The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation

by Stephen W. Porges

A collection of groundbreaking research by a leading figure in neuroscience. This book compiles, for the first time, Stephen W. Porges’s decades of research. A leading expert in developmental psychophysiology and developmental behavioral neuroscience, Porges is the mind behind the groundbreaking Polyvagal Theory, which has startling implications for the treatment of anxiety, depression, trauma, and autism. Adopted by clinicians around the world, the Polyvagal Theory has provided exciting new insights into the way our autonomic nervous system unconsciously mediates social engagement, trust, and intimacy.

Genres: Psychology, Nonfiction, Science, Neuroscience, Mental Health, Health, Counselling

347 pages, Hardcover

First published January 1, 2011

Reviews

[Michael · Rating 4 out of 5]

I'm giving this book 4 stars because of the importance of the research and theory that Porges presents here.
The book itself is however very difficult to read. Many of the chapters repeat the previous chapters at length which is very frustrating.
That all being said Porges contributions to the fields of medicine and psychology are seminal and paradigm changing. His formulation of the hierarchical organization of the autonomic system in humans and its evolution explains human development and psychopathology in ways that allow more powerful interventions and insights than ever before. Stephen Porges has contributed to a powerful movement in affective neuroscience that is only just beginning to transform the field.

[Kevin · Rating 3 out of 5]

This book is an important contribution. But it is also frustratingly repetitive. For a more comprehensive view, this book is best paired with Panksepp & Biven (2012). Archaeology of Mind: Neuroevolutionary Origins of Human Emotions.

I present Porges' main thesis here: https://kevinbinz.com/2019/02/05/the-...

Why is this book need to be complemented by another? A metaphor may help motivate my recommendation.

The brain is a vehicle, with many interlocking subsystems contributing to overall driving performance. Porges only pays attention to the wheels (the autonomic nervous system). He is correct in saying that other major theories of cars ignore the wheels (he explicitly faults Panksepp’s Affective Neuroscience for discounting the periphery). But if Porges focuses on the wheels and Panksepp focuses on the engine, there is no one working to illustrate how these two systems interact.

Before Porges, the autonomic nervous system was described in the language of paired antagonism: the SNS turns behavior on, the PNS turns it off. Porges’ instead conceives the ANS a tiered, phylogenetically ordered response hierarchy. And this is a meaningful advance. There are three categories of tires, not two.

But Porges’ “taxonomy of tires” tries to explain too much. A host of psychiatric disorders (autism, social anxiety, post-traumatic stress disorder, borderline personality disorder, and more) are explained by anomalies in RSA (and thus, dysfunction in the social engagement system). He is probably right in linking the new vagus to this disorders. But a single system cannot explain the incredibly diverse set of symptoms represented by these disorders.

How might we explain the diversity of these phenomena? Two methods suggest themselves:

1. The syndromes share the same ANS signature, but different neural mechanisms (same tire, different engine).
2. The syndromes have subtly different expressions in ANS signature (same category of tire, different specific implementation).

I wish Porges spent more time exploring autonomic biology in more detail (the second method above). Which particular subsystems of the old vagus produce immobilization? How do they differ from those that simply regulate homeostasis? What are the different functions served by different tracts, and/or different neurotransmitter chemistries? What does the ANS interact with the immune system?

The polyvagal theory does gesture in how each autonomic system might serve as the basis for primary emotions (a unified theory of cars). These include the obvious (fear is implemented in the SNS!). But there are more interesting assertions, such as,

* Rough-and-tumble play is a hack where the organism feels safe, but mobilizes resources for behavior (approach motivation and safety).
* Social tranquility is a hack of the immobilization system (immobilized fear becomes immobilized love). This is a putative explanation for breastfeeding and certain sexual behaviors, and is thought to be mediated by oxytocin.
* Social protection behaviors are thought to mobilize resources through vasopressin.

While this is a good start, a Unified Theory of Emotions must link the neural substrate of reactive anger (a whole neural network, including e.g., the medial amygdala) to the neural substrate of the mobilization system (the lateral hypothalamus). We need an account of how cars work, not just tires and engines.

[Morgan Blackledge · Rating 4 out of 5]

Polyvagal Theory (PT) is an evolutionarily grounded, neuroscientific and psychological construct that explains the role of the vagus nerve in mammalian threat response and emotion regulation via social connection (co-regulation) initially introduced by Stephen Porges in 1994.

This book is ridiculously dense.

And notoriously unrelatable.

But kind of a must-read if you’re interested in PT.

That being said, don’t start with this one.

I know I sure didn’t.

Start with:

The Pocket Guide to the Polyvagal Theory by Stephen W. Porges.

Read my review if it here: https://www.goodreads.com/review/show...

Tackle this one after you’re a little bit more familiar with some of the basic concepts.

Don’t let this review scare you off though.

This book is very worth reading.

[Carolyn · Rating 5 out of 5]

The Polyvagal Theory offers a paradigm shift in neuropsychiatric approaches to treatment. Porges explains why medicine, psychology and social behavior hinges on neurophysiological underpinnings, and how current practices need to change to become more effective. Everyone with a brain should read this book! Here is a podcast interview with Stephen Porges of the Brain-Body Center at University of Illinois at Chicago, in which he discusses the principles of polyvagal theory: .

[Harrison · Rating 4 out of 5]

This one was pretty dry and repetitive, but the information is so valuable, it was worth it. Porges integrates emotion, visceral states, brain regulation, evolution, and a bunch of other cool stuff into a framework that makes everything make sense. Thank you, nature, for my myelinated vagus.

[Ioana · Rating 5 out of 5]

Teoria polivagală a fost pentru prima dată enunțată în anul 1994 de către Stephen Porges, în urma numeroaselor cercetăti întreprinse de acesta, impactul teoriei fiind oferirea unor explicații neurofiziologice plauzibile pentru o serie de experiențe traumatice suferite de oameni. Autorul pleacă de la premisa că omul este un animal social și nu poate supraviețui fără capacitatea de a interacționa cu ceilalți oameni, iar această interacțiune trebuie să fie una sănătoasă, pentru ca oamenii să își regleze reciproc starea fiziologică și pentru ca aceștia să creeze relații în care să primeze starea de siguranță.

Teoria polivagală se bazează pe evoluția sistemului nostru nervos și face referire la nervul vag, canalul bidirecțional care leagă creierul de corp. Canalul vag conține căi motorii care merg de la creier la organe și căi senzoriale care vin de la organe către creier. Așadar, principalul obiect al teoriei polivagale este comunicarea creier-corp.

Cartea abundă în informații valoroase despre neurofiziologie, neuroanatomie și evoluție, autorul explicând cum nervul vag nemielinizat, mai vechi în ordine evolutivă, în momentul în care ajunge la organele situate sub diafragmă, poate să reacționeze, în situații traumatice, ca un sistem defensiv, perturbând astfel sănătatea psihică și fizică, consecința fiind apariția unor probleme medicale precum sindromul colonului iritabil, fibromialgia, obezitatea, etc.

Legătura creier-corp este deopotrivă fascinantă și fragilă. Extrem de importantă, în tratarea traumei, este înțelegerea reacției, și nu evenimentul traumatic, iar cunoașterea și îmbunătățirea sistemelor prin care oamenii răspund la traumă – printr-un sistem de luptă, fugă sau deconectare (disociere) sunt relevante pentru identificarea căilor ce permit apariția spontană a comportamentelor de angajare socială ce facilitează creșterea, recuperarea și sănătatea.

O carte din care am asimilat multe informații pe care nu le știam, incredibil de bine documentată și extrem de valoroasă. O recomand cu încredere !
Cartea este tradusa la editura Herald.

[Lorilee · Rating 2 out of 5]

I am now complete with this book. It is a heady read. Took me three years to slog through it. Whew! Sure am glad that's over! Sorry, Stephen Porges, I think overall I must be honest...your writing is - well - beyond me . . . in all ways . . . finally.

[Danielle Morrill · Rating 5 out of 5]

Read this book because Dr. Daniel Siegel credits Porges with the important concept of neuroception. I remain skeptical of arguments that dictate “part X of the body is the cause of reaction Y” and this theory leans on that in some areas and transcends it in others.

It is amazing how far emotion research has come since this was published in 2011, and I think an updated theory will probably emerge that takes even greater integration of the whole-body system.

For anyone reading this book, I think it is well paired with the of Lisa Feldman Barrett “How Emotions Are Made”

[Alexis · Rating 3 out of 5]

The theory is excellent and extremely valuable in informing case conceptualization and treatment for a variety of emotional, social, and mental health challenges. However, the text is a hard read for non-neuroscience clinicians (at least, it was for me). I read the book hoping to better understand how the Polyvagal Theory applied to individuals who had experienced psychological trauma; this book met this goal, but I often got lost in the technical terminology. If this is your goal, I would recommend Bessel van der Kolk and Pat Ogden's books, which better integrate the theory into its implications for interventions, in a way that is more concise and reader-friendly. I may also check out Porges' pocket guide, as I hear this is intended to be more accessible to individuals who are not neuroscientists.

[Karen · Rating 3 out of 5]

Interesting stuff, but the book comes across as a collection of essays that the author has only invested minimal time to integrate. As a result, for example, the basics of the Polyvagal Theory are reiterated over and over again throughout the book.

[Nate Bate · Rating 4 out of 5]

Stephen Porges extensively details the physiological reality of safety. In other words, what happens in our nervous system for our bodies to feel safe. I think most of us would acknowledge there is interplay between body and soul, but it seems that most of us (at least the people I run with and including myself) have not given thought to what our bodies are communicating to us.

My largest take-away for the book was explanation on how nervous system can respond beyond the fight or flight reaction. The Polyvagel theory deals with the secondary way our nervous system can deal with a threat - immobilization. This gave me a category that I didn't have before, and I could easily trace the concept to reality.

The next biggest take-away was the correlation of trauma and immobilization. Although, this theory mostly can only deal with the identification of this correlation. Developing treatment for this, according to Porges, is still in its early stages.

Finally, the book lays out the various ways we can experience safety most notably (in my opinion) including the social interaction factor. This has profound implications for our constant use of media today as it relates to the experiencing physical safety.

I found the book to be very repetitive, and this is in part because of the layout of the book being a series of lectures/conversations. Because the subject matter is rather technical, the repetitiveness would be welcome for some. Also, for those who enjoy story to help them connect to the subject matter will be happy with what they find in this book. The book starts with a glossary of terms. I think this should be moved to the end because this can discourage some readers from making it to the important premise this book presents.

I am grateful I read this book, and it will provide me with plenty to think about for a long time.

[Alex Zoloto · Rating 3 out of 5]

This text contains incredibly important and enlightening information about how the human body reacts to stress and social interaction. Unfortunately, it is written in a very dry, scientific voice that can be difficult to comprehend. I think the book could be much improved, and the information made more accessible, by giving more background on physiology (I had to look up and research a lot to keep up with everything) and by explaining the concepts with examples and more layman terminology.

[sarah mcGonagle · Rating 4 out of 5]

listened to this as i self-administered shock treatment for a truly interactive experience! (๑ > ᴗ < ๑)
good stuff!

[Gry Ranfelt · Rating 2 out of 5]

This book has some interesting ideas, but I have a few gripes with it.

1) Structure
The book has an interview form, which in the beginning is nice, but which, by the end, becomes repetitive. He keeps explaining the same things over and over again, and it becomes frustrating as a reader, because you keep on reading this stuff you already got because you want to see if there's something new.

2) No ambitious solutions
Several times Porges states that if your neurosystem is overactive, you need to tend to it, and not ignore it. I agree with this - but I also think the overarching goal should be to raise one's "bar" for when you become overreactive. Porges neatly tip-toes around this issue. Every time an interviewer tries to get at it, he just repeats stuff about breathing and respecting one's system and that it's trying to save you.
Basically I, as someone with anxiety and stress issues, would have liked a whole lot more on the topic of self-regulation.

3) Lack of evidence.
You kind of just have to buy into it all. I don't want a heavy, scientific record here, merely something more substantial and creditive than what is given here. Potentially a section where he discussed critiques of the theory - since it is a THEORY - and why he thinks it holds.

Other than that, I found it to be an engaging read when not repetitive (so for the first 2/3 of the book or so).
Basically: learn to activate your parasympathetic system by using slow, controlled out-breaths, listening to music with rich prosody, avoiding low-frequency noises if you're highly reactive, rocking can help calm you and facial-and-body-language help us communicate to each other whether we are safe to approach, and so we can use our social interactions to make each other feel safe.
While reading the book I've tried to experiment with some of these ideas, and I do think much of it is applicable. I was especially surprised about how autistic children use swinging or rocking to self-soothe. I'm not autistic at all, but when I was a child I would swing for an hour almost every day. I wonder if that was my attempt to self-soothe/regulate.

Overall: I recommend it, but have patience, padowan.

[Rick Wilson · Rating 4 out of 5]

It’s a fascinating theory. Very technical at times. “This nerve connects to that process” type writing. The writing is not very engaging or particularly well presented, but I think this is a really important theory if proved out a bit.

Essentially, we look at the nervous system as a series of layers that react to external stimuli/threats. Our ultimate goal is survival. So Porgess examines these responses and their neurological basis. Which results in a lot of dry talk. But the ultimate gist I got was that our “reptile brain,” ANS, is a latent survival mechanism that gets misued and at times overstimulated from traumatic events. Which results in protective Encoding of trauma as an increased likelihood of activation of the lowest survival mechanism of the nervous system. Fight, flight, freeze. It’s nearly a vestigial process. Almost like how our immune system gives us allergies.

There’s obviously a lot more to it. But the theory makes a lot of sense to someone who has experienced a good chunk of trauma first hand. I look back and it seems like my usual processes were hijacked by a sort of ham-fisted operator. The world narrows to survival. So I guess that’s one anecdotal point in favor of this.

I don’t know anywhere near enough about neuroscience to be able to evaluate the quality of the theory though. And that gives me pause, as this is proposing to pretty radically change the way we think about trauma and development. Big claims require big proof.

[Cassy Schraft · Rating 2 out of 5]

While the information presented throughout the book was incredibly informative, it seemed more like a messy compilation of research journal articles than a well thought-out and put together book. This book is definitely geared towards those practicing in a medical or research setting, and while the information can be useful background knowledge for those working with clients with trauma backgrounds and attachment disorders in other settings and in a variety of other roles, there is very little in the way of how to apply this theory in practice. As a therapist largely working with individuals with severe trauma histories, I was most disappointed in the lack of application presented.
Those who do not have a strong medical or science background may struggle with reading this book, as it is not written in layman's terms.

[Lynelle L · Rating 4 out of 5]

The subject matter is intriguing and important, and deserves a higher rating. However, the book is hindered overall by repetition and medical language. No doubt this is due to the book being a compilation of essays, papers and research that, to doctors, therapists and others in the medical field the medical jargon, is essential. To the everyday reader, however, the repetitive segments and research procedures take away from the wonderful connections made.

[Sasha · Rating 4 out of 5]

Written mostly for an audience fluent in neuroscience, this book was nonetheless a fascinating compilation of papers exploring the importance of the vagus in regulating emotional states and the benefits of vagal studies. With implications in physical and mental disorders, human behavior, and therapy, Porges' polyvagal theory makes for insightful reading.

[Michael Maloney · Rating 5 out of 5]

Not an easy read, but very informative and worth the effort in helping understand our responses to traumatic events and mange our emotions. It also looks at these things from a scientific lens, specifically evolution based. I'd love to read more on this topic. A great book for clinicians in understanding anxiety, trauma, and attachment.

[Julian · Rating 3 out of 5]

A highly detailed and somewhat repetitive tome on the polyvagal theory and neuroception. However, the pervasively interesting message that we can only connext creatively and intimately with each other under conditions of unconsciously perceived conditions of safety, is a compelling one.

[Vanessa · Rating 4 out of 5]

Not quite as informative from a scientific perspective as I had hoped for, as far as application goes, but very good and I think still pretty groundbreaking.

[Hidy Kong · Rating 4 out of 5]

Introduction to/definition of Polyvagal theory appeared at the beginning of every chapter, which seemed too repetitive.
The idea itself was interesting.

[Christopher Johnson · Rating 5 out of 5]

One of the best on what distinguishes humans from other mammals, and about the vagal system that can override the autonomic nervous system if properly developed.

[Pamela · Rating 4 out of 5]

Scientific. Interesting and helpful for therapist.

[Tomás Narvaja · Rating 2 out of 5]

Really poorly put together book with solid information, although definitely some very problematic aspects, particularly in his discussions on gender/sex.

[Jung · Rating 5 out of 5]

"The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation" is a book by Stephen W. Porges, a prominent neuroscientist and professor of psychiatry. Published in 2011, the book introduces and explores the Polyvagal Theory, a comprehensive theory that helps explain the autonomic nervous system's role in regulating emotions, behavior, and social engagement.

Key concepts of the Polyvagal Theory include:

1. Autonomic Nervous System (ANS): The theory focuses on the autonomic nervous system, which is responsible for involuntary bodily functions. Porges identifies three subsystems within the ANS: the ventral vagal complex, the sympathetic nervous system, and the dorsal vagal complex.

2. Social Engagement System: The ventral vagal complex is associated with the social engagement system. When this system is active, individuals are more likely to engage in social interactions, feel safe, and experience positive emotions. This aspect of the theory emphasizes the role of the nervous system in mediating social behavior and relationships.

3. Fight-Flight Response: The sympathetic nervous system is linked to the fight-flight response, which is activated in situations of threat or danger. This prepares the body for quick action, such as fighting or fleeing, and is associated with increased arousal and stress.

4. Shutdown Response: The dorsal vagal complex is associated with the shutdown response, also known as the freeze response. This response is activated in extreme situations of threat or perceived helplessness. It is characterized by immobilization, dissociation, and a reduction in metabolic activity.

5. Polyvagal Hierarchy: Porges introduces the concept of the Polyvagal Hierarchy, which describes the organization of the three subsystems in a hierarchical manner. The ventral vagal complex is considered the most evolved and is associated with social engagement, while the other subsystems are involved in responses to threat.

6. Neuroception: The theory introduces the concept of neuroception, which refers to the neural circuits responsible for detecting safety, danger, or life-threat in the environment. Neuroception influences the activation of the different subsystems of the autonomic nervous system.

7. Clinical Applications: Porges discusses the clinical implications of the Polyvagal Theory, emphasizing its relevance to understanding and treating conditions such as anxiety, trauma, autism, and other mental health disorders. The theory provides insights into how therapeutic interventions can target the autonomic nervous system to promote regulation and resilience.

"The Polyvagal Theory" by Stephen W. Porges delves into the foundational principles of the Polyvagal theory, offering a unique perspective on the interplay between neurobiology and behavior. Dr. Porges explores the role of neuroception, a subconscious system shaping emotional responses, and introduces three neural circuits influencing defense and social behaviors. The book examines the vagus nerve, distinguishing between the vegetative and smart vagus, crucial for understanding the impact of physiological states on relationships and well-being. Highlighting the intricate balance between physiological responses and social connections, the theory is applied to stress vulnerability, discussing the parasympathetic and sympathetic nervous systems. The concept of respiratory sinus arrhythmia (RSA) as a measure of stress vulnerability is introduced, emphasizing its role in understanding individual differences in stress responses. Ultimately, the book offers valuable insights into shaping emotional experiences, stress responses, and fostering social connections for improved mental health and overall well-being. Stephen W. Porges' work on the Polyvagal Theory has had a significant impact on the fields of psychology, psychiatry, and trauma research. The theory has provided a valuable framework for understanding the physiological basis of emotional and social experiences and has influenced therapeutic approaches aimed at promoting well-being and emotional regulation.

[Sarah Cupitt · Rating 4 out of 5]

Good for if you've ever wondered why you instantly click with some people and not with others. I think this book went a little over my head so I will likely either re-read at a later date or come back to these notes.

Notes:
- Developed by Dr. Stephen Porges, the theory provides a unique lens through which we can comprehend the biological underpinnings of our emotions, social connections, and responses to stress
- neuroception = a subconscious system that scans our surroundings and the people in them, influencing our emotions and behaviors.
- wrongly identified = can lead to mental health challenges such as anxiety, depression, and autism
- three neural circuits that influence our defense and social behaviors: the ventral vagal complex promotes calm and communication, the sympathetic nervous system prepares us for action in the face of threats, and the dorsal vagal complex can induce a shutdown response in overwhelming situations.
- The Polyvagal theory also examines the vagus nerve. It differentiates between the vegetative vagus that controls unconscious functions, and the smart vagus that manages conscious, social interactions. This distinction is vital for understanding the impact of our physiological state on our relationships and overall well-being.
- When the amplitude of RSA is high, it indicates a healthy functioning system and a greater capacity for behavioral flexibility. On the other hand, a low RSA suggests a compromised system and a heightened vulnerability to stress.

Favourite quote:
- “People with impaired social engagement systems are prone to misinterpret safety as a threat and objective danger as safety. Their visceral feedback system fails to protect them, or prevents them from engaging in the fullness of what life has to offer.”

Good quotes:
- “Playing nice" comes naturally when our neuroception detects safety and promotes physiological states that support social behavior. However, pro-social behavior will not occur when our neuroception misreads the environmental cues and triggers physiological states that support defensive strategies. After all, "playing nice" is not appropriate or adaptive behavior in dangerous or life-threatening situations. In these situations, humans - like other mammals - react with more primitive neurobiological defense systems. To create relationships, humans must subdue these defensive reactions to engage, attach, and form lasting social bonds. Humans have adaptive neurobehavioral systems for both pro-social and defensive behaviors.”
- “To switch effectively from defense to social engagement strategies, the nervous system must do two things: (1) assess risk, and (2) if the environment looks safe, inhibit the primitive defensive reactions to fight, flight or freeze.”

[Beth · Rating 5 out of 5]

This book is not for light reading.  It is better understood by professionals in the medical and mental health field. Even for a mental health professional, such as myself, it is still very heavy on medical terminology which is complicated and difficult to understand in much of the book.  Reading this book made me feel like a medical student, and maybe not even that, because of how difficult it was to make it through some of the reading. It’s an in depth understanding of affect regulation versus emotional regulation, the automatic nervous system, parasympathetic activity, i.e. vagal tone, neural regulation of the heart, fight flight freeze response, faulty neuroception, neural circuits and maladaptive physiological reactivity. Porges introduces a term he coined, ”Neuroception”,  to describe how neural circuits distinguish whether situations or people are safe, dangerous, or life-threatening; to trigger or to inhibit defense strategies. 

The theme of the book is centered on what is written on page 54, “The polyvagal theory... articulates how each of the three phylogenetic stages in the development of the vertebrate autonomic nervous system Is associated with a distinct autonomic subsystem that is retained and expressed in mammals. These autonomic subsystems are phylogenetically ordered and behaviorally linked to social communication (e.g. facial expression, vocalization, listening), mobilization (e.g. fight or flight behaviors), and immobilization (e.g. feigning death, vasovagal syncope, and behavioral shut down).” Incredibly well written book, quite detailed, and informative. But, again, extremely difficult to read for someone that is not well-versed in medical terminology, anatomy and physiology. For mental health counselors, the polyvagal theory explains the evolution of the autonomic nervous system providing neurophysiological foundations for adaptive behavioral strategies for affective experience, emotional expression, facial gestures, vocal communication, and contingent social behavior. If you can make it through all of the medical language, it is a very valuable theory to understand in helping clients move from maladaptive physiological states to adaptive processing of sensory information.

Three other books that are a must, written in collaboration by Stephen Porges and Deb Dana are: Clinical applications of the Polyvagal Theory: the emergence of polyvagal informed therapies, The Polyvagal Theory in therapy: engaging the rhythm of regulation, and Polyvagal exercises for safety and connection: 50 client centered practices. 

[Leo Beck · Rating 2 out of 5]

I would probably review this book better if I had a greater understanding of the technical terms and familiarity with the theory. I recognise how important the theory is, and the effort that the author goes to explain over and over again his theory, but it was not a very pleasant listening experience. It was confusing, with a lot of repetition, and not suitable for someone who is not well versed in the biology and mapping of the autonomic nervous system. It did not help that the audiobook version did not include the tables that he refers too.

I would probably have appreciated the book form more. I learned a lot of new things, but only a fraction of what the book is about. It is too complicated for its own good for casual readers of these theories and trauma.

[Sarah Mohr · Rating 5 out of 5]

This book presents a complicated picture of the important and cutting edge polyvagal theory that has begun to inform trauma based care in psychology. While it was highly technical and beyond my ability to understand in places, the overall understandings that I gleaned from the text will help me in my work as a social worker, as well as my life as a mom and wife. Excellent research, thought provoking and informative. Highly recommend to anyone interested in psychology who is willing to plow through the science.