The Polyvagal Theory in Therapy by Deb Dana

Author:Deb Dana
Language: eng
Format: epub, mobi
Publisher: W. W. Norton & Company

The Reciprocity, Rupture, and Repair process is designed as a way to track reciprocity and build a habit of repair. In this process, clients learn to deconstruct an incident, understand it autonomically, and use their nervous system to guide the repair. Repeatedly engaging with this skill creates a habit of tracking autonomic connection, attending to disconnection, and practicing repair. The therapist actively helps their client track moments of rupture and together, therapist and client explore ways to create repair.

• Track reciprocity: Tracking reciprocity is dependent on the ability to be tuned in to the relationship and recognize moment-to-moment shifts. As clients learn to use autonomic state shifts to track reciprocity, questions to explore include: How does your autonomic state send the message that we have fallen out of reciprocity? What is the autonomic state shift? Is there an autonomic difference between when you create the rupture or are on the receiving end of the rupture?

• Notice and name the rupture: Once a rupture has been recognized, the next step is to help your client explicitly notice and name the experience. In everyday experiences, ruptures are often dismissed or disregarded. If unacknowledged and unnamed, they can’t be repaired. In this step, the acknowledgment and naming is through the language of the autonomic nervous system. Rather than talking about the story of the rupture, making meaning and assigning blame, ruptures are described through changes in autonomic state and protective responses (“I noticed a shift toward disconnection”), identification of cues of danger (“I felt a sympathetic alarm in response to your voice”), and habitual response patterns (“When you moved a bit away from me, I felt myself mobilize to fight and then quickly collapse”).

• Find the right repair: The repair requirement is for a return to ventral vagal safety and co-regulation. To bring about a successful repair, take time to explore what your client’s autonomic needs are to feel fully repaired and reconnected. It often takes a few attempts to find the regulating words—the words that mend the tear. When there is a return of reciprocity, the repair is complete.

• Come back into connection: The last step of the process is to make an intentional, explicitly named return to relational connection. Identify the steps of the process and celebrate the outcome. Feel the autonomic return to a ventral vagal state and the activity of the Social Engagement System. Taking time to savor the experience of resolution and return to connection begins to create an autonomic expectation of safely navigating future ruptures.

Even small moments of misattunement will be autonomically registered and, if not recognized and repaired, will build into a more consequential experience of disconnection. With a successful repair experience, clients begin to gain confidence in their abilities to engage in repair. Successful repair experiences invite a commitment to building a habit of repair.

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