The Polyvagal Perspective: A Plain-English Review
Porges, S. W. (2007) — Biological Psychology
Polyvagal Theory has become highly influential in trauma-informed and body-based approaches to therapy. In this 2007 paper, Stephen Porges sets out the theory in detail and proposes a way of understanding how changes in our autonomic nervous system may relate to behaviour, emotion, social connection and responses to threat.
What is Polyvagal Theory?
At its heart, Polyvagal Theory asks us to think about the autonomic nervous system not simply as something controlling functions such as heart rate and digestion, but as part of a wider system involved in how we respond to our environment.
Porges proposes that different neural pathways support different adaptive responses. These are associated with social engagement and connection, mobilisation such as fight or flight, and immobilisation or shutdown.
An important aspect of this perspective is that these responses are understood as adaptive rather than simply pathological. A defensive response may make sense when viewed in the context of what the nervous system is attempting to protect us from.
Safety, connection and the nervous system
One of the reasons Polyvagal Theory has attracted interest within psychotherapy is its emphasis on the relationship between physiological state and our capacity to engage with other people.
Porges proposes a social engagement system, linking autonomic regulation with processes involved in facial expression, vocalisation, listening and social communication. The theory suggests that physiological states can support or constrain our capacity for connection and defensive behaviour.
This offers an interesting perspective clinically. Someone struggling to connect, settle or remain present may not simply be making a conscious choice. Their bodily state may also be contributing to what is possible for them at that moment.
Why I find this useful in practice
In my own work, I find aspects of Polyvagal Theory particularly useful when considered alongside Somatic Experiencing, attachment theory and other understandings of nervous-system regulation.
It provides an accessible language for exploring experiences such as feeling safe enough to connect, becoming mobilised or overwhelmed, withdrawing or shutting down, and gradually finding greater flexibility between different states.
Importantly, I don't see these states as things that simply need to be eliminated. They can be understood as protective responses that may have developed for good reasons.
That perspective can help shift the question from “What is wrong with me?” towards “What might my nervous system be trying to do here?”
What does the research actually establish?
This is where some care is needed.
Porges' 2007 paper is primarily a theoretical paper, not a clinical trial demonstrating that Polyvagal Theory is an effective therapy. It presents an account of the theory and draws on neurophysiology and proposed evolutionary changes in autonomic regulation.
Some of the specific evolutionary, anatomical and physiological explanations proposed within Polyvagal Theory have subsequently been challenged by other researchers.
That doesn't necessarily answer the separate question of whether clinicians and clients may find aspects of the framework useful. But it does mean we should distinguish between clinical usefulness as a way of understanding experience and scientific evidence supporting the particular biological mechanisms proposed by the theory.
I'll explore those criticisms in later reviews in this series.
What I take from this paper
For me, one of the most valuable ideas is relatively simple: our physiological state matters.
Our ability to connect, engage, defend ourselves, withdraw or feel sufficiently safe to explore an experience does not occur independently of the body.
That fits particularly well with the way I work therapeutically — paying attention not only to thoughts and emotions, but also to bodily sensations, impulses, movement, relationship and shifts in nervous-system state.
Polyvagal Theory is one framework for making sense of those processes. I find parts of it clinically useful, while remaining interested in how the science develops and where aspects of the theory may need to be revised.
Reference
Porges, S. W. (2007). The Polyvagal Perspective. Biological Psychology, 74(2), 116–143.
Comments