Therapy Chat Episode 499: Trauma + The Vestibular System with Kim Barthel

Date: September 23, 2025
Host: Laura Reagan, LCSW-C
Guest: Kim Barthel, Occupational Therapist

Episode Overview

In this engaging and informative conversation, Laura Reagan welcomes renowned Canadian occupational therapist Kim Barthel to explore the intricate connections between trauma, the vestibular system, and holistic healing. Together, they delve into how sensory and vestibular processing influence development, attachment, regulation, sense of safety, and even therapeutic interventions. Both emphasize curiosity, humility, and embodied experience as essential to evolving consciousness in mental health practice.

Key Discussion Points & Insights

1. Kim Barthel’s Philosophy & the Holistic Lens of Occupational Therapy

[04:17 – 07:47]

• Kim introduces herself and describes her mission as supporting “the conscious evolution of the human spirit.” She highlights the unique, global, humanistic perspective of occupational therapists.

• OT considers “mind, body, spirit, heart, emotion, and all the interactive components” (05:43), viewing healing as a journey rather than a destination.

• Quote:
  “Consciousness is a state of awareness of how I am embodying my day to day experiences... Increased awareness and connection... gives us a chance to elevate our ways of relating.” — Kim Barthel (06:05)

• Kim offers immersive, embodied clinician training (e.g., “Moving to Higher Ground”), focusing on in-person work with children and personal growth through experience, not just intellectual learning.

2. Embryological Connections: Heart, Brain, and Interconnectedness

[08:37 – 11:18]

• Kim shares a striking embryological insight: during development, the heart is above the brain and briefly “slides across the front of the brainstem where it sends in little shoots... into the brainstem, specifically the nucleus ambiguous, and becomes part of the heart vagal connection.” (09:10)
• This underscores the deep, literal interconnection of heart and mind.
• Kim and Laura emphasize curiosity, humility, and the ongoing evolution of understanding in neuroscience and trauma treatment:
• Quote:
  “Just when I think I know something, it’s like there’s more to know... it requires a humility, an evolution, so to speak.” — Kim Barthel (11:18)

3. Trauma, Sensory Processing, and the Vestibular System

[13:58 – 22:25]

• Kim describes her theory of “psychosensory intervention,” the integration of sensation, movement, attachment play, and neurobiology for healing trauma in children (and adults).
• Trauma can manifest as disruptions in sensory processing. Children with developmental trauma often receive diagnoses such as ADHD or learning disabilities, but underlying sensory disembodiment is frequently missed.
• The vestibular system, our “most primitive sensory system,” is fully formed in the womb and forms the backdrop for all other sensory processing, including the sense of self and boundaries.
• Kim shares: “All traumas... seem to include some kind of boundary violation. That feeling of ‘this is me and this is not me’ is an embodied experience.” (17:08)
• Tools like Lycra (spandex) are used to help restore bodily boundaries in trauma work.

4. The Vestibular System in Development & Trauma

[18:19 – 25:50]

• The vestibular system is critical to “feeling gravity, [forming] a reference point to the ground… groundedness, to feel safe in an upright position.” (19:24)
• Kim describes “neuroception” (Dr. Stephen Porges’ polyvagal theory): our body’s unconscious detection of safety or threat, synthesized by both internal and external sensory cues.
• Laura shares a personal story: her child’s strabismus surgery led to dramatic changes in sitting and development, illustrating how vestibular and visual systems interconnect.
• “The vestibular-ocular reflex... lives in your middle ear... helps the eye muscles work so you can track and shift your gaze... so if there is a challenge with the vestibular system, it’ll impact the eyes, and vice versa.” — Kim Barthel (24:08)

5. Trauma, Vision, and Lifelong Regulation

[25:50 – 29:00]

• Kim explains how trauma alters the visual system: chronic stress promotes peripheral vision (scanning for danger) over detailed focus.
• Example: traumatic births or hypervigilant childhood environments shape lifelong bodily and sensory adaptations — both challenges and resilience.
• “Our amazing capacity to heal and adapt… is champagne material. But often there isn’t a consideration of what that survival took.” — Kim Barthel (28:20)

6. Recognizing Hidden Trauma and Its Somatic Impact

[30:28 – 36:51]

• Trauma in infancy (e.g., birth complications, maternal separation) is often overlooked but shapes foundational sensory, emotional, and cognitive patterns.
• The vestibular system’s disorganization is highly linked to anxiety and orientation in space, involving the hippocampus and “place cells.”
• Discussing eating disorders, ADHD diagnoses, and late-identified neurodivergence, Kim stresses the importance of considering trauma and sensory disruptions, rather than only behavioral or cognitive categories.
• Quote:
  “Neurodiverse-affirming practice is a big part of being trauma sensitive.” — Kim Barthel (36:46)

7. Attachment, Loss, and the Body’s Role in Trauma

[33:17 – 42:36]

• Laura shares her own childhood experience: after her mother left, she became uncoordinated and struggled academically, connecting attachment loss to developmental and sensory shifts.
• Both highlight the variety of ways trauma can manifest (“collapse,” hypervigilance, learning challenges).
• Kim: “Anything that disrupts the authentic sense of expression of self and the feeling of safety can be coded as traumatic. The loss of a parent is one of the most intense traumas.” (34:53)

8. The Vagus Nerve, Vestibular System, and Regulation

[43:04 – 48:49]

• Kim relays Dr. Porges’ statement: there’s no direct known connection between the vestibular system and the vagus nerve, but “everything is so interconnected.”
• Vestibular input (especially movement) is linked to sympathetic activation (alertness, readiness). The “spinning” motion (horizontal canal) can activate the parasympathetic system (vagal) — e.g., vomiting as a protective, down-regulating reflex.
• Simple interventions (e.g., “office chair therapy”—spinning) can reset regulation, engage the diaphragm, and reconnect body awareness.
• Upside-down/inversion postures affect blood flow and heart rate via baroreceptors, engaging healthy ventral vagal responses.
• Laura references Dr. Arielle Schwartz’s use of balance for self-regulation (“standing on one foot... brings you back to center”).

9. Sound, Polyvagal Practice, and Upcoming Resources

[49:08 – 50:51]

• Kim shares info about her upcoming contributions to the Polyvagal Practice Summit (August 28–29), which will focus on sound, music, and their impacts on healing.
• Her live course “Attachment Matters” will launch in Australia in November 2025.
• Resources mentioned: “Handbook of Childhood Trauma and Dissociation” (Gomez & Hosier, with Kim’s chapter), plus Kim's website (kimbarthel.ca) for further training.

Memorable Quotes

• “Who am I? I am a human who has a deep love for humanity, and my mission... is to support the conscious evolution of the human spirit.” — Kim Barthel, 04:24
• “All traumas in some way seem to include some kind of boundary violation. That feeling of ‘this is me and this is not me’ is an embodied experience.” — Kim Barthel, 17:08
• “The vestibular system... impacts all aspects of human function, emotion, cognition, motion, time and space. So when that system is struggling… the platform upon which other systems scaffold from don’t work so well.” — Kim Barthel, 19:24
• “Anything that disrupts the authentic sense of expression of self and the feeling of safety can be coded as traumatic.” — Kim Barthel, 34:53
• “Neurodiverse-affirming practice is a big part of being trauma sensitive.” — Kim Barthel, 36:46
• “Our bodies inform us, but they also are recipients of [trauma]. So muscles become collapsed, they become hypertense systems, our immune systems have an impact... Each of our bodies shape all of their functions to what we are experiencing.” — Kim Barthel, 41:32

Timestamps for Key Segments

| Segment | Start Time | |-------------|---------------| | Kim’s introduction & holistic OT | 04:17 | | Heart–brain embryology & interconnectedness | 08:37 | | Trauma in sensory systems | 13:58 | | The vestibular system's role | 18:19 | | Vestibular–ocular case example | 22:27 | | Trauma’s effect on vision | 25:50 | | Sensory/vestibular impact on anxiety & spatial memory | 32:13 | | Personal story: Attachment loss and sensory changes | 33:17 | | Vagus nerve, vestibular input, and regulation | 43:04 | | Sound, music, polyvagal updates, resources | 49:08 | | Upcoming events and closing thoughts | 49:58 |

Style & Tone

• The conversation is both clinical and warmly personal, with a blend of technical explanation, story-telling, and reflective curiosity.
• Both host and guest emphasize humility, ongoing learning, and embodied/experiential knowledge as central to effective practice.

Summary Takeaways

• The vestibular system is fundamental to developing a sense of self, safety, and regulating complex trauma reactions.
• Trauma can be “embodied” in sensory systems, sometimes masquerading as learning or behavioral disorders.
• The body’s interconnected systems—including vision, vestibular function, vagal regulation, and attachment—shape the trajectory of healing.
• Therapeutic approaches that honor the sensory, embodied, and relational aspects of trauma can unlock profound potential for healing—especially when undergirded by humility, curiosity, and self-compassion.

For more info, resources, and Kim’s future trainings, visit kimbarthel.ca.