Polyvagal Theory:A Framework for Healing and Connection
Tera Murray
Northeastern University
UWW Independent Study
Dr. Erica Meiners
April, 11 2025
Polyvagal Theory(PVT), was developed by Dr. Stephen Porges in 1995 during his
presidential address to the Society for Psychophysiological Research. His groundbreaking paper,
“Orienting in a Defensive World: Mammalian Modifications of our Evolutionary Heritage”
(published in Psychophysiology, 1996), proposed a new understanding of the autonomic nervous
system (ANS), by integrating evolutionary biology, neurophysiology, as well as trauma and
behavior. The ANS is part of the peripheral nervous system. That regulates involuntary
physiological processes, including heart rate, digestion, respiratory rate, and stress responses. It
operates unconsciously to maintain homeostasis and adapt to internal and external demands.
PVT emerged from 40+ years of research and has since revolutionized our understanding of the
autonomic nervous system (ANS) and its role in emotional regulation, social behavior, and
trauma recovery.
At its core, the theory explains how our nervous system evaluates safety and danger and
life threat through a process called neuroception- an unconscious detection system that shapes
our physiological and emotional response (Porges, 2011). PVT’s emphasis on-neuroception
explains why certain environments or interactions activate panic or numbness. Recognizing
these patterns allowed me to develop strategies to shift into a ventral vagal state, where healing
and connection become possible.
The ANS is part of the peripheral nervous system. That regulates involuntary
physiological processes, including heart rate, digestion, respiratory rate, and stress responses. It
operates unconsciously to maintain homeostasis and adapt to internal and external demands.
The traditional model of the ANS is described by having two branches, sympathetic nervous
system (fight/flight), activated through mobilization, and parasympathetic nervous system (rest
and digest), responsible for calming the body. Porges expands this by identifying three
hierarchical circuits that evolved in mammals to optimize survival and social connection (Porges,
2011). By recognizing these states, individuals and therapists can better navigate trauma, stress,
and relational dynamics.
Deb Dana (2018) a clinical social worker and author of Anchored: How to befriend your
nervous system using Polyvagal Theory. Dana visualizes PVT as a ladder representing shifts in
autonomic state (ladder can be modified for those who are scared of heights or disabled). The
Ventral Vagal sits at the top of the hierarchy. Moving down the ladder, we encounter the
Sympathetic Nervous System, followed by the Dorsal Vagal Complex. As we descend, the
exercises of PVT become increasingly vital. The characteristics of the three-tiered hierarchy are
as follows:
Ventral Vagal (social engagement)- Promotes safety, connection, and communication.
Physiologically, the ventral vagal regulates heart rate, facial expressions, vocal tone, and
listening. Behaviorally, when active, we feel calm, engaged and able to connect with others.
Feelings of connection are all signs of a ventral vagal state, cultivated by mindfulness, play, and
co-regulation, and a reciprocal influence of nervous systems in relationships (Dana, 2018).
Sympathetic Nervous System( mobilization)- Prepares the body for action (fight or flight)
Physiologically the heart rate increases, adrenaline spikes and muscles tense. Behavior becomes
anxious, angry, hypervigilant or panic ridden.
Dorsal Vagal Complex (immobilization/shutdown)-This primitive survival response
(freeze/collapse), the heart rate slows, dissociation is induced, along with numbness or fainting.
Behavior becomes dissociative or withdrawn.
Deb Dana (2018) visualizes PVT as a ladder representing shifts in autonomic state (ladder can be
modified for those who are scared of heights or disabled). Ventral Vagal is the top of the ladder,
where one feels safe and social, smiling, relaxed breathing. Feelings of connection are all signs
of a ventral vagal state, cultivated by mindfulness, play, and co-regulation, and a reciprocal
influence of nervous systems in relationships (Dana, 2018).
This theory is critical as it helps us humans to attune with our nervous systems. We have
a biological need for connection and co-regulation-which is the reciprocal influence on nervous
systems in relationships. These vital relationships begin in infancy. When a baby is in distress,
they rely on their caregivers' nervous system to regulate their own. When a infant does not
receive the coregulation while in distress, the trauma will disrupt the neural pathways leading to
chronic dysregulation
For me, PVT has been transformative in my own healing journey. During a period of
profound distress, understanding my nervous system's response helped me move from survival
mode toward safety and connection. This personal experience fuels my passion for integrating
PVT into my future clinical practice, alongside modalities like Eye movement Desensitization
and Reprocessing therapy, family systems therapy, and dialectical behavior therapy (DBT).
Polyvagal Theory truly saved my life. During a period of dark dissociation and emotional
shutdown, traditional talk therapy was not enough. Learning about the autonomic ladder, the
three-tiered hierarchical system, and how my body shifted between fight/flight, collapse, and
moments of safety-gave me a roadmap for regulation. Exercises such as grounding techniques,
and co-regulation practices, helped reconnect with my body and rebuild my trust in relationships.
PVT doesn’t just describe trauma; it provides actionable tools for recovery, making it
indispensable in trauma-informed care. As a future therapist specializing in trauma, I plan to
integrate PVT with other aligned evidence based modalities, including:
EMDR is a system that processes traumatic memories, while PVT aids clients in staying “within
their window of tolerance” during sessions to track autonomic states. “Window of tolerance” is
a concept describing the range of emotional and physiological arousal within which individuals
are able to function and regulate their responses to stress.
Family Systems and Co-regulation recognizes that dysregulation often stems from early
attachment ruptures. Using PVT can help families acknowledge their nervous systems response
and practice co-regulation (Dana, 2018).
DBT (Dialectical Behavior Therapy) & Vagal Regulation is a type of therapy that focuses on
helping individuals manage big emotions and improve relationships. PVT’s framework aligns
with DBT, teaching clients to move from sympathetic arousal (panic), to a ventral vagal state
(grounding).
Somatic Practices is an effective way to incorporate art, music, and movement as a way for
clients to access ventral vagal and ground in their body.By mapping a clients’ nervous system
and identifying activation (danger signals) and glimmers (safety cues), interventions can be
tailored to support regulation and resilience.
Despite Stephen Porges’ groundbreaking work and widespread adoption, PVT has faced
criticism. Paul Grossman, author of Biological Psychology, critiques the lack of direct neural
evidence (Grossman, 2007). He assesses that PVT overgeneralizes, believing that not all trauma
fits neatly into the three neural pathways (dorsal, sympathetic, ventral vagal). Lastly, he argues
cultural bias, stating that PVT assumes safety is signaled similarly across cultures (e.g., eye
contact might not be safe for all). Neuroscientist Lisa Felman Barre, argues that PVT
oversimplifies the ANS by proposing rigid hierarchical states (ventral, sympathetic, dorsal),
without accounting for the brains predictive , context-dependent of bodily states. Barrets’s
constructed emotional theory suggests that autonomic responses are highly individualized and
shaped by experience, not fixed evolutionary pathways. She contends that PVT claims lack
integration and modern neuroscience on interoception and brain-body interactions. Georg
Northoff, neurophilosopher and psychiatrist, critiques PVT for neglecting the role in the brain's
intrinsic activity in shaping autonomic responses. He argues focus on peripheral nervous system
reflexes top-down cortical regulation (e.g., reflects an interaction of internal stimuli with
spontaneous produced endogenously), which is critical for understanding trauma and emotional
responses. Porges (2011) responded by acknowledging PVT as a framework, not a complete
science. Integration with other models such as somatic practices addresses gaps. The critiques
highlight the need for more neuroscientific studies to validate PVT’s mechanisms. Integrative
approaches combining PVT with other trauma models to avoid reductionism, as well as ensuring
responsible application to ensure that therapists use PVT as a broader toolkit rather than a
standalone cure.
For me, the lived experience of PVT’s effectiveness outweighs any academic debate..
However, engaging with critiques ensures I apply PVT thoughtfully in my practice. The next
steps for myself and other practitioners who are interested in incorporating PVT into their
practice is pursuing certification in PVT-informed therapy. Dana offers books (The Polyvagal
Theory in Therapy) and online workshops ( Rhythm of Regulation). Polyvagal institute also
provides certifications, webinars, and resources (Polyvagal Institute). Trauma Research
Foundation hosts courses by Porges and other experts. (Trauma Research Foundation). Studying
somatic body based therapies such as yoga as a way to compliment PVT. For foundational
Knowledge, clinicians starting with books and literature such as The Polyvagal Theory (Porges),
and Anchored (Dana). By combining structured education, somatic practices, and
self-experimentation, practitioners can ethically and effectively integrate PVT into their practice.
Polyvagal is more than a clinical tool, it’s a lens for understanding human resilience. By
grounding my practice in PVT while remaining open to critique, I aim to support my clients in
reclaiming safety, connection, and vitality.
Resources
Porges, S. W. (2011). The Polyvagal Theory (pp. 27-58).
Dana, D. (2018). Polyvagal Theory in Therapy (pp. 45-72).
Grossman, P. (2007). Biological Psychology, 74(2), 263-285.
Porges. S. W. (1995). Psychophysiology, 32(4), 301-318.
Barret, L.F. (2017). How Emotions Are Made: The Secret Life of the Brain. Houghton Mifflin
Harcourt. (See Ch. 6 on ANS critiques).
Northoff, G. (2018). The Spontaneous Brain: From The Mind Body to theWorld-Brain Problem
MIT Press.