What the perinatal autonomic cascade means
Why it Matters
Detail of the Doni Tondo, 1506-1508, Michelangelo, Gallerie degli Uffizi, Florence, Italy
Yesterday we published the preprint of a paper entitled ‘The Perinatal Autonomic Cascade: A Sequential Model of Neonatal Autonomic Initialization’. Today I want to explain to you a little bit of what it means and why it matters.
If you haven’t had your head in the sand for the past decade, and you are anywhere near the healing arts, as patient or practitioner, you have been hearing for a long time about the healing power of the vagus nerve. The vagus is the primary conduit of the ANS, which, to gloss it in a certain manner, is the neural architecture of the mind body connection. The ANS controls the deepest biological levers that govern your moment-to-moment experience of wellbeing/ illbeing.
Many people working in trauma therapies over the last couple of decades have recognized that the primary archival sites of allostatic load are peripheral, locked into tissue localized at sites in the body where incomplete autonomic responses did not execute, or where shutdown responses did not thaw: not in the cranial brain. Archived allostatic load changes things in the brain because it changes the input architecture of afferent signaling to which the brain respond. While some recent (opinion) papers would have you believe that these mechanisms are in predictive processing networks in the brain, which is not false, it misses the point entirely, which is that predictive processing is driven by the quality of afferent signal. It is not decoupled from sensory and interoceptive inputs. Changing the brain’s predictive processing upstream - in the brain - without addressing the allostatic loads in the input system is a bit like adjusting the thermostat in a burning building so that the thermostat can tolerate a fire.
Less alarm signal, yes. Building is still on fire.
When I work with people in the Hearth Science autonomics clinic, one of the remarkable and predictably strange things about this is that often people arrive with a presenting condition that seems directly attached to an event (e.g. a surgery, an impact collision, etc.) and as we work on the healing trajectory, it turns out that there are other events with a similar pattern – e.g., down to the specific way that a person rotates an arm to attempt to catch themselves when falling – that are ‘buried’ underneath the thing that brought them into the clinic.
Having just come from Rome and Florence, where Etruscan buildings were overset by Roman architecture, which was used as foundation for Renaissance buildings - this is a little bit of what comes to mind. The foundations of the newer buildins ARE the older buildings. They often sit right on top of them, in their footprint.
As clinical example– I recently worked on a case with someone in their late forties where an event that happened at 29 years old (a bicycling accident), an event that happened at 4 years old (a fall), and an event that happened at 9 months old (a surgery as a result of something falling on the person) all had essentially identical movement escape action pathways. A particular twist at the trunk, one hand coming up and across the body in a specific arcing motion, the other hand coming up secondarily, the turning away of the shoulders, neck, and face.
What does this mean?
Often what we are treating with the Autonomic Nervous System is simply the most obvious visible surface of an autonomic architecture that has deeper, older, and invisible priors. Something the body has been trying to do again and again since it was interrupted when it first happened.
Ok- why am I telling you this?
Well, if you think about being born and how strange it is- essentially the transition from a fetus that is more-or-less a marine animal being fed, watered, and breathed from outside– to an air-breathing, water-drinking, food-eating, terrestrial animal that has to organize movement against gravity, there has to be some set of mechanisms for turning all of this newly needed equipment on. The heart has to reorganize its beat mechanics, the lungs have to inflate and activate, the body has to pressurize so it can maintain blood pressure against gravity, the body has to activate thermoregulation, the balance systems have to initialize.
That mechanism IS the Perinatal Autonomic Cascade.
It is not the only mechanism, or the total mechanism, or the final mechanism: it is neural ignition of all these systems. A bit like firing up an engine for the first time. Neurology is not the only mechanism of bodily signaling- neurochemistry is also profoundly involved, diffused through vascular architecture and across fascial architecture, but the wiring, down to the finest unmyelinated fiber networks, has to initialize in terrestrial format.
We have now precisely mapped this sequence in its totality in two adult patients. The first one happened June 6. We did it partially again June 13&14 with a different person, but their birth story made it more complex. We did it completely again on June 27.
I have been seeing and working with elements of the cascade in isolation for a long time. I have seen elements of it in dozens of patients. I sensed that there might be a larger architecture at play. Now we have witnessed the complete sequence two times. N=1 could possibly be an anomaly. N=2 with something this intricate? Unlikely. Obviously we are early stage with this, but the implications are pretty significant. Why?
Because if the pattern from the hundreds of complex cases we have seen at the clinic holds true, and in fact much of what is presenting to us as active symptomology is in fact reverberations, echoes, or repetitions (the available visible surface) of early autonomic events that have been lost to us because we don’t remember them consciously, didn’t have a felt vocabulary to resolve them when they happened, and didn’t know what they were at the time– then what we have found here, with the perinatal autonomic cascade, is the ‘source document’ of incomplete structuring that may be the original incomplete or unstructured source of the allostatic loads whose pattern language expresses itself later in life as pathology. Likely across an extraordinary number of disease vectors, since the cascade is what activates and coordinates so many biological systems.
On the converse side of this, on the salutogenic (health-creating) side, perhaps the reason some people are so enduringly healthy is because they did complete this at birth.
What we are hypothesizing, and in the midst of documenting, is that completing the cascade later in life may, at a neurological level, reset the baseline conditions of organism such that it can reorganize truly from the ground up. In plain words, resetting the original autonomic template for thriving.
May you be well this day.
-Gabriel
DO YOU WANT TO LEARN THIS?
I am teaching an advanced three hour class on the Perinatal Autonomic Cascade August 8. It is part of a series of three advanced classes I am teaching on zoom this summer. If you are not ‘advanced’ in this work, you are still welcome to come, you will find it interesting, I am just likely to use a level of technical terminology some of which you will not understand, and my primary pedagogical purpose in these classes is to train wellness professionals to begin to recognize and make use of elements of the cascade in their treatment protocols, which means that I will not answer basic questions.
If you recognize yourself in this story, think you may have had a difficult birth, were told that you did, et cetera, and you are interested in experiencing this work directly, I run a boutique, high-selectivity clinical practice at the intersection of advanced autonomic science and complex case intervention. It is referral-based and intake evaluated. A lot of our referrals come from neurologists, integrative medical practices, advanced somatics practitioners, etc. It is also expensive: not a general wellness offering. I work with people around the world, primarily over zoom. I see a limited number of people face to face at our eco-reserve in the Bay Area.
We have a couple of clinical spots available in late July and August. A couple more in November and December. First step there is to fill out a clinical intake form.
LEARN MORE ABOUT THE AUTONOMICS CLINIC, DECIDE IF IT IS RIGHT FOR YOU.
Here is the paper. Again, fairly technical but you’ll get the gist of it even if you don’t have a technical background. You can read about the nine phases of the cascade itself, and what they are accomplishing for the organism. A second of our foundation papers, after the paper on Epistemology. Freely available as a resource, as are all our lab’s papers on ResearchGate.
Join us for an advanced class
July 25 - Autonomics of Breath (learn more and register)
August 8 - The Perinatal Autonomic Cascade (learn more and register)