Polyvagal therapy
Polyvagal therapy, also known as polyvagal-informed therapy, is a modality that integrates insights from Dr. Stephen Porges’ Polyvagal Theory to enhance the body’s regulation of the autonomic nervous system. This therapeutic method focuses on activating the body’s “social engagement system” to help manage states of dysregulation such as anxiety, depression, and post-traumatic stress disorder. The primary goal of polyvagal therapy is to foster a sense of safety and connectedness, enabling individuals to better regulate their emotions and achieve a state of calm instead of a shutdown or hyperaroused state.
What are the origins of polyvagal therapy?
The Polyvagal Theory introduced a new understanding of the autonomic nervous system, elevating our understanding of the role of the vagus nerve in emotion regulation and social behavior. Originating from his research at the University of Illinois, Chicago, Porges’ theory posited that the vagus nerve is critical in controlling the heart rate via its connections to the ventral and dorsal branches, influencing our capacity for social connection and stress response.
This approach is often integrated with other forms of psychotherapy, such as eye movement desensitization and reprocessing (EMDR), and is particularly effective in treating conditions where the autonomic nervous system is dysregulated; which, is common in trauma-related disorders like post-traumatic stress disorder (PTSD).
When is polyvagal therapy used?
Polyvagal therapy is employed across various settings, including individual sessions, group therapy, and family counseling. Its versatility makes it suitable for a wide range of individuals, particularly benefiting those who have experienced trauma or suffer from conditions linked to dysregulation of the autonomic nervous system.
Its effectiveness is rooted in the understanding of the biological psychology of human behavior, particularly how the nervous system interacts with experiences of safety and threat.
Polyvagal therapy can be beneficial for veterans suffering from PTSD, individuals with a history of sexual assault, and those experiencing complex trauma. The therapy’s focus on regulating the nervous system and fostering a safe environment makes it highly effective for anyone who struggles with feeling safe and secure in social contexts, including people within the LGBTQ+ community who may face ongoing stresses related to social engagement and acceptance.
How does polyvagal therapy work?
Polyvagal therapy operates on the principle of helping the body’s nervous system feel safe. At its core, this approach focuses on the vagus nerve, a critical element of the autonomic nervous system that influences how we process stress and danger signals.
This nerve plays an important role in determining whether we should react to a situation that’s perceived as threatening with a freeze, fight, or flight response (rooted in the sympathetic nervous system), or a dorsal vagal state, which is when someone becomes so overwhelmed they shut down.
In polyvagal therapy, the therapist helps the patient engage their vagus nerve in a way that promotes a sense of safety. This is done through techniques that trigger the “ventral vagal” state—a physiological condition associated with calmness and social engagement.
For instance, through breathing exercises, guided imagery, somatic practices, or even social interaction exercises, patients learn to regulate their body’s response to stress. This is somewhat similar to how exposure therapy works for phobias, where the brain is taught to perceive a previously feared stimulus as non-threatening, and people use coping skills to help shift their automatic stress responses.
By repeatedly guiding the body into this state of calm, polyvagal therapy teaches the nervous system to choose this pathway more often, even in potentially stressful situations. The result is an enhanced ability to self-regulate emotions and remain calm under stress. Essentially, the therapy retrains the nervous system to automatically find a state of balance, reducing the likelihood of tipping into extreme stress responses and helping individuals feel more connected and secure in their daily interactions.
What is polyvagal therapy like?
During a polyvagal therapy session, therapists often begin by assessing the client’s current physiological state and exploring their history with safety and threat perception. This involves asking questions like, “Can you describe a time when you felt safe?” or “What experiences make you feel threatened or on edge?” This helps the therapist understand the client’s baseline of nervous system regulation and guide the therapeutic process effectively.
The sessions typically involve activities designed to engage and train the vagus nerve, such as controlled breathing exercises, guided relaxation, and sometimes gentle physical movements to promote a state of calm. Therapists might also use techniques such as sound therapy or gentle touch, which are believed to stimulate the vagal pathways.
Additionally, clients may be given ‘homework’ or practices to incorporate into their daily lives, such as mindfulness exercises, journaling to track mood and physiological changes, or specific tasks designed to increase their capacity for social engagement and emotional regulation. The focus on integrating bodily awareness with emotional processing is a key trait of polyvagal therapy, aiming to enhance the client’s overall resilience and capacity for emotional regulation.
How long does polyvagal therapy take?
Polyvagal therapy sessions can vary in length and frequency depending on the individual’s specific needs and the severity of their conditions. Typically, therapy might consist of weekly sessions that run for about 50 to 60 minutes each. The course of treatment can be short-term, focusing on specific issues, or extend to long-term support for more complex emotional and physiological dysregulation.
Is polyvagal therapy effective?
Polyvagal therapy has gained attention in the mental health community for its innovative approach to treating anxiety, trauma, and stress-related disorders. Research into polyvagal therapy shows promising results, particularly in the treatment of conditions that involve dysregulation of the autonomic nervous system.
One study suggests that interventions based on Polyvagal Theory can significantly improve symptoms of PTSD and anxiety by fostering a state of calm and safety that the theory argues is necessary for social engagement and stress recovery. These interventions focus on activating the ventral vagal complex, which supports social communication and self-soothing capacities, essential elements for mental health recovery.
Moreover, the therapy’s emphasis on developing safe, therapeutic relationships and environments aligns with broader evidence in psychotherapy that highlights the importance of the therapeutic alliance and setting in effective treatment outcomes. By combining physiological strategies with psychological support, polyvagal therapy helps patients develop better emotion regulation strategies and reduce their physiological symptoms of stress, which are often resistant to traditional therapies.
However, it is important to note some debate within the scientific community about the extent of the applicability of Polyvagal Theory. Critics have pointed out that while the theory is compelling, more rigorous empirical research is needed to fully validate the mechanisms it proposes. Despite these ongoing debates, the practical applications of polyvagal principles in therapy have been beneficial for many, particularly those with trauma histories who have found traditional methods ineffective.
How to find a polyvagal therapist
If you think polyvagal therapy might be right for you, it’s important to speak with a licensed and experienced clinician. There are many types of mental health care providers who practice polyvagal therapy, including licensed marriage and family therapists (LMFTs), licensed clinical social workers (LCSWs), psychologists, psychiatrists, psychiatric nurses, licensed professional counselors (LPCs), licensed mental health counselors (LMHCs) and more.
On top of finding someone specializing in polyvagal therapy, you want to make sure they meet your other needs. For example, if you’re struggling with post-traumatic stress disorder (PTSD), you may want to find a polyvagal therapist who also specializes in PTSD. In addition, finding a therapist who accepts your insurance can make therapy much more affordable.
You can find a therapist who accepts your insurance and specializes in polyvagal therapy by using Grow Therapy. After filtering for your location, insurance, and needs, you can then select “Polyvagal Therapy” from the “Treatment methods” drop-down.