Polyvagal Theory & Trauma Treatment

Our understanding of how the Vagus Nerve functions has revolutionized trauma treatment- and beyond- as profoundly as Freud’s seminal considerations of “the unconscious” that shaped how psychological experience was understood and treated for the better part of a century. While us folks in trauma treatment have been “early adopters”, as we are continuously on the hunt to penetrate the heart of trauma, I fully expect that, with time and research, Polyvagal focused interventions will be disseminated across mental health- or mind-body care- much like Mindfulness has. (See my Integrative Mental Health & ACEs page to see how a dual perspective of “mind” to the right and “body” to the left, is not consistent with the evidence).

What is the Vagus Nerve?

The Vagus Nerve is the Tenth Cranial Nerve, which happens to be the longest nerve in the autonomic nervous system. Consequently, it is far reaching and one of the most important nerves in our body. The vagus nerve helps to regulate many critical aspects of human physiology, including the heart rate, blood pressure, sweating, digestion, social engagement, even speaking. It runs from the brain and runs through the auditory system, muscles and nerves involved in facial regulation. respiration, cardiac, lowers the heart rate. (Link to Heartmath). and digestive system. It ends right below your diaphragm.

How does the Polyvagal system work?

The Polyvagal system refers to the 3 pronged nervous system: the sympathetic nervous system, which is the fight/flight system, and the 2 branches of the Vagus nerve: the ventral vagal branch and the dorsal vagal branch.

The Good:

When the vagus nerve is toned and functions well, the ventral vagal branch serves to activate the parasympathetic system: putting “the brakes” on the sympathetic system arousal, the fight-flight responses that occur through trauma exposure and in PTSD.

The “vagal brake” restores a feeling of calm and relaxed state, recovery from a stressed state, characterized by tension, or actual trauma.

This beneficial effect occurs through the Social Engagement System, (SES), which is activated by the ventral vagal branch.

In a nutshell, what this means is when you are functioning from a ground, stable, secure, safe and centered place, you can engage socially with ease. You can use your social environment to help you with stress and tension. That’s why people seek out other people to process what’s happened when stressed. In part, that’s why my profession exists. Why it is that engaging with a professional therapist works.

The Bad

When the ventral vagal branch is not toned, it can lead to “slippage”, which means the “vagal brake” slips involuntarily and so you shift out of interpersonal regulation back into sympathetic activation, associated with anxiety, agitation, panic, restlessness, inattention, and active traumatization (with the full awakening of your fight-flight response). This can be an underlying reason why you are easily triggered or elevated social anxiety.

The Ugly

The dorsal vagal branch governs a primitive survival function: the freeze response (at the extreme end of the continuum, think playing dead, and at the other end, numbness, detachment, and dissociation).

Dissociation is a hallmark of Complex Trauma. It is why 95% of my clients require something other than the Standard EMDR protocol. Trauma is subversive. It creates a schism in your relationship with yourself, disconnecting you from your own resources and strengths, including the SES you are endowed with. Many of the interventions I use are informed by the findings of Dr. Stephen Porges and what many talented professionals have elaborated on the relationship between dissociation, trauma, and the Poly vagal system, such as Dr. Bessel van Der Kolk, Dr. Stephen Levine, Dr. Sandra Paulsen, Dr. Janina Fischer, Dr. Sebern Fisher.

*** Chronic depression is frequently supported by dissociative structures, as a result of maladaptive coping due to developmental trauma- aka attachment trauma- or adverse child experiences.

On the other hand, chronic anxiety, is supported by the other branch of the Vagus nerve, as well as is a cluster of diagnoses: Bipolar Type 2, ADHD, and/or Borderline Personality Disorder. These symptoms are reinforced by, a dysregulated vagal system that was hijacked by chronic stress and so your vagal brake is offline. So much so that even when everything is fine, you just can’t let it go.

The well toned vagus nerve is associated with a strong SES, which has calming and soothing effects reflected in rhythmic oscillations in heart rate variability, which is why I offer Heartmath, as part of my Mindfulness and Compassionate Mind Training Program.

In addition to the above interventions, I am pleased to offer a leading edge intervention developed by Dr. Stephen Porges, who discovered the powerful role of the Vagus Nerve for trauma treatment. It is a unique auditory intervention that enhances therapies, expediting the process of internalizing safety and stability, by going straight to the source to apply the “vagal brake”, to reset your SES. This intervention is the Safe & Sound Protocol (SSP).

Safe & Sound protocol

The SSP is an auditory intervention in which you listen to specially treated music designed to tone the vagus nerve. It requires 5 consecutive treatments, 1 per day, for 1 hour per session. It is done in the office, maintaining the integrity of a safe, distraction free environment. The intervention has been researched heavily by academic institutions for over 25 years. It began as an intervention for children with sensory and behavioral problems. As the role of the vagus nerve in disorders of traumatic stress became clearer, it was expanded to adults recovering from trauma and deemed to be a revolutionary adjunct to treatment. Its only been available on an outpatient basis for a limited time.

The SSP is NOT a replacement for therapy, much like medication is not a replacement for therapy. Therefore, if you are not already working with me, you may purchase an SSP intervention for me, only with a referral from your therapist. Or, you may purchase the 12 week package, in which I pair SSP with a secondary therapeutic intervention and allows me to work til you for another 7 sessions.