Trauma, anxiety and Polyvagal Theory – tools for recovery

Hello,

In this blog, I’m going to look at our innate responses to risk, threat, and danger. I will do this through Polyvagal Theory which is used for working with trauma but also offers useful tools for any of us to use when we feel anxious, dysregulated, or overwhelmed.

Polyvagal theory is all about safety and how the vagus nerve reacts to it. Humans are born wired for connection because we are safer when we are connected to others. Our autonomic nervous system is always monitoring our safety or risk, often without our conscious awareness. The developer of Polyvagal Theory, Dr. Stephen Porges, calls this “neuroception”. Our neuroception alerts us to danger and is therefore vital but it is possible for it to become heightened and give us false signals. Our neuroception can be on overdrive and we need to calm our nervous system before we can utilize our perception to organise, identify and interpret the information.

The vagus nerve is divided into two parts, the ventral vagal pathway (unique to mammals) and the dorsal vagal pathway (which developed earlier in evolutionary terms). When we feel safe, connected, and social, our ventral vagal system is in charge. The dorsal vagal pathway responds to danger. When we have a neuroception of danger, we move from safe and social to mobilised (fight or flight) ready to take action to return us to the safe and social state. If we feel trapped and unable to take action to escape the danger, we become immobilised (freeze) and shut down to survive.

Deb Dana uses the imagery of a ladder to describe the three states. At the top of the ladder, we feel safe, we tune in to conversations, our heart rate is regulated, we breathe fully, may feel happy, interested, and peaceful. At the top of the ladder, we can see the big picture, the world, and people around us. We can feel productive at work, we can do things with others, we are organised, we are regulated. Health wise, we have a sense of wellbeing, a good immune system, we sleep well and can take care of ourselves.

When something triggers a neuroception of danger, we go into flight and fight action as we move down the ladder. Our heart rate speeds up, our breathing becomes short and shallow, we feel the mobilising rush of adrenaline, we feel anxious, and we are alert to danger. If we stay in this mobilised state, we may experience panic attacks, anxiety, outbursts of anger, inability to concentrate. Health wise, we can experience sleep problems, memory issues, headaches, muscle tension, stomach problems and be vulnerable to illness.

If our action taking does not work and we are trapped, we cannot move ourselves back up the ladder. We fall to the bottom and immobilise. Here we become numb, we shut down to others, we dissociate from the world. We might feel too exhausted to act, hopeless and abandoned. This can lead to depression, isolation, memory problems and no energy for day-to-day tasks or to care properly for our health.

Text Box: At the top of the ladder feeling safe, connected, productive and regulated. Ventral vagal.
Text Box: At the bottom of the ladder feeling disconnected from everyone and everything. Freeze.
Text Box: The middle of the ladder feeling anxious and mobilised to act on the neuroception of danger. Mobilised. Flight and fight.

We move between these states frequently during a day but usually it doesn’t take much conscious effort to get back to the top of the ladder. Imagine, setting off for work, your morning has started well, and you are in ventral vagal state at the top of the ladder. Suddenly you encounter a huge traffic jam, it’s not moving and as the minutes tick by you realise you will be late for work. You move down the ladder into mobilise. At this point you are primed for action. You might remember an alternative route, take it, and quickly move back up the ladder to ventral vagal. If you can’t take action, you may move further down the ladder into immobilise. You think, “What’s the point, I’m late now, all I can do is sit here”. Usually then we can move quickly back to mobilise and plan how to mitigate this disaster when we finally get to work. These moves between state may happen several times a day, we navigate them well and get on with our day.

However, what happens when our neuroception is on overdrive because either the threats are real and huge, because there is little we can do to solve the problem or get away from the risk or if the threat is not in our here and now but rooted to incidents in our past? If we are not to become trapped in this level of anxiety or sink further into an immobilised state, we need to find ways to calm our autonomic nervous system. It’s likely that each of you already has some great ways of doing this and I wrote about some of these in my anxiety blogs.

You may also find it useful to have some safety cues that can help lead you back up the ladder. These can be things you physically do or replicate to help, or they can be used at any time through activating a memory. Deb Dana suggests finding your safety cues in the categories of who, what, where and when:

Who – people (or animals) who make you feel safe. They can be alive or dead, you may know or have access to them or they may be people you haven’t met or spiritual figures. You can have several for different reasons or moments.

What– what do you do that feels nourishing, that makes you feel on the top rung of the ladder? Exercising, music, cooking, gaming, sleeping, talking, singing, art?

Where – where are the physical spaces that feel safe to you? Your home, the beach, the countryside, the football pitch, the coffee shop, the car, your bed?

When – when do you feel at your best? What time of day? Early morning, climbing into bed, after the kids are asleep, Friday evenings?

It can be useful to reflect on your own safety anchors and practise activating the memories to use as cues to calm you when you are in situations where feeling mobilised to fight or fly is not helpful.

It is all about what works for you. If you can listen to your neuroception and know where you are on the ladder at any given time, you can learn who, what, where and when is and isn’t helpful to you when trying to return to ventral vagal state. You may also recognise a time of overwhelm, when you are finding that you are unable to activate your ventral vagal state and you feel continually mobilised or immobilised. They are the signs that you need to take time for yourself and seek help. It is also useful to reflect and recognise that this can happen to any of us and that we can recover and heal with the right help.

I hope this has given you another way of thinking about our common experiences. I find the ladder imagery useful both for my own noticing of where I am, but also as a common language for talking with others.

Warm wishes,

Alyson