Polyvagal Theory and Befriending the Nervous System

If you do a Google search for “Polyvagal Theory,” more than 500,000 results pop up, and if you search for “Stephen Porges,” more than 150,000 results appear. Polyvagal Theory has made a remarkable journey from a relatively unknown and controversial theory to its wide acceptance today in the field of psychotherapy.

Polyvagal Theory traces its origins to 1969 and Dr. Porges’s early work with heart rate variability and his “vision that monitoring physiological state would be a helpful guide to the therapist during the clinical interaction.” As Dr. Porges wrote, at that time he “looked forward to new discoveries applying these technologies to clinical populations. I had no intention of developing a theory.” Polyvagal Theory was born out of the question how one nerve—the vagus nerve—and its tone, which Dr. Porges was measuring, could be both a marker of resilience and a risk factor for newborns. Through solving this puzzle, now known as the vagal paradox, Dr. Porges created the Polyvagal Theory.

Three organizing principles are at the heart of Polyvagal Theory.

  • Hierarchy: The autonomic nervous system responds to sensations in the body and signals from the environment through three pathways of response. These pathways work in a specified order and respond to challenges in predictable ways. The three pathways (and their patterns of response), in evolutionary order from oldest to newest, are the dorsal vagus (immobilization), the sympathetic nervous system (mobilization), and the ventral vagus (social engagement and connection).
  • Neuroception: This is the term coined by Dr. Porges to describe the ways our autonomic nervous system responds to cues of safety, danger, and life-threat from within our bodies, in the world around us, and in our connections to others. Different from perception, this is “detection without awareness,” a subcortical experience happening far below the realm of conscious thought.
  • Co-regulation: Polyvagal Theory identifies co-regulation as a biological imperative: a need that must be met to sustain life. It is through reciprocal regulation of our autonomic states that we feel safe to move into connection and create trusting relationships. We can think of the autonomic nervous system as the foundation upon which our lived experience is built. This biological resource is the neural platform that is beneath every experience. How we move through the world—turning toward, backing away, sometimes connecting and other times isolating—is guided by the autonomic nervous system. Supported by co-regulating relationships, we become resilient. In relationships awash in experiences of misattunement, we become masters of survival. In each of our relationships, the autonomic nervous system is “learning” about the world and being toned toward habits of connection or protection.

Hopefulness lies in knowing that while early experiences shape the nervous system, ongoing experiences can reshape it. Just as the brain is continually changing in response to experiences and the environment, our autonomic nervous system is likewise engaged and can be intentionally influenced. As individual nervous systems reach out for contact and coregulation, incidents of resonance and misattunement are experienced as moments of connection or moments of protection. The signals conveyed, the cues of safety or danger sent from one autonomic nervous system to another invite regulation or increase reactivity. In work with couples, it is easy to observe the increased reactivity that occurs when a disagreement quickly escalates and cues of danger communicated between the two nervous systems trigger each partner’s need for protection. In contrast, the attunement of the therapist–client relationship relays signals of safety and an autonomic invitation for connection.

Humans are driven to want to understand the “why” of behaviors. We attribute motivation and intent and assign blame. Society judges trauma survivors by their actions in times of crisis. We still too often blame the victim if they didn’t fight or try to escape but instead collapsed into submission. We make a judgment about what someone did that leads to a belief about who they are. Trauma survivors themselves often think “It’s my fault” and have a harsh inner critic who mirrors society’s response. In our daily interactions with family, friends, colleagues, and even the casual exchanges with strangers that define our days, we evaluate others by the ways they engage with us.

Polyvagal Theory gives therapists a neurophysiological framework to consider the reasons why people act in the ways they do. Through a polyvagal lens, we understand that actions are automatic and adaptive, generated by the autonomic nervous system well below the level of conscious awareness. This is not the brain making a cognitive choice. These are autonomic energies moving in patterns of protection. And with this new awareness, the door opens to compassion.

Find out about upcoming programs with Deb Dana at Kripalu.

Excerpted with permission from The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation, © 2018 (W.W. Norton), by Deb Dana.

Deb Dana, LCSW, is a clinician and consultant specializing in working with complex trauma and the coordinator of the Traumatic Stress Research Consortium in the Kinsey Institute.

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