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What does Nervous System Regulation have to do with Therapy?

Updated: Oct 7, 2023

A regulated nervous system describes a state where we can move through stressors, stay present, engaged and relational, and have the capacity to process our experience.

A dysregulated nervous system describes a state in which we enter high levels of arousal and feel overwhelmed, becoming either aggressive or withdrawn or shut down.

Part 2 of a three-part series.

This is part two of a three-part series of blogs that will explore and contextualise nervous system regulation in the arenas of self-care, psychotherapy and meditation. Part 1 offers an overview of nervous system science, and suggests tools and techniques to grow your capacity to keep your nervous system regulated. If you are new to nervous system science I suggest you read that blog first.

In this second blog, I explore the relevance and role of regulation in therapy, and what working in this way might look like inside of a therapy journey for both the client and the therapist.

Early therapy experiences.

My earliest experience of having therapy was really dismal. It took place in a dilapidated building in Bristol, where I had to travel up several floors in a rackety wrought iron lift, and then wait in a grubby room to be invited into the therapy space.

Once inside I was greeted briefly by the therapist who then simply looked at me until I spoke.

I was 19, really overwhelmed and had little understanding of what therapy was. I felt completely intimidated, had no idea of what was expected of me, and didn't know what to say. I already felt ashamed for needing help, and I left the session feeling more ashamed and in a fairly dissociative state. I think I returned once or twice, but pretty quickly gave up going because I felt too stressed by the experience.

Thankfully, for whatever reason I wasn't completely put off, and I started with a different therapist a few years later. This time after my first session at her house, I got in my car, and something made me double take at my reflection in the mirror whilst I was reversing out of the parking space.

I could see something different in my eyes that was very unfamiliar. It looked like I was much more here, and I distinctly remember the relief I felt in seeing myself this way.

It is only now, looking back through a nervous system lens, that I have more understanding of what was going on for me at a deeper physiological level in those experiences.

The first one exacerbated an already dysregulated state in my system, whereas the second one supported me to come into a place of regulation.

What is nervous system regulation?

Blog 1 covers what regulation is in depth, so I won't repeat the detail again here. However, it is important to say that being regulated is not synonymous with being calm. Instead, it describes our capacity to navigate through different states of arousal between hyper-aroused (fight or flight) to hypo-aroused (freeze).

When a stimulus triggers a response in us, if we are able to feel, process and move through our response (rather than getting stuck in hyperarousal or hypoarousal), we will be increasing optimal place of regulation known as our Window of Tolerance (WOT). If however, we are not able to process our response, our WOT will stay narrow and our perception of, and reaction to the world will be filtered through the lens of a fight/flight or freeze threat response.

Our WOT is not fixed in size. We might have a large window for spending time alone, and a small window for being in groups, or vice versa. Depending on what other stressors we are experiencing, our window may also vary in the same situation at different times.

Three keys to understanding and practicing regulation in therapy.

1) Basic nervous system education:

Having some understanding of the science of our nervous system / stress responses can go a long way to relaxing our minds and bodies. Many things from nervous system science are useful to know, but here I highlight just four points that are imperative to understand for the therapeutic journey:

  • Our nervous system wiring is part of our biology. Although many of us show up to therapy feeling ashamed about the ways we behave in life, the truth is our systems are wired to react in the ways that they do. It is not because we are bad or wrong.

  • Nervous system responses operate at the level of the unconscious. Through a process called neuroception, our systems are constantly scanning for cues of safety and cues of threat and then acting accordingly outside of our awareness.

  • Regulation in therapy is about coming out of protection and into connection: When relationships are unsafe and ruptures are left unrepaired, our nervous systems learn the language of protection. When relationships are safe and ruptures are repaired our nervous systems learn the language of connection.

  • Our nervous system defence mechanisms are on our side. Simply put they are our best attempts to survive, manage risk and seek safety.

If as clients, we are supported to understand and live from these principles, they can become the ground from which we can start to loosen from shame based stories about being exceptionally messed up and fear based habits of protecting and defending. Instead we can begin the process of becoming more conscious of our survival based responses, and start to get curious about how to interrupt and change patterns of reactivity that are no longer necessary.

2) Client therapist Relationship:

The relationship between the therapist and the client is a very significant factor in the therapeutic process.

a) Safety.

If our systems have not known safety in relationship, a substantial part of the therapy process will be to slowly explore how it is to be invited into a relationship that intends safety and repair. The most shocking but simultaneously relieving milestones in my own therapy journey have been when I have felt safe enough to consciously experience my default setting of unsafety. For me these moments came about through being allowed to feel unsafe, being allowed to reject the therapist's offers of connection without being punished for it, being allowed to set my own boundaries around space and physical contact. Through being allowed to act as if I am still unsafe, it has become possible to realise what a default this has been and that it is now no longer true. Moments like these build incrementally and over time support a nervous system that is wired to protect, slowly thaw and rewire to connect.

b) Co-regulation.

A healthy experience of co-regulation is an important element of therapy. Remember that dysregulation comes about when we are unable to process our feelings and experiences. Co-regulation is the experience of learning to process them with the support of a connecting individual. When a therapist remains stable in their WOT and stays present to us, our nervous system will start to register cues of safety. These will then translate into physical and emotional responses such as our defences lowering, our bodies relaxing and our capacities to connect and communicate slowly increasing. Through the support of co-regulation our ability to feel, stay present to and process our experiences grows. We start to internalise an increased capacity to move more fluidly between different states of nervous system arousal. Our increased WOT thus enables us to take part more easefully in the continual flow of co-regulation that happens between humans, supporting us to create trusting relationships both in and out of therapy.

c) Repair.

Relational conflict is one of the most common triggers of dysregulation, causing our WOT to shrink as familiar patterns of fight and flight are activated.

Whilst we might not always have full blown conflict with our therapist, it is almost inevitable that they will 'get it wrong' for us at times, either misunderstanding something that has been said, or totally missing a cue that feels important to us. A simple moment of misunderstanding, or not noticing something significant can register as very threatening inside of a system that carries 'a history of misattunement and unrepaired relationship rupture.' Deb Dana.

A key moment in the therapeutic process occurs when we feel safe enough in the relationship to acknowledge our hurt and mistrust to ourselves and a therapist.

These moments, whilst requiring a lot of courage and a willingness to feel and communicate discomfort, offer golden opportunities for nervous system healing and strengthening. The gold is in discovering that we now have some degree of choice to either stay in, or return to connection, in moments that feel threatening to our system. With the support of a skilled therapist who is willing to take responsibility for their part in what happened, (and who understands and respects the distinction between intention and impact), it becomes possible for us to experientially realise that we can survive misattunement or misunderstanding whilst staying in connection. Going forwards, this supports us to become more robust in the inevitable ups and downs of human relating.

3) Specific Practices:

Exploring practices that can be employed inside of and away from sessions is an empowering and strengthening addition to this kind of therapy journey.

Slowing down: Our defence patterns are habitual, fast and familiar. They require us to hone our attention so that we see that we do not have to act on them. Slowing down is an antidote to dysregulation and an invitation into attunement. We become more conscious of our urgent agendas to get somewhere, rather than coming into the present where everything can be experienced more fully.


Orienting: This is a really practical and accessible exercise that involves pausing and using our senses to consciously notice our current surroundings. As we spend time feeling our feet on the ground and taking in the sights and sounds we are silently communicating to our nervous system that we are in fact safe and that it can relax. For a downloadable 10 minute recording on orienting please go here.

Tracking and Mapping: The neuroception process of our nervous system is one that scans automatically, wordlessly and unconsciously. However, these internal responses are then translated to thoughts, emotions, somatic feelings and impulses, all of which can be brought into our conscious awareness. When we learn to track our moment to moment mental, emotional and physical experience, we are effectively bringing consciousness to what was previously unreachable.

If we continue to track our experience overtime, it will become possible to distinguish the specific markers of our three nervous system states of feeling:

  • Regulated ~ Engaged, safe and able to process; (inside our window). ,

  • Mobilised ~ Defensive and vigilant; (fight or flight /hyper)

  • Shut down ~ Collapsed and unreachable; (freeze / hypo).

Once we are able to map our states, we can then get curious as to what supports us to return to, and increase our WOT.

Conclusion: How we stay realistic about the journey

Nervous system regulation takes time and in my experience it is a cyclical process rather than linear. Old patterns repeatedly seem to clear and then reappear. Trusting the process and the slow intelligence of our systems is key, and in and of itself is an act of regulation.

It is also important to realise that we are not only changing our personal stories and states. We are also taking part in a collective and generational shift of choosing something other than our long history of mistrust, defence and armouring. Committing again and again to return to the path of building our capacity for regulation is nothing less than a beautiful act of service to ourselves, each other, our world and the wider circles of life that surround it.


My work

I walk with lived experience of trauma, and am in an ongoing journey of healing through therapy, meditation and cultivating joy for life.

I have many decades of experience training large teams to work on crisis mental health and addiction services and have developed an approach to listening that is sustainable and offers protection from burnout. I am trained as a mindfulness instructor and am currently completing my psychotherapy training as a Hakomi Practitioner.

I offer group training and 1:1 support.

If you would like to explore working with me I can be reached on


Blog 1 What Does Nervous System Regulation Have to do With Me?

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