
Polyvagal Theory informs all the work I do and teach
Polyvagal Theory
Polyvagal Theory, developed by Dr. Steven Porges, is one of the greatest game changers in treatment I’ve seen over my 30-year career as a therapist. It has changed not only how we treat trauma but also how we understand the neurobiology of being human. I was lucky enough to see Steven Porges about 16 years ago at a conference. That presentation led me to dive deeper into his work, which completely transformed the way I see people and the way I do therapy. We are finding that PV Theory affects our understanding of psychological principles and treatment as well as the relational aspects of being human. Because it is so grounded in biological responses, PV Theory means we can bring compassion to our humanness in a way that is important to each of us.
So, what is Polyvagal Theory? Polyvagal Theory is the idea that as we evolved evolutionarily, we needed different available physiological states. Particularly as we evolved into being mammals, we developed a sense of caring for our offspring and the need to be connected to our tribe. The “theory” part of the Polyvagal Theory is about the theory’s connection to evolution.
As humans, we have three states: social engagement, fight/flight, or freeze/collapse/shutdown. These three states are elicited by our perception of threat. They are biological and nervous system responses to our neuroception, a term that Porges coined to define how we perceive threats in the environment. Neuroception is not a cognitive perception as much as the body’s assessment of threat in the environment, as determined by our nervous system.
These states have biological underpinnings that lead to physiological states. These physiological states 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 safety, the social engagement state (the Ventral Vagal Complex) is present—meaning we can be present, and we can use relationships to regulate, connect, and feel safe. 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 life threat, the body will move into freeze, immobilization, or collapse—part of the Dorsal Vagal Complex.
It’s important to know that these physiological states actually dictate our behavior patterns. For example, if our fight/flight system is most present, we will not be available for connection. If we are in freeze or shutdown/collapse, we will not be able to take the action we need to take, that is, using our fight/flight system or our social engagement system. If we feel safe, our nervous system will be present, aware, and responsive, meaning we can respond and not react. This social engagement state (Ventral Vagal Complex) is critical, placing the body in the physiological state of health, growth, and restoration. It is the foundation for healthy relationship skills. Most of our struggles in being human are about these states working together less effectively or getting stuck in a state.
Based on our life experiences, genetics, and epigenetics, these physiological states can become dominant. In some families, people could possibly have their flight or fight extinguished from their repertoire of options. If it was not safe to fight or flee, due to what would happen if the child tried to fight or flee, then someone might learn to not have healthy flight, like setting boundaries, saying “no,” or even advocating or taking care of themselves with others. Flight could also get extinguished, where someone might stay in bad jobs or relationships, as it is not an option to get away.
The good news is that there is help to support shifts in the physiology that lead to changes in health, relational vitality, and options in our behaviors. Doing that is all about connecting to the body and changing our state. We now know that embodiment, and truly being in one’s body and paying attention to body cues, is a huge part of healing as well as learning skills to change our states.
Polyvagal Theory Chart

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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