My name is Gabriel Kram, and I’m the Convener of the Restorative Practices Alliance, the Co-Founder of the Academy of Applied Social Medicine, and the Founder and CEO of Applied Mindfulness, Inc. I’ve done doctoral-level work in 6 disciplines related to wellbeing because that’s what I needed to do in order to heal myself. Because we have 40 advisors in our organization spread across 20 disciplines of wellbeing, and because we are regularly conversing with thousands of wellness providers across a variety of medical and mental health domains, I’m going to start by observing some patterns that inform the premise of this class, and then I’m going to make several assertions. If either the patterns or the assertions are incorrect, you are welcome to stop reading. But if they are not, I invite you to attend closely, because this may change the way that you practice. My first observation comes from the past ten years of our consulting work, where we served first many patients in medical and mental health, delivering trauma-informed applied mindfulness interventions, and then tens of thousands of providers as we migrated our work upstream seeking to magnify our impacts by training and supporting caregivers.
Observation #1: Most modern people are stressed out.
Medical literature (and our research) suggest that between 60 and 80% of visits to primary care physicians are stress-related . A 2018 study by the American Psychological Association suggests that in any given month, 80% of American adults have experienced a major stressor. Dr. Vincent Felitti demonstrated, in his seminal Adverse Childhood Experiences study, the largest epidemiological study of trauma ever done, that 80% of American adults have experienced some form of Adverse Childhood Experience. While I’m writing this, my office window is closed because where I live in Northern California we are experiencing, for the third year in a row, intense wildfires that have made the air unsafe to breath outdoors, somewhat ironic because the pandemic has made it unsafe to gather indoors. The proximate cause of these fires was a series of a-typical thunderstorms that dispelled a heatwave, but which caused lightning strikes that ignited 560 fires in three days (the previous year’s fires were caused by the power company: man-made electricity or nature-made electricity, go figure). The distal cause is climate change, caused by a civilization that has an unsustainable relationship with the living world, and forestry management practices that failed to utilize indigenous ecological knowledge, and so led to 100 years of accumulated deadwood, as well as mis-guided forest growth. These wildfires are happening on top of a climate in the Bay Area that has, like much of the United States, been deeply impacted by the police killings of George Floyd, Brianna Taylor, Rayshard Brooks, and many other Black Americans, leading to a level of social unrest, which leaves people seriously fearing (or desiring) massive social disruption. That takes place against the backdrop of a global pandemic, which has had, and is having massive impacts both on health and economies. Distillation: there are threat cues all around us. People have a variety of things to be legitimately stressed out about. The times are uncertain. Something in the very fabric of our modern world has gone deeply wrong.
Assertion #1: This stress is showing up as increased acuity in your patients
My assertion, now, is that as a wellness provider, you are noticing that due to all of these factors, the acuity of your patient’s/client’s distress is increasing. My further assumption is that because your job is to help people, and you care about people who are in distress, this increased acuity for patients translates not only into increased intensity, difficulty, and responsibility for you, but that in addition to the possibility of you yourself having possible concerns in common with your patients, puts you at increased risk for vicarious trauma, burnout, or at the least finding this moment stressful and challenging for yourself. Like I said, stop reading when you disagree.
Returning to the large context, I would propose to you that what has gone wrong is very deep, and quite simple. For 99.9% of human evolutionary history, our entire project of culture was centered around connection. I would propose to you, as connection phenomenologist and deep nature connection expert Jon Young does, that culture’s job is to connect us to three things: ourselves, one another, and the living world. Jon goes further to say that you can’t call our modern living experiment a culture, because it actually excels in disconnection. Jon points out that when we feel connected to something, have a relationship with it. What we have a relationship with, we value. When we value something, we take care of it. When we don’t, we don’t. This applies to ourselves, one another, and the living world. Modernity is, by design, a disconnection engine.
I invite you to pause for a moment here and to think about some of the things that you are connected to. One of the beautiful things about connection is that we can be connected to so many things. Think about people you are, or have been, connected to, from childhood on. Think about places, from childhood on. Think about times in your life when you’ve felt most connected to yourself. Consider non-human creatures you feel or have felt connected to: maybe a pet, or a tree, or a bird. What about hobbies? Do you feel connected to any hobbies? How about your ancestors? What about forests, or beaches, or mountains? Perhaps you feel connected to a discipline or an art form? A spiritual lineage…your garden? An instrument? An author whose work you admire? Your morning tea or coffee? A meditation practice? A type of cuisine? A particular workout? And then, as you reflect on things you feel connected to, I would invite you to take a moment to feel into your body, to notice your breath, and to notice how it feels inside you when you pause to dwell on your connections. Perhaps just pick one, and hold it in your mind’s eye, considering and reflecting on its many facets. If you feel inspired to do so, make a list here of some of the felt qualities you notice arising in your body-mind:
A LIST OF QUALITIES THAT ARISE WHEN YOU FEEL INTO CONNECTION
Good. I hope that, at the simplest level, that felt good.
Now I would propose to you that, for many people, the arrival of the pandemic occasioned a sudden connection famine. People stopped receiving a nutrient that many of us didn’t realize we were getting, because it was contextually so embedded in our day-to-day, like air, like water, that we were taking it for granted. Each micro-moment of connection during the day, were we to apply a neurophysiogical lens to this, is a moment when your ventral vagal system activates. Every time this happens your deep neural platform shifts, and when that happens your filter changes. Your deep neural platform, and I’m speaking Polyvagally now, referencing the seminal work of Dr. Stephen Porges, our advisor and the Honorary Chair of our Neurophysiology faculty, shapes five facets of your experience. Operating in the depths of your Autonomic Physiology (your automatic brain), it shapes:
Neural platform is like a set of glasses that filter your reality, a set of glasses that you can’t take off, that literally shape what you feel in your body, what you notice around you, and how you interpret it. Many of us, through micro-moments of social interaction– a quick nod to someone in line at the store, an acknowledged courtesy, a handshake, a hug, a fist bump, were receiving a staccato pulse of connection nutrient that suddenly dried up and went away. For the first couple of months perhaps we didn’t notice. In isolation, we aren’t receiving that connection nutrient–especially when we are all wearing masks, and can’t see one another’s faces, where social cues are largely expressed. This deprivation is magnified for people who live alone. At a certain point–now five months in, many people have experienced a profound baseline shift. They will say things like, “I don’t feel like myself.”
To bring this home in a very practical way, the stress response always just happens, while the relaxation response needs to be cultivated. This is always true. Ancestral culture did the job of bringing us back into regulation as a matter of course, because the way we lived prioritized connection. Modern culture has deviated from this baseline, acceleratingly. In the absence of connection, the stress physiology progresses, unattenuated and self-reinforcing. People don’t feel like themselves, because if we have some elements of mental and physical health, our sense of identity is connected to the self we know arising from a baseline in connection physiology. The self emerging now for many people is the self arising from many months of continuous threat.
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The New Exercise
The new exercise is neural exercise. The antidote to all of this, in parallel with transformational structural change, is what we call Turning on the Connection System. If the ambient context isn’t providing connection cuing, we need to activate these neural circuits some other way. As wellness providers, I would propose to you that in addition to mitigating patient’s distress, one of the most powerful ways we can serve their wellbeing, and our own, is by evoking our own Connection Systems. The paradox of course, is that distress has to be accurately assessed, then down-regulated, before connection can be turned on. And this is why many providers we talk to are finding that traditional mindfulness-based interventions are failing them in this moment: because traditional mindfulness practice is contra-indicated when your body is in a neural platform of threat. I’m going to say that again, because it is so important. Mindfulness is working with attention, and attention potentiates experience. What you focus on gets bigger. So, if your inward awareness is that there’s a threat, and you apply mindfulness inwardly, you are going to get very aware that you feel threatened. This generally is not helpful.
A 3-Step Plan
We therefore propose, both for you, and with your clients, a 3-step plan.
1) First, you need to assess neural platform in the present moment. You need to figure out which neural circuitry is active right now. Thankfully, there are a limited number of choices here. In order to do this with fluency, you need to be able to very accurately track your client’s physiological state.
2) Once you’ve figured out how to which neural platform is active in the present moment, you need to down-regulate this threat response using targeted neural exercises that meet the needs of that state. For example, if you find yourself in fight or flight (sympathetic) neural platforms, the body is going to want to move. Movement-based practices are therefore indicated here: stillness-based practices are contra-indicated. We have developed a compendium of 150 practices, referenced in relation to which neural platforms they most usefully support. That is the learning platform on which you are taking this course.
3) Once you’ve adequately down-regulated the threat platform, focus on turning on the connection system. In order to do this, again, there are a wide variety of neural exercises that you will find useful.
The course in which you’ve enrolled will help you to sharpen your skills across all domains of the above, re-inforce the Restorative Practices model, and polish your abilities to conceptualize, see, and intervene in a Polvyagally-informed manner in service of your client’s wellbeing. This is connected to our larger work of supporting providers, in order to empower them to support their clients, in service of creating a global human multi-culture grounded in safety and connection. We are a global multi-cultural alliance with a four-fold bottom line: raise awareness, increase social justice, increase ecological responsibility, and generate revenue. We hope you find this course exceptionally useful to your personal and professional development as a healer.