Guest blog from Benjamin Fry
Trauma is a mental health problem. Isn’t it? Not everybody would agree: Peter Levine’s famous quote is that “trauma is in the body and not in the event.” Therefore, there is something not simply ‘mental’ about it. Nonetheless, in the real world, where insurance, government policy, regulation, and red tape govern access to treatment, it is via mental-healthcare pathways that trauma (as they understand it) is addressed.
As such, trauma treatment suffers from the same difficulties as other mental-healthcare modalities; it is hard to define and objectively unmeasurable. Not all healthcare treatments suffer from this problem. We treat a broken leg by wheeling the subject into an x-ray machine and taking an exact picture of the problem. Imagine doing the same for mental health. Then we could even justify the cost of a procedure to fix it. Approximately 99% of the time, an x-ray approach will achieve a full recovery for a broken leg. But what did we do before the x-ray machine existed? How did we diagnose and treat complex physical conditions before the MRI was invented? How did we come to conclusions about neurobiology before the FMRI?
The history of medicine is fused with the history of technology. With accurate equipment comes correct diagnoses and funded care. So, where is the x-ray machine for treating trauma? If it is really in the body (as Peter Levine says) why can’t we just go and look at it?
Over ten years ago, I set up Khiron Clinics, and this same question would plague me as we treated clients, particularly in groups. I fantasised about a ‘nervous-system-ometer’ which would show us how our activation was going during an interaction or group. I wanted a traffic light system on our sleeves to let us know how others were doing so that as a group we could all try to come into that magical place of group connection (or ventral vagal).
In 2016, I had dinner with Dr Stephen Porges. I asked him if he could build me a system like this for my clinic. I visualised something like a wearable device with a body-worn display. He amazed me by saying not only was it possible, but he’d already done it with a camera. I’d never even considered that possibility. Following our dinner, we started a journey together to explore this technology, which he had called the PhysioCam.
Five years on, after quite a journey, we have the first ever working model of this technology in use at Khiron Clinics. Initially, we placed the lab kit (which included wires, a laptop, a tripod, and a camera) into a consulting room with a computer screen to display the traffic lights of colours. The traffic lights worked brilliantly at tracking the activation of our clients, but the hassle of using them was impractical. You had to log into the computer, start the programme, and then another programme, etc. We learned very quickly that therapists like to talk to clients, not look up log-in codes and deal with error messages!
As a result, we went back to the drawing board and created a consumer version. We now have a system with just two nice balls, one to house the camera and the other to glow with the traffic light colours. You turn it on, point it at the client, and forget about it.
There is no doubt that it works, but so what? What does it work for? To answer that, we turned to the Polyvagal Theory’s clinical guru, Deb Dana. Deb helped us trial the use of the original system at the clinic and in her own training, so she is ground zero of PhysioCam clinical innovation. I interviewed her recently about why and how to use this technology. One key point she empahsised was about validation.
According to Deb, trauma clients have often lost touch with their bodies. For many, the body is not a safe place to go to anymore, so they lose the valuable cues that come from these vital evolved pathways. The PhysioCam helps them recover it, like a pair of crutches help people with injuries to walk again. I love that idea.
Deb thinks this may really change the way we work for the better, and that one day people will look back and ask how trauma and other mental health issues were treated without the PhysioCam.
It is an exciting new dawn in trauma treatment, and we are currently looking for our first cohort of early adopters to collaborate with us on using this technology in practice. Deb and I will be working closely with our first few dozen customers to support them and learn from them
Benjamin is the founder of Khiron Clinics and Televagal. Both are innovative companies in the UK working in mental and behavioural health. He studied Physics and Philosophy at Oxford, has an EMBA from Oxford Said Business School and a MA in Psychotherapy and Counselling. He is also a published author and experienced television presenter