Emotions are called feelings because you feel them. Your vagus nerve is part of the highway that transmits stress, anxiety and fear throughout your body. Our behaviours and experiences are created and regulated via our nervous systems. Explore the curious interactions between how you think and how you feel, and how that impacts how you learn and behave. We all get stuck in grooves of thought and can rely too heavily on our autopilots. Hear how a physio and a thoughtful teacher or mentor can help you get unstuck.
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Full Transcript:
Matt: We're talking about the Vagus Nerve, and I have questions about the Vagus Nerve because it's very trendy. There were all these therapies coming up that are about the Vagus Nerve. I have the facts question: what the heck is this thing? And then I want to know—to what extent is intervening on your Vagus Nerve a helpful way to soothe anxiety? What does it do?
Brent: It does end up being—getting latched onto as the trendy kind of thing. People have written books about treatments for Vagus Nerve, or this or that. It's a bit too much like, "Okay, it's coming down to this structure. It's your Vagus Nerve is the problem"—which is rarely the case. I have seen some people where it's clearly that's the thing that's wigging them out, but...
Matt: What does that look like? When it is clearly—you got a Vagus issue—what's going to happen for a person?
Brent: Well, that goes back to understanding a bit about what it is. It's one of your cranial nerves. So you have your brain, and then your spinal cord, and at every level down your spine a spinal nerve branches out as the electrical wiring to two different parts of your body. Parts of them go to sensation, parts of them go to muscles. Your Vagus Nerve comes from the upper part of your neck but has branches down in front of your neck, kind of under your collarbone, and it's a big part of what innervates a whole bunch of your organs—like your heart and your stomach and your diaphragm.
Matt: Does "innervate" mean like, connect you to? It's the wiring to?
Brent: Exactly, yeah. Plugging into the electrical grid. So your brain and your spinal cord are your fuse box, and then you've got all these wires that branch out to help you be this big collection of sensory feedback loops where there's signals going out and signals coming back in constantly. That helps your body regulate your ability to feel and see and move. And your Vagus Nerve is fairly unique in that it helps regulate a lot of your autonomic systems in your body.
Matt: Autonomic means things that you don't consciously control?
Brent: Yeah, a lot of things that are happening under the hood that are keeping you alive that you're not really attuned to most of the time. Your diaphragm is a big breathing muscle—that's two big, half-domed umbrellas in your mid-abdomen that drop down, that help pull air into your lungs. It—the nerve—is part of this long snaking nerve that goes from the top part of your neck, comes down into your torso, and is the electrical wiring to a lot of your key organs that keep you alive and affect how you feel. So if your stomach is churning, or your breathing rate's kind of going, or your heart rate's kind of going, part of why and how that's happening is via your Vagus Nerve. It also innervates part of your inner ear—your vestibular apparatus—which is another dataset that helps you understand where you are in space.
Matt: So the Vagus Nerve is a part of that? When that goes wrong—like, your actual fluid could have a problem in there or something mechanical?
Brent: Well, not explicitly. It's part of the electrical wiring to your inner ear. You can have different things go wrong in your ear that can start...
Matt: Right.
Brent: That nerve branches to lots of parts in your head, parts in your body. If you are undergoing a lot of stress, that will start to manifest in parts of your body that the Vagus Nerve is responsible for. So that doesn't mean it...
Matt: Why? Why does the Vagus Nerve want to transmit stress? Like, my fantasy is that the Vagus Nerve is like, "You're getting too stressed, buddy. I'm going to gate it. I'm going to make sure we don't stress out your organs or something."
Brent: It's just part of how it manifests. That nerve connects all those things, so let's blame that nerve.
Matt: Like blaming the highway for a crime that was committed using a highway.
Brent: Exactly. So if you can see these collections of things—like, "Oh, your stomach's doing weird stuff, you're getting kind of dizzy, your heart, your breathing kind of funny"—it doesn't mean it's necessarily that nerve. Let's treat that nerve. But it pulls things together. If we can try to help do things that help calm stuff down around that nerve, it might be calming to you. By means of gentle manual therapy or releasing things in and around there—or help draw people to the tension of those areas—you can help calm your system. In terms of how it's getting kind of wonky... you can see people—you put your hands on their chest or their neck and you see they can start getting this kind of hard twitch kind of thing that seems to be centered in and around their heart. Or their stomach can keep churning into knots. If you get to know them, you see how prominent stress is, or how anxious or worried they are. Part of it might have come from external factors of their family or their job or their past. They start getting so uncomfortable in their body—whether their body's twitching, or their stomach's churning, or they're getting dizzy—that that actually becomes the stressor of how uncomfortable they are. You can try to put them in a better environment, but now their discomfort has become the primary thing. So you have to try to find some means of calming that down before they're going to have any chance of dealing with the stuff that's in their environment.
Matt: Let me see if I understand that. Something stressful happens—you lose your job. And then you have a stress response. And in that moment, it over-stimulates the Vagus Nerve? Is that what happens? And that person starts to feel a bunch of... somebody's like, "Oh, my tummy hurts because I'm anxious." Is that the Vagus Nerve sending a signal that you're anxious?
Brent: Again, not explicitly that it's just the Vagus Nerve doing that, but that's the pathway of how that ends up happening—that your stomach churns into knots when you're anxious, yes.
Matt: So then the electrical system—the highway—conducts this information to your stomach and it gets active. And then that information comes back up that nervous system to your brain, which is like, "Oh my God, my stomach's hurting," or "my chest is hurting"—increase the stress. And you get a positive feedback loop where now it sends more stress down to the system, so it reads more stress, and then you get stuck. And then like, the external stressor is gone—you got your job back—but that thing is all still firing like crazy.
Brent: Yeah, and it can trigger a fear response. If you don't put the two together into like, "I'm uncomfortable," you think, "Do I have cancer in my stomach? Do I have an ulcer?" I think one of the most commonly prescribed medications is proton pump inhibitors—PPIs—from doctors for indigestion-type feelings. Which is, "So my stomach's problematic, go to your doctor. Here, let's try to control the acid in your stomach. Here's a pill." I don't have to change anything in my world besides take this pill a bit more often. And long-term use of those... it can make it all worse.
Matt: Right, because the actual source of the acid is not some biological overproduction, but it's actually being caused by your brain and that wiring system as a response to stress.
Brent: Same thing with inflammation. Generally, the medical system's relationship with pain thinks everything is inflammation-based. Sometimes that's the case. Usually it's a dysregulation or irritation in your nervous system that's causing things to tense or guard, and that tension creates discomfort which can lead to something locally being inflamed. But the inflammation itself was not the starting point of that. It was a symptom. That, again, is where pills and medications tend to come at treating the symptom. And sometimes you need to treat the symptom to calm a person down to get them to a place where they might be able to have the capacity to deal with the cause.
Matt: Interesting. So then to what extent when you intervene on the Vagus Nerve—whatever that looks like, I know there are various interventions—how would that reduce that feedback loop? Just by literally reducing how much signal is going back and forth? It's just the highway—like, deal with the problem that's causing that. When you successfully intervene on a Vagus Nerve—to the extent that you can—what happens? Does it just get less fiery?
Brent: Again, I'll qualify that it's less the nerve itself, is more the person, and the nerve is part of that person. I've learned a lot of osteopathic manual therapy called Visceral Manipulation, which is a manual therapy technique that's targeted around more treating—or trying to help just feel, assess, move a little bit, help connect a person to—the tissues around their organs. On the premise that people experience a lot of their emotions in and around their organs. If you're really sad, you can have a heavy heart. If you feel a lot of grief, a lot of that tends to be in and around your bronchial tubes. If you're anxious, your loops of your small intestine turn, trying to churn into knots. And your Vagus Nerve is tied to that experience. So trying to help calm or treat the Vagus Nerve is via the fascia around those organs. People have more of a connection to feeling the tension they hold in their muscular system, less so what might be in and around their organs because you can't touch them as much. If you understand the anatomy of where organs are and what they're attached to on the inside—and the general kinds of stresses and emotions people tend to hold in around them—you can, with your hands, start to push on people in a way that starts to just kind of engage those tissues. Help people feel that that's where they're holding something. If you can hold it and take it into a bit of a position of ease... and get people breathing a little bit... it can help them let something go. Which in itself creates a calming sensation in the body, which then will calm a bit of that overactivity that's happening within that Vagus Nerve. Because it does affect different parts—like around your heart, or around your stomach, or into your ear—it's like you can get less amps running through the system. Again, using that electrical grid scenario: there's a certain number of amps running through you. If you crank up those amps too high, it gets dysregulated. If they get too low, it's dysregulating. We function well in a certain range. We can globally have a whole bunch of coffee and see how you feel, or very locally in certain parts of our body you can start feeling like there's too much signal—my body's paying way too much attention to my arm or to my stomach. And it's a means of subtly helping people kind of calm that down in just a more of a manual therapy kind of way.
Matt: Interesting. And what I like about the thought is that it's kind of uniting two ideas—which is something you've said with basically every treatment you offer: "I can ease the tension in your system, and then you have to use that eased tension to find out how to ease the tension in your system." And that is a key relationship between treating somebody and the way that they need to make changes themselves.
Brent: It's the whole, "You can give a person a fish or teach them how to fish."
Matt: Yes. In this case, it's kind of like, "Let me catch a fish for you and show you, and then I'm going to give you the rod."
Brent: Exactly. There are fish in that lake. Here's proof.
Matt: Exactly.
Brent: And like, maybe it's you that's making it so you can't figure out how to fish. Let me show you how to do this a little bit. That's where you have to start just calming people down a little bit and let them go through a cycle of seeing that like, "Oh, I felt better. I come back, I'm all amped up again. Oh, I feel better." That's where they start finding a bit of some motivation to... maybe they got to do something to not be totally reliant on me to do that for them.
Matt: But they can draw on those moments with you to access them, because I think that's a huge part of teaching someone something—is giving them access to the cognitive state they need, or body state, to actually do it. And like you're saying, sometimes they just can't even get there themselves. So that's maybe an interesting thing that practitioners do, is create a memory almost. Like, I think about that in a first session—if I'm doing math, I really want that kid to have the feeling of, "Oh, I know how to do math. Oh, I got that." Because as soon as they can lock in on "I can get it," there are moments where "I have got it." Then their homework goes better when I'm not there.
Brent: I've noticed that with my daughter after you've taught her some math. Actually, she's starting to actually teach some other kids math in class right now, which has been good.
Matt: Yes! That makes me really happy.
Brent: But you can try to give people the tools to do it themselves. That's where and why most different forms of meditation and yoga and things have breathing practices in them, because your emotional state gets reflected in how you are or aren't breathing. And it's one of the physiological systems that does happen under the hood—like, you're not totally paying attention to how you're breathing, it will keep you alive. But if you can learn how to tune into that and do different forms of box breathing, or 4-7-8 breathing, or different... that gives you access to calming down your Vagus Nerve and your body as a whole.
Matt: I discovered something. I think I was telling you about this app that I found called "The Way." It's a meditation app that's extremely technical, which I really love. And the technique around breathing that I had never tried is labeling the in and out breaths. Just, as it comes in, you just say to yourself "In." And as it goes out, you say "Out." And it has brought a relaxation to my breath that no other breathing exercise ever has. I have this theory that it's related to linking the breathing to your conscious mind. A word is the most conscious thing our brains do, is create a word. So when you have a deep physical sensation and then you have a word for it, I think that integrates your sense of breathing. And I notice that I will start hearing in my head "In... Out..." just walking around, and I'm not even thinking about it.
Brent: Need to put some kind of context around it. Where I like to tell people to do 4-7-8 breathing—that you're going to breathe in for four seconds, hold it for seven seconds, out for eight seconds—it's same kind of thing. You've put some kind of label on it. In my office on the wall I have a poster that has a picture where we can see a woman—and she's kind of translucent—you can see all the organs underneath. And try to just point out to people how big your lungs are, and that they start above your collarbones, wrap around your heart, and they're underneath your whole rib cage. That there are these big balloons inside you. So trying to visualize these two big emotional bags inside you that, while you're doing that 4-7-8 or the "In" or the "Out," that you're inflating them to the point that it makes your rib cage stretch a bit. And so you can actually visualize what's happening in there. You're thinking about it a little bit. And even at that point you've paused for a sec and you're engaging in the process of your breathing.
Matt: Yeah. And you brought your attention into your body, which is a huge problem for a lot of people who have their attention out here. People are like, "Take a deep breath"—which actually can cause you to hyperventilate. The exhale has to be longer. The hold and exhale has to be more than the inhale. Usually like by a—you know, in 4-7-8, it's like a four-to-one ratio. And that's something I never learned. And now I say to my students, "Take a deep breath out"—which is actually illogical, but they totally get it.
Brent: Again, more tilt on the anxious side, don't realize that they're not breathing out. If you're having a bit of a panic attack, you're trying to get air in. So trying to tell people to breathe can actually be counterproductive. It's: "You got to calm a little bit and do a slow, longer out, and then a shorter in." And then they'll realize they start finding the space a bit more.
Matt: What I want to bring up is something that I feel like we could just scratch the surface on, because it's a huge topic. I'm really specializing in a tiny caseload and focusing on major transformative change wherever I can. Especially if I'm working for people for like a year—they're paying me like a private school tuition—I want to provide two private school tuitions worth of value. So that's got me thinking about the mechanisms of transformative change, or radical change. And I want to say at the outset, I'm not talking about radical change that happens in a moment of insight, because I don't think I've ever seen that happen for real. Like, you have a moment of insight, but then the next day you forget and then you don't do your homework or you don't do the thing and then it's gone. So I'm talking about when people really change the way in which they relate to the world. And I'm trying to identify, like, what are some of the crucial variables? I mean, we're not going to get that done in this conversation. But a question I have for you and for me is: when somebody has made an incredible change, what did they change? What variables did they self-regulate? And of course, it differs by person and all that. One thing I'm thinking about in my work is parental involvement—something I never thought of earlier. And now I've noticed that in all the cases where the radical change happens, the parents are on board for what we're doing and they don't have like a lot of resistance, or I've worked through the resistance with them. What do you think?
Brent: The biggest thing I could say I would... that I've witnessed or I've seen... has been people that have decided to do psilocybin-guided journeys.
Matt: Word.
Brent: I've seen people that have been really stuck. I can keep putting out fires for them... they have grooves of thought that they cannot get out of, and that is the fundamental part that's making them uncomfortable. And I've seen people work with counselors and do like a big psilocybin-guided journey and then come back... like, within the first couple weeks of after that. And first off, feel how differently and less tension they hold in their bodies—particularly around their heart and chest. And then see people be a bit stunned by it and kind of not know what to do with that information of what just happened to them. And some for better and for worse initially. And then seeing them over six months or so start to make little changes over time that just changed how they relate to the world.
Matt: What's interesting there is you're saying that that allows them to make small changes on a daily basis for a long time.
Brent: Yeah.
Matt: That's interesting, because it is a big experience. And I do think that there is such thing as an "anchor state"—like a state you can go back to. I don't ever know with Derren Brown, the magician hypnotist guy, if it's real. But he has this crazy special where he gets people to rob an armored car without telling them to. He just creates all these like "anchor mental states" around action, and he subliminally tells them to do it. And he selects a group of twenty down to the three most... actually the four, and one of them doesn't do it. The four most vulnerable people. But their action—that crazy impulsive action to rob an armored car, which is not a real car—is a relationship between what they're doing in that moment and all these anchor states they can now remember, which are like, in this case, around criminality. But it's interesting to think about how, as a practitioner, you can provide an anchor moment—like we were talking about with the fish, too—that then allows somebody to do small things in the future. Like I'm thinking about the math again. It's like, they're in their homework. They're not feeling that amazing feeling when they were working with you and they really got it. They're feeling confused. But they no longer feel that they could never get it. And that is creating the openness for them to try for another five minutes, which then starts a positive feedback cycle where like, "Oh, that kind of worked." So next time I can give it seven minutes, or I can do it two days this week. Because that's what I've noticed, is that transformative change comes when somebody decides, "Like, every day I am going to do something a little bit differently." And what I think is constant is that they're focused on the situation and like they're focused on making a change. But it's those little adjustments—you know, 1% a day compounded over 365 days is huge. Now I'm starting to think, oh, there's a relationship between the big moments and the ability to stay persevering in the little moments.
Brent: Very much so. And the nature of my job, I see people through a lot of big moments and can see how it either can take them down, or be the thing that was traumatic at the time but was the impetus to change over time. I see people that have gotten car accidents, or had their partners die. I see a lot of people where they're just transitioning to retiring and figuring out their new identity as a retired person. I've seen people thrive in that, or seen a number of just some older people that have their partners all of a sudden died, and so some big shock to the system things. Once you kind of deal with that, it can be the thing that be like... Or I saw a guy wake up in a hospital bed after having a heart attack in his early 50s and his hospital bed said, "I'm going to do the Iron Man this year"—after never having done a triathlete in his life and was not built to be an Iron Man guy. And went and did the Iron Man for like the next four years in a row until I'm like, "Okay, this is now a year to take off from doing the Iron Man."
Matt: Yeah. "You did it. Now all your joints hate you and you need to take a break."
Brent: Sometimes you do need a shock to the system because we are creatures of habit and we get down into just grooves of thought and how we do things, and just the thought that you could never experience something different—that people have a hard time seeing that.
Matt: A lot of times in a case, a person might be thinking "There's no hope for me." And I'm thinking, "Oh no, something's going to happen in your life." Like, I can see your response of... some shit is going to hit the fan at some point and you're going to respond to that. But what if instead of that, we like tried to create a bit of that experience right now, so you don't have to bottom out on it? You don't have to wait until you have a heart attack or whatever. And I think it's an interesting thing to think about how a clinician's job might be to like—without a trauma—try to create a similar experience. You can't literally do those experiences, but you can create some peak experiences. Like the relief you've mentioned—you create a moment of relief. For me, I think it's usually a moment of confidence for somebody who has not felt confident.
Brent: It's something that does shock the system or rattle them a little bit to help them be like, "Whoa, like, it can be different? I kind of liked it that way. How do I get that?" Without being creating some level of addiction.
Matt: And maybe that's the memory piece. This is super speculative, but addiction is highly focused around the seeking and wanting behaviors—not the actually what you get. Which is why you get addicted to something that doesn't make you happy. But being able to savor the result—which is less of that seeking and more of the reward part—and being able to bring that up in your mind, oh that feeling when I felt good. We were talking about quitting caffeine. And when I was having trouble with that last week, I anchor-stated back to this moment two weeks ago when I could feel my reduced caffeine reducing my stress. Like it's a physical memory of it. So I think this anchor state idea is interesting for maybe even teaching to people. I'm thinking about clients I might mention this to and have them try to actually bring up an anchor state, like when they felt confident in math, or something when they're feeling dejected.
Brent: People that have had a hard time for a long time, they can tend to withdraw and do less and less and less. Trying to find something to make them do that's hard... we want to support people, but we also coddle people. So create a little controlled trauma in their life and make them do something hard, and then see that they survived it and might feel a little better on the other side.
Season 1 of Why Things Hurt & How We Learn has 8 episodes - click here to visit the podcast page and see them all