Polyvagal Theory in Light of Current Neuroscience: A Plain-English Review
Manzotti et al. (2024) — Developmental Psychobiology
Polyvagal Theory has been influential in discussions about the autonomic nervous system, safety, social connection and emotional regulation. At the same time, aspects of the theory have been questioned as our understanding of neuroscience and autonomic physiology has developed.
In this review, Andrea Manzotti and colleagues revisit Polyvagal Theory in light of research that has emerged during the roughly 25 years since the theory was first proposed.
Rather than simply accepting or rejecting the theory, the authors examine both its strengths and its limitations.
Looking at Polyvagal Theory through newer research
The authors bring together findings from several areas, including comparative anatomy, embryology, epigenetics, psychology and neuroscience.
They explore how newer research might contribute to our understanding of the vagus nerve and its relationships with autonomic regulation, development, interoception and social processes.
This broader perspective is useful because the autonomic nervous system does not operate in isolation. It is interconnected with many other physiological and psychological processes throughout development.
Development and relationship
An interesting aspect of this paper is its attention to development.
The authors consider the vagal system from early life onwards, including its possible importance within the relationship between parent and child.
This connects with something I find particularly relevant clinically: regulation develops within relationships.
Our ability to regulate ourselves isn't simply an individual skill that suddenly appears in adulthood. Our nervous systems develop within environments and relationships, and experiences of connection, responsiveness and safety can form part of that development.
This is one area where I find Polyvagal ideas sit particularly well alongside attachment theory and body-based approaches.
Interoception and the body
The review also considers interoception — our perception of signals arising from within the body.
This is particularly interesting from a Somatic Experiencing perspective because therapeutic work often involves becoming curious about sensations, impulses and subtle changes occurring within the body.
Interoception isn't the same thing as Polyvagal Theory, but research into it gives us another way of understanding how bodily signals can contribute to emotion, behaviour and our experience of ourselves and the world around us.
What about the criticisms of Polyvagal Theory?
This paper takes a different approach from the Grossman critique discussed in the previous review.
Rather than arguing primarily against the theory, Manzotti and colleagues examine Polyvagal ideas alongside more recent scientific findings and explicitly consider both strengths and limitations.
That doesn't mean the scientific debate has been resolved.
Some of the specific evolutionary and physiological claims associated with Polyvagal Theory remain contested. This paper represents one contribution to an ongoing scientific discussion rather than a final answer.
Why I think this matters clinically
As a practitioner, I don't think we necessarily need to choose between accepting Polyvagal Theory completely or rejecting everything associated with it.
In my experience, aspects of the framework can be genuinely useful when combined with Somatic Experiencing, attachment theory and other understandings of regulation and relationship.
Ideas around safety, mobilisation, withdrawal, connection and changing physiological states can help us become curious about what is happening rather than immediately treating a response as something that needs to be removed.
At the same time, I think it's important not to present a useful therapeutic framework as established neuroscience when parts of its biological explanation remain debated.
What I take from this paper
What I appreciate about this review is its attempt to keep the conversation open.
Science develops. Theories change as new evidence emerges, and useful ideas can be refined rather than simply accepted or discarded.
For me, Polyvagal Theory remains one of several frameworks that can help us think about the relationship between the body, nervous system, safety, connection and protective responses.
I find aspects of it particularly useful alongside Somatic Experiencing and attachment theory, while remaining open to how our scientific understanding of these processes continues to develop.
Reference
Manzotti, A., Panisi, C., Pivotto, M., et al. (2024). An in-depth analysis of the polyvagal theory in light of current findings in neuroscience and clinical research. Developmental Psychobiology, 66(2), e22450.
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