On Wednesday, November 12, we hosted Maria Kratsios, LCSW, and Founder & Chief Clinical Officer of Nest Behavioral Health, for a Pathway Session on trauma. Maria is a well-respected psychologist, educator and speaker who is passionate about healing trauma using a holistic, polyvagal theory-based treatment approach.
Maria set the stage for the Zoom session by first describing her own personal journey, which took her from a successful career as a Wall Street investment banker to a critical stage in her life following the birth of her first child. She also alluded to her own family of origin history, and which included developmental trauma. After the birth, she decided she could never return to the banking and finance world. Instead, Maria went to grad school, attained a Master’s in Clinical Social Work, and has dedicated her second career to helping others heal from trauma.
Maria gave us a primer on polygagal theory, which is a way to describe our nervous system and its automatic responses. Specifically, the vagus nerve, which runs from the brain down into many other organs, scans the environment for cues of safety and danger. Our bodies respond in a fight-flight-freeze way at times, based on the perceived danger. According to the theory, our nervous system has three main response states. By degree of perceived risk, they are:
- Dorsal vagal state – the most protective state, triggered by feelings of hopelessness, helplessness, or being trapped. In this state, our body shuts down, or “freezes”. In Polyvagal Theory, this is called ‘immobilization.’
- Sympathetic state – the second most protective state, triggered by perceived danger or challenge. This state activates the fight-or-flight response, increasing heart rate, blood pressure, and muscle tension and is activated when we’re in a dangerous or threatening situation. Termed ‘mobilization’ in Polyvagal Theory, this utilizes the “sympathetic” nervous systems in our bodies.
- Ventral vagal state – the optimal state for health and well-being, characterized by feeling safe, connecting, resting, and social engagement. There are many ways of stimulating the vagus nerve to get into this state, such as walking, yoga, meditation, nutrition, laughter, singing, massage, dancing, and cold water face immersion.
Maria discussed what happens when people experience developmental trauma from experiences in their families of origin. These individuals, like all of us, are hardwired towards connection and protection, yet can’t get it from their own family members. The vagus nervous system is trying to self-regulate, but is conflicted because the love, acceptance, and feelings of safety just aren’t there for them. These individuals are trapped within their families, and swing from the sympathetic “fight-flight” state and dorsal “freeze” states.
This developmental trauma leads to chronic disrepair and disregulation of the vagus nerve. With Maria’s NEST practice (started about 4 years ago), the first step is to do a holistic assessment of the individual’s nervous system. Maria does the evaluations herself, and then recommends specific treatment methods. EMDR, DBT, somatic experiencing, CPT, Internal Family Systems Therapy, and Psychodrama are some of the approaches which others on the NEST team specialize in.
For many individuals that have experienced trauma, drugs become a solution. Drugs do have the effect of shifting the state of the nervous system when disregulated, they just shift it in a different direction. For instance, if the disregulation is towards an agitated state, drugs like alcohol and opioids can be calming temporarily. Unfortunately, this shift does NOT lead towards regulation.
Maria will accepts patients with substance use disorder, and partners with experts like recovery coaches. She finds that the majority benefit from EMDR, especially when following the 8 phases of this therapy approach. For some, the bilateral stimulation alone can stabilize the nervous system, but a more comprehensive EMDR treatment approach is preferred.
Maria recommends Deb Dana‘s books and approaches as invaluable, because she is an expert on how to apply polyvagal theory in practice. Just click here for one of Deb’s latest books and click here for her Polyvagal Card Deck.
The participant feedback from this Trauma Pathway was uniformly positive, given Maria’s “story”, her insights, and all the questions she addressed during the Q&A segment. To view the YouTube replay of the Zoom Session, just CLICK HERE.