Even though the client is the one making the map, it is a dyadic process. Because transitioning between states is difficult for many clients and can lead to extended periods of dysregulation, it's important for therapists to send autonomic cues of safety, creating a shared experience of befriending.
COMPLETING THE PERSONAL PROFILE MAP.
Begin with a blank Personal Profile Map (I've attached a template) and coloured markers. The map can be drawn in pen or pencil, but my preference is to add colour to the mapping process. Colour is one of the first ways we learn to distinguish objects, and studies show colours evoke physiological arousal and psychological effects (Yoto, Katsuura, Iwananga, & Shimomura, 2007). Working with markers takes adolescents and adults out of their ordinary habits, interrupting ingrained patterns of using pens, pencils, or typing. Offering coloured markers brings clients' attention to the ways map making is more than a top-down cognitive exercise and invites them to move into a different way of experiencing. For children, who are not yet immersed in the grown-up ways of working, crayons and markers are still linked to creativity.
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...choose the coloured markers that represent that autonomic state with the question, "What colour are you drawn to as you prepare to map sympathetic danger, dorsal vagal life- threat, and ventral vagal safety?" This is an opportunity to practice making an autonomically informed choice by tuning in to the information communicated from the autonomic state rather than listening to a cognitive story about colour.
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During the map-making process, each state will be activated as it is mapped making it essential to end by completing the ventral vagal "safe and social" section as this is the autonomic state you want your clients to actively experience at the end of the exercise. Begin by completing the sympathetic section and then move to the dorsal vagal section. The shift from sympathetic to dorsal vagal is a move down the autonomic hierarchy and for most clients this is a familiar pathway. After the dorsal vagal section, finish the map by filling in the ventral vagal section. The transition from dorsal vagal back into ventral vagal is more challenging and requires going through sympathetic mobilisation. To support the return to ventral vagal regulation, you can guide your client with use of a breath to begin a return of energy (a sigh is often a sign of the system seeking regulation); offer cues the Social Engagement System watches for (warm tone of voice, eye gaze, perhaps leaning in a bit using proximity to signal connection); and nee the sequence of leaving dorsal vagal collapse, mobilising through the sympathetic nervous system, and coming into ventral vagal connection.
Mapping a state involves activating and then documenting the qualities of that state. When bringing sympathetic and dorsal vagal states to embodied aliveness for the purpose of mapping, help your client titrate the experience with just enough of a flavour, or taste, of the state for it to be accessible for mapping. For the ventral vagal state, invite your client to experience "filling from their core to their skin" creating a fully embodied and alive experience. Ask your client to sense their embodied experience (neuroception) and then bring that experience to awareness (cortical perception). Invite your client's attention to thoughts, feelings, body responses, and behaviours: "For each state, fill in the section by writing what it feels like, looks like, sounds like. What happens in your body? What do you do? What do you feel? What do you think and say?"
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To give some examples to assist in that process, here are the introductions I often use for each phase.
Sympathetic nervous system:
Remember a time when you felt the sense of sympathetic mobilising energy moving through you. You might feel a sense of too much energy flooding your system, a sense of unease, perhaps even a sense of being overwhelmed. You might think one more thing will put me over the edge! And now let just enough of it into your mind and body to get. flavour of it, and then begin to map it.
Dorsal vagal:
Think of a time when you felt the dorsal vagal sense of disconnect, a sense of collapse. There's not enough energy to run your system. If you were in a room full of people, it might feel as if there was a Plexiglass shield between you and them - you could see them but couldn't reach them. It might feel like depression. It's hard to find hope. Just let a tiny bit into your mind and body. Just enough to get a taste of it. And now begin to map it.
Ventral vagal:
Think of a time when you felt the flow of ventral vagal energy. The sense that everything is okay, not wonderful or perfect but okay. The world is safe enough, and you can move through it with ease. Bring this moment to life and let it fill you....from your core to your skin. And when it's fully alive, begin to map that.
As your client fills in their map, have them notice how their sleep, relationship to food, and use of substances is affected in each section.
When your client finishes each section, ask them to complete the two sentences, "I am....." and "The world is......" These two sentences identify the core beliefs at work in each state, and, although not new realisations, clients often recognise them in new ways.
At the completion of the mapping exercise, ask your client to share each section with you following the same order in which the map was created: sympathetic to dorsal vagal ending in ventral vagal.
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Get to know the body, behaviour, and belief landmarks they have identified. In this process, you and your client can sense the shifts, noticing together difficulty or flexibility in moving between states. This is a time of ventral vagal connection as you remain curious and compassionate and actively engage your client in co-regulation.
Some clients struggle to find a moment of ventral vagal regulation. They may believe that ventral vagal energy is missing in their nervous system. One client told me she was convinced her vagus was broken! The present-moment attuned connection between you and your client can be the source of safe social engagement that brings the ventral vagal state alive for mapping. You might ask, "In this moment, between us, in this safe space, what is your autonomic nervous system telling you?" Connection with a pet is another way to find a moment of ventral vagal safety. A loving connection with an animal predictably brings a ventral vagal response. Research with dogs and the owners has shown that an elevated human heart rate is regulated when an owner is reunited with their dog (Beetz, Uvnas-Moberg, Julius, & Kotrschal, 2012). Experiences in nature also bring the ventral vagal state alive. A person's relationship with nature has been shown to have important effects an well-being (Nisbet, Zelenski, & Murphy, 2011); time in the natural environment reduces stress (as measured cortisol levels) and affects psychological health positively (Ewert, Klaunig, Wang, & Chang, 2016). When relationships have been a source of dysregulation, nature can be a pathway to finding a ventral vagal moment to map.
Using the Personal Profile map help your client consider which state they most often use to navigate daily living. An alarmed, hyper vigilant sympathetic response or a dulled, nonreactive dorsal vagal response? For some clients the border between ventral vagal and sympathetic responding is their familiar spot. Without sympathetic vigilance, they feel unsafe. For other clients, the flavour of dorsal vagal disconnection is their accustomed place. For many clients, the starting point is "dipping a toe" in ventral vagal energy and getting used to the state of safety that their nervous system has not had access to. A client's place on their autonomic ladder helps guide your session. In a sympathetic or vagal state their autonomic nervous system stays locked in story of survival while a ventral vagal state brings connection and opens the system to the possibility of change. Once your client can map their autonomic states, together you can assess safety and risk from an autonomic perspective. Nearing the end of a session, the question "Where are you on your map?" is a reliable gauge for exploring what would be helpful for your client as they transition back into the world beyond the safety of the therapy session.
Sometimes clients act from a simple desire to do something, sometimes their actions are prompted by and unmet need, ad knowing where they are on their map offers useful information. Take the question to engage or not to engage? Remembering that state drives story, a decision to engage might be a ventral vagal-inspired desire to be in connection with someone or might be a sympathetically driven need not to be alone. One brings a story of friendship and reciprocity, the other a story of the relentless search for connection. On the other side of that question, a decision to not engage might again be a ventral vagal experience of finding delight in an evening of reading and a story of self-care or a dorsal vagal experience of despair with an accompanying story of being a misfit.
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Clients get to know themselves through map making. In the process of creating their Personal Profile map, clients learn to turn toward their experiences without judgement and see their dysregulation as an attempt at protection and their need for connection as a common human need.