The Polyvagal Ladder

When I first wrote about the polyvagal theory I didn’t expect you to be interested. But there has been an ever increasing demand for more information, so here it is. We are still leaving out most of the neuroscience behind the polyvagal theory to make it easier to work with.

 

People used to think that our autonomic nervous system was made of 2 subsystems, the sympathetic nervous system (SNS) and the parasympathetic nervous system (PSNS). The PSNS is represented by the vagus nerve. Porges revolutionary discovery was that the vagus is actually made of different parts that come from different areas in the brain. The ventral part covers the functions in face, brain and heart, the dorsal vagus reaches down to the intestines (ventral and dorsal are just fancy words to say that one is more in the front and one more to the back).

We will be looking at these 3 systems, ventral vagus, SNS, dorsal vagus, in the context of stress responses.

 

The polyvagal ladder

There is a set order in which our body will react to stress.

We are moving from calm& socially engaged (ventral vagus)

to flight&fight (SNS)

to shut down&dissociation (dorsal vagus).

 

 

 

The ventral vagus – social engagement system

Because we know that this can be difficult to teach to Littles we call the ventral vagus Bob. He is a social guy who likes to be around people, communicates well and helps us to feel connected and like we belong.

Bob is active when we feel safe. The felt safety is more important than actually being safe. So when we are in a tricky situation but we are with people we trust we might be able to stay calm.

When Bob is active we

• are relaxed,
• our heart rate slows down,
• we take full deep breaths into our belly
• our blood pressure goes down and hormones are balanced
• we show facial expression while talking with prosody
• make eye contact (and interpret eye contact from others correctly)
• and even make safe body contact,
• feel drawn to engage with other people,
• tune out other sounds to focus on human voices
• and register cues for problems correctly without losing our calm
• ….
• ….

Bob is a smart guy. With him we are able to

• pay attention,
• talk&listen
• learn and
• solve problems
• in collaboration with others
• while being able to sit still

This really matters in school or at work.

Other people have a Bob too and when all Bobs are active we feel safe and maybe even happy and like we belong. We end up giving and taking in our relationships with regulated people.

In this state we tend to see interruptions as either neutral or unimportant. That is because “the story follows the state“. When we interpret a situation the narrative we are creating is within the safe circuit.

Within this safe&socially engaged state our body uses its energy for health, growth and restoration.

This is the top of the polyvagal ladder, the place we are aiming for. An active Bob feels good and is healthy for our body, because energy can be used for restoration.

 

 

The sympathetic nervous system – flight&fight

When we pick up cues that we are not safe our stress levels rise and we step down on the polyvagal ladder. The focus moves from our face and heart to our limbs. We call this mobilization system Izzy. She is full of energy that is meant for short and intense outbursts to fix a tricky situation quickly. Izzy will naturally go into flight first and see if she can create some distance to what she perceives as danger. If there is no option to get away or we were raised in a certain way, Izzy will jump right into a fight.

When Izzy is active we

• have a higher heart rate/ blood pressure
• breathe faster,
• sweat
• have stress hormones flooding us
• our eyes go wide
• our pain tolerance goes up
• and our muscles get tight
• we speak louder and faster
• can’t feel complex emotions and
• if we have facial expression at all it reflects fear or anger
• ….
• ….

Izzy is strong but her interests are pretty limited. Unlike Bob she is not good with communication and she might hear human voices without comprehending what was said or not hear them at all.

But she is really good at identifying possible danger and dealing with emergencies. Because the story follows the state her interpretations of a situation might lead to her judging, attacking or blaming others when there really was no threat and she gets offended by small interactions that Bob would recognize as sarcasm or unimportant. (Ts should be careful not to try humor on Izzy, she often can’t handle that well).

Izzy is meant to be active for short periods only, but with a background of cPTSD we are often stuck with her and don’t see much of Bob.

It is what creates chronic anxiety and hypervigilance and is probably the reason for chronic pain issues like fibromyalgia.

Izzy doesn’t just cost our body a lot of energy, she is also bad for our relationships. When people see Izzy, all tight and stressed and without a pleasant facial expression, their Izzy gets activated a little and they back off to return to a calm state of Bob. We look like a threat to them. We on the other hand might keep distance from people instinctively and social engagement is lost.

 

 

The dorsal vagus – shutdown &dissociation

When arousal levels rise even higher we take another step down the ladder. We might actually have a sinking feeling in our guts. That is where we meet the immobilization caused by the dorsal vagus that we will call Moe.

Moe isn’t about emergency management anymore, Moe is mere survival. This is where we go when escape is impossible and we are helpless and overwhelmed. Moe is also called the freeze response and includes dissociation. We will stick to the idea of shutdown because we can enter this state without an obvious feeling of dissociation or literally freezing.

Moe shows in

• a drop in heart rate/blood pressure
• feeling cold, from the inside out
• shallow breathing up to apnea
• no movement, stiff
• possible loss of muscle tension
• high pain tolerance
• numbness
• hopelessness & shame
• avoiding eye contact/ looking down
• sitting slumped over
• eyes looking ‘dead’ or distant
• no facial expression
• no more speaking/language skills
• no social exchange
• ….
• ….

Moes brain functions are even lower than Izzy’s. We might get disoriented and unable to keep track of time and our memory is only picking up bits and pieces. That is why our trauma memories are usually so fragmented and why we sometimes remember so little about a therapy session.

Social engagement is practically impossible for Moe. That is why he feels so lonely. Because the story follws the state Moe’s stories are usually about helplessness, overwhelm and shame.

Moe is part of us and his job is to help us die relatively painlessly or give us a chance to escape when dangerously wounded. Like with Izzy it was never meant to be a chronic state. But chronic it becomes when we face chronic trauma.

 

 

When we move down the ladder we lose the functions of the previous stage. When we go into Izzy-mode we lose our ability for calm social engagement and clear thinking, when we hit Moe we lose our ability to actively protect ourselves.

We can learn to move up the ladder and be around Bob more often. It is possible to overcome both chronic Moe and chronic Izzy.

It might be important to know that when we are coming from Moe we have to pass Izzy to get to Bob, just like climbing up a real ladder. It means that we need to enter mobilization to overcome the immobilization so we can enter calm. People who live in a chronically dissociated state often get scared when they run into Izzy and spin back into dissociation to avoid the tricky sensations. Same is true for people who are chronically hypervigilant. Meeting Bob might feel scary and unknown and we might spin back into what feels safely familiar.

That is why it is important to practice climbing up the polyvagal ladder in the presence of a safe therapist who will help and only take small steps.

It takes effort, but it is worth it. We will be able to experience peace, calm, love, deeper friendships and belonging.

All this is a huge part of trauma healing. Some say it is the biggest part.

 

 

You can practice recognizing Bob, Izzy and Moe in yourself or others. It is a fun exercise to try to find them in movie characters first. You don’t have to stick to these names, but it helps if you (and your Littles) and your therapist share a vocabulary to describe these states.

Because it is physiologically more correct and we can add mixed states to explain things like play or intimacy I think that over time the polyvagal ladder might replace or integrate the concept of the window of tolerance.

 

 

More about the practical use of the polyvagal ladder in

The Rhythm of Regulation

 

or „The polyvagal theory in therapy“ by Deb Dana

If you are totally hooked by this topic, listen to the polyvagal podcast

They explain things a lot better than I do.