I talked about the vagus nerve in a previous webinar and I had a bunch of questions about polyvagal theory specifically and the validity of it.
And so I thought it might be valuable to kind of go into that.
So in case you're unsure of what that is,
Polyvagal Theory is,
It was developed by Stephen Porges,
And it's really become hugely popular in therapy.
And really,
I think it's become a standard explanation,
It seems,
Just in terms of how stress and trauma work in the body specifically.
Yes,
It's very popular,
And although there's tons of stuff that's really popular out there,
Not everything is actually valid and great and useful and those types of things.
I will say there are some useful bits to polybagel theory,
But there's some real serious problems as well.
When we look at the core science of theory.
A lot of scientists who are experts in there and I'm talking like different streams of science.
So,
Neuroanatomists,
Physiologists,
Evolutionary biologists,
All of them from their area of expertise are coming in and looking at this.
And there are some things,
Like I said,
That are clinically helpful,
And I will get into that,
Especially from a therapy stance when we're looking at that.
But when we're looking at you know,
What's more maybe scientifically supported,
There's probably better ways of understanding what's happening in our nervous system.
So I'm going to try to keep it easy to follow through.
So you don't need to be a neuroscientist with a fancy degree to understand this stuff.
Okay,
So I did talk about the vagus nerve previously.
It's the long wandering nerve.
It runs from our brainstem all the way down into our chest,
Into our belly,
And it's connecting our brain to our heart and our lungs and our gut,
Just a bunch of different organs.
So the name polyvagal comes from the idea that there's multiple branches of the nerve and each of those things do different things.
But basically,
When we look at polyvagal theory,
It's describing different branches and three modes to our nervous system and the way that our nervous system can operate.
So the first mode,
So to speak,
Is the safe and social.
It's the ventral vagal when we're looking at polyvagal theory.
And so based on the theory,
It's saying,
You know,
This is when we feel connected.
This is when we're feeling calm.
We can make eye contact.
We can read facial expressions.
We can manage our emotions,
Our voices.
Is warm,
Where we're open to engagement.
This is the state where kids are meant to learn best,
Right?
And it's considered a new branch and supposed to supposedly be unique to mammals.
So that's the first mode.
The second mode is fight or flight.
And so that's the sympathetic.
And this is the mobilization response where We're going to feel our heart pounding,
Our muscles get tense,
Right?
That's where we really see anxiety show up,
And it can show up in a kiddo who's more of a wiggle bottom in class.
Maybe they're looking around the room more.
Maybe they're running away.
Maybe they're snapping and swearing at you,
Right?
So that's kind of that response.
And then the freeze response,
That's the shutdown.
That's known as dorsal vagal.
And this is considered the old sort of primitive reptile era system.
And this is when you're really in extreme danger.
That's the branch that just shuts everything down.
It's the immobilization response where we freeze,
We go numb,
We might dissociate.
And so we might see a kiddo who goes completely blank,
Or they just sort of check out,
For example.
So you can see we've got this three-tiered ladder with the ventral vagal,
The safe social at the top,
In the middle is the sympathetic,
The fight or flight,
And then the bottom is the dorsal vagal,
The shut down and the collapse.
And the idea is when we're stressed out or we're traumatized,
We drop down this ladder.
And so the goal of therapy,
According to this framework,
Is to climb back up to that top rung.
So you can see it's clear,
Like no wonder people love it.
It's just,
There's a clear visual.
It's really easy to explain.
It gives everybody similar language for what's happening in the body.
It's giving us a way to talk about how,
You know,
Those sort of awful,
Confusing,
Gross physiological sensations are happening.
And we're understanding them as biological and automatic.
And so when we have that,
You know,
That's helping us increase our self-awareness.
It's helping us shift away from what's wrong with me to I know what's going on in my nervous system.
It's just helping remove some of that shame,
Some of the blame.
I mean,
All that's a good thing,
Right?
There is some benefit about the meaning of it,
Really,
When we're looking at it.
But the problem is,
The biology of it all.
Yes,
We understand why it's so easy to love.
It gives us that language,
Reduces shame and blame.
And there's a lot of researchers out there.
One was Paul Grossman.
He showed that these three specific brain pathways that Porges describes don't really work exactly the way the theory actually suggests.
And the freeze response involves different brain structures completely.
So we're always learning so much more about the brain.
The science of this is still evolving,
Right?
So we really do need to stay on top of the research with all of this and not just grasp on to one new shiny theory and development.
But this isn't something new,
I will say.
Researchers have actually spent decades studying the vagus nerve,
Studying the heart,
Studying the autonomic nervous system.
None of this is actually new.
So we do wanna be mindful of that,
But we wanna make sure we're staying on top of things and not just the fancy schmancy things that are popular on social media,
Because that's really important.
But there's a few claims that we should really look at here.
So the first one is the claim that that dorsal vagus,
That old reptilian sort of branch,
Is what causes your heart to dramatically slow down and trigger that freeze or collapse response when you're feeling like you're in extreme danger,
Right?
Like a possum playing dead,
For example.
When we look at the neuroanatomy,
Of it,
The brain region where the dorsal brain,
The dorsal branch comes from,
It's really controlling our gut.
Our stomach and our intestines and our digestive system.
So really,
Essentially what that means is it doesn't have a lot of effect on our heart rate.
Okay,
So just looking at the biology of all of this,
It's incorrect.
The ventral branch is actually responsible for almost all of the rapid heart rate control,
Which we've actually known since the 70s.
So it's not like a new finding,
Right?
So this branch is what's really driving the heart rate.
So both the heart rate is increasing and we see this dramatic slowing in the freeze response.
And that's the ventral branch,
Which is very different from what the polyvagal theory says.
Because what Polly Vagel says.
That part is responsible for safety,
For social connection,
But it's actually also the one involved in the freeze response.
So you can see that's a pretty significant problem for the theory when we're looking at it from a biological stance.
It doesn't really neatly divide into ventral equals safe and dorsal equals shutdown.
It just doesn't equate to that.
So when we look at the real biology,
It's obviously way more complicated than that.
Now there is some more recent research in 2024,
Strain and colleagues,
They were looking at the heart slowing.
So there is some heart slowing.
So there might be some role in the dorsal branch,
But that's a long way from saying,
Like,
They're stretching,
Right?
They're saying maybe there could be,
But that's a really long way from saying that the dorsal vagus definitely is the primary driver of cardiac shutdown,
Because that's what the theory claims.
And that's older research than even the polyvagal in the first place,
Right?
So the polyvagal was already built on existing,
Well,
Incorrect knowledge.
But knowledge that was already out there,
Okay?
So anyway.
I go on.
So next one we're looking at polyvagal theory.
It was saying.
.
.
According to the theory,
Mammals evolved this special myelinated vagal pathway,
Basically this sort of fast-conducting highway,
This nerve fiber.
So it's just like a paved highway pathway in the brain.
And so based on the polyvagal theory,
It's saying that other animals don't have that,
That this is a new pathway that's supposedly allowing us to be social creatures.
And I think that that's probably the most thoroughly debunked part of the whole theory.
When we're looking at comparative biologists who study anatomy across different species,
They've really pushed back on this for a very long time.
There's so much work out there showing that those highways are found in other species,
Lungfish,
Frogs,
Sharks,
Sharks,
Birds,
Reptiles.
These structures go back,
You know,
500 million years.
So it's not a new thing,
Right?
So that's another claim that this theory is making.
It makes biological sense when you think about it.
What probably drove the evolution of this,
You know,
Fast cardiac control,
It wasn't social bonding.
It was transition from living in the water to now being able to breathe air.
When you're an animal switching between water and air,
You need to have rapid,
Precise control over your heart to match your breathing.
And so that was really a survival problem,
Not a social problem.
OK,
So we just got to be careful.
When we look at the social behavior,
The theory,
Polyvagal theory,
Implies that reptiles and fish are basically these antisocial beings because they lack that special vagal system.
And that's another area where comparative biology just doesn't support the theory.
We know that reptiles and birds and fish,
They show complex social behaviors,
Very complex social behaviors.
So the idea that you need this mammalian vagus to hold up a social life,
It just doesn't hold up,
Right?
When we look at that.
Another piece to talk about too is the one when we're looking at the central tools that comes with polyvagal theory is this idea that you can measure something called respiratory sinus arrhythmia or RSA for short.
And that this number tells you about the person's vagal tone and their sense of safety.
Okay,
So RSA,
It is a real thing.
It's just a natural variation in your heart rate that happens as you breathe.
So your heart speeds up slightly when you inhale,
It slows down when you exhale.
We know this,
Okay?
It is related to vagal activity to the heart.
But the problem is how Polyvagal is using this.
So the theory is treating RSA as if it's a direct window into our overall vagal tone.
Like a single number can tell you exactly how your entire vagus nerve is functioning across all organs that it's touching.
But physiologists have really shown that this vagal control is very organ specific.
So how much vagal activity is going in your heart is not the same as how much is going on in your gut or in your lungs.
So it's like measuring the water pressure in your kitchen and then concluding how you know the water pressure is in every pipe in the whole entire house,
Even though you're only basing it on the kitchen sink,
Which we know is just not accurate.
On top of that,
This RSA is influenced by a bunch of factors that have nothing to do with the vagus nerve at all,
Like your breathing rate or your breathing depth,
Your sympathetic nervous system activity,
Even your age,
Things like that.
RSA naturally declines as you get older.
So being able to treat it as this sort of clean,
Direct measure of psychological safety It's it's a categorical mistake.
I mean,
Scientists call it a category mistake.
You're confusing the measurement for the thing itself.
Okay,
So I mean,
This stuff is just,
You know,
Maybe a little bit more complex,
But just understanding we can't put all of our faith in one theory,
Especially when there's so many areas that are incorrect.
One more area that I want to make sure I address is neuroception.
So this idea from polyvagal theory is that our nervous system is constantly scanning the environment below our conscious awareness,
Detecting whether things are safe or dangerous.
And this is something that I have talked about.
It's just easy language to be able to talk about.
It is an appealing idea as well.
But when you look at how,
You know,
Modern neuroscience actually understands the brain,
The dominant model right now,
Based on what we understand,
Is called predictive processing or active inference.
And this is something that I have been talking a lot about as well.
So in this view,
Instead of sort of passively scanning and reacting to what's going on in the environment,
The brain is actively building a model of what it expects to happen.
And I've been talking a lot about how our brain is a prediction-making machine.
So it's building this model of what it expects to happen and then comparing the prediction against what actually is occurring.
And when there's a mismatch,
That's the prediction error,
That's where learning and adjustment happens.
And so when I talk about exposure therapy,
For example,
Like I need you make a prediction of how terrible it's going to be and what's going to happen.
Then we're going to collect data and see what actually did happen.
The bigger the mismatch between my prediction and what actually does happen,
That's where learning happens.
That's how we can rewire the brain.
So the brain is more like a fortune teller.
It's constantly looking at making bets about the future and then updating when it's wrong.
So it's not just the smoke detector waiting for danger.
It's really more about the prediction of what's going to happen.
And then we'll update itself.
Now,
Like I said,
I do use the smoke detector metaphor because it is language that we all get.
But I also teach it alongside the fact that our brain is a prediction-making machine.
I use the thermostat analogy too,
And I will be talking about that coming up.
But if we really start to look at it,
And I'm just getting really specific with the biology and neuroanatomy and all of that kind of stuff.
Clinically,
If we start to look at the neuroception model,
We can accidentally pathologize normal arousal.
And that's really where I get really concerned.
So a person's heart beating faster before a presentation,
It doesn't necessarily mean it's a threat response.
It doesn't necessarily mean that they're dropping down on this polyvagal ladder,
Right?
The brain is generating energy to deal with an uncertain situation.
That's completely normal.
It's completely healthy.
It's to be expected.
The problem is when we're telling someone their nervous system is in a dangerous state.
Right?
Especially when they're just experiencing ordinary arousal.
When we're saying,
Oh my gosh,
You're going down the ladder.
We're gonna make their anxiety worse.
We know.
Thinking that this is bad is actually gonna make it worse,
Right?
And there's lots of research.
We know Keller in 1996 did a huge research study where they were looking at people with high stress.
People with high stress who thought that the stress was bad died earlier.
Had more complications and died earlier than people with low stress.
But people with high levels of stress who thought that stress was actually a good thing was helping them be successful.
They live longer than either of the other two groups,
Even the people with low stress.
So it's all about how we think about it.
And so if we're constantly telling people,
Oh my gosh,
You're going down into dorsal vagal,
We need to do all of these things.
I mean,
We're just making it worse.
So thinking their feelings are bad makes it more likely that they're gonna be dysregulated.
So we want to make sure we're not pathologizing.
And I think that that's really important.
Now,
Yes,
There are some helpful pieces to talk about when we're looking at the stress response.
But we can't treat it like it's settled biology,
Like it's factual-based biology.
And I think that this online world of ours these days,
We're facing this crisis of credibility,
And especially when you've got people out there with big names.
And they're being endorsed by other big people.
There's just so much incorrect information out there.
We always have to check the validity of things,
Especially if you're in a helping role.
I find even professionals are teaching and using so many problematic approaches,
Largely because of a lack of training in things like neuroanatomy.
So it's really important if we're going to be talking about the brain-body relationship that we actually have an understanding of the brain-body relationship.
And I do think it's helpful for everyone.
And even though you might just be a parent If you aren't listening to this It's important that we're actually questioning and pushing back and doing our own research.
Even for you,
Go back and look at the research.
Push back against me.
I think that that's really important.
I think we're losing this battle.
Critical thinking skill in the first place,
To be very honest,
Just because we are using AI and all of these other things and then the algorithms.
And so just these popular theories are getting pushed more and more and more everywhere we look.
So we just need to start using our own brain a little bit.
But when we're looking at credibility,
There's a lot of citation issues within Porge's work as well.
So it's not just the theory that he's developed.
When we look at his actual citations from which he built his theory on,
Is really problematic.
He cites the wrong journals.
He cites incorrect authors.
He misrepresents other people's work.
That's a problem,
Right?
And Porteous isn't the only one.
I'm not just picking on him.
We all need to make sure we're being our own little scientists and looking at this.
So when those scientists you're building your work off of says you're getting it wrong,
That's a big red flag,
And that's what happened.
The other scientist that he was referring to was like,
No,
That's not at all what we're saying.
That's complete misinterpretation of our work.
It's really important we're doing our research.
This whole theory really relies on an outdated evolutionary principle,
One that was actually dismissed over a hundred years ago.
That's what the whole theory is based on.
So,
You know.
Some big problems out there.
But it's still uber popular.
There are some strategies that do actually work.
We just want to make sure that we understand it's not what is working.
It's not because of the polyvagal theory being right,
Okay?
So I think that that's really important.
Let's look at why some of these techniques do work.
Okay?
Because some of them do.
It's just for the wrong reasons.
So instead of focusing on vagal toning,
We can think more broadly of helping the body move towards balance and regulation.
That's what we need to work on.
So now I talk a lot about not using breathing,
For example.
Check out my previous episodes.
I've got a lot where I focus on breathing becoming problematic when we use it at the wrong time,
When we're trying to get people to calm down.
Trying to get kids to calm down or,
You know,
Before they do anything.
We just want to make sure we're not teaching the wrong lessons to kids.
But I will say we know that slow,
Deep breathing,
Especially with a long exhale,
Is helpful.
Now,
Porges would have said that breathing moves you up the safety ladder.
But when we're actually seeing what's actually happening,
It's a more sort of straightforward and I would say better documented sort of approach.
When you take a long,
Slow exhale,
You stimulate these baroreceptors These are pressure sensors in your blood vessels.
So when we signal that,
It triggers this rapid cardiac inhibition.
So what happens is your heart rate slows down.
Your blood pressure drops a little bit.
Your parasympathetic nervous system becomes more active.
So it's just basic cardiovascular physiology rather than some special evolutionary story about the vagus.
That's what's happening.
Breathing works.
It does.
We just don't need to dress it up in some fancy language,
Okay?
So when you understand what's actually happening,
You can be more precise in how you're using it.
You're not guessing about which vagal branch you're activating.
One that I do teach all of the time is mindfulness.
This is a top-down regulation in which your prefrontal cortex,
So your thinking,
Planning part of your brain,
Your self-regulating part of the brain,
It's exerting this inhibitory control over your amygdala.
It's telling your amygdala,
It's not an emergency,
Right?
So it's exerting that control and other deep brain structures that generate defensive responses.
So it's telling the emotional brain,
Hey,
Not an emergency,
You can back off a little bit.
So when we're practicing mindfulness,
We're basically strengthening our brain's ability to put on the brakes on its own alarm system.
So it's not so sensitive and ringing those false alarms all the time.
This fits with another model which I will get into next week because I think it's important to show that there are other models out there.
The problem is research doesn't come out and hit general public?
It takes,
On average,
17 years to hit the general public,
And this is part of the problem.
Why?
Right?
So we want to make sure that we're on top of this,
But I'll come back to that next week.
But really,
The key point of all of this when we're looking at mindfulness,
It's the cortical activity,
So your higher brain managing your lower brain.
Polyvagal theory emphasizes this bottom-up brainstem-driven processes,
But the evidence for mindfulness is all about top-down control.
So again,
We've got to be really careful.
Another one,
Co-regulation.
It's a big one.
I talk about this all the time,
Right?
It's so important when we're looking at emotion regulation.
So the idea that being around a calm,
Safe person helps our own nervous system calm down.
Yeah,
I mean,
This was really a central idea in polyvagal theory and co-regulation is definitely real.
That's really important.
When we use a calm voice,
When we have open body language,
When we have warm facial expressions,
Our eyes are wide.
We genuinely reduce the other's sympathetic activation.
But when we look at the biology behind it,
Again,
It's a complex sort of multi-sensory integration across the cortical,
Limbic brainstem networks.
It's not just the vagus nerve doing this.
Our visual system is reading the other person's face.
Our auditory system is processing their vocal tone.
Our limbic system is processing the emotional content.
It's a whole brain sort of phenomenon.
Pet therapy we know can help through attachment and comfort and co-regulation with another living being.
There are,
Of course,
Somatic practices.
So humming,
We know,
Can be really helpful.
Singing,
Rhythmic movement,
Yoga,
All effective.
Humming and singing are helpful because they use motor pathways of the throat and they modulate respiratory rhythms.
And so rhythmic,
It just like,
Hmm,
Or I was just reading about this voo breath,
Right?
Those things can just help with that.
Rhythmic movement,
It engages well-established physiological reflexes.
Yoga combines breathing and movement and attention just to shift to this Autonomic balance.
All of these things work through the cranial nerve functions and an integrated nervous system,
All of the reflexes that you have.
That are documented independently of polyvagal theory.
Now,
One other angle that I think we should all know about and I still always find fascinating is the role of belief.
I did just talk about this,
But I've talked about it in previous episodes and I've just talked about it here.
But again,
I just want to bring it back to as a reminder in case you haven't listened to it.
So I talked about Keller's work,
Right?
Thinking about stress.
Crumb's research,
When people believe that they drank an indulgent,
Fattening,
Sugary,
Calorie-laden drink,
They showed significantly different hormonal responses than people who thought they drank a healthy shake.
Right?
But they had a very different physiological response,
Right?
Everything that was going on in their body based on their belief.
Or believing stress is a helpful thing,
You know,
Living healthier and longer than people with low stress,
Right?
So those are just a lot of examples.
So when someone does a breathing exercise and believe they're activating their ventral vagus,
Right,
It has nothing to do with the ventral vagus,
It's just the belief itself that could be part of what's making that intervention feel effective.
But I also know a lot of people who are dead set against breathing,
So it's not going to be effective.
So it's kind of like that placebo effect.
Either way,
Our brain is responding to the narrative that we have about that strategy.
We know that breathing exercises work well because of real physiology,
And the belief adds that additional layer of effectiveness on top.
But and this is why I wanted to have this episode today.
We just don't want to build.
This therapy on inaccurate biology just because the belief is powerful.
We need to make sure we're actually having true explanations and true understandings of what's going on because that's just as reassuring and empowering as well.
And it's more than just getting the science right,
Too.
There are actual risks if we're using polyvagal theory.
There's a medical safety concern if you believe that fainting or having a dramatic heart rate.
Dropping are always a dorsal vagal shutdown,
Right,
A psychological response to a perceived threat.
We might not actually look for medical conditions.
Like maybe there's vasovagal conditions where people pass out,
Right?
It's a common medical condition where they're just fainting because of a reflex arc that's happening.
It's often triggered by anxiety,
But it could be pain,
It could be standing too long,
And that these things happen.
But it really does need medical evaluation.
Sometimes it needs medical treatment.
So if we're just labeling everything as dorsal vagal collapse,
And we're always working on this trauma response.
We could be missing something that actually needs a medical doctor's attention.
So we just want to be careful.
And like I said,
We really want to avoid pathologizing normal arousal.
That's really a huge one.
That does way more harm than good because this is where people get hopeless and helpless and they never think they're going to get any better.
And then they're stuck in spirals and they're always thinking like it's just fueling the shame and the blame and everything else.
So if we're teaching someone that any increase in your heart rate or in your alertness means you've dropped into sympathetic activation or you're in a threat state,
You're teaching them to be afraid of their own normal physiology.
You're turning every feeling of excitement,
Into an emergency or every feeling of nervousness,
Which feels the same way as excitement into some evidence that something is wrong.
And then that's why so many people get stuck.
And we know transdiagnostically,
It doesn't matter what people's diagnosis is.
If they believe,
Like.
.
.
Transdiagnostically,
People believe something is wrong with them,
Right?
And we don't want to generate and reinforce that narrative.
Arousal isn't pathological,
Right?
Our brains generate energy to deal with uncertainty,
To prepare for some action,
To facilitate learning,
Just to help us with whatever the situation is.
So getting your heart rate up before a presentation means your brain is doing its job.
It's doing exactly what it's supposed to be doing.
But if you're someone who's been taught that polyvagal ladder,
Then maybe they're interpreting,
I'm dropping out of my window of tolerance.
I'm losing ventral vagal control.
I can just increase their anxiety about being anxious in the first place and make it worse.
And now they really are too overwhelmed and over aroused when it's like,
Okay,
No,
I know what my body's doing.
I know what's going on.
And if you are a therapist,
You know,
If people find out that everything you're doing and everything that you taught them is wrong,
I mean,
That's a problem too.
So,
You know,
There are some beneficial pieces,
It's just for the wrong reasons,
Right?
And even with parents,
You know,
If kids find out you're wrong,
Because you've been teaching this,
And now you're like,
Poor just doesn't know what he's talking about,
Or this ladder thing is so stupid,
Whatever.
They already think our advice sucks.
This is just gonna make it worse.
So all this to say,
I mean,
The problem is,
It's just become too overgeneralized.
That's the problem with polyvagal theory,
Really.
It's become too overgeneralized.
We can't reduce,
Our entire complex nervous system into a simple ladder.
Right?
And,
You know,
It just ignores the fact that you can feel alert and safe at the same time.
You can be physiologically calm,
But in this emotionally numb sort of state,
Right?
There's a lot more to think about,
But I wanted to leave it there for today just because I know that this has become a huge debate and I had some questions about what I thought about it.
So,
You know,
I wanted to share my thoughts about it.
It's just a big message here,
Really,
And that's to be careful.
Just be careful.
There's so much incorrect information out there,
Especially when it comes to things like anxiety and emotion regulation.
So we just want to be careful.
Next week though,
Tune in,
Because I'm going to go into what we know actually works as of now,
Based on our understanding right now,
And give you a better theory that does take into account sort of everything that we know about neuroanatomy and addresses some of the things that we talked about today.
So help those kiddos be bold and courageous.
Hopefully this episode was helpful.
If you found it helpful,
And I will talk to you next time or I'll see you next time.