Above: Professor Stephen Porges talks about The Polyvagal Theory.
When you feel threatened how do you react? Do you feel angry, anxious, enraged, numb? Compelled to attack? Flee? Hide? Or grounded to the spot, unable to move, speak and feeling barely able to breathe? A relatively new way of understanding of how we respond to danger can help us make sense of ourselves, how we interact with our world and how this influences our relationships and mood. This knowledge can help us develop strategies to make us feel safe and enrich our lives.
The PolyVagal Theory (PVT), the brainchild of Professor Stephen Porges (possibly one of the most brilliant minds alive today), provides a holistic understanding of our nervous system, senses, emotions, social self and behaviours. Porges proposes that one of the most fundamental jobs of our body’s nervous system is to keep us safe. To this end, three (sub) systems have evolved over time; each controlled by a different branch of the vagus system.
Monkey, Fish & Reptilian Brain
Our most evolved and healthiest way of being is the Social Engagement System (our Primate System). In this mode, our bodies can function uninterrupted and we feel safe, calm and socially connected. The tasks of this mode include feeding, vocalizing, head tilt and turn, gaze, facial expression, voice perception and listening. We need to be in this mode to reduce metabolic demand to grow, develop, learn and heal.
When we feel under threat a different mode is activated; our fight or flight response which is linked with the ‘fish’ part of our evolutionary history. In this mode, our nervous system is called to action and we feel compelled to either fight or run to safety. Our body experiences a stimulating set of physiological changes, felt as anxiety, anger or blind rage (which one we feel is partly determined by our thoughts and interpretation of the triggering event).
If we feel like our life has been seriously threatened a third system may be activated. We may respond with our most primitive ‘reptilian’ mode, by playing dead. Physiologically, this system is deactivating. Although this may be a good short term strategy and healthy for crocodiles it isn’t great for mammals, for any length of time, because it does not meet our greater demand for oxygen (our heart rate drops dramatically during this mode). Psychologically this is felt as dissociation or feeling ‘numb’.
Feeling Safe & Sociable
It is important that we are able to adapt to our environment when we are safe (enabling the ‘Social Engagement System' so we can work, play and reproduce) and unsafe (enabling defensive mechanisms) a task Prof Porges calls ‘Neuroception’. How efficiently we do this (homeostatic variability) is shaped during our early years. If we experience a lot of trauma (such as poor attachment or attunement to our caregivers, physical pain or threat or deprivation), when we are growing up, we may be less efficient at responding to threat and we may be more likely to interpret situations as threatening (activating our defensive modes). This has a real impact on how we can cope with stress and on our mood. As social animals it also impacts our relationships because we need to be in the Social Engagement System, most of the time, to function well socially. If we feel less socially connected when we feel threatened and frightened this has wider implications for society.
Porges (and others) are doing a lot of work developing this understanding to help people who have experienced trauma develop strategies to feel safe (to experience Neuroception of Safety which Porges says work by 'applying the vagal break') and to inform wider systems (such as schools and political policy), therapies (such as touch, music, play and body therapies) and interventions. It is a fascinating and growing area bridging psychology, biology and neuroscience.
For me, it is of particular interest because the heart is central to our nervous system which made me wonder whether congenital cardiac anomalies could compromise our response to stress. This may, in part, explain why members of this population are at increased risk of a wide range of psychosocial vulnerabilities including anxiety and depression. To date, these difficulties have been accounted for by secondary factors (such as feeling different, missed schooling or physical limitations). However, a physiological explanation has wide implications and provides strategies to optimise normal development of social and defensive behaviours and inform therapeutic interventions. It is an understanding that calls for a paradigm shift in medical care where stress and disruptions of connectedness are proactively minimised.
My work in this area will be published as a chapter in a book edited by Prof Stephen Porges and Deb Dana, Psychotherapist forthcoming from Norton Press as part of their Interpersonal Neurobiology series titled Clinical Applications of the Polyvagal Theory: The Emergence of Polyvagal-Informed Therapies. I was delighted to present this work as a Keynote at The Congenital Cardiac Nurse Association's annual conference in July, 2016 in Worcester and at the British Psychological Society’s Annual Conference, 2017 in Brighton. I look forward to presenting it at the The World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS) in Barcelona in July. This is an area of interest and research, with wide implications, that I look forward to developing.
Relevant Links & Strategies to Keep Safe
-Simple strategies to promote feelings of (Neuroception of) Safety / apply the vagal break here.
-Prof Stephen Porges Website
-Deb Dana, LCSW
-The Greater Good Science Center: The Science of a Meaningful Life
-National Institute for the Clinical Application of Behavioral Medicine