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Polyvagal Theory informs all the work I do and teach

Polyvagal Theory

Polyvagal Theory, developed by Dr. Stephen Porges, is a significant breakthrough in trauma treatment. As a therapist with 30 years of experience, I have witnessed its transformative impact on how we treat trauma and understand the neurobiology of being human. I was fortunate enough to attend a conference where Dr. Porges presented his work 17 years ago, and it inspired me to delve deeper into his research. This led to a complete transformation in the way I perceive people and conduct therapy. PV Theory has a profound impact on our comprehension of psychological principles and treatment, as well as the relational aspects of being human. Since it is rooted in biological responses, PV Theory enables us to approach our humanness with compassion, which is crucial for each of us.




The Polyvagal Theory is a concept that explains how our physiological states and the vagus nerve are interrelated. This nerve has evolved as we evolved as mammals and is connected to our capacity for caring for our offspring and for affiliation with family and community. In essence, this theory emphasizes the significance of social connection and how it is deeply ingrained in our biology. These connections keep the body in health and homeostasis for optimum physical and mental health.


As humans, we have three primary nervous system states: social engagement, fight/flight, or freeze/collapse/shutdown. These three states are elicited by our central nervous system’s assessment of threat. They are biological and nervous system responses to neuroception, a term that Porges coined to define how we detect and respond to threats in the environment. Neuroception is not a cognitive perception and occurs below cognitive awareness. What is most important about this is that it will always determine our state. 


These 3 states have biological underpinnings that lead to physiological states. These physiological states also affect how we feel and how we behave while limiting our behavioral repertoire. In this way, our neuroception has huge implications for our health, as well as how we function relationally. If we feel safe, the social engagement state (the Ventral Vagal Complex) is present—meaning we can be present, and we can use relationships to regulate, and connect with others in a way that feels good. Similarly, if we feel a sense of danger, the fight/flight system (Sympathetic Nervous System) is activated. In this state, our body is mobilized and ready to act. Finally, if our nervous system perceives a life threat, the body will move into freeze, immobilization, or collapse—the  Dorsal Vagal Complex.


It is important to understand that our behavior patterns are influenced by our physiological states, which act as an intervening variable of human behavior. For instance, if our fight/flight system is dominant, we may not be available for connection. Conversely, if we are in a freeze or shutdown/collapse state, we may not be able to take the necessary action, such as using our fight/flight system or our social engagement system. 


Feeling safe allows our nervous system to be present, aware, and responsive, enabling us to respond rather than react and be relational with ease. This social engagement state, also known as the Ventral Vagal Complex, is crucial as it places the body in a physiological state of health, growth, and restoration, forming the foundation for healthy relationship skills and connection. Most of our struggles in being human arise from being stuck in a particular state or lacking the flexibility to access the state we need.


Our life experiences, genetics, and epigenetics can cause certain physiological states to become dominant, leading to a fairly constant state of fight/flight or freeze/shutdown/collapse. However, experiences can also interrupt an individual's ability to respond with fight/flight or social engagement. For example, if someone has been in situations where it was not safe to fight or flee, they may learn to not have a healthy fight response available to set boundaries, say "no," or advocate for themselves. Similarly, flight could also become less available as an option based on early experiences, leading to someone staying in bad jobs or relationships, as it is not an option to get away. Lastly, without early relational support and caregiving, accessing the social engagement system might also be difficult.


The good news is that there is assistance available to help us make positive changes in our health, relational capacity, and behaviors. This support is based on the idea that by connecting with our bodies and changing our state, we can shift our physiology and improve our overall well-being. We now understand that paying attention to our body's cues and truly being present in our bodies is a crucial part of the healing process. Additionally, learning skills to change our states can also be incredibly beneficial.

Polyvagal Theory Charts

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Any and all diagnosis can be present on this chart—as psychiatric diagnoses are connected to states being regulated or not regulated. This also explains the idea of states—and the importance of being aware of our states. This awareness can then lead to ways to create resiliency and the importance of cultivating non-trauma states, like connection, gratitude, self-compassion, and mindfulness.


In summary, Polyvagal Theory is a non-pathologizing lens that helps us better understand the nervous system and how it impacts the way we show up in the world, relationally and otherwise. It is critical to bring in this way of seeing as so much of our behavior is more about the physiology in our body rather than any kind of lack of strength or coping strategy. The good news is that we can all work toward improving our resiliency because resiliency is actually learned.

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"Through Ruby Jo’s training, I learned a wonderful synthesis of somatic work and polyvagal theory-based neurobiology. I use the skills throughout my day personally and extensively with my clients."

– Karin Lee Hughes MD (she/her/hers)
Mind Body Physician, Board certified in Family Medicine and Hospice and Palliative Medicine


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