When I first heard Jan Winhall speak about the intersection of the nervous system and addiction, I immediately thought of the PDA teens and adults in our community who are reaching for substances or engaging in self-harm.
In this episode she explains how addiction and self-harm function as nervous system state regulation strategies, what conventional models get wrong, and what it actually looks like to support someone through this from a place of safety rather than shame.
Winhall brings a wealth of knowledge to the conversation as a trauma and addiction psychotherapist, developer of the Felt Sense Polyvagal Model, and author of two books on treating trauma and addiction through embodied awareness. I hope her insights support you.
Key Takeaways
- Addiction as a Nervous System State Regulation Strategy | 00:06:52 The conventional model frames addiction as either a moral failure or a brain disease. Jan offers a third understanding grounded in polyvagal theory and neuroplasticity: addictive behaviors are strategies the body uses to shift nervous system states when there is not enough perceived safety. When someone is in a chronic sympathetic state, the wine bottle or the substance moves them into dorsal, into numbing and relief. When someone is in a chronic dorsal state, high-risk or stimulating behaviors move them back up into sympathetic mobilization. The body cycles between these states because it cannot stay in either extreme indefinitely. The behaviors become addictive because they work, at least in the moment, and because there is no other available path to felt safety.
- What Cutting and Self-Harm Do in the Nervous System | 00:10:05 Self-harm functions within the same trauma feedback loop. Cutting can release a sympathetic surge when the blood appears, which shifts a person out of dorsal numbness. It can also trigger the release of endogenous opioids that bring the body back down into dorsal relief. The person is not being manipulative or seeking attention. They are doing what their nervous system has learned will shift an unbearable state into something survivable. Jan describes working with women in her first job who were all self-harming, all addicted, and all diagnosed with borderline personality disorder. She did not accept that framing then and still does not. What she saw was a population of trauma survivors whose bodies were doing exactly what bodies are designed to do.
- Not Being Seen Is Traumatic | 00:37:30 Jan describes the privileged neurodivergent teenagers she saw in her clinical work who came to her saying I have everything, why am I like this? What they were experiencing, she explains, is the trauma of not being seen and fully delighted in for exactly who they are.
- What Healing Actually Looks Like With a Teen | 00:43:21 Jan describes her clinical work with teens as beginning with co-regulation and the building of a relationship where the teenager feels genuinely safe. That means meeting them where they are, including the sessions where they spend the entire hour talking about how much they did not want to come. It means creating an environment where they can say anything as long as they are respectful of the basic boundaries. It means finding something to fall in love with in the person sitting across from you, because that delight is the container in which a teen can begin to explore shame, identity, and the behaviors they have been hiding from everyone else.
- Neuroception, Interoception, and the Paradigm Shift | 00:22:55 Interoception is the body's capacity to sense what is happening from the inside: the tightness in the chest, the quickening of breath, the feeling of something that has not yet found words. Jan's Felt Sense Polyvagal Model combines polyvagal theory with a body-based practice to help people slow down enough to listen to what is already happening in the body rather than suppressing or bypassing it.
Relevant Resources
Felt Sense Polyvagal Model Institute — Jan Winhall's institute where she teaches the Felt Sense Polyvagal Model internationally, including graphic models of the nervous system that can be downloaded and used with children and families.
Somatic Mondays With Jan Winhall — Monthly community gathering focused on nervous system regulation for people navigating addiction and recovery, hosted by Jan Winhall and Recovery Reimagined.
Dr. Sean Inderbitzen on LinkedIn — Autistic therapist, parent, and author of two books on polyvagal theory and autism, referenced by Jan Winhall in this episode as a recommended resource for neurodivergent families.
Understanding PDA — Free class where I teach the nervous system disability framework and the polyvagal concepts that underlie the addiction and self-harm patterns Jan describes in this episode.
Burnout — Free class with context for the dorsal shutdown and burnout states that Jan's work helps illuminate, particularly for families whose teens are reaching for substances or engaging in self-harm.
Paradigm Shift Program — My signature program where the nervous system framework, felt safety, and the accommodation toolkit are taught live, creating the kind of co-regulated container Jan describes as foundational to all healing.
