"There is a voice that doesn’t use words…. Listen!". An exploration of psychological safety through the lens of psychobiology.

Abstract

The mind-body connection has long been understood across cultures, where multiple approaches to psychological healing rely on body awareness and body connection. However, this approach seems to have been lost somewhat in the modern world and particularly in Western approaches to mental health care. There is emerging evidence that body-based treatments are effective in reducing mental health symptoms and disorders such as functional neurological disorders (FND). Experienced clinicians who specialise in complex mental and physical health, are advocating for the inclusion of physiologically informed therapies and techniques to compliment the already well established ‘top-down’ approaches. These ideas are discussed further in the initial chapter.
Chapter 2 describes the systematic review, which was conducted with the view of understanding the relationship between physiological responses to stress and adult attachment representation. A total of 10 papers were reviewed and there was evidence of Bowlby’s internal working model, as supported by individual differences in physiological responses. However, responses to stress across studies, were not always consistent and other perspectives were discussed, including a dimensional view of attachment. The benefits of using physiological data in clinical settings to further aid understanding of an individual, was highlighted.
The empirical paper described in the final chapter, explored the physiological underpinnings of FND. Previous research has identified patterns in interoceptive awareness and dissociative tendencies in the condition, however this study wanted to consider FND from the perspective of psychological safety, as defined in Polyvagal theory. A cross-sectional study was conducted with participants who had an FND diagnosis and completed measures of interoceptive awareness, body awareness, neuroception and symptom severity. Psychological safety did not differ from normed populations but a pattern of co-activating sub and supradiaphragmatic responses was found with interoceptive awareness partially mediating the relationship between autonomic dysfunction and symptom severity.

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Identifiers

ORCID for Holly Hannah McMenamin: orcid.org/0009-0001-6931-3377

ORCID for Gaby Pfeifer: orcid.org/0000-0002-8737-1255

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