Webb Therapy Uncategorized Polyvagal Theory and Trauma – Dr. Stephen Porges

Polyvagal Theory and Trauma – Dr. Stephen Porges

Stephen Porges, psychiatry professor and researcher, on the polyvagal theory he developed to understand our reactions to trauma:

[Paraphrased] Polyvagal theory articulates three branches of the autonomic nervous system (ANS) that evolved from primitive vertebrates to mammals. First, there is a system known as ‘freeze’, which involves death feigning or immobilisation. Second, the ANS has a ‘fight or flight’ system, which is a mobilisation system. And third, with mammals, there is what Porges calls, a social engagement system (SES), which can detect features of safety, and actually communicate them to another. The SES may also be referred to by some as ‘rest and digest’, which Porges theory suggests is a function of the Vagus Nerve – the tenth cranial nerve, a very long and wandering nerve that begins at the medulla oblongata. When an individual experiences feelings of safety (within an SES state), the autonomic nervous system can support health restoration. In terms of dealing with a life threat, an ordinary person will most likely go into a feigning death, dissociative state of ‘freeze’.

Polyvagal theory in psychotherapy offers emotional co-regulation as an interactive process between therapist and client which engages the social engagement system of both therapist and client. Social engagement provides experiences of safety, trust, mutuality and reciprocity in which we are open to receiving another person, just as they are.

The following extract has been retrived from https://www.theguardian.com/society/2019/jun/02/stephen-porges-interview-survivors-are-blamed-polyvagal-theory-fight-flight-psychiatry-ace

Polyvagal theory has made inroads into medical and psycho-therapeutic treatment, but how should it inform how people treat each other?


“When we become a polyvagal-informed society, we’re functionally capable of listening to and witnessing other people’s experiences, we don’t evaluate them. Listening is part of co-regulation: we become connected to others and this is what I call our biological imperative. So when you become polyvagal-informed you have a better understanding of your evolutionary heritage as a mammal. We become aware of how our physiological state is manifested, in people’s voices and in their facial expression, posture and basic muscle tone. If there’s exuberance coming from the upper part of a person’s face, and their voice has intonation modulation or what’s called prosody, we become attracted to the person. We like to talk to them – it’s part of our co-regulation.

So when we become polyvagal-informed, we start understanding not only the other person’s response but also our responsibility to smile and have inflection in our voice, to help the person we’re talking to help their body feel safe.”

Clink on the link below to hear Dr. Bessel van der Kolk, one of the world’s leading experts on developmental trauma, explain how our long-term health and happiness can be compromised by prior exposure to violence, emotional abuse, and other forms of traumatic stress.

https://youtu.be/53RX2ESIqsM

Related Post

When “Trauma” Became a Buzzword: What We Gain and What We Lose when Clinical Language goes MainstreamWhen “Trauma” Became a Buzzword: What We Gain and What We Lose when Clinical Language goes Mainstream

Not long ago, words like “triggered,” “gaslighting,” “narcissist,” and “neurodivergent” belonged almost exclusively to therapists’ offices and psychology textbooks. Now they’re everywhere; in workplace training sessions, community organisations, TikTok comment sections, and casual conversation between friends over coffee. That shift has brought some genuinely important changes. But it’s also introduced some problems worth taking seriously.

The real wins

It would be unfair to dismiss this cultural shift outright. There are meaningful gains. More people today can identify manipulation, coercive dynamics, and emotional harm than any previous generation. Mental health conversations have been destigmatised in ways that would have been hard to imagine twenty years ago. People who were historically silenced, particularly those from marginalised communities, finally have language that validates their experiences and gives them permission to leave harmful situations. That’s progress

But then there’s “concept creep” (pathologising the ordinary or “diagnostic inflation”)

Psychologists use the term “concept creep” to describe what happens when a word originally defined by strict clinical boundaries starts expanding to cover increasingly ordinary experiences. And that’s precisely what happened with “trauma.”

Clinically, trauma refers to experiences that overwhelm the nervous system i.e., genuine threats to safety, severe harm, events that exceed a person’s capacity to cope. These days, the same word is regularly applied to being disagreed with, having a relationship end, receiving criticism, or simply feeling uncomfortable. Events like relationship breakdowns, job loss, or failure can be genuinely devastating, and for some people, under some circumstances, they absolutely do meet the clinical threshold for trauma. The distinction isn’t really about the type of event. It’s about the impact on the nervous system and the person’s capacity to integrate the experience.

When everything qualifies as trauma, the word stops doing useful work. Worse, it can actually undermine the resilience people need to navigate a genuinely difficult world.

The nervous system problem

Here’s where it gets important. In actual “clinical” trauma, the brain’s threat-response systems activate intensely. Memory processing is disrupted. The body mobilises for survival in ways that can leave lasting marks.

Discomfort is different. It involves real emotional activation, it’s not pleasant, but cognitive flexibility remains available. The capacity to think, reflect, and choose a response is still intact.

When people learn to label ordinary emotional discomfort as trauma activation, the consequences compound. If discomfort feels equivalent to harm, avoidance becomes a logical response. But avoidance prevents the gradual building of tolerance. And without tolerance, the world gets smaller.

Trauma as identity and social currency

In some online communities, there’s an uncomfortable dynamic worth naming: being “highly traumatised,” “chronically triggered,” or “deeply misunderstood” can confer real social benefits — belonging, validation, moral authority, and attention.

This doesn’t mean the experiences aren’t real. But when distress becomes central to someone’s identity, letting go of that distress can start to feel like losing themselves. Recovery, paradoxically, becomes threatening.

The fragility trap

In certain environments, fragility functions as a kind of protection. If I am highly sensitive, others must accommodate me. Challenge becomes inappropriate. Accountability becomes unsafe. The person is shielded, but the cost is enormous.

Resilience, both psychologically and biologically, develops through graded exposure to stress. We become capable through encountering difficulty, not by avoiding it. Systems that never face adaptive pressure weaken over time. This is simply how human development works.

Why this moment matters

Several things are converging right now. Social media algorithms reward extreme emotional narratives. Identity formation increasingly happens in digital spaces that amplify distress. Institutions have frequently overcorrected towards protective language in ways that, whatever their intentions, can inadvertently signal that discomfort is dangerous. And while there’s been important growth in awareness of systemic injustice, the corresponding emphasis on individual agency has sometimes been lost.

We’ve swung from “suppress your emotions entirely” to “your emotions define reality.” Neither extreme serves people well.

Holding the middle ground

What good support actually looks like isn’t dismissing people’s experiences, it’s deepening them. The distinction that matters is between trauma-informed practice and what might be called trauma-indulgent practice.

Trauma-informed means understanding that harm genuinely impacts nervous systems, avoiding shame, recognising power imbalances, and creating safety. It’s grounded and necessary.

Trauma-indulgent means treating all discomfort as harm, reinforcing avoidance, allowing emotional reasoning to override reality, and quietly removing personal responsibility from the picture. It feels compassionate in the moment but tends to leave people worse off over time.

In practice, holding the middle ground means validating what someone feels while gently asking whether something was truly unsafe or simply hard. It means acknowledging difficulty while also reinforcing capacity. It means introducing a reality that doesn’t get much airtime in online spaces — that we can’t always control how those around us speak or behave, but we can build our own tolerance and capacity to regulate.

The question underneath everything

There’s a deeper ethical question running through all of this: are we reducing suffering in the long run, or just distress in the short term?

Protecting people from discomfort today, if it increases fragility tomorrow, is not a kindness. But exposing people to challenge without adequate safety and support risks re-traumatising those with genuine wounds.

The balance isn’t complicated to describe, even if it’s genuinely difficult to hold: safety, combined with graduated exposure, combined with a genuine sense of agency.

Anyone supporting others through difficulty needs a calm nervous system, a high personal tolerance for distress, and the capacity to sit with being perceived as insensitive when holding a difficult but necessary line. Clear values and genuine boundaries aren’t optional extras — they’re the model.

The world remains economically uncertain, socially polarised, and digitally relentless. People will encounter disagreement, rejection, imperfect institutions, and others who handle things badly. Preparing people for a world where everyone is perfectly considerate is not just unrealistic — it’s a disservice.

Quality Social Connections (Relationships)Quality Social Connections (Relationships)

Did you know that through a series of controversial (and incredibly sad) experiments, psychologist Harry Harlow, was able to demonstrate the importance of early attachments, affection, and emotional bonds on the course of healthy development. Harlow discovered that love and affections may be primary needs that are just as strong as or even stronger than those of hunger or thirst.

1 Think positive

This sounds easier said than done. I challenge you to intentionally consider alternatives to your habitual, default thinking pattern. We all want to be liked by others – because we want to belong to a group and to feel valued, needed and wanted. Worrying about social situations is very natural because we want to be perceived by others in a certain way. Other people’s perceptions are out of our control. So, we worry about it. We worry about things that are out of our control. We also know that we control our own behaviour, therefore, we feel responsible for behaving in ways that will mesh with others. We believe the likelihood of being liked will increase if we behave in certain ways.

Worrying can become problematic if we overthink past and future interactions, and perhaps we choose to avoid some or all interactions to protect ourselves. But then we don’t get the social connection we need.

I challenge you to think positive. Choose that instead. It will take energy because it might not be your default thinking pattern. Set your positive intention. Use mental energy. Trust that the opposite of your thinking can be true as well.

2 Forget comparison – unless you are a clone of someone else, you don’t have their genes, their life experience, their upbringing, their family history etc. It’s kind of illogical to compare yourself to someone else if you think about it, hey.

Don’t be concerned if others appear to have more or better friends than you. Quality and enjoyment matter more than quantity. Savour the moments of connection, wherever you can find them.

3 Anticipate change

Our life circumstances can leave us vulnerable to a sense of isolation. Relationships shift over time, and we may lose touch with friends who were once important. People form new relationships, move away, start families, become busier at work or start studying etc. Accepting change as normal can help you adjust to a change in your relationships. Just as we grow, evolve, and change, so will our relationships. Couples who were once in love will fall out of love. And friendships that were once enjoyed may become less enjoyable overtime.

4 Tolerate discomfort

Anxiety may cause you to avoid socialising. Understand that feeling awkward or embarrassed in social situations does not mean you are doing anything “wrong”. I remember a period I went through growing up. I noticed people around me starting to use for sophisticated language. I thought I had nothing of value to say, or nothing of interest. I would struggle to form sentences in my head. I was becoming so anxious that my social cognition was compromised. Learning to be comfortable with myself, relaxing into conversations, and listening more deeply to the other person helped me. I remember going on dates thinking I have absolutely nothing to say to this person. That cognition, that thought, wasn’t true. It was part of a larger story that I was creating in my mind.

Reach out to others and your skills will improve with time.

5 Listen well

Practice listening. Ask questions and really listen to the answers, rather than just waiting for your turn to talk, or worrying about how you will respond. If you’re curious about what someone is saying, your mind will naturally form a question or recall a similar experience that you can share.

Respond warmly to people’s experiences through your posture, facial expressions and words. Put the mobile phone away and be present.

6 Rehearse

Out of practice with small talk? Spend some time thinking about questions you can use when conversation stalls. You might ask if the other person has been overseas or travelled, what music do they like, or what movies they like to see at the cinema. A natural question to ask is what did you get up to today? What do you have planned for the weekend?

I once attended a training for work. The facilitator shared her experience of often finding herself in similar situations, and she decided to formulate a “go-to” script for when she became tense, and a conversation stalled. Rather than panic, she had a mental go-to script to bridge the gap until the conversation returned to a natural flow. Sometimes it’s nice to allow for a silence, scan your environment and discuss something happening around you.

7 Go offline

Social media helps many people, but it can also increase disconnection, depression, loneliness, anxiety, and headaches. Ensure you have a healthy offline life. Perhaps invite trusted online friends to an offline meeting to build your relationship.

8 Help and service

Helping someone gives a feel-good rush. Oxytocin and dopamine neurotransmitters have been shown to be involved in human bonding. These chemicals can make us feel pleasure. Create a bond with someone by offering help or asking for it. If we’re not someone who asks for help often, the people who know us well will likely feel closer to you because you need them for something, nourishing the bond you have. Have you noticed that strangers in the street are often very willing to help someone with directions? It makes people feel good to help others and be helped in return. Something as little as assistance with a bag or holding a lift can help people feel seen and cared for.

9 Get involved

I know this one may make some people go “Eeeeek” and cringe. However, evolutionary and developmental psychology … and all psychology, has suggested time and time again, that feeling part of a larger community and getting involved makes us feel alive and part-of. Joining in connects you to other people, unites you in a shared activity, and provides an easy way to get to know people better.

Have you ever watched a group of people in the street having a laugh, or watched people playing a sports game, or doing an activity together – while you’re sitting alone on the outside. You might mock them to yourself to make yourself feel superior or protected. We’d rather be part of. It’s just the truth.

10 Manage stress

Everybody has some social situations they dread. Practice simple stress management techniques, such as breathing deeply and slowly, to help keep your stress in check through awkward moments.

We need stress to perform optimally. Befriend your stress. When it becomes overwhelming, recognise that it’s happening, allow it to be there, investigate where it’s living in your body, and nurture that part of yourself. Talk to a trusted friend in times of excessive or toxic stress. Do whatever you need to come back home to yourself. Rest. Drink water. Eat nutritious food. Shower or bathe. Spend time outdoors in nature. Watch something on tv. Listen to music. Come home to your true self, recharge the batteries, and then jump back in. You’re allowed to switch off for a while.

11. Practice, practice, practice

Relationship skills can be learnt. Don’t be discouraged. Remember that social connections are good for you. If you feel like you need support to build better connections skills, a counsellor or therapist can help.

We learn from new experiences. They create, wire, and strengthen, neural pathways in the brain. You can be silent and listen during social interactions. Get curious about the other person. Ask questions. Share some of your story and ideas. And breath. Practice makes progress – not perfection.

Mortality DeterminantsMortality Determinants


Overall Global Leading Cause of Death

  • Ischemic heart disease (coronary artery disease) – Still the #1 cause of death worldwide.
  • Followed by: Stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, and cancer (e.g., lung, liver, colorectal).

Breakdown by Category

By Age

Age GroupLeading Cause(s) of Death
Infants (<1)Neonatal conditions, birth complications, infections
Children (1–14)Accidents (injuries), infections (low-income countries), cancers (e.g., leukemia)
Youth (15–24)Road injuries, suicide, homicide (varies by country)
Adults (25–44)Injuries (road, drug overdose), suicide, HIV/AIDS (in some countries), heart disease
Middle Age (45–64)Heart disease, cancer (esp. lung, colorectal, breast), liver disease
Older Adults (65+)Heart disease, stroke, cancer, Alzheimer’s disease

By Gender/Sex

GroupLeading Cause of Death
Cisgender MenHeart disease, cancer (lung, liver), accidents
Cisgender WomenHeart disease, cancer (breast, lung), stroke
Transgender IndividualsElevated risk from violence, suicide, and HIV/AIDS (especially trans women of color); limited large-scale data
Non-binaryInsufficient population-specific data, but risks often parallel those of trans populations or assigned sex at birth

By Race/Ethnicity (Example: United States)

GroupTop CausesUnique Issues
White (non-Hispanic)Heart disease, cancer, drug overdose
Black or African AmericanHeart disease, cancer, higher stroke risk
Hispanic/LatinoHeart disease, cancer, diabetes
Native AmericanAccidents, liver disease, diabetes, suicide
Asian AmericanCancer (leading cause), stroke, heart disease

Note: Disparities arise from systemic inequalities, access to care, and social determinants of health.


By Sexuality (LGBTQ+)

  • Limited global data, but in many regions:
    • Higher risk of suicide, mental health disorders, substance abuse, HIV/AIDS (especially among MSM and trans women).
    • Discrimination and healthcare avoidance contribute to worsened outcomes.
  • Common causes of death still include heart disease and cancer, with higher rates of premature death linked to stigma and healthcare disparities.

By Geographic Region

RegionLeading Cause(s)
High-Income CountriesHeart disease, cancer, Alzheimer’s, stroke
Low- and Middle-Income CountriesInfectious diseases (TB, HIV), maternal mortality, stroke, heart disease
AfricaHIV/AIDS, malaria, lower respiratory infections
AsiaStroke, heart disease, chronic lung disease
North AmericaHeart disease, cancer, drug overdose (opioid crisis)
EuropeHeart disease, stroke, cancer
Latin AmericaViolence (in younger adults), heart disease, diabetes

By Profession

  • Agricultural/farm workers: High injury rates, pesticide exposure, suicide
  • Construction workers: Falls, injuries, exposure to toxins (e.g., asbestos)
  • Healthcare workers: Infectious disease, burnout, mental health risks
  • Military/first responders: Combat-related injuries, PTSD, suicide
  • Office workers: Sedentary lifestyle risks (heart disease, diabetes)

Occupation-linked deaths often relate to environmental exposures, physical risks, or psychological stressors.


Conclusion:

Across almost all demographics, heart disease remains the leading cause of death, followed by cancer, stroke, and—in certain populations—accidents, suicide, or infectious diseases. However, the underlying causes (social, economic, political) differ significantly based on identity, geography, and profession.

Would you like this formatted into a chart, infographic, or specific to a country or report you’re working on?