Stephen Porges 2017 book The Pocket Guide to The Polyvagal Theory is much more readable than his comprehensive 2011 book The Polyvagal Theory. This new book is intended to offer the concepts in the earlier book to a wider audience. The concepts are particularly relevant to those clinicians involved in treating people who have suffered trauma.

A glossary, an explanation and five conversations

The book begins with a glossary of the relevant terms and concepts involved in the Polyvagal Theory. It then continues with one chapter explaining the neurobiology of feeling safe. The rest of the book consists of five chapters. Each of these is the text of a conversation between Dr. Porges and one of three interviewers: a psychologist, a therapist and a massage therapist. This book is subtitled The Transformative Power of Feeling Safe and that’s what the book is all about.

What happens when we feel safe

Porges explains how the vagal nerve, the tenth cranial nerve, is the primary component of the parasympathetic nervous system. Two motor pathways lead from two areas of the brainstem, travel through the vagus nerve and wind up in different parts of the body. The ventral vagus arises in the same part of the brainstem from which arise the nerves controlling the muscles of the face and ears. When we feel safe, this component of the autonomic nervous system supports health, growth and restoration. If we feel safe, we signal this to others through our posture and tone of voice. When we feel safe, the muscles of the middle ear tense to reduce the influence of low frequency sounds. This functionally improves our ability to process the human voice.  When we feel safe, we are open to interactions with other people in a mutually satisfying manner.

What happens when we don’t feel safe? Porges coined the work interoception to describe the unconscious monitoring of bodily processes by the nervous system to pick up threats of danger in our immediate environment. This generates feelings which we can be conscious of. We realize that there is something wrong although we many not be able to say what it is. We need to react. Initially, information sent through the ventral vagus can remove the block that normally slows down the heart’s pacemaker. The heart will beat faster. This may not not provide enough increased energy to deal with the situation. Then the sympathetic nervous system is activated to send messages downstream to the adrenal glands. The command is to makes adrenaline which will further speed up the heart and shunt blood to our muscles for the “fight or flight” response.

One of Purge’s contributions to our understanding is to have identified how the dorsal vagus, which slows down physiological functioning, comes online if fight or flight is unavailable to us. This slowing down works in reptiles which can tolerate a slowed heart beat. This reaction in other mammals can lead to feigning to be dead, which can stop predators from further attack. However in humans, whose brains need a relative greater proportion of the oxygen and glucose carried by our blood cells, this slowing down of the heart rate can lead to fainting and is generally not the best solution we want to make.

Wow, and this is the easier-to-understand book! Porges makes the point that clinicians need to make efforts to insure that their clients feel safe. This could involve reducing, if possible, those low frequency noises in a building that could trigger a feeling of lack of safety in their clients. Therapists want to have tonal variability in their voices when speaking to their clients to activate their client’s social engagement system. Therapists want to have their clients feel safe with them to engage in the difficult work of discussing past experiences of lack of safety.

If you would like to learn more about how to feel safer, call Specialized Therapy Associates at 201-488-6678 or check out our website