Veterans, people who have experienced childhood abuse, and others who have experienced trauma are often left with emotional and psychological scars. Despite decades of effort, there are no clear-cut answers about how to heal them.
Pharmaceutical solutions, talk therapy, and support groups help some people but not others. Some trauma researchers believe trauma can leave an emotional imprint, not just in our psyche, but in the tissues of the body.
The polyvagal theory, created by Stephen Porges, provides one way to understand the emotional impact of trauma on the body and ways to treat anxiety, depression, post-traumatic stress disorder, and other mental health conditions. The theory can also provide a framework to examine the way we all experience our emotions and moods.
Porges’s theory describes three primary states of the autonomic nervous system and how we can identify which state we are in and when we change states, as well as how to improve our state to optimize our mental health.
The 3 States
As you read about the three states, see if you can identify times when you have experienced them in yourself or observed them in others.
Social Engagement: The healthiest state of the autonomic nervous system, according to Porges, is the state of social engagement. This is the state we strive to be in when we aren’t dealing with an immediate threat or stressful situation. We feel safe, open to experiences and people, trusting, creative, etc. Being in this state allows us to function effectively, think clearly, and make decisions.
Fight or Flight: When we feel threatened, our sympathetic nervous system activates and we enter an energetically aroused state classically described as fight or flight. Specific hormones flood our body, and our muscle functioning increases, our blood pressure goes up, and we become more aggressive or scared.
The fight or flight response has been studied for decades, and we now know it comes with consequences. Our decision-making tends to be more impulsive and we are less patient as well as more irritable and prone to anger. Staying in this state for too long can lead to health and relationship problems. We tend to have a hard time interpreting situations accurately due to the influence of strong emotions.
In a healthy individual, this state will be temporary and they will return to social engagement when the threat is gone. However, in some individuals, this state becomes chronic and they remain in it most of the time, unable to return to a state of social engagement. Chronic stress is an example of being stuck in this state. This is known to lead to many chronic health problems, such as heart disease, digestive problems, headaches, muscle tension, and more.
If we stay in fight or flight too often and for too long, we become exhausted or give up and may drop into the third state of Porges’s theory: shutdown.
Shutdown: In the shutdown state, we are still nervous and scared but have given up fighting. This state is closely related to depression. In the state of shutdown, we have a hard time feeling joy or getting interested in doing anything. We lack energy and focus and we don’t want to interact with people. It’s hard to make decisions, and we may experience increased aches, pains, and soreness. We are prone to feelings of sadness, shame, and guilt and may feel worthless, apathetic, and hopeless. We may lose our appetite or want to overeat.
This state preserves energy when compared with the fight or flight response. If a state of fight or flight returns, we will leave the shutdown state quickly. For example, research on depression has shown that exercise or strong anger can bring someone out of a depressed state. If the shutdown state lasts too long, it can turn into chronic depression.
According to the polyvagal theory, the three major states of the autonomic nervous system are hierarchical in the sense that when the highest one, social engagement, is functioning, it shuts off the other two, while the second-highest state, fight or flight, can shut off the lowest one, shutdown.
While everyone enters the three different states routinely in different circumstances, some people will return to a state of social engagement relatively quickly when a stressful situation concludes. Other people have a harder time returning to that baseline.
Treatments Based on Polyvagal Theory
While some may challenge Porges’s theory, it has proven useful in clinical settings. Perhaps you can see how these states play out in you or the people around you. The value of the model lies in showing that feeling safe and bringing on a return to social engagement is the key to ending the chronic states of fighting, fleeing, or shutting down that some people get stuck in. Techniques derived from this model have been used to treat PTSD, major depressive disorder, bipolar disorder, and even autism.
Without necessarily being aware of the state of a person’s nervous system, therapists try to create this sense of safety and trust in a social exchange as a basis for doing therapeutic work.
Researchers have long speculated that this relationship itself is curative in ways unrelated to what therapists and clients talk about. In order to promote continued positive social interactions between sessions, I often advise clients to maintain consistent positive social interactions with people they like and care about.
At the time, I was unaware of Porges’s theory that this connection could be changing the state of their autonomic nervous system to social engagement while turning off the other states. The polyvagal theory provides a useful perspective as to why consistent positive social interaction improves people’s moods and confirms the practical experience that many therapists observe with their clients.
One type of therapy based on polyvagal theory recommends thoroughly mapping the way the three states manifest in you. You make detailed descriptions of the way you feel, think, and behave in each state and identify situations and events that cause you to move between the states. This allows you to avoid or cope with events that trigger undesirable states and empowers you to take actions that move you back into a state of social engagement after you become aware that you left it.
At a more basic level, this practice encourages you to look inside and reflect on your response to your environment and the events that transpire around you. This alone is at the heart of many self-improvement and healing practices.
Other types of treatments based on polyvagal theory are designed to improve the functioning of your autonomic nervous system in direct physical ways, such as specific massage techniques.
If you read the descriptions above and think that your autonomic nervous system is chronically in a state of fight, flight, or shutdown; you may benefit by seeking the state of social engagement.
Stanley Rosenburg’s work, “Accessing the Healing Power of the Vagus Nerve” is a good place to begin. Over years of providing physical, hands-on treatments focused on the functioning of the autonomic nervous system, Rosenburg has demonstrated his techniques to be extremely effective for both physical and emotional problems. He also has very simple tests and exercises you can perform at home on yourself.
Michael Courter is a therapist and counselor who believes in the power of personal growth, repairing relationships, and following your dreams. He can be reached at mc@CourterCounsel.com