Therapy is both an art and a science. The science of therapy can be appreciated through the lens of polyvagal theory (PVT) which offers a neurophysiological and evolutionary understanding of how we heal. Neuroscience can be very technical, which can make it seem irrelevant or difficult to grasp. Understanding the basic concepts of polyvagal theory offers a new and hopeful narrative for mental health.

Typically, when people first come to therapy there is an emphasis on self-understanding through creating a narrative around the events of one’s life. Therapy offers a space to reflect and make sense of events, perhaps even offer a compassionate lens and validation that the events were very hard. This is an example of “top-down” processing. While it can be helpful, reflection alone doesn’t necessarily change one’s learned responses to those events, years, or possibly decades later.  

Polyvagal theory shifts the focus from reflecting on “events” to understanding “responses” to the events that are embedded in our physiology (nervous system) and core beliefs about self. By understanding how our nervous system learned to respond in the best way possible to harmful events, we can then recognize how those responses continue to show up and discover new ways of teaching our nervous system to respond in a way that leads to health and restoration.

Neuroception

Dr. Stephen Porges developed PVT through his research in evolutionary biology.  Porges helps us understand therapy and trauma healing through the language of the nervous system.  A key term that he coined that is essential for understanding PVT is neuroception.

Neuroception, is the nervous system’s ability to feel safe or detect danger from signals that are coming from the environment or within the body. This response is completely involuntary, happens without conscious awareness, and is determined by a combination of evolution and individual life experiences.

Because neuroception is in part developed by personal experiences, each person has a different neuroception of safety which means that a triggering event will be received differently for each individual.  People who grew up in unsafe environments by necessity may have had to adapt by being hypervigilant to potential threat.  The nervous system likely learned to be overactive, attuned to signs of danger and may still be sensitive to stimuli like sounds or people approaching. That process can turn “neutral” events into a trigger for the nervous system to anticipate danger where none actually exists.

The concept of neuroception also empowers us to know when we are in a comfortable state, which is the goal of therapy.  When we are at ease within our nervous system, we feel safe enough to explore the world, connect with others, enjoy solitude, and access states of rest and restoration.  It sounds simple, but when one has lived in a state of self-preservation, accessing this state can feel impossible or fleeting because of that overactive nervous system.  

Polyvagal theory evolves our understanding of healing from harmful life events to include healing the nervous system in order to feel safe enough to live life with more joy and resilience.

So What is the Vagus Nerve?

If you were to strip away your skin to see the vagus nerve, you would observe a complex system of nerves originating from the brain stem and branching upwards to the face and downwards to the body and all the vital organs. The term “vagus”, means wanderer which reflects the extensive wandering system of this one nerve.

To make things more complex, the vagus nerve has different systems within it that have different functions. Each function corresponds to evolutionary responses to threat and safety that exist within every human body.

3 Physiological States and Corresponding Vagus Nerve Systems

Different physiological states are associated with the vagus nerve function in a hierarchical nature. Using the metaphor of a ladder, this means we can move through these states in a particular sequence.  Understanding our responses can help us determine what state we are in and help us identify effective treatment options

Let’s look at these states starting at the top of the ladder where we want to spend the most time in a place of social connection and well-being.

Ventral Vagal - Social Engagement System (Top)

This corresponds to the physiological state of feeling safe and connected.  It is the optimal state for human beings as we have this complex nervous system that is wired for safety through social connection. Without this capacity, we would not survive as infants.  This part of the vagus nerve is found in the face and neck where we express and process social connection through eye contact, sound, voice, and turning of the head.  From an evolutionary perspective, this is the newest part of the vagus nerve and distinct to us as humans.

Sympathetic Nervous System - Mobilization (Middle)

This part of the nervous system is responsible for taking action when there is a perceived threat.  The body mobilizes into a fight or flight reaction where energy goes to the muscles and heart for mobilization and self-protection.  

A sympathetic state is not always about threat as it can also be associated with mobilized states for creativity, competition or just getting stuff done in life.  Our goal is not to get rid of sympathetic states, but to be in them more skillfully and not only as a response to threat, either real or perceived.

The sympathetic nervous system is the second oldest part of the nervous system and is common to all mammals.

Dorsal Vagal - Disconnect/Shutdown (Bottom)

This is the most primitive part of the vagus nerve and kicks in when the body has to shut down if the system is overwhelmed and the perceived threat is too great to handle.  In this state hopelessness kicks in leading to a freeze response, dissociation, a collapse, and sedated emotions.  

It can be very hard to move up the ladder from this state as there can be comfort in shutting down.  We require energy to get activated into a sympathetic state so we can take effective action to do what is good for us,  This may happen through grounding and orienting practices that bring energy into the system so that we can ultimately get back to the top of the ladder to a socially engaged state.

This is the oldest part of the nervous system from the reptilian age.

How Does Therapy Help? Psychoeducation and Co-regulation

There are a number of ways how polyvagal theory can help in the process of therapy.

The first way is through “psychoeducation” or learning about the psychology of our experiences. Reading this blog is psychoeducation. Polyvagal theory (PVT) informed therapists can teach you the language of PVT and an understanding of self through the language of the nervous system.  With this language, you can start to create a map of understanding your own nervous system, in turn creating a new and compassionate language towards yourself and how you adapted to harmful events in life.

The second way that PVT-informed therapy helps is by providing a container of co-regulation.  We learn to feel safe when we have the experience of being seen and supported by another person.  In childhood, we learn to self-regulate with the presence of a regulated and regulating other, ideally the parent.  If this experience is missed, we have the opportunity to learn this later in life through therapy and other healing relationships with trusting others.

Lastly, a PVT-informed therapist can support your nervous system healing through different exercises for the vagus nerve.  Examples include meditation, neurofeedback, Safe and Sound Protocol, Heart Rate Variability training, and yoga.

At New Pathways, we specialize in somatic approaches which are supported by PVT. If you would like to learn more about treatment options at New Pathways, explore our website or contact us. 

For further information about these strategies, have a look at our other blogs or recommended websites:

• https://integratedlistening.com/polyvagal-theory-a-primer/