Book Review: The Pocket Guide to the Polyvagal Theory
I came across the polyvagal theory some time ago in my ongoing study of finding ways to help people recover from trauma. I have come to realize that there is so much to this theory that pervades all of our behavior and feelings. Stephen Porges’ polyvagal theory is truly phenomenal.
Porges’ book, The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe is another in the Norton series on interpersonal neurobiology and was written to give a nontechnical overview of the theory. It is organized in the form of edited interviews and conversations, mostly with Ruth Buczynski of the National Institute for the Clinical Application of Behavioral Medicine.
The book begins with an extensive glossary of the terms used in polyvagal theory and a chapter on the neurobiology of feeling safe. Porges writes about the evolution of his theory over the course of his career, which began in in the 1960s in psychophysiology and the study of heart rate variability.
Porges’ research helped move psychology from a focus on solely behavior and the cognition to also include feelings and feedback from the body. Eastern philosophy has long recognized the oneness of mind and body, but the polyvagal theory has helped the Cartesian west move into recognizing that the dichotomy of mind and body is false. Polyvagal theory is revolutionary in many ways and Porges’ scientific research has had an exceptional and positive effect on trauma treatment.
The theory has made the workings of the autonomic nervous system and the social engagement system much clearer. The autonomic system is not the classic on/off of the sympathetic and parasympathetic systems. It also includes workings of the myelinated mammalian ventral vagus, primarily connected to the organs above the diaphragm and the unmyelinated reptilian dorsal vagus, primarily connected to the organs below the diaphragm.
We have two defense systems. We are wired to seek safety and to survive. The vagus nerve is the tenth cranial nerve, it also regulates our facial muscles and allows us to give feedback to each other about our intentions. For example, in play, we know when someone crosses the line into aggression by the interplay of the vagal systems of the players. It reminded me of sports psychology research that showed how when young children are left to themselves they develop play that is inclusive, cooperative, and safe. When adults get involved, it becomes competitive and exclusive.
“The face-heart connection provides humans and other mammals with an integrated social engagement system that detects and projects features of ‘safety’ to conspecifics through facial expressions and vocalizations that are covariates of autonomic state,” writes Porges. How we look, vocalize, and listen “lets us know whether we are safe to approach.” Feeling safe is the key to our being, and the polyvagal system is instrumental to that.
The vagal nervous system is also involved in our middle ear, and Porges has a system called Safe and Sound Protocol that uses the vagus for treating anxiety, trauma, attention issues, autism, borderline personality disorder, and more.
Porges also address the problems with behavioral diagnoses. Diagnoses seem to be more important for billing than for understanding underlying effects. There are underlying shared effects and processes among several psychiatric diagnostic categories, like being highly sensitive to noise with resulting flat facial affect, poor vocal prosody, and dampened vagal control of the heart.
Porges writes that he composed this book with the “hope that furthering an understanding of our need to feel safe will lead to new social, educational, and clinical strategies that will enable us to become more welcoming as we invite others to co-regulate on a quest for safety.”
I hope that polyvagal theory becomes common knowledge over time and finds its way into areas like politics and governing, education, and economics. I thought of the zero sum assumptions of game theory, and the individualism of neoliberal economic theory as I read this. We do best when we work together and achieve more when we feel safe. So much of our culture is based on feeling unsafe, and thereby causing others to feel unsafe.
For an introduction to the theory and to Stephen Porges, his website includes articles, interviews, webinars, podcasts, body perception questionnaires, and more. And I encourage you to read this book. I do hope that subsequent editions may include an index. That was my only disappointment in an otherwise remarkable book.
The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe
Stephen W. Porges
W. Norton and Company
288 Pages, Softcover