Therapeutic Tools: The Polyvagal Solution
Neuroscience Reaffirms Ancient Traditions
As trauma therapists studying the Polyvagal Solution, we regularly observe how emotion, thought and physiology are not separate systems. Over the centuries, ancient practices have focused on techniques to link body and mind. Now Western science is pinpointing the precise neural mechanism: the vagal nerve. The vagus serves to connect our neurophysiological systems with our brains and emotions, a “bridge” running in both directions.
So when we see trauma patients with anxiety, pain or obsessive thought patterns, we can describe their trauma as truly being trapped in the body. Previously, I featured the work of Dr. Stephen Porges, Research Professor in Psychiatry at University of North Carolina — Chapel Hill. Dr. Porges’ research discusses how the vagus (also called the 10th cranial nerve) has evolved over time to have two main branches, one older and one more recent. Each serves a specific purpose in the body’s response to trauma.
Polyvagal nerve response can be categorized in several ways :
- “Fight or Flight” — the unmyelinated, older vagus nerve mobilizes the entire body in a high state of activation;
- “Playing Dead” — also related to the older vagus, this reaction to threat triggers a shutdown or freezing. While many animals collapse or freeze in the face of extreme stress, humans might respond by withdrawing into a dissociative state;
- “Tend and Befriend” — our newer and myelinated vagus nerve uses social engagement strategies to respond to a threat. Exclusive to mammals, the nerve prompts the brain to search for cues or attention from others. We process, for example, facial expressions or tone of voice. Our heart and brain respond to the information we receive; we may calm down or activate based on that input. Explore The Polyvagal Blueprint for Trauma, Connection, and Recovery with expert Kathy Kain as part of the Expanding Beyond Trauma in Theory and Treatment webinar series.
Therapeutic Applications of Polyvagal Theory
The vagus plays a significant role in life-long problems with intimacy, trust and safety. Trauma persists partly because of the body’s inability to release it, resulting in a “traumatized” personality. We may see such clients presenting with a flat affect and flat vocal tone — signs of vagal shutdown.
How can practitioners create an experience of safety for the traumatized patient? The Polyvagal Solution helps with a client’s ability to feel safe — not just intellectually, but also physiologically and emotionally — may begin with the therapist’s own use of techniques to calm the vagus. Our facial expression, tone of voice and eye contact project cues that affect a client’s heart rate and auditory muscles via the vagal nerve.
So the attuned presence of the therapist in a clinical setting truly does impact a patient’s body and mind. Rather than focusing on treatment protocols with a client, we must be receptive, non-controlling and non-judgmental in order to open and deepen the mutual experience of safety.
Anxiety is one of the central and most troublesome features of trauma. When clients present in a panicked state, we can use the opportunity to help them cultivate awareness of their body responses to stress, such as increased heart rate and shallow breathing.
Breathing and Music as Intervention Techniques
By guiding anxious clients to notice one piece of the pattern, we may create an intervention that allows them to regain a greater sense of ease. Let’s use the example of the breath. We can help by reminding the client to count inhalations and exhalations, practicing this breathing pattern with them.
“Let’s count to four on inhale and eight on exhale.” A few cycles of this intervention can regulate neural responses to the point where we may gently discuss the experience. Maintaining a calm, varied tone of voice, we then congratulate the client for learning a new coping skill and offer encouragement to continue the practice.
Dr. Porges also advocates the use of certain types music for patients with trauma, autism and/or hypersensitivities. Therapeutic use of this music affects the tiny muscles of the middle ear connected to the vagal nerve. Dr. Porges suggests that re-regulation of the entire nervous system can be supported by helping the client train the muscles of the inner ear to actually listen differently, “tuning” to calming sounds created by a friend, therapist or a carefully chosen piece of music.
We’re continually expanding our knowledge about trauma and the Polyvagal Solution in the realm of energy psychology and somatic therapies. If you’d like to learn more about this, take a look here. Dr. Peter Levine’s April webinar Shifting from Constricted Past to Embodied Presence and Forward Action. This training offers professionals a look at the somatic treatment of traumatic memory.