Psychoeducation: Activation & Deactivation, Window of Tolerance, Resourcing, Counter & Stress/Trauma Vortex

Sep 10

Written by our therapist, Ardelle, MSW, RSW

What is Psychoeducation?

Psychoeducation refers to a therapeutic process which helps to inform and educate clients on understanding their symptoms and experiences.

Knowledge is power, and can help clients shift their internal dialogues, narratives and judgements about their experiences.

When individuals start their therapy journeys with me, I love incorporating psychoeducation into the early stages, and throughout our time together.

Why I do psychoeducation:

Normalizing/De-stigmatizing.
It’s quite common that when people begin their therapy journeys, they have internalized that their symptoms are some sort of moral failing. Many clients have self-reported to me “I feel like I am going crazy” or “I feel like I am failing.”
When we don’t have an understanding of what or where these symptoms are coming from, our experiences can feel out of control, disorganized and very distressing. Educating clients on what and where these symptoms come from can alleviate that distress.
Road-Map.
Many clients that come to me have never done therapy before. Psychoeducation can provide a road map of what to expect each session, and even long-term.
While I cannot make promises or predict where therapy will take us, I can provide a general guideline to clients on what to expect along the way. This can help clients have a sense of control and agency within the process.
Psychoeducation as Self-Assessment.
Psychoeducation is a tool that clients can have in their back pockets at all times. Having language to describe their experiences supports clients in having more agency around identifying symptoms and then resourcing and supporting themselves as symptoms arise.
Psychoeducation allows for clients to better organize their experiences, further aiding in empowerment and mastery over symptoms, emotions and sensations. By no means am I encouraging clients to intellectualize, rather, when we have a road map of what is occurring, we are better equipped to ride the waves of activation and deactivation.

Common Psychoeducation I Use:

Activation and Deactivation

During therapy sessions, we ride waves of activation and deactivation (Kain & Terrell, 2018). Activation refers to a physiological response where clients might experience mild states of fight, flight or freeze.

Activation is followed by deactivation, which refers to the process of finding regulation. When we allow space for our bodies to process through sensation, our bodies have an innate ability to move towards health and regulation. If our body needs support in this process, the Clinician will support through resourcing and orienting as a way to deactivate any remaining activation.

Here are some clues to help understand how activation and deactivation can show up during a session.

Activation During a Session:

Increase heart rate
Increased muscle tension
Feelings of nausea
Dizziness
Cold hands/feet
Feeling floaty or “out of it”
Sleepiness

Deactivation During a Session:

Relaxed yet alert
Increased access to sensory system - the room feels brighter, increased ability to notice sounds inside and outside of the room
Noticing the absence of tension, discomfort in the body
Increased ability to make contact (verbally, eye contact) with the Clinician
Feeling more settled, anchored.

(Kain & Terrell, 2018)

2. Window of Tolerance:

The Window of Tolerance is a term coined by Dr. Dan Siegel (1999) which depicts our nervous systems as having an optimal range of functioning, managing stressors and regulating emotions.

When we are outside of our window of tolerance, we are likely in states of fight, flight or freeze.

Ideally, I like to see clients living in their window of tolerance; the reality is that when clients are beginning therapy, they are experiencing diminished access to their window. For some clients, their window is very small, and they end up living in chronic states of fight, flight or freeze.

The goal of our work together is to increase this window, creating more capacity and vitality within their life. Here are some ideas of what these experiences might look like. It is important to note that there is a good chance that some will oscillate between these states.

Window of Tolerance:

Presence
Connection to self and others
Feeling safe
Curious, responsive, creative and playful
Ease in articulation of thought processes
Awareness of personal and others boundaries

Fight/Flight:

Hypervigilance
Tension, constriction
Racing, high energy
Overwhelmed, ruminating
Anger, defensiveness
Aggression, impulsivity, reactivity

Freeze:

Hypovigilence

Numb
Low energy, lethargic
Disconnected to self, others
Passive, shut down
Collapsed, flat affect
Inability to formulate and articulate thought process

(Kain & Terrell, 2018)

3. Resourcing, counter-vortex and trauma/stress vortex

If you have sat with me, there is a good chance you have heard these words before.

Resourcing

A resource (Levine, 1997) refers to anything that helps us to stay more tethered or grounded during the session (and afterwards).

A resource can be internal or external to us and supports us in having more capacity to manage activation during the session.

We can find resources by orienting ourselves through our senses (touch, smell, taste, sight, hearing). For example, a blanket, a swivel chair, a warm drink are all ideas for resources external to us.

Internal resources include imagery, supportive memories, pleasant or neutral places and physical sensations.

Counter-vortex

Ultimately, resources help us to build capacity for our counter-vortex.

A counter-vortex (Levine, 1997) is the space in which we feel anything from neutral and okay to grounded and present; it’s the space where healing occurs.

Trauma/stress vortex

Increasing counter-vortex through resourcing and orintating supports us in working with the trauma/stress vortex (Levine, 1997), which is the space where we notice activation.

Often, clients will begin therapy with a large trauma/stress vortex, and a smaller window for counter-vortex.

The work we do throughout sessions is braiding counter-vortex (feeling okay, grounded) with trauma/stress vortex (activation) as a way to increase capacity and bandwidth for our counter-vortex (feeling okay).

References:

Kain, K. L., & Terrell, S. J. (2018). Nurturing resilience: Helping Clients Move Forward from Developmental Trauma--An Integrative Somatic Approach. North Atlantic Books.

Levine, P. A., PhD. (1997). Waking the Tiger: Healing Trauma: The Innate Capacity to Transform Overwhelming Experiences. North Atlantic Books.

Siegel, D. J. (1999). The developing mind: Toward a Neurobiology of Interpersonal Experience. Guilford Publications.

You Don't Have to Carry Your Trauma Alone

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