Adolescent Medicine & Child Psychology

Biography

Biography: Art O’ Malley

Abstract

The Art of BART (AOB) is an integrated approach to psychotherapy which incorporates elements of trauma focused cognitive behaviour therapy (CBT), Eye Movement Desensitisation and Reprocessing (EMDR), mindfulness and sensorimotor psychotherapy (SP). This workshop initially discusses the connections of the autonomic and peripheral nervous systems. These have changed from early descriptions by John Langley to the paired antagonism theory of Walter Hess to the modern Polyvagal theory of Dr Stephen Porges. The connections of the headbrain, heartbrain and gut brain are explained. The Polyvagal theory is discussed in relation to safe, unsafe and life threatening environments. There are evolutionary links between the human vagus nerve and that of our reptilian-brained ancestors. This is explained schematically by showing the extent of the path of the vagal nerve, which is known as the “wanderer”. The role of the periaqueductal grey matter and neuroception are discussed in relation to traumatic stress. The different aspects of the social engagement system are discussed along with the relationship to cardiac vagal tone. The different types of processing in trauma are explained. This includes the integration of top down and bottom up processing in the brain. I introduce readers to my concept of the quintessential brain, which is an updated version of the triune brain first proposed by Peter McLean. I have developed a model to explain the changed levels of arousal and dissociation secondary to trauma. The use of the acronyms: RAPIDS, WATER and FROZEN are easily understood by patients and clients experiencing these symptoms. The five stages of BART psychotherapy are explained The latest research on the links between the immune and nervous systems are discussed. Finally the implications for treatment of traumatic stress because of the altered wiring of the body’s autonomic nervous system are discussed in relation to some case examples. Future directions for BART Psychotherapy including research are discussed.