Polyvagal Theory - tips for nervous system regulation during trauma therapy
By a trauma therapist in Denver, Colorado
If you’ve ever had a panic attack or trauma response, you’ve likely been told to take deep breaths to try to decrease the intensity of the experience. Maybe you’ve rolled your eyes at this or dismissed it as a lazy technique used by therapists to give you something to do when these responses occur. Or maybe you figured it was a distraction method to get you to focus on something other than the feelings that accompany these experiences. It’s possible you even felt invalidated or dismissed by the person suggesting this. It would be understandable if you had any of these responses, because not everyone explains how and why deep breathing works to regulate our responses to distressing situations or memories.
When it comes to trauma therapy and healing PTSD a lot of the focus gets put on the cognitive reprocessing aspect of trauma treatment.
While this can be an essential part of working on resolving trauma, we cannot separate our brains from our bodies.
As a matter of fact, ignoring the physical aspect of trauma responses could increase the intensity of therapy and decrease our tolerance for distress as we work through distressing memories.
Polyvagal theory and the associated techniques help bridge the gap between the cognitive aspect of trauma treatment and the physical responses that are often experienced between sessions. This theory is based on observations of the nervous system as it observes and responds to threats in the environment. Specifically, it is a theory about regulating the physiological responses to perceived threats.
What are physiological responses?
So, what does all that mean? Basically it means that Polyvagal Theory focuses on the increased heart rate, dry mouth, pit in the stomach, sweaty palms, and fight-or-flight of it all. These are physiological responses, meaning they involve one of our five physical senses. These responses are signs that our body is getting ready for some kind of action. Instead of putting energy towards digestion, salivation, or conversation, our body starts preparing us to flee, fight, fawn, or freeze. It pumps out adrenaline and gets our body ready for some kind of survival mode.
This is great when there’s a physical threat we need to protect ourselves from, however, when it is in response to a non-threatening trigger such as a distressing memory, these responses hijack our brains.
This hijacking shuts off the prefrontal cortex, the part of our brain used for reasoning and deliberate decisions, and gives all the energy to the amygdala, the part of the brain responsible for emotion. This cycle reinforces our response to the initial trigger, signaling danger, sometimes in response to something that won’t physically hurt us in that moment.
The Vagus Nerves
Polyvagal sounds really fancy and complex, but it just means “many vagus''. In this case, it is talking about the system of vagus nerves that run between our brain and our organs. These nerves send messages to and from our organs, such as our stomach or lungs. There are four vagus nerves taking messages from the organs to the brain and one sending messages from the brain to the organs. This means that the brain is receiving four times as many messages from our body than our organs are from the brain. It is set up very well to circumvent the trauma responses to triggers that are not an immediate danger.
It works best if this system is primed, so to speak, by co-regulation during childhood. Co-regulation is when parents or caregivers create ongoing safe social experiences and demonstrate attunement with the child’s needs.
Co-regulation can be as simple as picking up a crying baby to soothe it, or as complex as leading a child through breathing exercises after an injury. This builds distress tolerance and feelings of self-efficacy during difficult situations, leading the child to believe they can safely feel their own emotions and do hard things.
We can still learn to self-regulate even if co-regulation wasn’t a part of our childhood. Safe relationships, therapy, practicing meditation, deep breathing, and other polyvagal activities can help increase our distress tolerance and decrease the intensity of the trauma response.
How does it work?
Here we are back at deep breathing.
Breathing in and out deeply, with each inhale and exhale lasting a minimum of five seconds, can lower your stress hormones, slow your heartbeat, and soothe your mind and body. The deep breaths expand the lungs and diaphragm, pressing the organs against the vagus nerve, and sending a message to the brain that all is well.
After all, deep breathing is something we do when we’re relatively relaxed, or even sleeping, not when faced with, say, a T-Rex.
Activating the vagus nerve through regular practice of the activities listed below can help decrease anxiety, depression, trauma responses, and panic attacks.
By soothing the nervous system and activating the vagus nerve, we can strengthen our nervous system regulation and increase our distress tolerance. Being less on edge means that we are better able to distinguish non-threatening triggers from threats that need a fight-or-flight response.
Polyvagal Self-Regulation Activities
In addition to deep breathing, the following activities help with self-regulation and distress tolerance. They are especially helpful to practice between sessions of trauma therapy, as they can help decrease the response to memories, dreams, and other triggers.
Cold Water Application: exposing the body to cold water or cold air for as few as 30 seconds stimulates the vagus nerve, decreasing the nervous system activity that keeps us on high alert.
Mindfulness-based Movements: Mindful physical activity involving social engagement helps us safely shift from the aroused state induced by the activity to calmer, less aroused states.
Humming, Singing, and Gargling: These activities cause vibrations in the vocal cords and eardrums, which can directly stimulate the vagus nerve.
Remembering Pleasant Events: reminiscing about moments where we felt safe, loved, or content can stimulate the release of oxytocin, a hormone that helps calm and relax a person during stressful moments. Imagining spending time with trusted people who make us feel safe and loved can also stimulate this hormone and encourage our social engagement system.
Playfulness - playfulness is necessary in a world full of stress and triggers. Engaging your playful side through daydreaming, writing, art, a friendly sporting activity, or playing with pets helps engage the vagus nerves and release tension.
Visiting Calm, Soothing Places: When we are in an environment that we perceive to be safe, our vagus pathways slow our heart rate and inhibit our nervous system responses. This also stimulates growth and restoration in our body. When we feel safe, we can heal and relax. Our systems can return to baseline functioning when we are in non-threatening environments.
How to get started
Polyvagal theory and practice can seem overwhelming and complicated at first; however, you can start practicing these activities very simply. Setting aside three minutes to focus on breathing deeply or turning up your favorite song and singing or dancing along are good, simple places to start. Incorporating these into your life daily with the help of a trauma therapist can decrease reactivity to triggers between sessions of trauma therapy. Plus, singing and dancing along to your favorite song is fun!
