Introduction to Polyvagal Theory (PVT)

 Polyvagal theory (PVT) is a multi-disciplinary approach to understanding the effect of trauma on the body and mind.  The term “poly” is used here to denote the two branches of the Vagas nerve, a dorsal primitive branch that is unmyelinated, and a ventral branch that develops after birth and is tied to volitional motor function, primitive instincts, and social behavior. (Porges) While complex, the theory describes a more primitive “dorsal vagal complex,” tied to patterns of “immobilization and freezing” which result in elevated levels of stress, social anxiety, fear, anger, and dissociation.  Polyvagal theory stresses the importance of the Vagas nerve as the primary part of the parasympathetic nervous system (PANS).  Vagal tone is a descriptive term for the body’s ability to adapt to stress and describes the ability to self-soothe and return to a calm baseline. 

The Bibliography

In lieu of a references page for each blog post, I have a included the references for the entire subject, to be expanded as content increases. For ease, I reference the last name of the author in the blog paragraph for more important works.

The Role of Primitive Reflexes

The development of the ANS, including proper vagal tone and a healthy fight/flight/freeze response, is dependent on primitive reflexes that present in the earliest life stages. Primitive reflexes are innate, instinctual, and involuntary movements that initially offer protective movements to sensory stimuli (Pryor). More simply, they are life-saving movements to protect us from harmful sensations. The withdrawal from a hot object wasn't learned—it is a reflex.

The Intersection of TCM with Polyvagal Theory

 In both adults and children, retained reflexes mobilize qi and blood into the large skeletal motor muscles to prepare for flight. These large skeletal muscles correspond to the Yang channels in the body. Strong patterns of spasticity are observed directly in the fascia and often do not resolve with appropriate treatment. Additionally, adult survivors of childhood trauma exhibit long-term issues of malabsorption, middle jiao deficiencies, and autoimmunity that appear to be due to long-term inhibition of the enteric nervous system and involution of the thymus.

The Role of Primitive Reflexes in Personality Development and Emotional Regulation

It was previously believed that these reflexes nearly always integrate in childhood and are largely ignored in western medicine unless needed to rule out an upper motor neuron defect such as a stroke or to establish brain death.   New data have emerged, however, that primitive reflexes are NOT always integrated in childhood, are reactivated in any kind of trauma and can remain active for years following a traumatic event in both children and adults (Mastagova). For the purposes of this discussion, it is helpful to clarify what is meant by trauma, since it is unique for each person.  Trauma, simply put, is any physical or emotional event that overwhelms the buffering capacity of the nervous system to maintain a sense of calm and to maintain an optimal environment for growth, rest and repair. Trauma is an internal experience in chemistry and emotional hormones, modulated by the ANS.  The buffering capacity of the nervous system is created in childhood.  

Timeline of Somatic Therapy and Bodywork Styles

Psychotherapy has undergone a fascinating evolution, expanding from its early roots in talk therapy to increasingly incorporate body-centered and movement-based approaches. In the early 1900s, pioneers like Frederick Matthias Alexander began exploring the connection between the body and mind, leading to the development of somatic therapies. Over time, various body-oriented techniques emerged, such as Feldenkrais Method, Bioenergetic Analysis, Somatic Experiencing, and more. These methods acknowledged the importance of the body in emotional well-being, addressing trauma and personal growth through a combination of touch, movement, and mindfulness.  

Challenges in Modern Mental Health Care: A Critical Look at Current Practices and Limitations

As both a survivor of severe relational and developmental trauma and a practitioner of integrative medicine with over 20 years of experience treating trauma survivors, my first reaction to PVT was “So what?”  Years of extensive study and investment in various modalities for myself led me to question its contribution to therapeutic interventions. Polyvagal Theory sheds light on the extreme states of freezing and social discomfort experienced by many trauma survivors. Yet, while it provides a physiological pathomechanism, it doesn't offer new therapeutic interventions outright. This realization prompted me to explore broader challenges faced not only by trauma survivors but also by healthcare professionals navigating their own traumas within a demanding medical system. (1)

Further on the Developments for TreatingTrauma

The understanding and treatment of Post-Traumatic Stress Disorder (PTSD) and Complex Post-Traumatic Stress Disorder (C-PTSD) have significantly evolved over time. Here are some major milestones in the evolution of PTSD and C-PTSD treatment:

Understanding the Intersection of TCM, PCT and Neuorocience

The integration of Polyvagal Theory, Traditional Chinese Medicine (TCM), and modern neurological concepts provides a comprehensive framework for exploring the interconnectedness of various disciplines in healthcare. By examining the core principles and interrelationships between these fields, practitioners can deepen their understanding of the body's systems and develop more effective, holistic approaches to well-being. Polyvagal Theory serves as a foundation for understanding the role of the nervous system in emotional regulation and overall health. The vagus nerve plays a critical role in connecting the body's systems and maintaining balance, making it a vital component in both TCM and modern medicine. 

 The clinical applications of Polyvagal Theory emphasize the need for trauma-informed care and a holistic approach to treatment. Incorporating modern neurological definitions into TCM theory further highlights the connections between meridians, Sinew Channels, and myofascial pathways. This integration of knowledge enhances our understanding of the body's interconnectedness and the importance of a multifaceted approach to health. Practical applications, such as therapeutic protocols and the cultivation of Qi, provide practitioners with essential tools to optimize their practice. Additionally, the exploration of earthing offers further insight into the complex relationship between the body and the natural world. In summary, the convergence of Polyvagal Theory, Traditional Chinese Medicine, and modern neurological concepts contributes to a more profound understanding of health and wellness. By embracing a holistic perspective and integrating various disciplines, practitioners can better support their patients in achieving optimal well-being.

The Enteric Nervous System: An expanded View of the Spleen and Stomach

The Enteric Nervous System (ENS) is the most extensive and intricate part of the Autonomic Nervous System (ANS), consisting of approximately 400-600 million neurons. Present in two primary networks—the myenteric and submucosal plexuses—the human ENS begins its development during the gestational period and experiences its most active growth state peri-natally through the first year of life. (Waxenbaum JA, [Updated 2023 Jul 24])