Lindsey A.’s Reviews > Clinical Applications of the Polyvagal Theory: The Emergence of Polyvagal-Informed Therapies > Status Update
Lindsey A.
is starting
“A critical component of the polyvagal theory is focused on the show in neural regulation of the heart…. The neural regulation of the vertebrate ANS progressed through three global stages”
1. Calmed and cued others to calm; vagal pathway
2. Mobilization - fight or flight; PNS & adrenals
3. Ancient immobilization circuit - rapidly shutting down; vagal pathway, originating from brain stem area different from #1
— Apr 19, 2024 10:03AM
1. Calmed and cued others to calm; vagal pathway
2. Mobilization - fight or flight; PNS & adrenals
3. Ancient immobilization circuit - rapidly shutting down; vagal pathway, originating from brain stem area different from #1
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Lindsey A.
is on page 16 of 464
I need to sit with this one for a minute. Oof. This one !! 💡
• “Trauma was created by a betrayal of trust, a rupture within the context of a relationship, and by someone who was supposed to care for and protect the client.”
—> Attachment Theory
• “Hence, it was assumed that empathy, and the building of a caring relationship, were necessary and sufficient to repair the trauma…”
—> Notes below:
— Apr 19, 2024 12:05PM
• “Trauma was created by a betrayal of trust, a rupture within the context of a relationship, and by someone who was supposed to care for and protect the client.”
—> Attachment Theory
• “Hence, it was assumed that empathy, and the building of a caring relationship, were necessary and sufficient to repair the trauma…”
—> Notes below:
Lindsey A.
is on page 12 of 464
“Respiratory sinus arrhythmia: a paradoxical and opposite response, the heart rate actually decreased on inhalation and increased on exhalation”
—> measured by “vagal tone”
— Apr 19, 2024 11:16AM
—> measured by “vagal tone”
Lindsey A.
is on page 9 of 464
“We help contain these erratic fluctuations by SLOWING DOWN THEIR EXPERIENCE (how??) and CURBING THEIR INTENSITY (how??). As a person is able to experience a sense of control of their arousal (hyperarousal and/or hypoarousal), they renegotiate their relationship to the trauma”
—> this makes me think of how it’s helpful to be around models of “less reactive” responses
—> but how else is this fostered??
— Apr 19, 2024 10:47AM
—> this makes me think of how it’s helpful to be around models of “less reactive” responses
—> but how else is this fostered??
Lindsey A.
is starting
“… the profound disruptive impact of trauma on a significant portion of the population…. survivors of trauma often go through life without the opportunity to understand their bodily reaction to trauma or to recover the ability to regulate and co-regulate their physiological and behavioral state…. many are revictimized when discussing their experiences…”
— Apr 19, 2024 10:43AM
Lindsey A.
is starting
“Somatic Experiencing” & “Sensorimotor Psychotherapy”
—> bringing awareness to sensations, accessing and managing implicit memories
— Apr 19, 2024 10:40AM
—> bringing awareness to sensations, accessing and managing implicit memories
Lindsey A.
is starting
The polyvagal theory provides people who have experienced trauma, “an understanding of how, after experiencing life-threat, their neural reactions were retuned toward a defensive bias and they lost the resilience to return to safety.”
Talking about resilience reminds me of Berne Brown’s “Dearing Greatly,” in which she emphasizes the importance of building resilience….
— Apr 19, 2024 09:57AM
Talking about resilience reminds me of Berne Brown’s “Dearing Greatly,” in which she emphasizes the importance of building resilience….
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“The shutdown system (freeze)…. Results in fainting, deification… and dissociation”—> I relate the most to my freeze state presenting as dissociation.
—> I don’t think I’ve ever fainted or “shit myself” haha, but this makes me wonder how common that is. I suppose this makes sense why there are so many vulgar phrases about people feeling the need to dedicate when they’re scared?? I never really understood that.
—> “the body’s attempt to become inanimate in the presence of a predator” (i.e. playing possum)
—> “it’s important to note that the neural mechanisms involved in the fight-or-flight system (i.e. the sympathetic nervous system, SNS) AND the neural mechanisms involved in the shutdown system are also recruited during safe calm states to efficiently support homeostasis and to enable play and intimacy.”
—> okay so this leads me to rethink #3 - it may not be all that bad? There’s adaptive qualities to why we still have this reaction
—> “dissolution: evolution in reverse…. To explain the disinhibition of older brain structures when newer brain structures were damaged” (Hughlings Jackson, 1884)
Porges theory, rephrased by Levine: there’s “there basic neural energy subsystems (that) underpin the overall state of the ANS and their emergent behaviors, emotions, and perceptions”1. (Prev #3 above) Dorsal-vagal system: originated 600 million years ago in early fish species (jawless and cartilaginous, vertebral/segmental); immobilization, metabolic conservation, overall shutdown; target = internal, visceral organs
2. Sympathetic nervous system: global arousal system, developed next in evolution, from the reptilian period 400 million years ago: mobilization and enhanced action, fight-or-flight; target = limbs (note: this includes bony fish, amphibians, reptiles, and mammals; adrenal just includes reptiles and mammals)
3. (Prev #1 above) Social engagement system: only in mammals, esp. social mammals, mediates complex social and attachment behaviors (!!), utilizes the ventral branch of the parasympathetic nervous system, the “mammalian/smart vagus nerve,” linked neroanatomically to the CNs that mediate acoustic tuning, vocalization, and facial expression
—> hey I know these things (!!)
The social engagement system would be especially to know about as an SLP, since we already study so much about CN X (vagus) (!!) Have I not learned about this before?!
The newer mammal vagal circuit, #1, related to calm sates, was codified as the “social engagement system” (Porges, 2001); most accessible during states of trust and safety” !!
—> so if you’re in a social situation where you don’t trust them, or don’t feel safe, AND you have a history of trauma, it’s likely going to be hard to regulate your nervous system to feel calm when interacting with them. This sounds like a great explanation to reference. 💡
—> heathy relationships are built on trust
—> one of the foundational components of “Maslow’s Hierarchy of Needs” is safety
—> okay so HOW do we foster and shape this if their default vagal response is #3 immobilization/freeze?
—> my initial thoughts: it is so important to foster a sense of rapport, respect, collaboration, and belonging in good person-centered care and other types of social relationships, to help others feel like they can trust you, feel safe, and promote increased likelihood of regulation
—> in the first chapter, after this preface, Levine mentions concepts like “neuroception, interoception, developing a reliable sense of interoceptive awareness” as the foundational prerequisite to target before we can work on changing our “emotional states and habitual muscular and visceral states.”
—> “the sensory receptors for this are linked to the nuclei in the brainstem as a part of a complex feedback system.” Does this mean that we would have an even more difficult time with working on these skills if there’s degeneration and/or TBI impacting the brainstem? Probably. That’s unfortunate, if so.