Polyvagal Theory Helps Unlock Symptoms of PTSD-Dr. Arielle Schwartz

Getting Unstuck from PTSD

Polyvagal theory Dr. Arielle Schwartz

One of the painful repercussions of Post Traumatic Stress Disorder (PTSD) is the experience of a lack of control that can occur when you feel trapped by feelings of anxiety, panic, overwhelm, or despair.  Polyvagal theory, the work of Stephen Porges, M.D., offers a valuable framework for understanding and effectively responding to the intense emotional and physiological symptoms of PTSD.

“Healing the nervous system can take time and requires patience. Put the polyvagal theory into action in you life to increase your sense of freedom in body and mind” -Dr. Arielle Schwartz

The Nervous System: A Basic Model

EMDR Therapy Dr. Arielle Schwartz

A basic model of the nervous system shows that we have two components of our nervous system, one that is under our conscious control (e.g. moving your hand) and another that functions without our awareness (e.g. regulating our body temperature). The portion of the nervous system that functions without our conscious awareness is called the autonomic nervous system (ANS). All of our emotional expressions are mediated by the ANS as it either mobilizes energy through our sympathetic nervous system or conserves energy through our parasympathetic nervous system.

  • The sympathetic nervous system is associated with the fight or flight response and the release of cortisol (stress chemicals) throughout the bloodstream.
  • The parasympathetic is associated with relaxation, digestion, and regeneration.

The sympathetic and parasympathetic nervous systems are meant to work in a rhythmic alternation that supports healthy digestion, sleep, and immune system functioning.

The Polyvagal Theory

warm smile

Research by Dr. Stephen Porges offers an advanced understanding of the ANS, especially as related to trauma and PTSD. The autonomic nervous system is regulated by the vagus nerve or the tenth cranial nerve. The vagus nerve connects the brain to major systems in the body including the stomach, gut, heart, lungs, throat, and facial muscles. Broadly speaking, the vagus nerve has an inhibitory influence upon the heart and sympathetic nervous system activity. Borges uses a metaphor suggesting that the vagus nerve is like pressing pressing the brake pedal when driving a car. Removal of the parasympathetic “vagal brake” causes an increase in heart rate and greater vulnerability to stress.

The “ventral vagal complex” (VVC) also referred to as the “social nervous system” is a branch of the vagus nerve that functions as a refined brake which has a calming and soothing effected reflected in rhythmic oscillations in heart rate variability. From an evolutionary perspective, the social nervous system has evolved most recently.

When there is stress or any experience of threat (real or perceived), we will rely upon our VVC or social nervous system first to re-establish a sense of connection and safety. For example, “tend and befriend” behaviors are a stress response that attempts to re-establish a safe relational bond. However, if the social nervous system fails to resolve stress, we will progressively resort to evolutionarily older strategies. Next, we will draw upon sympathetic nervous system actions such as fight or flight to mobilize us into self-protection.

If the sympathetic nervous system is unsuccessful in re-estabilishing safety, we will default to the evolutionarily oldest part of the vagus nerve, the “dorsal vagal complex” (DVC). This more primitive strategy engages the parasympathetic nervous system in an unrefined manner which Porges refers to as an abrupt vagal brake. Here, the parasympathetic nervous system engages immobilizing defensive actions such as fainting, feigned death, or dissociation.

Importantly, both the dorsal vagal complex (DVC) an the ventral vagal complex (VVC) will exert inhibition on the sympathetic nervous system; however, the DVC can have serious repercussions on mental and physical health. On the other hand, the VVC is associated with increases in health and emotional wellbeing.

Our natural state of rest and safety allows us to engage our social nervous system (VVC) facilitating our ability to connect to others, feel playful, feel love, and relax into connection. You know that you are engaging the social nervous system when you are able to recognize when you are safe, be self-reflective, feel a warmth in your smile, and the sparkle in your eyes. Your social nervous system increases your ability to respond effectively when you feel keyed up with anxiety or shut-down with depression.

Furthermore, your social nervous system (VVC) is strengthened by myelination. Myelination is a fatty coating on nerve pathways that is increased through repeated use and results in increased speed and control. You can imagine here the myelination that occurs in the learning of a new piece of music for the piano. Initially notes are played slowly and carefully but with repeated practice you begin to create music, eventually without reading the music at all. Likewise, the pathways of the social nervous system are strengthened through repeated practice.

Mobilization into Play – Immobilization into Intimacy 

Whether you are feeling anxiety depression you can use tools to engage your social nervous system to re-establish higher order nervous system functions. For example, if you are experiencing anxiety you are likely in fight or flight, a key defense reaction of sympathetic nervous system. Sympathetic actions involve mobilization; the need to move your body to release the build of stress cortisols. You can engage your social nervous by rubbing your hands together vigorously and making physical contact to your own face, neck, upper chest, arms, and legs. You can also explore physical movements that feel safe and grounding such as going for a walk or shaking your arms and legs to release stress. When we feel safe we can engage our social nervous system to use the energy of the sympathetic nervous system to dance, play, and laugh.

Feeling shut down, collapsed, depressed, or numb is an indication that you are in the defensive reactions of your parasympathetic nervous system which is characterized by immobilization. If you have a history of trauma it is possible that you are perceiving threats in your environment that are not actually occurring in the here and now. This is because a common symptom of PTSD is confusion between the past and the present. In this case, your social nervous system can help you find clues that help you recognize that you are not in imminent danger now which helps you access the positive, relaxing elements of your parasympathetic nervous system of “rest and digest.” When possible, turn towards a loving connection with a friend, caring partner, or a pet. If you are able, make eye contact or call someone you trust and listen to the sound of their voice. You can also visualize a loving animal, friend, or protective ally to restore a felt sense of connection. When we can embrace immobilization with safety we can access the nourishment of the relaxation response.

Implications for Healing PTSD

sleep with cat

The polyvagal theory in action can allow you to increase your sense of freedom in body and mind when experiencing symptoms of anxiety, panic, or depression. Here are some suggestions:

  • Focus on the present moment
  • Engage the sense of smell with an essential oil that brings a positive association or feeling
  • Re-establish connection by calling a friend, snuggling with your pet, or loving self touch.
  • Express feelings through talking, writing, drawing, movement
  • Focus on your breath as a fine tuning mechanism to regulate the nervous system
  • Engage in a mindfulness practice such as meditation or therapeutic yoga
  • Allow yourself to play or get creative
  • Focus on the good by tuning into the beauty around you

Therapeutic implications of Polyvagal Theory inform Somatic psychology and EMDR Therapy. Healing the nervous system can take time and requires patience with the process and with yourself. You are not failing when you feel anxious or depressed. You are also not alone. Put the polyvagal theory into action in you life to increase your sense of freedom in body and mind Further Reading:

Want to learn more about healing PTSD?

book-cover

This post offers an excerpt from my book, The Complex PTSD Workbook, now available on Amazon! Click here to check it out.

About Dr. Arielle Schwartz

Dr. Arielle Schwartz

Dr. Arielle Schwartz is a licensed clinical psychologist, wife, and mother in Boulder, CO. She offers trainings for therapists, maintains a private practice, and has passions for the outdoors, yoga, and writing. Dr. Schwartz is the author of The Complex PTSD Workbook: A Mind-Body Approach to Regaining Emotional Control and Becoming Whole (Fall, 2016). She is the developer of Resilience-Informed Therapy which applies research on trauma recovery to form a strength-based, trauma treatment model that includes Eye Movement Desensitization and Reprocessing (EMDR), somatic (body-centered) psychology and time-tested relational psychotherapy. Like Dr. Arielle Schwartz on Facebook, follow her on Linkedin and sign up for email updates to stay up to date with all her posts.


Comments

Polyvagal Theory Helps Unlock Symptoms of PTSD-Dr. Arielle Schwartz — 16 Comments

  1. Anti-social people in your life can be the biggest source of stress, that’s why it’s so great to keep in contact with animals.

  2. Love this! As a combat veteran I can associate with what you’ve shared here, AND the methods of relieving the pressures of stress and anxiety. For me, Yoga was a God send! Best regards, Greg

  3. Thank you for this. This offers a possible explanation for a history of immobilization and flight methods of dealing with stress from PTSD.

  4. This section of your article is incorrect: “Porges identified that the vagus nerve does not simply have two branches but a third branch that plays a central role in the regulation of the nervous system.

    His polyvagal theory reveals that our nervous system reflects a developmental progression with three evolutionary stages of the vagus nerve. The earliest evolutionary action of the vagus nerve is the parasympathetic nervous system, the second stage of vagal nerve development is the sympathetic nervous system, and the most recently evolved portion is what Porges refers to as the “social nervous system.”

    It is not the parasympathetic or vagus that is divided into 3 evolutionary stages, but rather the nervous system is divided into 3 branches including ventral vagal, dorsal vagal and sympathetic.

    • Brian,
      Thank you so much for taking the time to note an error in my blog! After having written and taught about this, and I even studied with Dr. Porges himself I still find it challenging to articulate this theory. I will make the change you note today. I took a look at your website too. It is always to good to know of like minded practitioners and I see you have an office here in Boulder. I look forward to connecting with you in person some time.
      Warmly,
      Dr. Arielle Schwartz

  5. Thanks,
    Explains the Functional Neurological Disorder / Conversion Disorder where extreme stress and life threatening trauma can cause people to become paralyzed and unable to move.
    I have found animal therapy, positive environments and EMDR helpful for conversion paralysis, which is in line with this article.

    • Yes, Kate!
      Interesting last month I taught a training for therapists on EMDR and Somatic Psychology. One of the participants came with her therapy dog who helps her regulate her own trauma induced vagus nerge medical conditions. This dog was such a regulating presence for the whole room.
      Thank you for writing!
      Dr. Arielle

  6. Amazing information. This is a crucial part of my need to realign my damaged mental, physical Being… Two years ago at age fifty-four my elderly mother died suddenly, which helped shock me enough I was able to consciously wake up and see and begin accepting my lifetime of trauma bonding at the hands of a very ill malignant narcissist mother…. I was raised in a family of origin by religious ritual abuse, placed in the role of Identified Patient and thus I was bound by Stockholm syndrome….

    I am finding all my unmatched parts that are crying out for my attention and self care…. I know I am doing what I deserve since just last year I was sleeping only 2 hrs a night interrupted and now I sleep 6-8 hrs of solid sleep with dreams and restfulNess upon waking. My inner systems are finding peace enough to calm down and be reset to healthy functioning.

    No contact with 99% FoO for 2 years, lots of self care and self forgiveness and I am gaining growth and access to my Whole integrated and healing Self…

    And all without health care, doctors, therapists or friends… the severity and degree of the trauma proved too much for others personally and professionally… no judgement against them, only awareness for now i see how deeply this FoO dysfunction runs for generations and triggers people’s own personal fears and pain..

    I am blessed with one adult son who is heart and brain functioning enough to partner with himself and help meet my/our needs for mirroring, healthy supportive listening and having fun with, all in our new, safe Life free from oppression, fear and bondage of lies.

    • Ananda, Your story is quite powerful and speaks to resilience! You are incredibly strong to walk this healing path on your own. I do hope that at some point you are able to find health care providers who are not frightened by your past. Thank you for posting here.
      Arielle

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