The month of June gifted me the opportunity to be in the presence of two incredibly inspirational people whose work is really pushing forward the way that we view health and wellness. Not only did I get to hear Dr Gabor Maté discuss the links between emotional repression, chronic illness and unhappiness, I also got to listen to Dr Stephen Porges talk at the House of Lords during a parliamentary event on “The Neurobiology of Social Connectedness” (huge thanks to the efforts of Heather Mason for making this event happen).
[As an aside, Lord Richard Layard was also in attendance at this meeting. Another trailblazer, Layard wrote the best-selling book Happiness: Lessons from a New Science, and a follow-up on the topic of mental health called Thrive. He has had huge influence in making psychological therapy more widely available in the NHS (he made the economic case for IAPT - Improving Access to Psychological Therapies, the NHS service that provides treatment for common mental health difficulties. Prior to the implementation of IAPT, NHS support for such patient needs was sparse, if any) and is co-founder of Action for Happiness, an international movement to promote a happier way of living. I think he's too cool not to mention, but for now, back to Porges].
Dr Porges is Professor of Psychiatry at the University of North Carolina and “Distinguished University Scientist” at Indiana University, where he has created the Traumatic Stress Research Consortium. His research has spanned a breadth of subjects however of most interest to me and my work is a theory that he proposed in 1994 – the Polyvagal Theory.
The vagus nerve is a major nerve of our autonomic nervous system (ANS). The ANS can be thought of as broadly split into the sympathetic and parasympathetic branches. It is responsible for a range of things including the way that we respond to situations. These evolutionary programmed responses include (1)‘fight or flight’, the response governed by the sympathetic nervous system, that allows us to muster all of our resources to run away from or fight a threat that we feel we can escape from, and (2) shutdown, governed by our parasympathetic nervous system, that can allow us to dissociate (and thus protect ourselves psychologically) from distressing experiences and immobilise us so that we may remain motionless - a defence strategy which may be the only smart option in the face of grave threat to our survival that we can't escape from. Both of these responses are hardwired and adaptive in that they are designed to maintain survival, protect us and keep us safe.
Shutdown is the domain of the vagus nerve and understanding this response can help people work with feelings of trauma-related shame by providing an explanation for why they may have entered a state of dissociation and didn’t, or rather, due to our biological programming, couldn’t fight back.
Besides shutdown, Polyvagal Theory suggests that in mammals and humans, the ANS has evolved by developing a second branch of the vagus which enables us a third response, one based on social connectedness. This branch of the vagus serves a social engagement system – it allows us to emotionally relate to others as we are facially expressive, we are more easily able to listen and understand others, our heart rate is slower and our body feels relaxed and calm.
Porges discusses neuroception – the constant, unconscious processing of information coming from the environment and the body used to evaluate safety and threat (this is distinct from perception). Neuroception leads to a dampening down of our fight / flight and shutdown defensive systems and facilitates social behaviour in situations of safety. Whilst in situations of threat, neuroception promotes our defensive strategies of fight /flight to mobilise ourselves for action or shutdown to immobilise.
Porges suggests that we can become numb to or learn to reject these neural signals and that neural exercises such as yoga, mindfulness, breathing exercises, singing (both of which are inherent in yoga practise) via the vagal system have the capacity to reconnect the body and brain, and connect individuals via their social engagement system. In other words, they are practises with which we can regulate our physiological state. Porges's theory explains why slowing the exhale has the effect of calming via activation of the vagus nerve. Porges states that teaching people how the way that we breath relates to mood and anxiety states and teaching them how to breathe in a way that activates the vagus nerve is an excellent resource and this is certainly reflective of my experience in my client work.
If you’re interested to learn more about this, Porges has shared his findings and their implications for health care via many research papers, books and talks that can be viewed on You Tube.