Do you even regulate?

What is a good definition of “regulation” or “regulated”?

That’s a question that was asked in a recent Q&A I did and it’s actually a perfect start for this post I’ve been trying to write for a week now. It hits the nail on the head in terms of the problem I see with content that tells you to “regulate your nervous system”, or that suggests that a “regulated nervous system” is something that is aspirational, and achievable, through these hacks that someone teaches in a 30 minute workshop or at a retreat.

Nervous system regulation content often follows common marketing strategies: It takes a common situation, pathologises it, and sells you the solution. For example, that feeling of overwhelm, stress and restlessness that a lot of people are feeling? Now it’s a personal problem that can be solved by each one of us, individually, with the right breathing technique, tapping or shaking routine.

But there’s a problem here: The goal is rarely defined. Even if not put into these exact words, it is often implied that those who master “nervous system regulation” are able to remain calm in the face of the storm, steadily rising up to the challenges of daily life while speaking in a gentle voice to those around them. But is this an achievable goal when we consider how the nervous system works and how our reactions to our circumstances are constructed between our brains and bodies?

As I described last week, our autonomic nervous system reacts according to what our brain predicts is about to happen next. These predictions are based on our previous experiences. That explains why there is so much individual variation in how we react to different situations – while one person remains unimpressed, another might spiral into panic in the same situation. And there is also variation within-person – when we are sleep deprived or hungry, or when we have already had a bad day, we will react differently than when we slept well, are fed well and have had a good day so far. Is it realistic, then, to expect ourselves to be able to react calmly, and considerately whatever the circumstances? And is it fair to assume that in either of these scenarios, regulation should be achieved with a breathing pattern (rather than, for example, a snack, or a break, however small)?

You can see that it’s fairly impossible to determine a state that our nervous system *should* generally be in. Equally, you will also understand that “regulation” might be a much more difficult undertaking in different situations, the same strategies might not always do the trick and that is not a reflection on the individual.

What is often implied in the nervous system regulation content I come across, is that someone with a regulated nervous system, while possibly not always (but mostly) calm, should generally be comfortable with their emotions and reactions. They should be able to take control of themselves and act intentionally at all times.

Staying calm and comfortable in any situation certainly sounds appealing but is it really a realistic or even healthy goal? Life is stressful and things happen outside of our control that influence our emotions – and it’s ok to react to that. Expecting that we maintain some kind of zen at all times might lead to suppression of our responses, which could have negative effects for our mental health in the long run. In fact, if the goal is “comfort”, does that eventually lead to avoidance of discomfort? And is that sensible? A lot of mood disorders are associated with intolerance of discomfort – anxiety, panic disorder, OCD, for example. Therapy, then, does the opposite of “nervous system regulation” – therapists expertly guide patients or clients towards tolerance, comfort with the discomfort, instead of reducing it. Therapists I have worked with have told me that patients often rely on these regulation techniques as a safety net. That can feel comfortable but when this safety net fails (due to any of the factors I mentioned above, for example, sleep, hunger, general stress, or even just circumstances that prevent their use), it can make the situation even worse. Because in reality, life is often uncomfortable and resilience lies in understanding that discomfort doesn’t equal danger and that it does pass, not in trying to reduce or avoid the discomfort. And often, great things can be achieved when we learn to tolerate the discomfort we encounter along the way.

Of course, techniques such as certain breathing patterns, tapping or distancing can have their uses – as continuous practices they can get us used to getting out of our heads and in touch with our internal sensations. They can help us practice detaching from thoughts and moving our focus towards other things. There are many cultures in which breathing or movement practices have been part of mental and spiritual well-being for centuries – something that is probably not credited enough in the overwhelmingly white social media content on this topic. In acute situations they can help us put the brakes on an emotional spiral that might lead us to do something we might regret. For example, a situation that I frequently find myself in, as, I’m sure, do many parents: heated situations and misunderstandings with my kids. I often try to take a deep breath before I react to my kids’ shenanigans so I have time to consider whether they really need a strong response, and to avoid overreactions.

And that’s essentially also what these techniques do, first and foremost – they help us interrupt our habitual patterns of thinking, feeling and acting and (ideally) give us a minute to become more aware of what is going on and question and adjust our reaction. That’s what I’m convinced is their foremost working mechanism and use (see here, too). Secondary to this, if we are able to implement these techniques successfully (this requires practice!), they might also act physiologically on our system, for example, through an increase of available oxygen in our blood or through mechanical receptors telling our brain that our lungs are consistently inflating fully and slowly. Unfortunately, however, these breathing techniques, massages or tapping are sold as physiological “hacks”, that means as modalities that work “bottom-up”, overriding our own physiological responses. They are often sold as a physiological techniques that “solve” a problem without the need for cognitive input, without the need to think about it much or question how we got to responding the way we did and whether it’s justified. It’s regulation for comfort or as an automatic response – avoiding the (interal and external) circumstances that gave rise to our responses.

At the last moment before publishing this, I had a conversation with someone who suggested that “regulated” meant “flexible”, i.e., someone is able to calm down after experiencing arousal, in whichever form, and to become excited when that is warranted. That is probably the most sensible interpretation of nervous system regulation narratives that I have come across but not one that I have felt is commonly communicated in the content. I have seen explained along the lines of “a regulated nervous system is not always calm” but the techniques that are often taught and referenced, suggest that the goal is to reduce activation, to calm down.

But even if a “regulated nervous system” is completely in the eye of the beholder, what about the other side of the coin? Nervous system DYS-regulation?

More on that another time, maybe.

But there are some bigger issues with the “nervous system regulation bubble”. I alluded to this last week: Nervous system regulation is sold as an individualistic solution to issues that are often bigger than our own personal discomfort – lack of support for mothers, the general stress of life in times of climate change, war, famine and inequality, tech giants trying to make us more and more dependent on their platforms and services, and more. The message “all you have to do to be happy is just these three physiological hacks” falls short and borders on gaslighting when it feels like the world is on fire. It also falls short for people who struggle with mental health disorders and need professional help. In fact, the Venn diagram of people who tell you to regulate your nervous system and people who tell you “traditional” talking therapy doesn’t work is almost a perfect circle – and that makes the problem even bigger. When you combine stressful circumstances plus mental health disorders plus the avoidance of discomfort, plus a social media account with a huge following telling you that the therapist you just contacted might not be telling you the truth about the efficacy of their services, you can see how unsettling that might be for a vulnerable person. I don’t like it. I think you can tell. Nervous system regulation is not a universal solution for any and all discomfort

To close out, as always, the question: if there is some use in these techniques, then how can we talk about them with more accuracy and scientific validity?

We can be honest about what a well-practiced breathing practice, tapping routine or any other brake can and cannot do for us:

They can give us the self-awareness to recognize when we are about to overreact and the time to adjust our behaviour to enable us to think and protect our relationships with those around us. First and foremost, they enable us to break automatic patterns pf thinking, feeling and behaviour. What they don’t do is “hack” our system physiologically, on the contrary, they give us an opportunity to think, use our cognitive abilities, instead of getting caught in a spiral.

They can be a temporary solution that sometimes enable the use of long term solutions, for example, as grounding techniques during therapeutic work or to enable us to recognize and question our own patterns.

They are not long-term solutions or safety nets. They will not help us feel calm and happy at all times. And they will, most likely, not be the key to recovery from mental health disorders for most people.

We can also, as always, be specific about what we’re actually doing – instead of referencing “nervous system regulation”, we might talk about “calming down”, or, in the opposite case, “getting moving”. We might talk about “taking a breath” or “having a break”. This would also go a long way towards normalizing our struggle and need for support and away from the idea that we need individualized solutions or that something is wrong with the individual to be needing these techniques.

At the end of the day, I think, intentionally or not, the fact that the end goal of what a “regulated nervous system” should look like is only ever implied (and unachievable) and never precisely defined is part of the sales pitch and also what sets this content apart from therapy for mental health disorders. At the start of most therapeutic interventions, clients will clearly define goals with their therapist and identify steps to work towards them. In other words, there is an end point at which the therapist is no longer needed. In contrast, nervous system regulation can continue to sell as long as discomfort is experienced.

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