The Neuro-Phenomenology and Neuropsychology of SKIN

Willson_a2R2_0002.jpg

In November, 2018 at the Alliance for the Arts in Research Universities (a2ru) national conference at the University of Georgia, I was delighted to share a 20-minute talk (audio here) on the research into neuroplasticity, neuropsychology, and phenomenology that informs my work in developmental presentations of SKIN. People who hadn’t seen the play said they got a feeling for my work in hearing this, so I hope it stands up well on the page, below.

The Pedagogy of SKIN

a2ru National Conference, November 2, 2018

As an artist, I like to say it’s my mission to expand those impossible moments when injustice and heartache find grace. As a researcher, I’ve been on a related 30-year quest to investigate the mechanisms of action within creativity that transform us.

In my early days, before neuroscience was “a thing,” I studied psychoanalytic and discourse theory to understand figurative expression. More recently, I’ve been thrilled to discover the Sensuous Theory of Laura Marks, Jennifer Barker and others. I’ve been intrigued to pair that work with research into the neuroscience of creativity, psychotherapy and medical healing. I’ve also been really excited also to get connected with a2ru, and to start hearing about the work all of you are doing.

When I heard this year’s conference theme would be Arts Environments: Design, Resilience, and Sustainability, I thought SKIN might offer a pop-up arts environment that could provoke conversation about the role of live participants in every artistic environment and exchange.

Research in neuroscience keeps revealing ways our brains and bodies filter and even design the experiences we have, through selective attention and memory and in the ways we perceive and even prefer certain stimuli. Singer-songwriter Paul Simon recently summed up one consequence of this, crediting listeners as the ultimate authors of his songs. Citing the ways we rewrite melodies and substitute words in the car or the shower, he said: “how they hear it, that’s what the song is to them.”

Yet even as we co-author an experience, the experience co-authors us. Viewing Marni Schindelman’s arresting video, just now, on the PTSD that disaster site rescuers experience after hearing endlessly ringing cell phones, I think we got a visceral example of the way sensory impressions, emotional associations, and cognitions get absorbed into memory, into ourselves.

For me, this neuro-physical, co-creative dynamic between us and the world validates ideas central to the work of philosopher Merleau Ponty. Especially his ideas of reciprocity and entwining. Ponty recognized that just as one hand cannot touch another without itself being touched, the individual only knows of her existence in ways that are experienced through and entwined with the world she brushes up against constantly.

Viewed through this neuro-phenomenological lens, I see every aesthetic encounter as having the structure of a nerve synapse. With a sender, a receiver, and a magical gap in-between, where their handshake begins.

The sender and receiver literally overlap and get tangled up in the in-between. As you may know, back in the 80s and 90s, neuroscientists discovered we have these amazing “mirror” neurons. They’re also called “empathy neurons.” Mirror neurons give us a direct experience of everything happening outside of us. Right now, watching me, your mirror neurons make you feel like you are speaking. Smiling. Putting your hands on your head. It’s a nonstop game of Simon Says. Mirror neurons are thought to help inform our theory of mind, help us guess why the world behaves the way it does, so we can predict what dangers or opportunities are coming next. Our mirror neurons make us soak up the world, so the other’s experiences literally become ours, the outer world is a part of ourselves.

I see art as a laboratory where we enjoy experimenting with this overlapping in-between. Maybe art invites a special kind of contact with the world that’s especially effective at re-authoring us.

Yesterday, some of us overlapped at my performance of SKIN.

The play tells the story of a woman—let’s say, me—who uses creative practice to renegotiate the effects of sexual violence. She dives into a variety of media as both an artist and an audience. She’s an obsessive reader of Virginia Woolf; she’s a struggling songwriter and poet; she’s a struggling academic writing her dissertation and performing her classroom lectures. She’s also struggling with intimacy and even tries using sex itself as a generative aesthetic practice.

Dramaturgically, SKIN is constructed to build up a charge that I hope will ignite that synapse between me and the audience, you, to provoke a real-time transformational exchange. SKIN is especially likely to do this for survivors of contact sexual violence -- which the CDC says is 1 in 3 women and 1 in 6 men. But since the play is ultimately about resilience and vulnerability, it can send off sparks for anyone processing the big- and little-T traumas of life.

Yesterday, many of you generously completed audience surveys, to help me learn more about the ways SKIN works – I hope – to kindle transformation and even healing. So, let’s outline some of these hypotheses and a few early findings.

I should start by talking about danger and safety.

SKIN uses a few of the dramatist’s tools that evoke a sense of danger, and many that create safety. First, there’s the content. Trigger warnings are only a thing because discussing sexual violence can signal danger. There’s also a few bits of disturbing music and a loud, jarring noise that happens a few times in the show. There’s a movement section that is likely to disturb. And there’s the fact that the audience can’t hide. In most presentations of SKIN, the setup isn’t quite like yesterday. Normally, the audience is lit by a low, warm glow, instead of the same bright lights as me. We’re can all see each other, but you have a bit more cover.

As for tools that engender safety, the instrumental and sung music in SKIN is mostly soothing or upbeat. There’s a lot of jokes, with sprinklings of goofball clowning, and the overall tone and rhythm of the piece are quiet and regular.

I also use a mode of direct address that seeks an actual response. It’s designed to continually, even explicitly, reassure. However, I suspect my direct address and eye contact can be dangerous as well as reassuring, depending on what I’m doing.

Yesterday, half of respondents said they felt uneasy at some point during SKIN, almost 40% also felt anxious. A little more than 1 in 4 felt triggered at some point. One reported a panic attack.

At the end of the play, however, most people -- including those who felt triggered or had a panic attack -- reported feeling relief, and/or hope, comfort, safety, community, closeness. Almost 40% even felt fondness or love.

When you’re trying to spark transformation and healing, fostering safety and connection is both a means and an end. Feeling safe yet alert, even a bit nervous, is the ideal neuro-psychological state for learning something new. This is especially true for anyone who has experienced trauma, because of the ways trauma alters the brain.

A grounding in safety can also help us explore traumatic material without getting overwhelmed by fear. In an early draft of my play, one survivor told me she’d had a panic attack during a section that made her sit for too long in a frightening place. She said the panic attack continued to the end of the play.

In a later draft, another survivor had a panic attack late in the show. Whether due to her own resilience and/or due to changes I’d made in the play, this woman was able to come back and find relief in the final moments, which made her eager to see the show again. In fact, the first survivor also returned a few times – for the express purpose of practicing resilience.

There’s a circular, repetitive structure in SKIN which I hope brings the audience from safety to danger and back, again and again. In therapeutic practice, this pattern is called pendulating. It helps you desensensetize traumatic memories through repeated, brief exposures. In operant conditioning, which I’ve used to train a fearful dog, you expose the subject to triggers that aren’t too intense. You aim to keep things “sub-threshold” – below a level of arousal that would be too negative to permit learning – to keep expanding tolerance instead of reinforcing fear.

Every time we return from fear to a state of calm, our brains actually grow new neural fibers, called dendrites. These connections make it a bit easier to calm ourselves the next time we get distressed. Repetition literally builds resilience.

To dig into this a little more, I’m going to summarize the neurobiology of trauma in a kind of unscientific way, giving credit to trauma researcher Bessel van der Kolk, therapist and author Louis Cozolino, and neuroplasticity expert Norman Doidge.

Think of the brain as an orchestra. When the brain is well-regulated, all the sections play in sync. Signals between areas are efficient and effective – the players can call and respond.

Trauma dysregulates the brain. Instruments get drowned out or just stop playing. There’s a lot of static, and the signal to noise ratio is inefficient. Connections are less effective.

After trauma, threats start to seem more severe than they actually may be. Too many instruments – or the wrong instruments – pipe up with every flip of the conductor’s baton. Actually, a different part of the brain takes the baton. The amygdala starts calling the shots instead of our prefrontal cortex. The amygdala is said to have been the command center of our evolutionarily early and so-called “reptilian” brain, while the prefrontal cortex, our “executive function” developed later. I don’t agree with calling the amygdala a lizard instead of an executive, but you get the point. The amygdala is in control when the issue is life or death. And when the amygdala is dysregulated, we spend our lives in fight or flight.

Whether we’ve experienced trauma or not, any time we sense danger, three divisions of our nervous system step in to help us out.

First, the Ventral Vagal Complex, or VVC. The VVC looks around for help, making bids for social responses. The VVC is highly enervated in the throat and face. We start vocalizing, smiling, looking expressively for help. I think of the VVC as the orchestra’s strings and flutes.

If danger persists, then the barrel drums, trumpets, and cymbals of our Sympathetic Nervous System or SNS start to sound their SOS. When the SNS is this engaged, the brain can’t do much else, like encode memories. This is one reason people remember traumatic experiences in bits and pieces, instead of in flowing narrative form. I think it’s also why sensory experience can be frightening after trauma. It may recall us to that disjointed, disorienting place.

If we cannot fend off or flee danger, the feeling of being trapped and disempowered is the hallmark of trauma. Sometimes, the third level of our safety system steps in. The Parasympathetic Nervous System or PNS makes us play possum: we freeze and collapse. The oboe sustains a deep hum of life; maybe a pulse from the bass.

Normally, the Parasympathetic Nervous System works in a less severe way. Let’s say we escape danger. The PNS is the one that puts the brakes on the alarm bells of the SNS, returning us to calm. Then the “executive” prefrontal cortex takes back the baton. Research has shown that any time the dysregulated brain can engage the PNS, what Norman Doidge calls the signal-to-noise ratio improves. Players start picking up their instruments to call and respond again.

In the course of development, children repeatedly go from a calm, regulated state to a dysregulated state, and back, with their caregivers’ help. As I mentioned, neurologically, these repetitions build up those dendrites (and I’m sure other connections) which equip the brain so we can chill ourselves out.

After trauma, it’s like the volume on the amygdala has been turned up, so it’s harder to self-regulate. It’s hard to trust your next call for help will be answered. And it’s neurophysically harder to return from states of fear, rage, or shutdown, to feel safe and connected. It takes repeated cycles of dysregulation and reregulation to beef up those dendrites again, as well as our tolerance, so we can take a breath before the amygdala grabs the baton. We learn how to stay sub-threshold again as we evaluate danger, and we get better at letting the PNS do its thing afterward, to relax us and lower our guard.

Just as children let their parents regulate them, we constantly tune into each other and even the natural world to regulate ourselves. And we use art. We seek contact with a presence that does something to us, neurophysically, emotionally, everything-ly.

We surely use our mirror neurons to tune into others; to give us a palpable sense of another’s mind, heart and nervous system. But we also get regulated directly by sensation, through our bodies. We see this when parents use soothing or excited tones and rhythms, deep eye contact, calming or quickening touch. We also see it when a player catches the tempo from a conductor’s baton. Or on the dance floor, when we pick up the beat. Neuroscientific research has shown that even the rhythm of our brain waves gets in sync.

Body workers using the Feldenkrais technique have also observed that when one part of the body, say the hand, is in contact with the practitioner’s hand and moves from tension to safety, there’s a ripple effect and the rest of the client’s body follows suit. It seems obvious that a wide variety of sensory input can ripple through our bodies –when watching a pounding surf, or the wind in the trees, or the grace and torque of professional sports and dance.

We can be regulated by virtual stimuli – many real sensations are triggered through the imagination. But live encounters, face to face, are different in meaningful ways. When eye contact is possible. Interactive response. Even actual touch – not in my show but often in clown or avant garde performance.

I asked the audience yesterday to imagine watching a film of the performance, with all other variables unchanged. Over half believed they would lose a powerful sense of connection.

When we are attuned in a relational exchange, I think we can even experience what I’ve dubbed the hall of mirror-neurons. Where call and response – and response – start to overlap and blend. It’s hard to tell which of us had which feelings first. It happens in love. I also sometimes feel it at the end of my play. In the performance yesterday, I had just stepped down off the stage to stand closer to you. I opened and closed my fist in a gesture that resembles a heartbeat. The guitar was going strum – strummmmm, strum - strummmmm. I’ve learned that’s the cadence of calm breath – with a shorter inhale that excites the SNS, and a longer exhale that calms with the PNS.

As I make this gesture I open a bit, in trust. And I sense a shift in the room. In that magic in-between. I think you witness what I’m feeling – translated through your mirror neurons and your own embodied response. And I wonder if it makes you open a bit more, too. I sense that it may, which amplifies what I’m feeling. It opens me a bit more. Which you experience in me, amplifying what you feel, and so on and so on and so on.

We can also observe this hall of mirrors happening within groups. Like, say, an audience. SKIN breaks a few taboos, talking about sexual practice and sexual abuse, both of which can elicit shame. Just think back to high school to remember what it’s like when shame or taboo come up in a social setting. You can feel the wave of reaction, as people withdraw as a group.

One respondent said they experienced some shame, while two felt embarrassed at points. About 2 out of 5 said their awareness of the audience around them heightened at moments of discomfort.

In SKIN, I go to great lengths to disarm, comfort and reassure, as I said before. But the survivors who experienced panic attacks taught me that it’s not necessarily counter-productive if shame does get triggered.

Social psychologist Brenée Brown has described the way shame can short-circuit our access to vulnerability. Yet, shame is an inescapable part of living in culture. Brown’s research suggests that cultivating shame resilience enhances the vulnerability we’re capable of. At the risk of repeating myself, it’s my goal that whatever shame or discomfort the audience feels, by the end of the play we arrive together at a place of safety, vulnerability and authenticity.

In his masterwork, The Body Keeps the Score, trauma researcher Bessel van der Kolk says:

“Being able to feel safe with other people is probably the single most important aspect of mental health.… The critical issue is reciprocity: being truly heard and seen by the people around us, feeling that we are held in someone else’s mind and heart. For our physiology to calm down, heal, and grow we need a visceral feeling of safety….”

I asked what people felt yesterday in the final moments of SKIN. “Everyone led to a common place.” “Intimate awareness.”  “Intense yet truthful and necessary.” “Vulnerable/important.” “Welcome.” “At ease.” “Alive.” “It seemed like you saw us as well.”

83% of the audience said they felt more present with and/or seen by me in the final moments.

I crafted SKIN to offer more than a virtual experience, more than a call-to-action by example. I want actual reciprocity. The play puts me through my own cycles of repetition to rebuild trust in the world. In you. While inviting you to trust me. So we can beef up those dendrites and quiet our noisy brains. Find the courage to be vulnerable. And strengthen the neural pathways that make it quicker and easier, next time we’re frightened or hurt, to find our way back to joy.