How Psychotherapy Networker Symposium Presenters Misunderstand Polyvagal Theory

Attending the 2013 Psychotherapy Networker Symposium in Washington DC March 22-24, I was very impressed at the number of participants, quality of presentations, and the joyful community spirit that pervaded the event.

I was paying particular attention to how many people were familiar with Polyvagal Theory and its very significant implications for counseling. If I could fine-tune the message based on this experience, I would want to address three particular areas:

  1. Differentiating Normal Function from Stress Response. I heard several comments still characterizing the autonomic nervous system as “Fight/Flight” vs. “Rest & Rebuild.” The new understanding is that these are different categories. The Normal Functions refer to the baseline involuntary states of daytime alertness vs. night-time unconsciousness. Both are essential for optimum life functioning. The Stress Responses refer to the familiar Fight/Flight vs. Collapse and Dissociation. Recognizing whether the client is in a Normal Function vs. a Stress Response is central to effective body-centered counseling because this information guides which strategies might be deployed therapeutically.

  2. Understanding the sequential nature of the autonomic nervous system. In the old model (100 years old, as I learned during the weekend), the two branches sympathetic and parasympathetic alternate and complement each other. In the new model derived from Stephen Porges, there are three branches and appear as a sequential cascade from phylogenically newer to older. In the new model, under novelty or threat we play our newest card first (Social); if that doesn’t work we try our older more primitive strategy (Sympathetic), and if that doesn’t work we are left with only one card to play, the oldest and most primitive (Parasympathetic). In this model the Parasympathetic is the most dangerous and intractable, and the therapeutic intention is actually to re-establish the upper more modern responses via social contact and movement.

  3. The ventral vagus (“smart vagus”) was repeatedly characterized as parasympathetic. As the table above shows, the ventral vagus does not really qualify as parasympathetic; instead, it needs to be considered as something else, and in a category with other involuntary nerve groups with similar physiology. Porges’ descriptions identify a third category, not the same as either sympathetic or parasympathetic. The Social Engagement System, including especially five cranial nerves and unified in the core by the corticobulbar tract, is really its own system, forming a super-function that defines the “window of tolerance” containing experiences in neither hyper- or hypo- dysfunctional states.

John ChittyComment