30. Exploring Shared Language: Modulation and Regulation

In this episode, we delve into the complexities of sensory modulation and regulatory systems, discussing how we understand these elements and how they influence therapeutic practice. We explore the polyvagal theory, sensory modulation matrix, and how we can create shared terminology in those spaces. Through real-life examples and theoretical discussions, we bring to light the importance of precise language and shared understanding in clinical settings. The episode highlights the dynamic interplay between sensory processing, state regulation, and adaptive functions, offering insights into how therapists can better support children with diverse needs.

00:00 Introduction and Welcome Back

00:17 Celebrating Learning Communities

01:07 Community Feedback and Growth

02:30 Discussing Terminology in Therapy

04:06 Exploring Sensory Issues

07:27 Precision in Clinical Language

11:36 Understanding State Dependency

18:17 Polyvagal Theory and Regulation Models

22:07 Understanding Sensory Modulation and Regulation

22:39 The Interplay of Sensory Modulation and Neuroception

23:27 Linking Sensory Modulation to Treatment Plans

26:06 The Role of Arousal and Autonomic States

29:30 Practical Examples of Sensory Modulation

35:33 Integrating Polyvagal Theory and Regulatory Capacities

41:36 The Sensory Modulation Matrix

43:55 Building a Shared Language in Communities

TRANSCRIPT:

[00:00:00] Cory: hello. We're back. We're always saying we're back, but for everybody listening it's just the next episode. But I love doing this, so here we are and we have another... I think it's gonna be super fun, conversation to share with all of you. before we start that, I wanted to just do a little woo-hoo for the learning communities, as part of DFX team's awesome work.

They've put together the learning communities through their learning journeys, and it's kicking on, it's starting up. Definitely check that out, if you haven't checked that out. I'm sure if you're watching on video, you can see that I have my 12 week old strapped to me right now.

So the three, three of us, when we can manage it, we'll be jumping in there. And, a little birdie told me that we might do some live podcast recordings through that Amazing platform. So go and check it out and come and join us. I'm really excited to get that thriving.

It's already pumping. Did I miss anything Trace? Was there anything else that I should be adding in there? No.

[00:01:07] Tracy: Yeah. No, I just love that it's really a community and the idea of community is so very real for us. I think people feel that when they listen to the podcast and I meet new people it seems like every week that say I heard about you from the podcast. Or, it seems like you, and, Cory and Michelle just have such an incredible collegiality. , we also did receive this beautiful feedback recently from someone who just shared about how this feels like a space of real safe learning and genuine collegiality. And also that they could see the growth even in your skills alongside their own skills growing.

[00:01:48] Cory: Yeah.

[00:01:49] Tracy: and you know, I got to just relish that kind of comment and, and know that. It's really amazing and humbling and gorgeous how this is helping therapists worldwide to find community. And so we're growing that community and wow, it's just so,

[00:02:09] Cory: So fun.

[00:02:09] Tracy: the

[00:02:10] Michelle: Hmm.

[00:02:10] Tracy: the best.

[00:02:11] Cory: been on my learning journey since I literally was , like, I don't know, 22 years old. There I was fresh, had no idea what the heck was going on, but Tracy was there to guide me. So I'm so glad that she's there to guide all of us, um, in the wonderful complexity that we get to wrestle with every session, every day. Um, so today I am excited 'cause wrestling with terminology is exactly what we're gonna try to do today. So Michelle was sharing with me just two days ago that she was having a chat with some of her, allied health colleagues and, was kind of relishing, I'm putting words in your mouth, Michelle, but you can, you, you know, change them however you like to, but, um, for me it was a perceptive of relishing the experience of just explaining concepts that, as an ot, talking to another ot, there's a little bit of assumption that you're on the same page.

Um, whereas, you know, if you're talking to a dietician or a speech pathologist or a parent, any of, I mean even other OTs, when, when you're new into the field, there's, there's not, haven't built your base yet. So, it's been, from what I can gather, Michelle, fun to refine the capacity to to discuss. Some of the things that you are seeing with a shared client. So I don't know, should I throw it to you

[00:03:33] Michelle: Yeah.

[00:03:34] Cory: longer putting words in your

[00:03:35] Michelle: You've done beautifully, Cory.

I love the word relish. I'm not sure I would've used that this morning, but yes, I am relishing. It's come about because I've been working alongside two therapists, a dietician and a um, speechy. And we've known each other's works separately for a long time. We get on really well together.

We're working now on this project, and it was just a really interesting experience, um, for a few reasons. And I, I get this a little bit where people might say, oh, I didn't know OTs did that. So I think there's some assumptions based on prior experience really what OTs do. Like, do we just do handwriting, for example, are we just interested in, you know, equipment prescription or whatever.

So people come from, an understanding of what we might do and the words we use based on prior experience. So these, um, beautiful two OTs, we are discussing a case together. They'd identified that this child had some, in their words, sensory issues and that they appeared to be dominant and therefore I should take the lead with this case and in discuss.

[00:04:48] Cory: quickly it was it two OTs?

[00:04:49] Michelle: No, the dietician and the speechy.

[00:04:52] Cory: Okay. I heard you say two OTs, but I thought it wasn't OTs. I thought it was a dietician and speechy,

[00:04:57] Michelle: and speechy. Yeah. And so, they knew that, OTs look at sensory issues, um, whatever that means, let's talk about that later. And then it, the beautiful cherub and the family system, they're explaining, yes, I, you know, there were some sensory issues identified, but that is definitely not what I thought was the root issue.

And so, you know, this regulation and capacity to co-regulate was the root for me. And so when I started talking about that, I just saw their eyes glaze over. Like, what about those sensory issues and isn't that what you're gonna bring to the table? And, and so it was just really interesting.

So we've had to do, um, some backup before, you know, we can move forward. And I, you know, I guess what's also happening in parallel is, I'm, working with some new beautiful OTs, um, who I'm doing some mentoring work with. And so it's almost these go slow to go forward. And so some of these initial, sessions are really, you know, looking at what words they use and what do they mean by that and what words I'm going to use.

I'm certainly embedded and champion, the learning journeys and the spirit model and the step si. So that is just how I think and the words that are in, the different domains, the boxes on the spirit model. Is the words I'm going to use. And so it's almost like we have to, um, when we are working with other OTs or families, educators kind of scope out what we do, but also the language that we are going to use to describe what we do and what we are seeing, with the child.

Where we've tried to, you know, race forward, I might use the word arousal and in different environments, arousal's, you know, often associated with sexual arousal, I guess. So it's just like I can, you know, a dad asks me like, what are you, are you talking about?

[00:07:00] Cory: I love the dads.

They always, they always get me to be very specific. I, I do, I love it. I

[00:07:05] Tracy: yeah.

[00:07:06] Cory: dads, but like, it's just a different, it's just a different way to explain it. I love

[00:07:11] Michelle: And I think I love, I love that frankness and now, you know, I've just had these bank of words that I might use and then explain pretty immediately. So there isn't that sense of, what are you talking about, sexual arousal here, Michelle, what do you see to my kid? You know, what's going on? So I just thought it'd be really fun to, talk about that because certainly in the learning journeys and as we think about the spirit model and step SI, there is a language that we use and, um, I think when we're chatting together that we have over the years tried to make sure that we're all really perceiving, in a uniform way, the words and the language and how they integrate.

So we are all really sure that we're talking about the same thing.

[00:07:57] Cory: Yeah, a hundred percent. So I guess we. Want to try then, to use the spirit model with all of you who are listening, to unpack some terminology and just how would we explain that as best we can, to who aren't familiar. Uh, so that could be anybody, right? It doesn't have be a

[00:08:17] Michelle: Yeah.

[00:08:17] Cory: It can be the speechy and the dietician can be any therapist who's trying to just crack into, yeah, crack into pediatric.

Like you might be 10 years in, in a different part of OT and you're trying to get into peds and it's like, well, how do I wrestle with this new set of concepts? Um, or parents or educators, whoever. So not sure which term we start with, but, maybe Trace where, where's your gut instinct? Like, you are our wonderful leader in this domain.

Yeah, compass is a great term. So where, where should we deep dive into this?

[00:08:52] Tracy: yeah. Well, I think we'll start with the word sensory,

[00:08:55] Cory: Yes.

[00:08:56] Tracy: does that mean? And I wanna kind of plant this at the beginning of this whole episode, for us to try with each other, to remember, to that we have kind of two levels of thinking around terminology. The first is, for me, I'm always trying to help clinicians find

more precision that's mapped onto the science, because for me, that precision is what drives your clinical reasoning. I think already in this episode, we feel the flavor of our desire. The three of us in our trial log to find precision Because the word sensory from a treatment planning perspective 

[00:09:40] Michelle: Mm

[00:09:40] Tracy: tell you what you need to do. It doesn't give you any heft, it doesn't give you any insight. It doesn't bring anything. that raises the second audience, basically, which is kind of the colleagues that you had,

[00:09:55] Michelle: mm.

[00:09:56] Tracy: Michelle, who we are championing when they say we think there might be a sensory issue, and they don't need to have the level of precision that we need to have. Parents often enter a more, I wouldn't always say it's surface level because I think they have a

[00:10:13] Michelle: Mm

[00:10:14] Tracy: but their language may

[00:10:15] Michelle: mm.

[00:10:16] Tracy: surface level. then over time, some parents really get into a very deep level of wanting to discern, and not everyone does, not even every clinician does.

I'm not saying that that's like a value that you have to go to the deepest level, precision is available to us in different levels. So the two levels would be we want precision as much as possible and we want understanding that's highly accessible, is a hard balance to strike.

And I think it's even harder in our field right now because there's confusion around terminology.

[00:10:56] Cory: Hmm.

[00:10:57] Tracy: There's confusion around models. There's

[00:10:59] Cory: Yeah.

[00:11:01] Tracy: there's models being, shifted, that also creates confusion. So it's probably a conversation that we could have, know, once a year, almost like to develop precision.

And I also know that in my own career, it's been this ever journey of finding the language that matches the person I'm engaged with.

[00:11:28] Cory: yeah,

[00:11:29] Tracy: Mm-hmm. Mm-hmm.

[00:11:31] Cory: I agree.

[00:11:33] Tracy: Yeah, but let's start with sensory. So, you know, when somebody comes to me, and even just this week, I was doing a consultation with a family. They adopted a little boy when he was two, but he lived in their home since he was 15 months or so, he's 12

[00:11:54] Michelle: Mm

[00:11:55] Tracy: now.

So he's been with his family most of his life, he has a lot of, difficulties and, the parents. The describe that they thought somebody told them that the piece they were missing was the

[00:12:09] Michelle: mm.

[00:12:10] Tracy: sensory piece, and that's what brought them to developmental FX and opened the door to occupational therapy.

So what a

[00:12:18] Michelle: Mm

gift

[00:12:18] Tracy: that is, that this notion of sensory whatever that is, kinda lives enough out in the world, that sensory health and sensory awareness and you know, sensory rooms at the airport and at the museum. These are beautiful unfoldings of cultural and societal awareness of these issues. And it often does open the door and lead somebody. But then the tricky thing in this situation was that this little boy. He has difficulties with regulatory capacity and trusting relationships because of early abandonment and, having a mismatch sometimes of what on a sensory modulation level feels soothing and comforting to him versus what genuine, you know, kind of genuinely are trained to offer him. So it goes into the sensory level, but the issues are really emanating out of a different level of regulatory processing of self and other processing and we can't get to the right treatment plan if we call that a sensory problem. So to me, that's where the precision comes from. Yeah.

[00:13:34] Cory: think that's exactly what you were speaking to Michelle with your colleagues and I felt my heart like go or some resonance with your statement around what a gift that is that people have associated occupational therapy with somebody's having difficulty with the sensory, processing or, capacities. And that has brought them to us. And now we need to do the precision to help move forward. And Michelle, 'cause they said to you. Sensory issues like you are gonna work on the sensory issues. So maybe, flesh that out with us around how you, helped them come to understand or

[00:14:13] Michelle: Hmm.

[00:14:14] Cory: in a different way.

[00:14:15] Michelle: Yeah, look, it was great because I got a seat at the table you know, the child's issues is, with a really. Restricted, food intake. And so, you know, that couldn't sit anywhere, but, I certainly saw that, in hearing about the, child and family, that regulatory capacities were actually the root and that was impacting, sensory modulation.

So it was a state dependency, sensory modulation, issues. And so I was just putting it together a bit differently, but I got a seat at the table.

 And then it was like, well actually, you know, here let me, untangle it a little bit more precisely and use the ways that I would think about it.

And so I wanted to, kind of say, oh, thanks. But do you know, my wondering is more about regulation, given the history. And this is how I think about that and do you think about regulation and do you have to model? So let's land if we're gonna keep working together, three of us, it's really important for me to land on a few models so we can talk about regulation.

So I totally took it, it in a different, direction, but that, that identification of, individual differences, specifically sensation got me there and there. Now our little community, our little multi dis community here in Orange is going to create some shared language. And when I spoke to, why I was kind of clinically reasoning that regulation was perhaps the root that I wanted to investigate more in the assessment is I were like, oh yeah, oh yeah, we trust you with that.

I don't. I don't know why you got there. 'cause there's those sensory issues and shouldn't you just be going there? You know? So it's this dance of, um, sharing knowledge. How does that resonate? Do you trust me enough to kind of take us on a bit of a different tangent that you expected the OT to take you on and, um, we'll let you know how that goes.

[00:16:20] Cory: So.

[00:16:21] Michelle: got an initial, yeah. Okay. But you better deliver girlfriend.

[00:16:26] Cory: Well, I was gonna say we should you, because you said at the start, state dependency sensory modulation challenge, and what a terminology, amazing.

[00:16:36] Michelle: you know what? And on a Friday morning, which is when I met with them, it was kind of a bit twitchy, but I was like, I can't proceed with, without getting the groundwork here. So I know that's a lot and you know, I'll take you on the journey. It's a bit of a dance, isn't it? What's the just right challenge to get them to follow my lead? I could add more. It was auditory and tactile. Sensory modulation.

[00:17:01] Cory: Good. We love precision. What I was going to say is maybe we should just,

[00:17:06] Michelle: Step back.

[00:17:07] Cory: Yeah, we're just like, we could tackle that through the model, right?

[00:17:10] Michelle: Yeah.

[00:17:11] Cory: that, that's what we're here to try to do. And so state dependency, sensory modulation, and my brain is going straight into the s the sensory, affective and motor, in the center, in the core aspect of the model, Tracy, where you have those three elements pulling things together, considering all those elements. And you have split the, the sensory affective in motor functions into lower in the brain circuits and higher in the brain circuits. And so my brain's thinking about the lower components related to processing sensation.

And of the way that Tracy's helped me think about this, the lower components of the way we process affect. So I'm always linking those

[00:18:06] Michelle: Mm.

[00:18:07] Cory: together. And so how did you explain state dependency sensory modulation? Michelle, maybe start there. I don't know.

[00:18:17] Michelle: This is where I wrestle a bit with, accessibility because I use Stephen Porges, polyvagal theory, that that's the lens I use with the research I'm following. Sometimes I find that Dr. Dan Siegel's, model of modulation, that image is a little more accessible than the latter.

So at the moment I'm leaning towards, if you are entry level and you're, I'm just explaining regulation for the very first time I lean on Dan Siegel's model, I have it laminated. I pull it out and I map that out for families. So that's my entry. but I configure it in my brain. And when I'm talking to OTs or anyone who has some, you know, a few regulation models, there's lots of options.

I really am defaulting to, polyvagal theory,

[00:19:11] Cory: Yeah.

Do you want me to, to contribute then? You can help refine like how, how we're thinking maybe.

[00:19:19] Tracy: got it.

[00:19:20] Cory: So if I was going to try to do like a similar thing, Michelle, a hundred percent I'm right there with you around using the polyvagal information and science as best as I can to inform anyone I'm working with around what's going on? Or how do I think about this? I've actually, since your, I think it was a lecture, Tracy, in the Mind to Minds, study group.

[00:19:45] Michelle: Mm

[00:19:46] Cory: Uh, a little while ago back, so since that lecture, I think I have really just started to go with, is it high energy?

Is it low energy? Is it a positive experience or a

[00:19:58] Michelle: mm.

[00:19:58] Cory: experience? I was trying to use Deb Dana's ladder, and I, if people aren't familiar with that, it sort of helps you see the states as a ladder, which and I could be dead wrong, so Deb Dana, please

[00:20:15] Michelle: Come on. You're welcome on

[00:20:16] Cory: wrong

[00:20:17] Michelle: anytime.

[00:20:17] Cory: please. But I feel like it helps me vision that like there was an

[00:20:21] Michelle: Mm.

[00:20:21] Cory: basis to this process in terms of uh, not lowest but oldest. Oldest, right. And useful, but just older in our

[00:20:30] Michelle: Evolution.

[00:20:31] Cory: process is that really shut down immobilization function. And then as you have, some progression forward, um, then you have more of a fight flight option in times of danger or stress or threat. And then hopefully, you have the option to get to the top of the ladder, which is like a ventral vagal, social regulated state. And so I, I was trying to use that and I, I do think that's not a bad model in any way because it helps people just to see that, um, if you're trying to explain that element.

But I really love the fact I can put the arousal piece with the safety piece on your chart, Tracy, that you gave, which is just, I mean, it's just, again, it's still got the arousal of up and down. And I'm with you, Michelle. I do often explain as revving up or revving down from , Dr.

Dan Siegel's model of modulation. And I think that's really useful for just getting a bit of a sense of that mobilization of energy. But I love the safe and not

[00:21:41] Michelle: Yes. Mm.

[00:21:43] Cory: So I've started really just being like, and don't even sometimes use arousal. I just use energy because if I feel like the person's gonna get a bit weird about arousal, I'll use energy.

But I, I like the word arousal 'cause it's more specific. But anyway, so I'll just say to someone like, is this experience high energy and positive? I'll be like, like that's play right? Or is it low energy and positive? Like when you read a book or you kind of cuddle to settle down for bed or you know, is it high arousal and negative and not a good experience and now they are punching their brother?

Or, um, is it, you know, low arousal and negative and they have just kind of disconnected

I feel like that's the model I've come to now since that lecture, Tracy. So now I would love you to kind of us go even more precise here, Tracy.

[00:22:36] Tracy: So good. I love it. I love it so much. So there's different parts of this big vast sensory modulation and regulatory network. I read different things about it, but lately the number keeps being somewhere in the 80 to 85% our entire neural brain and body resources are dedicated to this set of systems. So it's big. It's not one thing.  And when you are with a person asking you a question or you're with a child in a treatment session, I think you do have to have models that are more complicated than just an over under model. And, and you have to begin the journey of precision. So what I wanna do before I, I. Move forward is, I'm gonna link this across all of the things we've talked about. I'm gonna try to paint a picture if I can. we're talking about the low route of s and the low route of a in the spirit model right now. And that's because we're talking about sensory modulation and it's intertwined to the low route of the arousal affective set of circuits.

So sensory modulation and affect and arousal are tied together, the foundation of them is the neuroceptive function that you're talking about, this kind of safety, threat discernment that happens and then how that activates the energies of the system

[00:24:16] Michelle: Hmm.

[00:24:16] Tracy: in the service of the positive or negative qualities. So the foundation is sensory modulation based because neuroception is drawn from the sensory modulation matrix is the word I think we use most of the time. so we have this matrix of sensory modulation that gives us information about the foundation of neuroception, and that sets the scene for how the rest of the regulation system is gonna operate. The Rest of the regulation system. Is telling us that that's the adaptive capacity that we're working on. So it's sensory modulation for the purpose of the regulatory adaptive capacity. So that's a big thing to say, right? When we see kids who are struggling with whether or not it has a sensory base, and that's the stories that we've shared today, is that people send them to OT sometimes for sensory issues because dysregulation and sensory issues somehow are kind of getting paired getting paired,

which is a good thing in the world, but then we have to sometimes deconstruct it

[00:25:28] Michelle: Mm.

[00:25:28] Tracy: it. So how we deconstruct is we say, what's happening in that basic. Am I comfortable? Am I not comfortable? Am I safe? Am I not safe? And how is that activating me or not activating me? What's happening there in the service of adaptation? And then how does that constrain or create a state? So the state is informed by the autonomic state, and that's what you just beautifully described, I think both of you. But that sits on top of the general arousal state. So Dan Siegel's model, he's drawing, from a lot of literature, but there's this general arousal state that's in the background. So we have general arousal and autonomic arousal that create our overall state, and that's founded in the sensory modulation of neuroception. So if we can name all of that, then we start to get closer to being able to figure out where do I head in

[00:26:35] Michelle: Mm.

[00:26:35] Tracy: my treatment plan. We still don't have all the pieces that we need, but we at least begin to go in the right direction. And how we translate treatment plan from this information is by identifying as clearly as we can what's happening in that at low route of S, low route of a, and how that then connects to all of our options. We use the STEPSI as the way to map out those options, but what you choose to do, like in task structure is really different if a child is presenting in an energetic state of protection versus openness, it's entirely, it really changes how you approach whole of it. So you wanna map it out.

So the map that I have in my brain is neuroception is, the foundation state gets constructed around that. Sensory modulation is a part of the opening and the closing of that window. And then the unfolding of that becomes A functions that we depict in this wheel of A. So if I'm more regulated or if I'm more dysregulated, that's gonna have an opening or closing a constraining. Or an, enhancing quality to it. If I'm in regulation, my capacities are enhanced and available and accessible, and if I'm dysregulated, they're constrained. So those capacities in the regulatory circuit, we can think about through the A functions, my affect and my, emotional energy, my social connectedness, my prosociality, my attention, and all of what attention means. and then the autonomic nervous system, obviously the action and motor system, the movement system itself. And then back to general arousal. So arousal and autonomic functions hold the container, create that constraint or that enhancement, and then they also are elaborated by experiences that match what the system needs. So, so it is a regulatory system that is responding to opportunities to embody the next option over and over and over and over again. Yeah. Is that picture painting in your mind, and how does that land for kind of the descriptions that we're struggling name here?

[00:29:22] Michelle: Trace. I love that. And I can't wait to listen to that again, because I think I've picked up something a little different again.

So an example of that might be a little child who has, difficulty processing, loud sounds. And if those loud sounds, if they're present, that, that child sensory modulation specifically the, arousal system in the a.

Might get more constrained. Their capacity, oh, I don't want to, I was gonna say their capacity to kind of tolerate that or self-regulate that will determine what happens next. If they don't have a lot of resources, capacities to help them regulate through that ongoing experience of loud noises, that's disruptive, they'll become more and more constrained.

And then at some point, it might kindle into, whatever their profile is that it might kindle into action, dysregulation. So then they'll get mobilized and move away or become externalized, behaviors. , For me that's how I'm trying to get more and more precise, rather than saying regulation dysregulation or, sensory modulation, difficulties processing, auditory import, particularly loud sudden sounds, using those five theys help understand the cascade that can happen.

Like what was initially constrained and then where did it kindle into what strategy did they use perhaps to help regulate. Am I kind of putting that together? Okay. And do you wanna refine that?

[00:31:09] Tracy: yeah, no, you're totally putting that together. I think there's one more

[00:31:14] Michelle: Yes.

[00:31:15] Tracy: as well, is that when we're, when we see somebody struggling, let's say with

[00:31:22] Michelle: Mm-hmm.

[00:31:23] Tracy: and in this case it's auditory, which happens to be, the reason that I'm making this qualifying

[00:31:28] Michelle: Yes. Yes.

[00:31:29] Tracy: Michelle, um, is that the question we wanna be

[00:31:34] Michelle: Mm,

[00:31:35] Tracy: ask ourselves clinically is, is the sensory modulation the thing that's

[00:31:40] Michelle: yes.

[00:31:41] Tracy: or is the state, the autonomic state in particular.

[00:31:45] Michelle: Mm

[00:31:46] Tracy: that. Because if a child is in a state where they're not feeling safe and they're feeling more protective by, by just the physiology of the way the vagus nerve works in particular, in that case, it's gonna make your ear sensitive to sound. Because you have to be more vigilant. You are more protective, and your ear, when you are in a state of protection, is no longer a receiver of sound.

It's an amplifier and a bouncer outer of sound. And so in that way, sound sensitivity that's intermittent could be telling us that a based in this in the child state, and it's not even in the sound. It's in the actual other system. And so we. We need to know that because that will help us to, find the right path forward. And so I think it's a beautiful example of how yes it is, seems like it might be sensory, but the sensory modulation system is a part of the regulatory system. It's not always the driver. It's sometimes the repercussion of, it's sometimes the result of the constraint in the system. And it's a necessary thing for us to become more sensitive when we need to protect ourselves.

We have to be more aware of the potential threats out there. And so it's always a either or question and it, it's part of our. Our discernment in this area is pause enough to really get a bigger picture of what's the story, what is the nuance, where is that coming from, so we can understand it. Right.

So in the case where it's not coming from protection first, and it really is that my ability to modulate sound um, leading me to have that as the dominant

[00:34:05] Michelle: mm

[00:34:07] Tracy: then exactly the way you, you

[00:34:09] Michelle: mm

[00:34:10] Tracy: to deconstruct that as the way that I would do that. And then the question is always, is that

[00:34:14] Michelle: mm

[00:34:16] Tracy: Mm-hmm.

[00:34:17] Michelle: so that might be the context is we observe a little child in clinic or in, a preschool setting. They're happily playing with peers. They're being creative and fun and dynamic and, open and engage. So in this, ventral, vagal state, and then there's a loud sudden noise, the door slams or something, and you're more clearly seeing that that was a disruptor.

So that would be a clear picture where it points more directed to sensory modulation of auditory input, versus they're, using Cory's language. They're, in a high energy state and they're buzzing around and probably, looking less adaptive, looking less social with their peers, less purposeful with their play.

So they're kind of revving high and loud noise, occurs then that's the second example that they're , they're coming from a higher arousal state and that influences their capacity to modulate. Sound and everything else.

Um, but in this example sound., I guess, um, using the word trigger, but that's the trigger or the disruptor, on that occasion. Isn't it interesting where we go on different journeys? 'cause this is not where I was gonna take us and we don't have to go there. But trace, I loved learning about the five A's, and it helped me become more precise.

but how do you map these models on? Do you now in your mind, come from this polyvagal theory and the regulatory capacities and use the five As to get more precision? Does that make sense? Do they interface together and you can use them cooperatively?

[00:36:01] Tracy: I use them a bit simultaneously

[00:36:03] Michelle: Yes.

[00:36:04] Tracy: in my own mind, but that also is because, you know, I've spent a long

[00:36:10] Michelle: Mm-hmm.

[00:36:11] Tracy: this knowledge, and so, it, it just, it's more authentic to me to

[00:36:17] Michelle: Mm-hmm.

[00:36:18] Tracy: instead of

[00:36:19] Michelle: Yep.

[00:36:19] Tracy: them because the, I know that that's how they

[00:36:21] Michelle: Mm.

[00:36:22] Tracy: and I think we all know that that's how they operate. But when you're first learning this, you have to do it a

[00:36:27] Michelle: Yes.

[00:36:28] Tracy: or you get lost in it. I think so for me, I have neuroception and the way Cory described this idea of energy being relatively activated or deactivated in relation to the positive or negative valence, that is the neuro

[00:36:45] Michelle: mm

[00:36:47] Tracy: So I usually have that as. Kind of the continual

[00:36:51] Michelle: mm.

[00:36:51] Tracy: that I'm just running through the sieve of my mind. And part of that honestly is also because neuroception is

[00:36:59] Michelle: Mm

[00:37:01] Tracy: It's moment to moment to moment. And the nervous system is drawing the energy from that surveillance and

[00:37:09] Michelle: mm

[00:37:10] Tracy: of threat or safety the time in order to adjust the rest of the system. I think that that's like

[00:37:19] Michelle: mm

[00:37:19] Tracy: thought that I have. And then, I might use how that results the grid that we were painting in that kind of describing that. That really creates these, these states of the

[00:37:38] Michelle: mm

[00:37:38] Tracy: system. So they're kind of sitting

[00:37:40] Michelle: mm.

[00:37:41] Tracy: Okay. And when I say state of the nervous system, that's really an autonomic reflection. Then I'm gonna superimpose that on the general

[00:37:51] Michelle: Mm.

[00:37:52] Tracy: and whether I'm in a window of tolerance that is open

[00:37:56] Michelle: Mm-hmm.

[00:37:57] Tracy: and where is it located relatively in terms of energetic activity

[00:38:02] Michelle: Mm-hmm.

[00:38:03] Tracy: So I'm gonna put those together sort of in my mind, but I'm gonna think through them kind of iteratively instead of sequentially. and I think that's the way I generally approach it. And then when I know that there's opening in the system, I'm wondering about what, how that enhances. The A functions, if there's constraint, I'm wondering how that kindles or restricts the A functions. So then that would be another iterative layer. So I usually come to the broader adaptive capacities of all those a's at the end of my thinking because it, it is more the

[00:38:48] Michelle: Mm

[00:38:49] Tracy: and the product of, and the beginning of it is more based in the sensory neuro

[00:38:56] Michelle: mm.

[00:38:56] Tracy: kind of function.

. So neuroception is this double valence function. Okay. The first part of it is safety threat. And based on that it mobilizes. Or immobilizes or activates or deactivates the resources that you need. So if you are in safety and you are in mobilization, you're gonna end up in that blended state of ventral and sympathetic

[00:39:28] Cory: Yeah. Yeah.

[00:39:30] Tracy: So neuroception, you put those two pieces together, circles behind it are the autonomic state. And sensory modulation is the matrix. It's telling you if it's safe or not. And it's also the mobilization and and immobilization of the thresholds and the activity based on neuroception. So sensory modulation is like the functionality of neuroception. everyone gets confused about that. Okay. But Neuroception is the foundation and then the polyvagal states are created by neuro perceptive signals. So those kind of are sitting there. Now they're gonna operate in relation to generalized arousal in relation to the window of tolerance, basically. if the neuro perceptive experience is within the window of tolerance, all of the A functions are enhanced. If the neuro perceptive experience creates movement out of the window of tolerance, then you start to have a constraint on general arousal, but actually on

[00:40:52] Michelle: Mm

[00:40:53] Tracy: A functions and the dysregulation that occurs is in response to that. So it does kind of work in a way like neuroception drives the

[00:41:05] Michelle: mm

[00:41:06] Tracy: polyvagal state and the polyvagal state

[00:41:08] Michelle: mm

[00:41:09] Tracy: operate within the window of tolerance. So those two things are

[00:41:12] Michelle: mm

[00:41:13] Tracy: relation to each other. They're not separate, but, but you, work in relation to each other and they produce the adaptive regulation function in concert together.

It's not

[00:41:26] Michelle: Mm

[00:41:27] Tracy: the other. It's both. And then the rest of the way that the A'S work is in response to what's happening in

[00:41:36] Michelle: mm. We just opened a can of worms because Tracy, I pretty much stalk you and I haven't heard you use the phrase sensory modulation matrix, so we don't have to go there today. But I just think this idea of language and, you know, we did dive into the sensory affective functions and their interconnectedness and how it impacts, our function really.

But we left poor M out. So I think we need to come back to M and I'd love to hear more about this matrix business. 'cause I've just got the movie matrix in my mind and I'm really buzzed about. What is she talking about? She's dressed in black. She's got a cap on. Are you the sensory modulation matrix? Lady.

Is there a film coming?

[00:42:28] Tracy: So yeah, we left m and we left the high route of

[00:42:31] Michelle: Yes.

[00:42:32] Tracy: of a, so we'll come back to those. But yeah, so all of that is very complicated and there is a sensory matrix, so we'll talk about that. But when we meet with a

parent or a teacher, we can keep it really simple. I usually start with whatever

[00:42:48] Michelle: Mm.

[00:42:49] Tracy: use and then I start to elaborate it based on where I think my understanding of this little

[00:42:56] Michelle: Mm.

[00:42:57] Tracy: that we're talking about, me, where the elaboration iss gonna enhance people's understanding understanding.

We all have deeper attunement, we all offer more compassion, we all offer more opportunity for finding adaptation. So understanding helps and that's why it's so important. But we don't have to understand

[00:43:21] Michelle: No.

[00:43:21] Tracy: layers all the time we want to, 'cause that's what fills our tanks, is just nerding out on this stuff as much as we can and understanding it. what you wanna do is find the just right level of understanding.

[00:43:36] Michelle: Yeah. And I think, um, I love your, term for the learning journey. The learning journey, because I think certainly that's what your offering for OTs, um, is and broader, probably your reach is very wide these days. Trace, um. So inspiring, um, is that there is a shared language in communities and there is a shared belief system and philosophies and models that we draw from.

And so I think for our ot, you know, community that a part of wannabe part of, you know, um, this resonates with them, then I think it's really powerful. I think in our own, um, ways that we are operating. So Cory and I are also doing mentoring. So in our little, you know, bubble communities, ot, um, us with our OT teams, they're wanting to understand the language and, and um, be included in these conversations.

Um, with parents and Multi dis teams and, you know, educators, we are creating our little communities and we're, really trying to, involve everybody in having this shared language, and it's not, I just need to say it's not always ours. I'm sitting in education centers and I'm trying to wrap my head around curriculum and outcomes and do, you know, it's like I need to understand their language and their systems and you know what works for them so I can.

Be a resource, or of service to teachers who are trying, whose job is to implement curriculum. If I wanna have a seat at that table, I need to know their language and the outcomes that they're trying to achieve. So it's not just a one way street, I will say, but I, I think to be embedded and included in a community, there just is that exchange of what does this mean for you?

And are we all talking the same thing? And is this, are these words accessible and do they resonate? And where they're not, you know, that, some people just sort of like, oh, that doesn't sit with me. I have a different belief or a different approach. No worries. Do you know what I mean? Like, you have to be true to you and, and where you're at.

So, um, yeah, it's a bit, I don't, I don't wanna sound so frank to say take it or leave it, but you just have to follow what resonates with you and, give people the opportunity, I guess, to be part of a community.