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October 9 - October 25, 2023
it is my hope to highlight the important role of feeling safe as an important component of the healing process.
From a Polyvagal perspective, deficits in feeling safe form the core biobehavioral feature that leads to mental and physical illness.
Polyvagal Theory emphasizes the adaptive function of spontaneous behaviors by focusing on the impact that behavior has on regulating physiological state. This perspective is based on an evolutionary model in which behavior is interpreted as adaptive if it enhances survival, minimizes distress, or influences physiological state in a manner that would optimize health, growth, and restoration.
Polyvagal Theory emphasizes the autonomic state that underlies the psychological feelings that define anxiety.
Polyvagal Theory focuses on the features of safety manifested in the social engagement system (see social engagement system) that enable attachment to occur. Prosodic voices, positive facial expressions, and welcoming gestures trigger through neuroception (see neuroception) feelings of safety and trust that spontaneously emerge when the social engagement system is activated.
Polyvagal Theory focuses on the observation that a diagnosis of ASD involves features that reflect a depressed social engagement system (see social engagement system). Thus, many individuals with ASD have voices without prosody, have auditory hypersensitivities, have auditory processing difficulties, do not make good eye contact, have flat facial expressivity especially in the upper part of their faces, and have severe behavioral state regulation difficulties that are frequently manifested in tantrums.
the sympathetic nervous system increases heart rate and the parasympathetic nervous system decreases heart rate through the vagus (the major neural component of the parasympathetic nervous system),
From a Polyvagal perspective, a focus on autonomic balance obfuscates the importance of the phylogenetically-ordered response hierarchy of how the autonomic nervous system reacts to challenges. According to Polyvagal Theory, when the social engagement system with the myelinated ventral vagal pathways is engaged, a unique autonomic state emerges that supports an optimal autonomic balance in the regulation of subdiaphragmatic organs.
The vagus is the tenth cranial nerve, which connects brainstem areas to several visceral organs.
Polyvagal Theory emphasizes that the need to connect with others is a primary biological imperative for humans. The theory emphasizes that through connectedness, physiology is co-regulated to optimize mental and physical health.
Biological rudeness is a cascade, which starts with a lack reciprocity to a spontaneous social engagement that triggers an autonomic state of defense and ends with an emotional response of being offended that may lead to an aggressive reaction.
From a Polyvagal perspective, the regulation of mood and emotion involves the neural regulation of the autonomic nervous system. Thus, the theory would lead to hypotheses that borderline personality distorder would be associated with a challenged social engagement system and especially the efficiency of ventral vagal pathways in downregulating sympathetic activation.
Polyvagal Theory refers to the social connectedness that define trusting relationships that humans have with others as a biological imperative.
Within Polyvagal Theory co-regulation involves the mutual regulation of physiological state between individuals.
Cranial nerves emerge directly from the brain, in contrast to spinal nerves that emerge from segments of the spinal cord. Cranial nerves are functionally conduits that contain both motor and sensory pathways.
Polyvagal Theory proposes that death feigning is an adaptive response to life threat when options for fight/flight behaviors are minimized, such as during restraint or when there is an inability to escape.
Dissociation is a process of losing a sense of presence resulting in experiencing a disconnection and a lack of continuity between thoughts, memories, surroundings, and actions.
Polyvagal Theory does not treat self-regulation as a learned skill, but interprets self-regulation skills as a product of the nervous system that can maintain feelings of safety in the absence of receiving cues of safety from another person. The theory emphasizes that through processes of co-regulation, an individual develops a capacity to self-regulate. The theory emphasizes that the mutual, synchronous, and reciprocal interactions between individuals that define co-regulation function as a neural exercise enhancing the ability to self-regulate in the absence of opportunities to co-regulate.
The sympathetic nervous system functions to increase blood flow throughout the body to support movement. Polyvagal Theory focuses on the role that sympathetic nervous system has in increasing cardiac output to support movement and fight-flight behaviors.
My work documented that a reduction in heart rate variability was a robust indicator of sustained attention and mental effort.
Evaluative models, when chronic, shift physiological state to support defense. The physiological states that support defense are incompatible with those that support creativity and expansive theories.
when it comes to identifying safety from an adaptive survival perspective, the “wisdom” resides in our body and in the structures of our nervous system that function outside the realm of awareness. In other words, our cognitive evaluations of risk in the environment, including identifying potentially dangerous relationships, play a secondary role to our visceral reactions to people and places.
Once we recognize that the experiences within our societal institutions such as schools, hospitals, and churches are characterized by chronic evaluations that trigger feelings of danger and threat, we can see that these institutions can be as disruptive to health as political unrest, fiscal crisis, or war.
The Polyvagal Theory restructures clinical disorders as difficulties in neural regulation of specific circuits associated with turning off defensive strategies and enabling social engagement to spontaneously occur.
Polyvagal Theory emphasizes that the neural circuits that support social behavior and emotional regulation are available only when the nervous system deems the environment safe and that these circuits are involved in health, growth, and restoration.
Safety is critical in enabling humans to optimize their potentials along several domains. Safe states are a prerequisite not only for social behavior but also for accessing the higher brain structures that enable humans to be creative and generative.
Polyvagal Theory emphasizes that our nervous system has more than one defense strategy and that the decision of whether we use a mobilized flight/flight or an immobilization shutdown defense strategy is not a voluntary decision.
For some people, specific physical characteristics of an environmental challenge will trigger a fight/flight behavior, while others may totally shut down in response to the same physical features. I want to emphasize that understanding the response, not the traumatic event, is more critical to the successful treatment of trauma.
the vagus is a cranial nerve that exits the brainstem and travels to the organs in our body.
Perception requires a conscious awareness, while neuroception occurs reflexively without awareness.
We often forget that medical procedures may convey cues to our body that are similar to physical abuse.
Whether or not an individual feels safe with the parent, caregiver, family members, or others during early development might moderate individual differences in vulnerability to trauma.
There has long been an assumption that if you can give the disorder a name, it will lead to improved treatment and will provide a better understanding of the disorder. However, it appears that diagnoses, especially within the area of mental health, have had a greater impact on the finances of clinicians than on understanding the mechanisms underlying the disorder that would lead to improved treatment.
I am not talking about curing; I am talking about reducing some of the symptoms to make life better for people with disorders.
If we listen to a voice characterized by a great degree of tonal modulation, our nervous system functionally starts triggering a state associated with safety.
As a species, we are very adaptive. If we come from families where parents are depressed or chaotic, we will adapt by not engaging them, and we literally will down-regulate our social engagement system.
They found that the people who got the warmth and kindness recovered from the flu faster.
The cues from the safe individual enable the sick or compromised person not to be in defensive states. When we are in a defensive state, then we are using metabolic resources to defend. It’s not merely that we can’t be creative or loving when we’re scared; we can’t heal.
As a clinical psychologist, when you look at clients’ faces and listen to their voices, you are inferring information about their physiological state because the face and heart are wired together in the brainstem.
an important clinical observation, especially in treating individuals with trauma, is the covariation of an emotionally flat upper face with a voice that lacks prosody.
Trauma treatment and diagnosis have been focused and biased on the event and not on understanding that an individual’s response to the event is the critical feature.
If our nervous system detects safety, then it’s no longer defensive. When it’s no longer defensive, then the circuits of the autonomic nervous system support health, growth, and restoration.
Often we have been taught, as part of a strategy to manage our behavior, to reject the feedback that our body is telling us.
If you start looking at the clinical symptomatology of people with trauma histories, we see a lot of subdiaphragmatic issues, whether it’s obesity or digestive issues or other types of neurophysiological problems.
The vagus is the major nerve of the parasympathetic nervous system, and functionally it connects our brain to our body.
mammals are very special vertebrates—they need other mammals to regulate their bodily states and to survive.
Trauma disrupts the ability to relate to others and to use social behavior to literally regulate vagal function—to calm us down.
We live in a medically oriented world that treats organs as if each organ can be treated independently and is not part of an integrative and interactive autonomic nervous system.
the true value in life is connectedness with other people.
We are not a car that gets something replaced or repaired—human organs are not equivalent to an automobile part. We are not a machine—we are a dynamically interacting living biological system. When we touch something, we touch everything within us and we also touch the people that we interact with. Physicians in the medical community need to become more connected to people they are treating.
