91 I Safety, Threat & The Nervous System (Part 1)

Check out the full series on ⁠⁠Youtube - Roots of Care Series⁠⁠

Overview:

We continue our Roots of Care series by exploring how symptoms serve as a form of communication, delving into the fundamentals of somatic experiencing and the practical application of polyvagal theory in clinical care. Together, we break down the nervous system’s adaptive states—including the social engagement system, sympathetic drive, and dorsal vagal shutdown—highlighting how trauma can shape the body’s responses. We reflect on our own skepticism about new models and discuss the value of separating emotion from physiology, expanding our capacity for self-awareness and connection with patients.

Three Takeaways: 1. Symptoms as Communication

A central takeaway is the perspective that symptoms serve as a form of communication from the body, attempting to convey underlying messages rather than simply representing pathology. This framework encourages clinicians to listen for what the body might be saying, shifting away from merely treating symptoms to understanding deeper causes

2. Polyvagal Theory as a Useful Clinical Lens

The episode explores polyvagal theory, which suggests the nervous system operates in a hierarchy of states (social engagement, sympathetic, dorsal vagal) that influence both physical and psychological health. Understanding these states can help explain conditions not easily addressed by a strictly biomedical model, such as IBS, fibromyalgia, or chronic constipation

3. Separation of Emotion and Physiological State

A powerful distinction is made between emotion and physiological nervous system states. For example, a racing heart might be interpreted as either excitement or fear, depending on context and learned associations. This separation can help clinicians and patients better navigate ambiguous sensations and foster self-awareness

Guests

• ⁠⁠Sophia Malik, ⁠⁠MD, MPH — Family physician and Somatic Experiencing® Practitioner (⁠⁠https://drsophiamalik.substack.com)⁠⁠
• Rachel Weiner, MD, MPH — Family physician

Resources mentioned

• ⁠⁠Somatic Experiencing® (SE™)⁠⁠
• ⁠⁠Compassionate Inquiry® (CI)⁠⁠
• ⁠⁠adrienne maree brown⁠⁠

Books

• ⁠⁠Vine Deloria Jr., The World We Used to Live In: Remembering the Power of the Medicine Man⁠⁠
• ⁠⁠Efu Nyaki, Healing Trauma through Family Constellations and Somatic Experiencing: Ancestral Wisdom from the Snail Clan of Tanzania⁠⁠
• ⁠⁠Alondra Nelson, Body and Soul: The Black Panther Party and the Fight against Medical Discrimination⁠⁠
• ⁠⁠Howard Thurman, Jesus and the Disinherited⁠⁠
• ⁠⁠Dean Spade, Love in a Fcked-Up World*⁠⁠
• ⁠⁠Peter Ralston, The Principles of Effortless Power⁠⁠

About Roots of Care A series on whole-person, trauma-informed, and community-centered primary care, produced as part of the Healthcare for Humans podcast.

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