Addiction, Self-Harm, and the Nervous System in PDA Teens and Adults: A Conversation With Jan Winhall | Ep. 169

When I heard Jan Winhall speak at the Polyvagal Institute 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. I knew I had to bring her onto this podcast.

Jan Winhall is 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. 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.

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 autonomic 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. A parent does not need to understand everything about a child's neurodivergence. They do not even need to like all of it. But the job of a parent is to see the child. When a child who is overwhelmed by social stimulation retreats to their room during a family barbecue, the parent's nervous system may be offended. The question to ask instead is what does their nervous system need, and how can I be curious about that rather than threatened by it?

• 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 offering chai tea and a banana after school. It means finding something to genuinely 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. The felt sense practices Jan uses are not top-down intellectual strategies. They are body-based, slow, and built on repetition, which is the opposite of how most of our culture approaches both healing and neurodivergence.

• 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 niggling that has not yet found words. Jan's Felt Sense Polyvagal Model combines polyvagal theory with focusing, the body-based practice she trained in with Eugene Gendlin, to help people slow down enough to listen to what is already happening in the body rather than suppressing or bypassing it. The nervous system state a person is in shapes what they perceive interoceptively. In ventral vagal, a bump on the street is an accident. In sympathetic, it is a threat. The same event, read completely differently by the same body, depending on where the nervous system is at that moment. This applies to parents as much as to children.

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.

Topics Covered

• PDA addiction self harm nervous system lens
• pathological demand avoidance teen substances
• PDA Jan Winhall felt sense polyvagal model
• PDA addiction state regulation strategy
• PDA cutting self harm dorsal sympathetic
• PDA trauma feedback loop addiction
• PDA not being seen is traumatic neurodivergent
• PDA teen therapy co regulation felt safety
• PDA neuroception interoception body based healing
• PDA Eugene Gendlin felt sense focusing
• at peace parents podcast
• PDA moral failure brain disease wrong model
• PDA neuroplasticity neural pathways addiction
• PDA privileged neurodivergent teen shame story
• PDA heteronormativity pathologizing model
• PDA addiction adaptation not disorder
• PDA parent nervous system offended curiosity
• PDA Sean Inderbitzen autistic therapist polyvagal
• PDA somatic mondays recovery reimagined
• PDA chai tea banana teen therapy co regulation