A Polyvagal Informed Approach to Therapy

Why a Polyvagal Approach?
I think that we can all relate to the reality that, sometimes, just changing the way we think isn’t always enough, or only works for a short time, under certain conditions. Advances in neuroscience and polyvagal theory, founded in scientific research by Stephen Porges, has evidenced the importance of the body-mind connection when it comes to mental health and wellbeing. These findings support my professional experience, that if we don’t sufficiently accommodate the needs of the nervous system in therapy, then it’s likely that either the benefits will be short-lived or the therapeutic process will be undermined by an experience of frustration or demotivation.

What is the Nervous System and how does it work?
The autonomic (automatic) nervous system controls everything you do, without us even thinking about it including breathing, walking, thinking and feeling. The Vagas Nerve is the longest and one of the most important nerves in the nervous system. It helps to regulate many critical aspects of human physiology, carrying messages to and from the body, so the brain can interpret them and take action. To use the analogy of a car; the nervous system is the driver, and the brain is the engine, responding to the actions of the driver.

As well as maintaining many of the primary functions of the body, the nervous system has also evolved to keep us safe from danger and does so through our internal radar system called Neuroception. This radar system is continuously scanning our environment, when ‘threat’ is detected, it automatically sends an alert through the vagus nerve to the brain, which then mobilises us for action. Without being aware of it, a release of adrenalin and cortisol moves us into the fight or flight response (anxiety, anger, avoidance) or a slowing of our heart rate and blood pressure, as our bodies employ a strategy of stillness (low mood, depression, detachment).

How this relates to our mental health?
So let’s get something clear, it is absolutely necessary and normal that we move in and out of emotional states over the course of our day. A little bit of fight and flight energy means that we get that project done on time, we open that bill and we go back to the house to check that we haven’t left the oven on. Similarly, we may require stillness, needing to spend some time alone, or maybe a duvet day to recharge our batteries. Importantly, our internal threat detection system plays a vital role in keeping us safe from actual danger; an intruder in our house or stepping out of the way of a car.

This is where therapy can help. Sometimes the messages triggered and sent to our brain by our radar system are misjudged. With an agenda of keeping us safe, our nervous system and brain can jump to conclusions and generalisations, based on the information its gathered and stored from our past experience and/or trauma. This is an automatic process that happens out of our awareness, that we might only notice when we respond out of context, maybe by snapping for no particular reason or avoiding a person or situation.

From a polyvagal perspective, problems with our mental health happen when our radar system regularly gets it wrong, mobilising us into action of slowing us down into immobilisation when it isn’t needed. Outside of a diagnostic category, like anxiety, depression or ADD/ADHD, clients can also describe their experience as a roller coaster of emotions, they might feel stuck or trapped, living their life from a place of survival. Other common indicators can include a general sense of detachment, poor motivation, a lack of enjoyment and a constant sense of unease and irritability.

Other indicating factors may include:

  • You find it hard to sit down and ‘relax’, jumping from one thing to the next.
  • You struggle to feel comfortable and connected with others
  • Your mood changes regularly, you get stuck in a particular frame of mind.
  • You become easily irritable, snappy or angry for no apparent reason.
  • You struggle to motivate yourself, get started or sustain a behavior.

What is the purpose of therapy?
The aim is to support you in understanding, interrupting and gradually changing these automatic responses, empowering you with an increased sense of control and self-compassion. Naturally as your ‘alarm system’ recalibrates, you will begin to step out of a mindset which focuses on ‘what could happen’ or ‘what did happen’ and instead focuses on the here and now, with an enriched sense of connection to yourself and others, as you begin to view the world from a place of safety rather than survival.

What happens in Therapy?
The term polyvagal can understandably evoke some apprehension. I have had people say that it sounds a little complicated. Be reassured that it really isn’t. We usually begin with a sharing of information as you gain an understanding of what the nervous system is and how it impacts your mental health and wellbeing. From there on, some clients prefer a more structured approach, specifically focusing on resourcing, understanding and application. Others benefit from a more flexible agenda, with space to explore thoughts, feelings, emotions and experiences, in a safe and non-judgmental way.