In fight or flight, the whole organism is mobilized. The ancient, unmyelinated vagal nerve is connected to the high state of activation required for the organism's defense against attack and fleeing to safety.

In the case of freezing or "playing dead," the whole organism is immobilized. This shut-down state is also related to the older vagus. Characterized by a reduced blood flow to the brain as well as certain dissociative features, this nerve activity causes a human to collapse , freeze, or feign death in the face of threat (as a mouse does in the grip of a cat). In human beings, this is often coupled with the psychological effect of dissociation. 

This dynamic has clear implications for the attuned presence of the therapist in the clinical setting - How does the practitioner use his or her own neurology, facial expression, and tone of voice to create an experience of safety for the traumatized patient? Attentiveness, adaptivity, and major healing shifts begin with the client's experience of safety - not just intellectually, but physiologically and emotionally.

Porges describes breathing pattern and heart rate variability as "portals" to observing vagal activity. Noticing these physiological responses can act as a window on how the nervous system's regulates body responses & homeostasis.Given this principle, we can help patients gain some awareness of their body's stress responses, which in turn can allow them to have greater control over that response. We can apply these principles in treating many conditions related to trauma and dissociation. 

Anxiety is one of the central and most troublesome features of trauma.  If we can address a client's anxiety and stop the cycle, we enable learning, adaptation, new skills, and new behaviors.  If anxiety is not sufficiently addressed therapeutically, change cannot take hold-and the person remains dependent on the clinician or medications to provide support and regulation.

If a client presents in a panicked state, we can decide whether to discuss the underlying causes-rarely helpful in the moment-or we can use the opportunity to help cultivate an awareness of her body's responses to stress, such as increased heart rate and shallow breathing.  Programmed for survival by the earlier vagus, these responses act as a vicious circle: anxious thoughts lead to the body's gearing up to fight or to flee, manifesting in short, shallow breaths and increased heart rate.  Each step in the cycle feeds on the other, and in no time the client is exhibiting a worried facial expression and looking around for unseen threats.

If we can guide an anxious client to notice one piece of the pattern, for instance the breathing, we may create an intervention that undoes the chain and allows him or her to regain a greater sense of ease.  We can help by reminding the client to count to four on inhale and eight on exhale.  It's also important to practice this breathing pattern with our clients, helping their agitated nervous systems attune to one that is calmer.  Repeating this exercise a few more cycles can regulate neural responses to the point where we can now discuss what happened with a gentle smile and a calm, varied tone of voice, witness courage for trying something new, and offer congratulations for learning a new skill that will support balance in any stressful situation.  

Porges also advocates the use of a certain range of music for therapeutic benefit in patients with trauma, autism, and/or hypersensitivities. This kind of music affects the tiny muscles of the middle ear, which are connected to the vagal nerve. He suggests that re-regulation of the entire nervous system can be supported by helping the client train the muscles of the inner ear to actually listen differently, "tuning" to calming sounds created by a friend, therapist, or piece of music. 

As trauma therapists, we already know that mind, emotion, and body are not separate systems. These new findings from neuroscience reveal that the vagus acts as an important bridge between our physiology and our thoughts and emotions. The neural regulation of our viscera and the workings of our conscious and adaptive meaning-making brain go hand in hand. Western science is finally pinpointing the precise neural mechanism for the practices that Eastern mystics have been using for thousands of years. Porges has highlighted the vagal nerve as a bidirectional link between brain and body. As we apply these important findings, we may come to view this conduit as an essential bridge between despair and hope and ultimately between trauma and wholeness.

For more information, visit the following links:
 

Stephen Porges "The Polyvagal Theory" Video

Wearing Your Heart on Your Face: The polyvagal circuit in the consulting room. By Ryan Howes

A Teleseminar Session with Stephen W. Porges, PhD and Ruth Buczynski, PhD 

We also invite you to a "last call" opportunity to sample our Healing Trauma and Pain through Polyvagal Science with Peter Levine, Stephen Porges, and me. Go here and scroll down to find this November series. Act now if you're interested, because these links will soon become inactive.

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