she outlines neural exercises that will provide resources to downregulate threats and enable spontaneous social engagement, which in combination create a fluid path toward co-regulation and embodiment
a nervous system in chronic states of threat downregulates opportunities to socially engage
Fortunately, through our evolutionary history, we as social mammals have developed a portal to downregulate our threat reactions through the neuroception of safety. However, access to this portal is greatly influenced by the neural state of the individual. If the autonomic nervous system is well resourced, we are resilient and there is a low threshold to trigger states of safety that would lead to spontaneous social engagement and co-regulation. Alternately, if we are locked into a defensive state, feelings of safety may not be easily accessible.
Functionally, the journey requires us to, first, become aware of the neurophysiological circuits involved in feelings of safety, danger, and life threat; second, become aware of the power of neuroception, the detection of cues of threat and safety without conscious awareness; and third, through visualizations and experientials, become of aware of the shifts in autonomic state. As a package, this sequence can be conceptualized as neural exercises, which would promote greater self-awareness and self-regulation, leading to greater resilience
Polyvagal Informed Therapies shift the focus of therapy from the traumatic event to the bodily feeling. This is an important theoretical transformation about how trauma is both treated and embedded in the survivor’s nervous system. On the foundational level, Polyvagal Theory emphasizes that physiological state forms the intervening variable that determines our reactivity to cues and contexts. Thus, the theory emphasizes that it is not trauma as an event that is the primary determinant of outcome. Rather, the theory emphasizes that it is the re-tuning of the neural regulation of the autonomic nervous system to support threat reactions that is the primary determinant of outcome
we created the Body Perception Questionnaire (BPQ). The BPQ is a relatively short questionnaire that evaluates the reactivity of our autonomic nervous system. The psychometrics are well established, and several studies have been published using the scale
As we embrace the core message of the theory that we are a social species without the accessibility of our mammalian heritage, we recognize we lack the neural resources to be safe and to co-regulate with others. This heritage pivots on two uniquely mammalian features: one, a neuroception process that enables the downregulation of defense states through reflexive detection of cues of safety; and two, a neural circuit, the ventral vagal complex, with its capacity to both calm defenses and provide cues of safety via an integrated social engagement system. This heritage links behavior and psychological experience with definable and measurable neurophysiological
mechanisms, a link that joins mental and physical health and dispels myths of their independence
This system works in predictable ways, and this shared experience brings us together. Looking through the lens of the nervous system, we understand that we are all trying to anchor in the state of safety that supports connection to self, to others, to the world, and to spirit and provides the energy we need to navigate our days. When the inner workings of our biology are a mystery, we feel as if we’re at the mercy of unknown, unexplainable, and unpredictable experiences. Once we know how our nervous system works, we can work with it. As we learn the art of befriending our nervous system, we learn to become active operators of this essential system.
Mindfully meeting the autonomic nervous system begins with understanding the way this system works and creating skill in following the moment-to-moment flow between action, withdrawal, and connection
With that awareness we can bring in practices to gently shape the system in new ways and enjoy the sense of ease that comes from living with a nervous system that responds with flexibility to the ordinary — and sometimes extraordinary — challenges we meet each day
The wonderful thing about this system is that it not only functions automatically with preprogrammed settings but, with Polyvagal Theory, it can also be adjusted
Through the process of evolution, three building blocks came into being one after the other: dorsal vagal (shutdown) around 500 million years ago, sympathetic (activation) around 400 million years ago, and ventral vagal (connection) around 200 million years
ago.
The second principle of Polyvagal Theory, the internal surveillance system, is defined by the wonderfully descriptive word neuroception. Stephen Porges created this word to illustrate how the nervous system (neuro) is aware (ception) of signs of safety and signals of danger. With a neuroception of safety, we move out into the world and into connection. A neuroception of danger brings a move into sympathetic fight and flight, while a neuroception of life threat takes us into dorsal vagal collapse and shutdown.
These three streams of embodied listening are always working, micro-moment to micro-moment, below the level of our conscious awareness. Running in the background, neuroception brings about the autonomic state changes that either invite us into connection with people, places, and experiences or move us away from connection and into the protection of fight, flight, or shutdown
When we bring perception to neuroception, we bring an otherwise nonconscious experience into awareness. We can work with our experience by taking the implicit experience of neuroception and explicitly noticing it and turning our attention toward the state that has come alive
The three principles of Polyvagal Theory — building blocks of the hierarchy, internal surveillance through neuroception, and regulating with others — are where we begin to understand and befriend our nervous system. Next we add the elements of well-being — context, choice, and connection — which help the nervous system anchor in safety and regulation
For instance, a friend sends me a message canceling our planned lunch, and without hearing her voice, seeing her face, or having more information, I’m pulled into anxiety and a story that I’ve done something wrong and my friend is upset with me
Context
There is a sweet spot for each of us where we have boundaries to create a framework for our choices and routines that include flexibility
Choice is the second element necessary for a regulated nervous system
The story of the autonomic nervous system begins around 500 million years ago with a prehistoric fish called a placoderm and the branch of the parasympathetic system we know as dorsal vagal
Immobilization and disappearing are the survival strategies of the dorsal vagal system
Around 400 million years ago, the sympathetic nervous system emerged in another now extinct fish called an acanthodian. With the arrival of the sympathetic nervous system, movement as a survival strategy was added and fight and flight were now possible. To get a flavor of the mobilization of this system imagine a shark attacking or a fish darting to escape.
Finally, around 200 million years ago, the other branch of the para-sympathetic nervous system, the ventral vagal system, came into being
As each new system emerged, it joined the older system rather than replacing it, and the architecture of the autonomic nervous system became more complex
Vagus means “wanderer” in Latin, and because of the length of this nerve (the vagus is the longest cranial nerve) and the ways it connects in so many places along its route, it seems it is appropriately named
Although we will talk about the vagus as one nerve, all twelve of our cranial nerves come in pairs, one on the left
side of the brain and one on the right. It is the right vagus nerve that connects to the heart and forms the vagal brake referenced later in this chapter
The information carried along this vagal pathway travels in two directions, with 80 percent of the information going from the body to the brain and 20 percent from the brain to the body
From the diaphragm downward is the realm of the dorsal vagus whose everyday, nonreactive responsibility is to regulate healthy digestion. In survival mode, the dorsal vagus takes us out of awareness, out of connection, and into collapse and immobilization. In this survival state, we feel disconnected and numb and have the experience of being here but not here and the sense of going through the motions of life without really caring. We suffer with digestive problems as our biological systems move into conservation mode, everything slowing down to maintain just enough energy to keep us alive. We hope that if we disappear, become invisible, and don’t feel what’s happening or inhabit where we are, we will survive. We escape into not knowing, not feeling, and a sense of not being. As you read this description you may even feel a flavor of your dorsal vagal energy activating in your system.
From the diaphragm upward is the realm of the ventral vagus. This is the place where we anchor in safety and can both self- and co-regulate. Our heart rate is regulated, and our breath is natural and full. We take pleasure in seeing the faces of friends and are able to tune in to conversations and tune out distractions. In a ventral vagal state we can acknowledge distress, explore options, and reach out for and offer support. We are resourced and resourceful. Our attention is focused on connection to ourselves, to others
One important ventral vagal circuit is the vagal brake. This particular circuit leaves the brainstem and connects with the sinoatrial node of the heart — the heart’s pacemaker — and it is through this connection that our heart rhythms are regulated. The vagal brake slows the heart rate to a healthy number of beats per minute (between sixty and eighty). Without this regulating influence, the heart would
beat dangerously fast. Because of the ways this pathway regulates heart rate, it is called the vagal brake. Like all efficient braking mechanisms, the vagal brake works to both slow down and speed up heart rate and bring the right degree of energy needed to successfully navigate moment to moment
The vagal brake also regulates our respiratory rhythm. It moves in a subtle pattern of release and reengagement with every breath cycle. On each inhalation the vagal brake offers a slight release and the heart rate speeds up just a bit, and then on the exhalation the vagal brake reengages, and the heart rate returns to a slower beat. To get a sense of how the vagal brake works, think about the hand brakes on a bicycle. When you’re riding downhill and want to go faster, you gently release the brakes and the wheels spin more quickly. Then, when you want to slow down, you gently squeeze the brakes
The function of the vagal brake is to allow us to feel, and use, some of the mobilizing energy of the sympathetic nervous system without being pulled into the survival state of fight and flight
Without the vagal brake we lose our anchor in safety and connection and move into the protective states of fight and flight
But if we lose connection to the vagal brake, we lose our anchor in the ventral system and move out of safety into a state of sympathetic survival. When enlisted in a survival mode, the sympathetic system activates fight and flight, and the hypothalamic-pituitary-adrenal (HPA) axis (a circuit that connects the hypothalamus and pituitary gland in your brain with the adrenals that sit on top of your kidneys) begins to release cortisol and adrenaline.
A polyvagal-informed understanding of our feelings, thoughts, and behaviors offers a way to be with our experiences instead of being hijacked by them
Since 2014, I have collaborated with Dr. Porges as a mentor, coauthor, colleague, and friend and have been actively translating the science of Polyvagal Theory into clinical application
understanding how the nervous system works is the path to finding the way back to regulation
Each chapter offers practices, labeled “explorations,” to bring the theory portion into an embodied experience
In order to co-regulate, I have to feel safe with you, you have to feel safe with me, and we have to find a way to come into connection and regulate with each other
Moving out of ventral safety into the energy of the sympathetic system, we have a sense of impending danger and enter into fight and flight. The world feels like an unsafe place filled with unsafe people. In this state we misread cues and experience neutral faces and certain tones of voice as signs of danger. Our hearing is tuned to listen for sounds of danger, and it’s easy to miss the sounds of friendly voices around us. We scan the environment, no longer just aware and alert; we are now alarmed and hypervigilant. We are on our own, separated from others, and we look at the world from an “us vs. them” or “me vs. you” mindset.
The ability to flexibly move between states is a sign of well-being and resilience. It is when we are caught in dysregulation, unable to find our way back to regulation, that we feel distress
Leaving regulation isn’t the problem
It’s only when we move out of safety and connection into one of the adaptive survival responses and can’t find our way back to a state of regulation that we suffer physically and psychologically
Autonomic listening is inextricably linked with the need for self-compassion. Self-compassion is an emergent property of the ventral vagal system. Survival states automatically activate self-criticism
By noticing a moment, or a micro-moment, of autonomic dysregulation and bringing some self-compassion to it, we enter into a process of listening
The challenge is to learn to tune in and turn toward your nervous system, bring curiosity and compassion to the experience, and stay out of judgment and self-criticism as you explore where your autonomic nervous system takes you. Some of the phrases I use to tune in and turn toward are as follows:
The ventral vagal pathway to the heart, joined with the nerves that control our eyes, ears, voice, and the way we move our head, make the
social engagement system truly a biological face-heart connection