by how much it has affected your biology. And so if you wanna think of it as a sequence, you have these first three patterns of stored trauma, the disconnection, the disruption and then the depletion. Those over time create a nervous system that is dysregulated. And that dysregulation over time creates the disease. And so if you have a chronic health issue, then that means that the body has adapted to that dysregulation more than if it has not developed disease yet. And so as I actually started trauma work and working with adopted and fostered children, I found it easier to work with their nervous systems and I was specifically working with children who had severe trust issues. And I could help shift their nervous system and help create a very different trusting, healthy relationship with their new parents, adopted parents, foster parents. Much faster than if I'm working with an adult, especially an adult who has a chronic health illness. Why? Because of the time factor. The longer that the nervous system has lived this way, the slower that change has to go in order for the nervous system to integrate that change over time. A child has not had enough as much years in that dysregulation. Even though their dysregulation can be severe and those were the kids that I was working with, I was working with the severe dysregulation in children. And it was faster to create the environments that they needed in order to make that shift because it was not decades that had also then compounded the adaptations of their biology to that dysregulation. I think it's fascinating that we can look at how long the biology really takes to manifest in disease from when the dysregulation started and how childhood adversity, childhood trauma, childhood toxic stress creates adult onset disease. We're talking about decades of adaptations happening underneath the surface. It's not like it's not happening then one day poof comes out of nowhere. It's been happening all along. It just can take that long for it to actually surface into symptoms and then the symptoms need to be noticed and then the symptoms need to be addressed and then it finally takes a while for those to develop into a condition or an illness and then that takes time to develop into a diagnosis. And so if a person is already at the stage of diagnosis, that is a long time of the nervous system living this way, which means that this way now fuels the safest way. And so the change has to be slower. I liken this to what we do in medicine. I had a patient who had to be admitted into the ICU because their sodium was so low. She came in, she seemed a little off. I did labs, her sodium was 121. I was a resident at the time. I had never seen a level that low. I call my senior resident, he's like, at that level, you're admitting her because she's going to the ICU. That's not just a leader of fluids, like she's going into the ICU. So we bring her to ICU and I get to have this experience of how do I get her sodium levels back up to normal. The longer time that she had been at that low level, the slower I had to go because a big change is dangerous to the nervous system. It can't integrate that. It can't process that. It can't make sure that it's making all the other adaptations to the systems, to the kidney, to the adrenal glands, to the heart. It has to adjust everything, everything real lines itself with a change like sodium levels. And so you can't go fast. You'll actually cause big swelling in their brain and create other problems if you go too fast, if you correct a low sodium too fast. You take that principle and apply it to storage vomit in the body and you realize that the longer it has been there, the more that the nervous system will need pacing to create that change and to have it feel safe. How do we accelerate that process? Ah, this is what gets me excited. This is where we will end this episode for today. The things that we can do to accelerate the healing of a disregulated nervous system. The integration of all the layers that the nervous system needs to have change feel safe. So we need to be working on parts levels. We need to be working on somatic memory levels. We need to be working at biology level. And that is what I would most want to leave with you from this episode. The biology piece is the most neglected piece in the nervous system disregulation repair. And yet your biology is what's really creating the ceiling effect for how fast you can create that change in that healing and have it feel safe enough because what if your nervous system is still in a state of energy conservation and it's going to say all change is just too much for us right now, that will create your seeing an effect. And so we may need to early on bring in mitochondria support. Magnesium is a common one that when we start supplementing with magnesium, people experience greater shifts in their therapy sessions because their nervous system is more resourced, which means change feels safer. Without the magnesium, it's going to say, hey, I'd love to integrate this therapy session for you, but I really don't have the energy to do that. And so great session, great job. And then we're going to go back to doing what we've always done because that's what I know to do. And that's what takes the least amount of energy to keep you alive. And that is what our nervous system is doing for us, my friends, I promised you a way to measure the patterns of unresolved trauma. And so I have put together an assessment, this is a short assessment, too many an assessment, I use a much longer assessment for those that I work with, but this is a way for you to quickly measure what degree of unresolved sword trauma might be showing up in my life and my relationships and my body that I can recognize, disregulation, as well as these other patterns. So that can be found at biologyautoma.com/quiz and I will have that link. the show notes for you as well. And what I really want to leave with you is the hope that I don't care how old you are. Repair can always happen. I have worked with people in their 70s, 80s, 90s as long as you are still alive. Your nervous system is still helping you stay alive and we can work with that nervous system. So don't give up. It is possible you are worth it. And thank you for joining me for this episode. I'm your host Dr. Eng and you can find more resources in the show notes. Lots of love.