How to be with others with awareness of polyvagal theory

I’m summarizing polyvagal theory, originated by Dr. Stephen Porges, from a 10:48-minute video interview of him. I’m doing this for my own understanding, and I want to share because it’s a new way of thinking about traumatic responses. It has major implications for my work, and I’ve added my own comments in brackets. I am sure I will continue to refine my understanding.

Dr. Porges says that polyvagal theory is the understanding of how our body reacts to various challenges. The autonomic nervous system [involuntary, like heart beat] has evolved in vertebrates, changing and adding new circuits that function in a hierarchy. The newer circuits can inhibit older circuits. The older circuits were circuits of defense.

[The image below is my attempt to describe the branches of the ANS and how we automatically behave when we feel safe and when we feel threatened. Remember, newer circuits can inhibit older circuits, so what do you do if your friend suddenly looks threatened — and there’s no actual threat in the present moment? You make eye contact and speak reassuringly — helping to move them from threatened sympathetic to safe social. If they freeze, you do the above and also engage them playfully, perhaps by squeezing their hand and inviting them to squeeze back — helping to move them from threatened parasympathetic to safe sympathetic to safe social. Thanks to Stephen Derkacz for the inspiration.]

polyvagal chart

hierarchical branches of the autonomic nervous system in safety and in threat, according to polyvagal theory

Most diseases, including chronic diseases of physical health, are really diseases of the autonomic nervous system, which changes with mental health as well. (See my 2011 post about the percentage of illness that’s related to stress.)

The newest circuit [that Dr. Porges’ research discovered in the vagus nerve] is a circuit for social interaction, only seen in mammals, who have a nerve running from the brainstem to the heart that’s also linked to the muscles of the face and head and is involved in vocalization, listening, facial expressivity, and gesturing.

This [social nervous] system enables our bodies to be in states that support health, growth, and restoration. It’s interactive. [We are very social creatures, and we automatically respond to seeing others’ facial expressions and gauging our relative safety.]

When the [social nervous] system doesn’t work, we start seeing the behaviors and symptoms associated with mental health issues: mobilized behavior, rage, tantrums, anxiety [sympathetic dominance, fight or flight].

Polyvagal theory got its name for an earlier study of the evolution of the ANS where Dr. Porges and associates identified another response: shutting down or passing out, which are considered dissociative states in mental health. Previously to this discovery, physiological immobilization associated with fear was not acknowledged in psychology and psychiatry, and it wasn’t included in studies of trauma. [When fight or flight fails because the person is unable to escape, they freeze.]

People who freeze in fear have nothing to be ashamed of. It’s in the autonomic nervous system, a reaction beyond their control. Understanding this shifts one’s identity from victim to survivor. Behavior isn’t always voluntary, having intention, being learned. There are a lot of responses that are implicit in the body.

Sometimes people who experience freezing blame themselves afterward. “Why didn’t I fight?” [We’ve heard this a lot recently about women who were raped or felt threatened with rape, like Dr. Ford and others in #metoo. Actually, they involuntarily froze.] It wasn’t a voluntary choice. Their body made this decision beyond their conscious awareness. If we had to make a conscious decision about whether to fight, flee, or freeze, we’d probably be dead. It’s adaptive for the species for our bodies to have this built in.

Our own personal history influences this. Learning through association is out of the realm of awareness. For example, when Dr. Porges was talking to a female colleague with a history of trauma and his voice deepened, she had a fear reaction, because that voice tone was associated in her memory with her father’s voice.

The body responds, and we don’t always know what we’re reacting to. In therapy, the person can come to appreciate the defensive, adaptive behavior of their body. We are always aware of our bodily responses that are triggered by memories associated with feeling unsafe, [even if we don’t immediately recall the memory].

When we recontextualize, we respect our bodies and appreciate these responses. Part of traumatization is disrespect for the body, feeling the nervous system failed us and feeling angry at ourselves. Be appreciative and love what the body did. [You survived.]

The organs below the diaphragm are part of this immobilization response. When people have had shutdown experiences, they experience irritable bowel and digestive problems.  Fight or flight responses are above the diaphragm.

Improving vagal tone

When do you feel safe? When are you on guard?

If you feel safe except when there is an actual threat to your safety, then you have high vagal tone.

If you feel guarded most or all of the time, even when there is no actual threat to your safety, you have low vagal tone. Low vagal tone can be raised.

I wonder what percentage of Americans feel threatened when they are not facing an actual threat. Perception of threat is, of course, subjective.

The vagus nerve is a big, long nerve — almost as long as the spinal cord and nearly as thick — that comes out of your brainstem, goes down your neck into your torso with branches affecting all of your organs except the adrenal glands.

Screen Shot 2018-11-08 at 9.30.02 PM

When you feel safe and relaxed, this nerve helps your organs function better. Your heartbeat slows, your breathing slows, digestion improves. This is when repairs take place.

The vagus also influences social functioning: facial expressions and whether your voice sounds animated, inviting engagement.

I’ve gotten interested in how to raise vagal tone and will be posting more about it as I research and learn. For now, here are some activities that can raise vagal tone:

  • singing or humming
  • pranayama (yogic breathing exercises)
  • gargling (it’s near the back of the throat)
  • feeling connected
  • cuddling
  • friendly eye contact
  • cold showers
  • compassion for self and others
  • gratitude
  • yoga
  • massage
  • craniosacral therapy

This is my first post while researching applications that I can use myself, share with my friends (including you), and apply to my bodywork clients. I will add links to subsequent posts below.

How to be with others with awareness of polyvagal theory

Immobilization/shutdown/dissociation/frozen, a trauma response built into the nervous system

Back in March 2012, I posted that I had started reading Peter A. Levine’s latest book, In An Unspoken Voice: How the Body Releases Trauma and Restores Goodness. My post included excerpts from Levine’s description of being hit by a car and his experience afterwards.

His experience serves as a useful model for being and staying present through trauma and recovery. He knew how to allow his body and emotions to process naturally so that he did not get stuck in a traumatic state (i.e., PTSD).

Well, I am still reading that book. It’s very, very rich. Some parts are rather scientific. I’m taking my time to really understand it.

Levine uses polyvagal theory (I just posted an interview with Stephen Porges, who came up with the theory) to explain the states that people experience and can get stuck in from traumatic experiences.

Because Somatic Experiencing Practitioners and other therapists (as well as astute loved ones) who are helping someone recovery from trauma need to know which layer of the nervous system is dominant at any given time in a traumatized individual, I am going to describe them.

First, the primary job of our nervous system is to protect us. We have senses that alert us to danger. We may react to a perception of a threat in our bodies before it ever becomes conscious in the mind. That’s because the autonomic nervous system (which is not under our control) is involved when trauma occurs. We react instinctually.

This is good to know. It means that your trauma reactions are automatic, not something you can control, so there’s no need to feel shame or blame yourself. You were doing the best you could.

There are two defensive states that occur when encountering trauma: immobility/dissociation/shutdown (freeze) and sympathetic hyperarousal (fight or flight).

I’m going to write about them in separate posts to avoid being too lengthy.

The more primitive nervous system state is immobility. (Primitive in that evolutionarily it comes from jawless and cartilaginous fish and precedes sympathetic hyperarousal.)

It is triggered when a person perceives that death is imminent, from an external or internal threat.

Levine also uses the terms dissociation, shutdown, and freeze/frozen to describe this state. Note: If you’re an NLPer, dissociation means the separation of components of subjective experience from one another, such as cutting off the emotional component of a memory and simply remembering the visual and/or auditory components. (Source: Encyclopedia of NLP)

Keep in mind that Levine is talking about dissociation as an involuntary post-traumatic physiological state that trauma victims can sometimes get stuck with. There may be some overlap. According to Levine, symptoms of being in this state include frequent spaciness, unreality, depersonalization, and/or various somatic and health complaints, including gastrointestinal problems, migraines, some forms of asthma, persistent pain, chronic fatigue, and general disengagement from life.

Levine notes:

This last-ditch immobilization system is meant to function acutely and only for brief periods. When chronically activated, humans become trapped in the gray limbo of nonexistence, where one is neither really living nor actually dying. The therapist’s first job in reaching such shut down clients is to help them mobilize their energy: to help them, first, to become aware of their physiological paralysis and shutdown in a way that normalizes it, and to shift toward (sympathetic) mobilization. 

The more primitive the operative system, the more power it has to take over the overall function of the organism. It does this by inhibiting the more recent and more refined neurological subsystems, effectively preventing them from functioning. In particular, the immobilization system all but completely suppresses the social engagement/attachment system.

Highly traumatized and chronically neglected or abused individuals are dominated by the immobilization/shutdown system.

Signs that someone is operating from this state include:

  • constricted pupils
  • fixed or spaced-out eyes
  • collapsed posture (slumped forward)
  • markedly reduced breathing
  • abrupt slowing and feebleness of the heart rate
  • skin color that is a pasty, sickly white or even gray in color

Brainwise, volunteers in the immobility state exhibited a decrease in activity of the insula and the cingulate cortex. In one study, about 30% of PTSD sufferers experienced immobility and 70% experienced hyperarousal, with a dramatic increase of activity in these brain areas. Most traumatized people exhibit some symptoms from both nervous systems, Levine says.

I feel the deepest compassion for people in this state, because I have experienced it myself: the spaciness, depersonalization, sense of unreality, and passive, disengaged attitude toward life. It was many years ago. If I could, I would reach back in time to that injured woman and give her resources she just didn’t have back then.

I feel so grateful for the trauma recovery work I’ve done, both with a therapist and on my own. I haven’t experienced immobilization for years, except briefly.

Next up: sympathetic hyperarousal/fight or flight.

An interview with Stephen Porges: polyvagal theory, or how the nervous system is affected in autism, ADHD, borderline personality disorder, and trauma

Nexus, Colorado’s Holistic Health and Spirituality Journal.

This interview with Dr. Stephen Porges, whose career is based on understanding the evolution of the human nervous system, outlines some of the basics of polyvagal theory.

This theory is being tested in trauma recovery sessions. It’s exciting because it helps explain how and why people freeze or experience fight-flight reactions in response to trauma — and the route back to normal, healthy functioning, no matter how long ago the trauma occurred or how often it happened.

Polyvagal theory is increasingly becoming part of the training of bodyworkers, therapists, and educators. In a future post, I will describe how to tell which nervous system (freeze, fight or flight, or parasympathetic) is dominant at any given moment.

This theory is based on an in-depth understanding of the vagus nerve, also known as the 10th cranial nerve, which wanders (the Latin word vagus means wandering, like vagabond and vagrant) from the brain stem down through the body, affecting the face, heart, lungs, and gut.

The brain evolved hierarchically in vertebrates, and the neural circuits of the older nervous systems are still present, accessed hierarchically.

RD: So one thing happens then another thing happens then another thing?

SP: Right. This influences how we react to the world. The hierarchy is composed of three neural circuits. One circuit may override another. We usually react with our newest system, and if that doesn’t work, we try an older one, then the oldest. We start with our most modern systems, and work our way backward.

So polyvagal theory considers the evolution of the autonomic nervous system and its organization; but it also emphasizes that the vagal system is not a single unit, as we have long thought. There are actually two vagal systems, an old one and a new one. That’s where the name polyvagal comes from.

The final, or newest stage, which is unique to mammals, is characterized by a vagus having myelinated pathways. The vagus is the major nerve of the parasympathetic nervous system. There are two major branches. The most recent is myelinated and is linked to the cranial nerves that control facial expression and vocalization.

Here’s how it works in action:

SP: Let’s say you’re a therapist or a parent or a teacher, and one of your clients, students or children’s faces is flat, with no facial expression. The face has no muscle tone, the eyelids droop and gaze averts. It is highly likely that individual will also have auditory hypersensitivities and difficulty regulating his or her bodily state. These are common features of several psychiatric disorders, including anxiety disorders, borderline personality, bipolar, autism and hyperactivity. The neural system that regulates both bodily state and the muscles of the face goes off-line. Thus, people with these disorders often lack affect in their faces and are jittery, because their nervous system is not providing information to calm them down.

RD: How will polyvagal theory change treatment options for people with these disorders?

SP: Once we understand the mechanisms mediating the disorder, there will be ways to treat it. For example, you would no longer say “sit still” or punish a person because they can’t sit still. You would never say, “Why aren’t you smiling?” or “Try to listen better” or “Look in my eyes,” when these behaviors are absent. Often treatment programs attempt to teach clients to make eye contact. But teaching someone to make eye contact is often virtually impossible when the individual has a disorder, such as autism or bipolar disorder, because the neural system controlling spontaneous eye gaze is turned off. This newer, social engagement system can only be expressed when the nervous system detects the environment as safe.

There’s much more fascinating information you can read by clicking the link at the top of this post.