The Polyvagal Theory of Trauma and its implications for the way we understand and work with clients

By, Luuk L. Westerhof, MSc

Abstract

In recent years, there has been growing interest in the study of trauma and its effects on the human body. The Polyvagal Theory is a relatively new theory that attempts to explain the relationship between the nervous system and the experience of trauma. This theory has implications for our understanding of how trauma affects the body and the ways in which we can treat it.

Keywords

Trauma; Polyvagal; Nervous System; Vagal tone; Neuroception; Therapy.

Introduction

Trauma is a reaction to a deeply distressing or disturbing event. It is a normal response to an abnormal situation. Trauma can be physical, emotional, or both. The physical effects of trauma can include shock, pain, and physical injuries. The emotional effects can include anxiety, depression, post-traumatic stress disorder (PTSD), and other mental health conditions (Levine, 1997, 2017; B. A. Van der Kolk, 2015; B. A. van der Kolk & McFarlane, 2012). Trauma is a complex and often misunderstood topic. There are many different theories out there about what trauma is and how it affects us. In this article, I’ll be exploring the Polyvagal Theory of trauma and its implications for the way we understand and work with clients who have experienced trauma. The Polyvagal Theory (Porges, 2011a) is a relatively new theory that has been gaining traction in the mental health field. It offers a new way of understanding the impact of trauma on the nervous system. This theory has important implications for the way we work with clients who have experienced trauma. The somatic approach to trauma is an approach that acknowledges the reality of the mind-body connection. This approach is based on the understanding that trauma is stored in the body as well as the nervous system. The polyvagal approach to trauma focuses on healing from a holistic approach. This article will explore the Polyvagal Theory of trauma and its implications for the way we work with clients who have experienced trauma. We will also explore the somatic approach to trauma and how it can be used to help clients heal.

What is Trauma?

Trauma is an emotional reaction to a deeply distressing or disturbing event that, at the time of the event, overwhelmed the individual's capacity to cope (Mate, 2019). Trauma is what happens inside of you due to what has happened to you (ibid). It is a broad topic and can range from disturbing personal experiences to widespread, collective experiences. It can include physical, emotional, and mental responses, and can result in a spectrum of psychological symptoms and physical effects (Herman & Van der Kolk; Mate, 2019; B. A. Van der Kolk, 2015). Trauma is both a subjective and an objective experience - it has individual, interpersonal, and collective components. It often manifests in disordered behaviors and psychological symptoms, such as dissociative episodes, difficulty sleeping, depression, post-traumatic stress disorder, or feelings of heightened or chronic fear.

Trauma is a reaction to a deeply distressing or disturbing event (Mate, 2019). It is a normal response to an abnormal situation. Trauma is the psychological and emotional impact of a stressful event or situation that overwhelms an individual’s ability to cope or respond (B. A. van der Kolk, 2000; B. A. Van der Kolk, 2015; B. A. van der Kolk & McFarlane, 2012). The effects of trauma are often manifested through visceral, endocranial, and somatoform disorders (Mate, 2019; Van der Kolk, 2015).

What is the Polyvagal Theory?

The Polyvagal Theory is a comprehensive theory of autonomic nervous system function. It was first proposed by Stephen Porges in the early 1990s (Porges, 2011b; Simon & Porges, 2012a) and has since been supported by a large body of empirical evidence. The theory states that the autonomic nervous system (ANS) is composed of three distinct branches: the ventral vagal, the sympathetic nervous system (SNS), and the dorsal vagal. Each of these branches serves a different purpose and is activated in response to different stimuli, especially stress (Porges, 1997, 2003b; Porges, 2011b; Porges, Doussard-Roosevelt, Stifter, McClenny, & Riniolo, 1999).

The Polyvagal Theory has important implications for our understanding of mental health. It can help to explain why certain disorders are more common in certain populations, and how the autonomic nervous system can be dysregulated in mental problems (Porges, 2011). It also has implications for treatment, as therapies that target the autonomic nervous system may be more effective for certain conditions. The sympathetic nervous system is responsible for the fight-or-flight response, while the parasympathetic nervous system is responsible for the rest-and-digest response.

The polyvagal theory states that the autonomic nervous system is constantly interacting with the nervous system, and that these interactions are constantly affecting our emotions and behaviors. The Polyvagal Theory is a theoretical framework for understanding the connection between trauma and the autonomic nervous system (Dana & Porges; Porges, 2003a; Porges, 2011b; Porges & Coles, 1976b). The theory suggests that trauma, or a traumatic experience, overwhelms the nervous system and causes disruptions in the way it functions, resulting in a variety of symptoms. This polyvagal theory is based on the understanding that the autonomic nervous system has three states: sympathetic (fight-or-flight), parasympathetic (ventral vagal), and freeze (dorsal vagal) (Dana & Porges; Porges, 2001, 2003b, 2007a; Porges, 2011b; Simon & Porges, 2012a). The theory suggests that when faced with a traumatic experience, the autonomic nervous system moves into a freeze state. In this state, the body and mind become overwhelmed, and it can be difficult or impossible to respond or regulate emotions.

The Polyvagal Theory: How the Nervous System Regulates Emotions

The Polyvagal Theory is a theory of how the autonomic nervous system regulates emotions (Porges; Porges, 1991; Porges, 2011b). The autonomic nervous system is the part of the nervous system that controls involuntary bodily functions, such as heart rate, digestion, and respiration. The theory posits that there are two main ways in which the autonomic nervous system regulates emotions: 1. The vagus nerve, which is responsible for the “rest and digest” response, and 2. The social engagement system, which is responsible for the “fight or flight” response. The theory posits that these two systems work together to regulate emotions. When the body is in a state of “rest and digest,” the vagus nerve is deactivated, and the social engagement system is activated. This results in a feeling of safety and relaxation.

Conversely, when the body is in a state of “fight or flight,” the social engagement system is deactivated, and the vagus nerve is activated. This results in a feeling of anxiety and arousal. When we are in a situation that is safe and we feel supported by others, the autonomic nervous system kicks in and we feel calm and relaxed. When we are in a situation that is unsafe or we feel threatened, the vagus nerve kicks in, and we feel stressed and anxious. The theory has a number of applications, such as in therapy, child development, and treating trauma.

The Concept of Neuroception

Neuroception is a term that was first coined by Stephen Porges in the 1990s (Porges; Porges, 2007b; Porges, 2011b). It refers to the ability of the nervous system to detect dangers and threats in the environment without the help of cognition (Dana & Porges). Neuroception is a process that happens in the brain that allows us to assess risk unconsciously and automatically in our environment. It is a survival mechanism that is hardwired into our nervous system and helps us to protect ourselves from harm. This process happens outside of our conscious awareness and can be thought of as our brain’s built-in alarm system. It is constantly on the lookout for danger and can be triggered by a variety of things, such as a loud noise or a sudden movement. Once triggered, our body reacts automatically to the perceived threat. We might freeze in place, our heart rate will increase, and we will start to sweat. This is all part of the fight-or-flight response, which is a natural and automatic reaction that happens when we feel threatened.

Neuroception is an important part of our lives and helps us to stay safe. However, it can also lead to problems if it is constantly on high alert. This can happen in people who have post-traumatic stress disorder (PTSD) or who live in a dangerous environment. It is an evolutionary mechanism (Porges, 2007a) that has helped us survive and thrive in the face of threat and adversity. Although we are not consciously aware of it, neuroception is constantly at work in our lives, shaping our decisions and behaviors in response to perceived threats. When we feel safe and secure, it is because our neuroceptive system has signaled that there is no danger. Conversely, when we feel anxious, stressed, or on edge, it is because our neuroceptive system has detected a threat. This can happen even in the absence of an actual threat, such as when we are anticipating a future threat. When we detect a threat, our nervous system signals the adrenal glands to release stress hormones, such as cortisol and noradrenaline, into the bloodstream. These hormones prepare the body for action by increasing heart rate, blood pressure, and respiration.

How Does Neuroception Impact Our Lives?

Neuroception has a major impact on our lives as it can affect how we interact with our environment (Porges, 2011b). For example, if a person is constantly in a state of neuroceptive alarm, they may not be able to properly process sensory information (ibid). This can lead to difficulty reading social cues and interpreting people’s intentions, which can affect relationships and friendships. Neuroception can also affect our ability to go about our daily lives. If a person is constantly scanning for danger, they may not be able to focus their attention on tasks or engage in activities they enjoy. This can lead to feelings of helplessness (Seligman, 1972, 1978; Seligman, Rosellini, & Kozak, 1975; Seligman, Weiss, Weinraub, & Schulman, 1980) and a decrease in productivity.

There are three types of neuroception: positive, neutral, and negative. Positive neuroception is when the brain notices a safe environment and response accordingly – allowing us to relax and enjoy our surroundings. Neutral neuroception is when the brain detects no threat, and our body remains in a state of homeostasis. Negative neuroception is when the brain perceives a possible threat and activates the fight-or-flight response.

The Impact of Trauma on Neuroception

Trauma can have a significant impact on neuroception. People living with PTSD tend to have an overactive fight-or-flight response, which can lead to increased anxiety and difficulty focusing on tasks (Herman & Van der Kolk; Roth, Newman, Pelcovitz, van der Kolk, & Mandel, 1997; B. van der Kolk, 2013; B. A. Van der Kolk). This is because their brains often perceive even the slightest of stimuli as a potential threat. This can lead to difficulty functioning in a safe environment and can make it hard to trust or form relationships.

The physical effects of trauma

Trauma is a deeply distressing or disturbing experience (Kirkengen, 2009; Mate, 2019; B. A. van der Kolk, 2000; B. A. Van der Kolk, 2015). It can be physical, emotional, or psychological. Trauma is a psychological term that refers to a deeply distressing or disturbing event that has a lasting impact on an individual’s mental and emotional wellbeing. Trauma can be caused by a single event or by prolonged exposure to a stressful situation.

The physical effects of trauma are often underestimated or ignored, but they can be just as debilitating as the emotional ones. Trauma can occur in response to a single stressful or life-threatening event, or it can be the result of long-term exposure to stressful situations. The physical effects of trauma can have a significant and lasting impact on our physical health. trauma can cause a range of physical symptoms, including headaches, gastrointestinal and visceral problems, and chronic pain. It can also lead to long-term health problems, such as heart disease, diabetes, and cancer (Mate & Mate, 2022). The good news is that there are effective treatments available for the physical effects of trauma.

The physical effects of trauma can vary greatly in intensity and duration. In some cases, physical trauma is immediately apparent and can involve physical pain, shock, and injuries. Physical trauma can be caused by accidents, physical assaults, extreme weather, or exposure to hazardous substances. The physical effects can be both immediate and long-term. Immediately following a traumatic event, an individual may experience physical shock, pain, and injuries (Porges, 2007a, 2007b; Porges, 2011a). Physical shock may involve rapid breathing, increased heart rate, and mild to severe pain (Rothschild, 2000). An individual may experience pain throughout the body or in specific areas if there are physical injuries. In the long term, physical trauma can lead to physical health problems, such as chronic pain, headaches, digestive problems, and even heart problems (Mate, 2019). Trauma can also lead to physical changes, such as a weakened immune system and higher levels of stress hormones (Mate, 2019). Physical trauma has been linked to physical disability, disability due to injury, and disability due to mental and physical problems.