Polyvagal Theory and Trauma
Polyvagal Theory and Trauma
What is the Polyvagal theory and how does it apply to working with complex trauma?
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What is the Polyvagal Theory
Neuroscientist Dr Stephen Porges asked an important question, how could one single nerve, known as the vagus nerve, be both a marker of resilience and a risk factor? His research findings solved a puzzle, known as the vagal paradox and introduced what is now known as Poly Vagal Theory. Polyvagal theory has provided a wealth of new and important information related to our nervous system and how we experience safety or unsafety.
Polyvagal theory can be understood as the science of safety. The theory provides us with a physiological and psychological understanding of our autonomic nervous system.
It speaks to how we move through states of energy mobilisation, engagement and disconnection. It helps us understand how our experiences of safety and connection are directly shaped by our experiences from infancy, childhood and adulthood.
When our autonomic nervous system is functioning well, it helps us to manage the daily challenges and stressors of life by shifting our physiological state. Ideally we shift in and out of our different nervous system states like stress and challenge (sympathetic nervous system arousal) with relative ease and our system is resilient enough to come back into regulated states of wellbeing and social connection.
So settle in, this blog is a long one that I was inspired to write because Poly Vagal theory in therapy is such an important topic!
The Effect of Trauma on Nervous System
When it comes to trauma, Polyvagal theory is important because we know that trauma interrupts our ability regulate our nervous system responses and feel safe in relationships. If we have a trauma history one of the challenges we face is being able to regulate our autonomic responses like fight, flight or freeze and to feel safe within our bodies and with other people.
In the case of trauma, our natural patterns of connection are replaced with patterns for protection. We become wired for threat, scanning our environment for cues of un-safety and danger, primed to respond.
If we have unresolved trauma it can feel as though we are always in a constant state of hyper vigilance ready to move into fight or flight. We might also regularly be in states of shutdown, feeling physically and emotionally collapsed or even dissociated and like we are walking around but feeling spaced out or ‘out of our body’.
Interesting side note about coming out of shut down…Peter Levine, who is a friend and colleague of Stephen Porges, studied the shutdown response through animal observations and somatic therapy with his clients. In his book Waking the Tiger: Healing Trauma, he explains that coming out of a shutdown response requires a shake or tremoring to discharge the stuck activation energy of fight or flight.
In the case of trauma where there was life threat, if our body has taken us into shutdown or freeze, and an opportunity to mobilise into fight or flight becomes available our bodies will move us into action. Polyvagal theory shows us how we can learn nervous system to befriend our responses for day to day well being and shift into different states to support our nervous system in healing trauma.
Let’s look a little more into our nervous system and how it works.
Our Nervous System
Our nervous system is a complex structure that gathers information from different parts of our body. The two main parts of the nervous system are known as the the central nervous system and the peripheral nervous system.
Central Nervous System
Our central nervous system is made up of our brain and spinal cord. Our brain has billions of interconnected neurons that work as one co-ordinating centre, responsible for a large number of bodily functions. Our spinal cord is made up of bundles of nerve fibres that connect many parts of our body with our brain.
Peripheral Nervous System
Our peripheral nervous system is made up of all the nerves outside of our brain and spinal cord. It can be divided into two systems known as the somatic nervous system and the autonomic nervous system.
The somatic nervous system is a system under our voluntary control and it allows our muscles and brain to communicate with each other. This somatic nervous system helps our brain and spinal cord to send signals to our muscles that help them move. It also sends information from our bodies back up into the brain.
The autonomic nervous system (ANS) is our involuntary system. It controls a number internal organs like our heart, lungs and digestive system which all run in the background without our conscious thought and effort. In the same way that we don’t have to think about each breath we take in, the ANS doing all it’s important bodily tasks in the background.
Our Autonomic Nervous System
Our ANS is complex and always working. As well as it’s important job of co-ordinating moment by moment functions like helping us breathe, getting our heart to pump blood and helping us digest food, our ANS is scanning our environment looking for cues of safety or un-safety and it is ready to translate the cues it receives, preparing us to respond.
There are two separate systems at work within our ANS are known as our Sympathetic nervous system (SNS) and our Parasympathetic nervous system (PNS).
The Sympathetic Nervous System
The SNS mobilises us to move when we are in dangerous situations. This is the system that engages our automatic fight or flight reactions.
An important component is the Hypothalamus pituitary axis (aka the HPA axis) which is a system that links the limbic system of the brain with our adrenal glands. You can think of the limbic system like the control centre for many of the body’s hormonal functions. The Hypothalamus and pituitary glands reside here (as does the amygdala) and together they produce hormones in response to physiological and psychological stress.
In times of trauma you can see the SNS in action:
1. activates the HPA axis.
2. The HPA axis produces neuro-transmitters which are hormones that act as chemical messengers. Think dopamine, norepinephrine and epinephrine (aka adrenaline). The body is producing these chemicals to help us protect and defend ourselves.
3.During this time our SNS and PNS work together to manage the many complex processes that are happening in our body. They also suspend any unnecessary bodily functions, sending energy instead to prepare us for action. We might experience blood rushing to our muscles, muscles contracting and tensing, our heart rate quickening, as we are primed to move into fight or flight.
4.The HPA axis is then deactivated once the stressful event or circumstance has passed and our PNS gets back into the drivers seat moving us into a state of relaxation and calm.
The challenge with trauma is that our HPA axis doesn’t get deactivated. Because of this, we can get stuck in that activation of fight or flight. We can feel anxious months or even years after the stressful or traumatic event has occurred. Our HPA axis becomes stuck in the on position, os that even when we actively try and reduce our stress and stay calm, we experience anxiety or ‘unresolved fear’.
The Parasympathetic Nervous System
The PNS works to relax and calm our bodies. When our PNS is activated our body starts to conserve energy by lowering our heart rate and blood pressure whilst also regulating our digestion. Many people have referred to this state as our ‘rest and digest state’ because of this. As our body registers that our experience is not dangerous and reads cues of safety in our environment and in our relationships we experience the calming effects of the PNS.
The PNS can also be activated in situations of extreme danger and life threat, as in the case of trauma. In these instances the PNS isn’t only slowing things down and moving us into peace and calm, its moving us into shutdown to try and conserve energy and support our bodies to try and lessen the traumatic impact. You’ll read more about this PNS activation and the Dorsal vagus below.
So what does all this have to do with the vagus nerve?
The Vagus Nerve
The vagus nerve is our tenth cranial nerve, and is sometimes know as the wanderer nerve because it is a long nerve that that begins at the medulla oblongata located in the lower part of the brain, sitting just above where the brain connects with our spinal cord. You can touch the place where the base of your skull touches the top of your neck and you will get an idea where it is located)
There are also two parts to the vagus nerve, the dorsal (back) and the ventral (front). Both of these parts have different functions. To understand their functions we need to talk about the three organising principles of Poly Vagal Theory.
Polyvagal Theory Explained
1.Hierarchy of a Stress Response
Polyvagal theory outlines how our ANS responds to the cues we pick up in our environment as well as the sensations and feelings in our bodies. There are three pathways, each with their own predictable patterns of response that follow a certain order and hierarchy. In evolutionary order from oldest to newest they are:
The Dorsal Vagus, our Immobilisation response which is 500 million years old.
The Sympathetic Nervous System, our mobilisation response, which is 400 million years old.
The Ventral vagus , our social engagement and connection response which is our newest evolution being only 200 million years old.
The image here can be thought of as a ladder. Our nervous system is designed to be flexible and responsive. We are meant to be able to move up and down this ladder with relative ease. When we exprience stress for challenge we may be in our regular safe, calm and connected state, we might try and engage another human being to help us or reach out for help. Step one on the stress response hierarchy.
From there if we don’t have anyone to help, or maybe someone isn’t interested in helping us or unable to we will start to move into our SNS response of mobilisation, our fight or flight response.
From here, if fight or flight aren’t going to be effective, because we cant engage in the fight safely or we cant get away, we will drop down another rung in the stress response hierarchy into our system of immobilisation, our dorsal vagal response.
If we have unresolved trauma we can find it very difficult to inhabit our social engagement system and feel states of calm, connection and joy. We may also be stuck in states of mobilisation or immobilisation or socialite between the two.
Polyvagal theory helps us understand that the two parts or branches of the vagus nerve calm the body, but they do so in different ways.
Dorsal Vagal
The Dorsal vagal (back side) of the vagus nerve responds to cues of danger. It moves us away from connection and into protection. When we experience a cue of extreme danger or life threat we can shut down and feel numb or frozen, we have moved into a dorsal vagal state.
When the dorsal vagus is activated we have shifted into immobilisation. This can be seen as freezing, going numb, blanking out, shutting down and dissociating. When the dorsal vagus is activated our PNS has kicked into gear and is not only slowing us down, it’s moving us into a place of complete freeze or. With animals in the wild we see this response when an animal may move into a ‘feign death response’ when it has been chased and attacked by a predator. All bodily functions shut down and only it’s emergency life support systems are running in the background.
Sympathetic Nervous system
I spoke about the SNS above, but as a reminder, our SNS the system that helps us mobilise or take action when we experience cues of danger. When the HPA axis becomes activated we are flooded with chemicals that give us an adrenaline kick. We can run away (flight mode) or prepare to engage with the threat in front of us (fight mode).
Ventral Vagal
Before polyvagal theory, our nervous system was pictured as having two parts. More activation signalled less calming and more calming signalled less activation. Polyvagal identified a third type of nervous system response known as the social engagement system. This is a unique mix of activation and calming that happens when we activate the ventral vagus.
Our social engagement system is the latest edition to being human. It is sometimes described as our face to heart connection because the ventral vagus is made up of the links between the vagus (heart), muscles in our face and head that control our facial expressions and muscles that control how we listen (auditory) and how we speak (vocalization).
It is through this system that the ventral vagus (front) of the vagus nerve responds to cues of safety, connection and social engagement. It supports us in the feeling of being physically safe and emotionally connected to others. In this state we can experience a sense of safety, peace, engagement and social connection with each other.
The ventral vagal nerve dampens our regular ‘active state’. Whilst our SNS is always active in some small degree, as each inhale of breath carries a slight activation of the SNS, our Ventral vagal allows us to control that activation in a subtle way, and has a different quality to the state of fight or flight.
Another important thing to note is that moving into a ‘Ventral vagal state’ takes milliseconds vs a sympathetic activation taking seconds and involving a range of fast chemical reactions. Once the fight or flight chemical reactions have begun, it can take our bodies 10–20 minutes to come back into balance or return to our previous state.
Our ventral vagal system does not involve these sorts of chemical reactions, which means that we can move quickly between activation and calming. This is good news for our nervous systems and being able to move into states of connection, peace and calm.
2. Neuroception
Neuroception is the automatic and unconscious process in which our neural circuits scan for cues of danger in our environment and in our social interactions. Think of this as your inbuilt invisible feelers that scan situations and people you encounter to determine whether they are safe or unsafe.
The process of nequrocpetion is always happening in the background without our conscious awareness. Unlike perception this is an automatic and unconscious process. In the same way that we take a breath and don’t have to tell ourselves to breathe, neurocpetion is happening moment to moment as we sense whats happening around us, inside of us us and with others.
In the process of neuroception, both sides of our vagus nerve can be stimulated (the ventral or the dorsal). This is particularly important for trauma survivors who may have whats known as ‘faulty neuroception’ where cues of safety are interpreted as cues of danger and cues of danger are interpreted as cues of safety.
3. Co-regulation
As we go through life engaging with the world, there are a myriad of moments when we will feel safe and others or in which we will feel uncomfortable, even in danger.
Polyvagal theory speaks to these different state shifts we can experience as being movements that happen within the hierarchy of our stress response.
Co-regulation can be thought of as the warm and responsive interactions we have with each other. It’s in these interactions that our ANS is interacting with another person's nervous system and it’s in this type of interaction that we experience the power of social engagement and a re balance our emotional and physical health can take place.
During our working week we might experience co-regulation and social engagement when sharing a hug with someone we care about or speaking with a close friend, or even taking our dog for a walk.
We may also find ourselves moving into our SNS response of mobilisation when feel threatened by a conflict with a co-worker or if we have a minor car accident. There may be other situations where we pick up on cues of danger and un safety and we feel trapped and unable to fight or flee. In moments of stress and danger we may shift into our dorsal vagal response of immobilisation. We might feel frozen, numb or collapsed and even move into dissociation.
Co-regulation is not only what we as human beings are wired for, it isa biological imperative. We need the experience of warm and responsive connections with one another to survive and thrive, this make sit an important component in healing trauma, particularly developmental trauma.
Trauma and Polyvagal Theory
If we have experienced trauma that left us immobilized, our ability to scan our environment for danger cues can become skewed. We can have ‘faulty nequrocpetion’ which means that we cant take in cues of safety as easily. We might instead read cues in our environment as dangerous even if those cues may be seen as neutral or benign to other people.
Depending on our trauma history we may have picked up on a number of interpersonal cues that our nervous system has associated to danger. It could be a slight change in someones facial expression, a particualr tone of voice, a body movement or posture even a smell. This can trigger someone with a trauma history to respond in familiar ways that our nervous system learnt to protect ourselves and survive. All of this happening automatically and without our conscious choice!
When our body picks up a cue that signals we may not be safe, it begins to react. For some people this cue may move us into a place of a mobilization response, springing into action to attempt to engage or neutralize the threat via fight or or get away from the threat via flight.
If we have experienced trauma, the signal of a danger cue can also move us directly from social engagement to immobilization overriding the possibility of the mobilisation response. This can challenging and confusing especially when we are unaware of how the hierarchy of our stress response works and how our nervous system has been shaped by the interactions we have had with others and the world. Just understanding this can normalise some of the symptoms of trauma you may be experiencing. They make so much sense from a Polyvagal perspective!
How to use Polyvagal Theory in Therapy
Trauma survivors do not feel safe. They do not feel safe in their own bodies or with other people. The beginning phase of working with trauma in therapy is called safety and stabilisation. This phase is about helping people who have experienced trauma understand the way their nervous system works. This includes a psycho-education component that is important for people to begin to recognise how their nervous system is responding. When we are mindful of our experiences and learning we turn on the Pre frontal cortex ( the part of our brain responsible for logic and reasoning) and down regulate the amygdala (threat centre in our brain).
As we begin to notice and name our experiences, we start to seperate our state from our story. We get to understand that this is how our nervous system is responding and that there isn’t something wrong with us, again, normal and expected responses when it comes to trauma and the nervous system.
Polyvagal theory in therapy also helps us normalise the impacts of trauma and triggers. Learning about how triggers work we can start to learn resources for our body that support us in regulating our feelings and emotions when were are triggered. We can learn to understand the wisdom of our body and slowly experiment with feeling more moments of safety and connection.
Polyvagal theory in therapy can be an effective resource to support people in healing trauma, as it can help us develop the ability to neurocept safety. Being able to nuerocept safety and ultimately having a felt sense fo what it means to feel safe, peaceful, connected and calm requires two things.
We need to be able to resolve cues of danger
We need to bring in cues of safety.
Resolving cues of danger and no longer being in a dangerous situation is only one part of healing trauma.
We also need to tune into and experience cues of safety and support that our nervous system can take in. This way we can move up the ladder from immobilisation, mobilisation and into social engagement.
There are a number of body based resources that have come out of Polyvagal research that can support our shift in social engagement and activate the ventral vagus.
Below you will find some of my favourite resources that I use and that are self-regulation resources. meaning that you can do them on your own. You can also find more exercises in the book Polyvagal exercises for safety and connection by Deb Dana.
I recommend discussing and working with these exercises with a trauma informed therapist. Doing our own work and using self-regulation is an important and necessary skill we can all make use of….and at some point to effectively start processing trauma we need co-regulate and go through the processing of trauma with a trusted and skilled professional.
I also want to add that it is normal that some of us may not have had the experience of growing up in warm, nurturing and safe environments where we could learn self-regulation from social engagement with caregivers who were loving and regulated human beings. This means that self-regulation skills can feel challenging or even impossible at times. If this is the case, the good news is need can learn self-regulation through co-regulation and therapy. Here are some of the Polyvagal exercises I enjoy for self regulation.
Polyvagal Exercises for Self Regulation
Safety in breathing
Did you know that we can breathe with intention and change the tone of our ANS.
Simply bringing attention to your breath can allow your breathing to begin to slow down and deepen. Slower breathing with a prolonged exhalation increases PNS activity in a good way, increasing our vagal activation.
Regulation of our breathing has also been show to influence our psychological states and can often improve symptoms of anxiety, depression and PTSD and because our emotions are linked to our respiration, when we move into slower and deeper breathing we can inhibit distressing emotions. Box breathing is an example of breath regulation.
Restriction breathing is where we constrict the larynx or glottis and add resistance on the exhale. This reduction in airflow brings an increase vagal tone. Whats known as Uijayi or ocean breath is an example of this type of breathing. This type of breathing brings a feeling of calm along with a sense of being alert and attentive.
A soothing sigh can also be a wonderful resource to soothe SNS activation. A sigh returns the ANS back to parasympathetic balance. The next inhale breath also usually comes more freely and deeply and they are not difficult to do. They can be a simple and easy resource to start to experiment with in your day.
Safety in Sound
Cues of safety and danger are received through sound. Interestingly the ANS responds to certain sounds as cues of danger. Low frequency sounds like the rumble of thunder are heard like sounds of a predator approaching. High frequency sounds like screams or a baby crying are experienced as signals of pain and danger.
One resource you can experiment with is humming. The larynx, or voice box, is connected to the vagus nerve. When you sing, hum, or say “om,” you activate the nerve. Humming increase our vagal tone and is generally pleasant for most people. You can take the next step from humming and move into singing. Singing is a type of guided breathing where we use many social engagement muscles including the larynx, lungs, heart, breath control, posture and facial muscles. All of which serve to increase vagal tone.
I also love Peter Levine’s Voo breath, which you can watch and experiment with.
Chanting is also another resource you can experiment with. Chanting combines sounds, breath and rhythm and activates the vagus nerve. When we chant a note like Om or a mantra we are working with our breath control and also extending our exhalation. Research also shows that chanting reduces anxiety and depression, blocks the release of stress hormones and increases our immune function.
Multiple studies have shown that listening to music with a slow tempo leads to a decrease in blood pressure, heart rate, and respiration rate. This is likely due to the link between our ears, vagus nerve, and parasympathetic nervous system. The vagus nerve is in close proximity to the ear, which means that when we hear sound and music, the vibrations of the sounds are resonating in our eardrums before traveling through the vagus nerve.
Finding the right music that feels good for you can support you in sending the message to your nervous system that you are safe. One of my favourite songs by Krishna Das you might like to try is on Spotify here.
Safety in Self-Touch
Touch stimulates our ANS and our vagus nerve that has been shown to reduce depression, pain and stress along with increased immune function. You can experiment with what kind of self touch feels right for you.
Touch can also be triggering so please pay attention to what feels right fo your body and your nervous system. Every person’s experience is unique and you are doing “me-search” into what feels right.
Options for self-touch
A hand or two hands over your heart or a hand more in the middle of your chest.
One hand on the side of your face and one had on your heart. A reminder of the face to heart connection of the vagus nerve!
One hand on your heart and one hand on your belly. Again check in if this feels ok for your nervous system.
holding your thumb with one hand and placing the other fingers over your hand.
Use your hands to ‘cup’ your eyes. Your fingers will rest on your forehead with your palms sitting over your eyes but not touching them. This brings in a nice PNS energy and activation as you feel the warmth around your eyes.
Remember a tactile experience of touch that is pleasurable. We can consciously recall positive memories where we have found touch pleasurable and savour them. Whether it was the feeling of a pet, a hug with a love one, our hand being held or a squeeze on the shoulder.
Bringing in Cues of Safety
As discussed, it is not enough to resolves cues of danger, we also need to actively bring in and experience cues of safety in our nervous system. We need to experience co-regulation. Safety can feel triggering as we may have had limited experiences of feeling safe, never felt safe in relationships or had our trust broken.
Safety requires:
Ongoing opportunities for co-regulation
Reliable relationships based on reciprocity
Time spent with safe people engaging in safe activities
Therapy is one part of the process of experiencing cues of safety.
Polyvagal theory in psychotherapy offers co-regulation as an interactive process that engages the social engagement systems of an individual. A trauma informed therapist will focus on helping you orient to cues of safety as part of Phase 1 safety and stabilisation work as well as helping you learn how to recognise and understand your different autonomic states.
Once you can recognise and respect the unique ways your nervous system has worked to help you survive, you can begin to work with self—regulation and experiencing co-regulation to access and deepen more moments of social connection or ventral vagal activation, helping your nervous system find it’s movement and balance.
The goal of regulating emotions is not to make feelings go away. Rather, the aim is to help clients build their capacity to ride the waves of big emotions and sensations. Initially, this occurs because they know that we are willing to join them in these difficult moments. In time, this process helps them learn that temporary experiences of contraction can resolve into a natural expansion of positive emotions such as relief, gratitude, empowerment, or joy ~Dr. Arielle Schwartz
I hope you have enjoyed this blog about Polyvagal theory and trauma. There are many pathways to healing trauma and we need many tools in our toolkit to work with trauma. This is one of the tools that can inform trauma treatment not the only tool! If you are on your own journey of healing it’s important to remember that we each have a unique nervous system and what feels useful for one person may not feel useful for another person and thats ok! I encourage you to keep working, don’t give up and find the right supports for you.