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

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The phrase “Say what you mean, but don’t say it mean” is all about the balance between honesty and kindness in communication.

Here’s what it means:

  • “Say what you mean”:
    Be clear and truthful. Express your real thoughts and feelings. Don’t beat around the bush or pretend to agree when you don’t.
  • “But don’t say it mean”:
    Speak with kindness and respect. Even when you’re being honest or giving criticism, there’s no need to be rude, hurtful, or aggressive.

Why it matters:

This phrase promotes healthy communication. It’s a reminder that:

  • You can be honest without being harsh.
  • Tone and delivery matter just as much as the words.
  • Empathy and respect should guide your conversations—even when it’s hard.

Eating Disorders DSM-5Eating Disorders DSM-5

Psychologists believe that the core issues of anorexia nervosa and bulimia nervosa are multifaceted, involving a combination of biological, psychological, and social factors. Here are some of the key issues:

Anorexia Nervosa

  1. Distorted Body Image: Individuals with anorexia often have a distorted perception of their body size and shape, seeing themselves as overweight even when they are underweight.
  2. Intense Fear of Gaining Weight: There is an overwhelming fear of gaining weight or becoming fat, which drives restrictive eating behaviors.
  3. Control Issues: Anorexia can be a way for individuals to exert control over their lives, especially if they feel powerless in other areas.
  4. Perfectionism: Many individuals with anorexia have perfectionistic tendencies, striving for an unattainable ideal of thinness.
  5. Emotional Regulation: Restricting food intake can be a way to manage or numb difficult emotions and stress.

Bulimia Nervosa

  1. Binge-Purge Cycle: Bulimia is characterized by cycles of binge eating followed by purging behaviors such as vomiting, excessive exercise, or misuse of laxatives.
  2. Body Dissatisfaction: Similar to anorexia, individuals with bulimia often have a negative body image and are preoccupied with their weight and shape.
  3. Impulsivity: Bulimia is often associated with impulsive behaviors and difficulties in regulating emotions.
  4. Shame and Guilt: After binge eating, individuals with bulimia often feel intense shame and guilt, which perpetuates the cycle of purging3.
  5. Co-occurring Mental Health Issues: Anxiety, depression, and other mental health disorders are commonly seen in individuals with bulimia.

Both disorders are complex and can have severe physical and psychological consequences. Treatment typically involves addressing these core issues through therapy, medical monitoring, nutritional counselling, and support groups.