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Psych Congress keynote: Polyvagal theory explained
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ORLANDO, Fla. — In a keynote presentation, Stephen Porges, PhD, distinguished university scientist at the Kinsey Institute, Indiana University Bloomington, and professor in the department of psychiatry at the University of North Carolina, Chapel Hill, discussed the polyvagal theory.
Before the presentation, Psych Congress paid tribute to Steering Committee member, Eric C. Arauz, MLER, who died on March 25. Andrew Penn, RN, MS, associate clinical professor at University of California, San Francisco, School of Nursing, and a close friend of Arauz shared their memories of him as well as how he impacted the field mental health. Among his many accomplishments, Arauz championed the polyvagal theory.
Porges introduced the polyvagal theory in 1994, linking the evolution of the automatic nervous system with social behavior and highlights the significance of physiological state in expression of those with behavioral problems and psychiatric disorders. The theory states that humans have physical reactions associated with their facial expressions. The theory is based on the relationship between visceral experiences of our own bodies and the voices and people’s faces, helping to understand the biology of safety and danger.
To begin, Porges discussed the processes that support the pursuit for safety and intimacy in humans, the first of which is the concept of connectiveness — a “biological imperative.”
“We don’t survive as human beings unless we can co-regulate and connect with others,” he said.
Connectiveness to others offers the neurobiological mechanism to join social behavior and both mental and physical health, Porges explained, and humans need social interactions to be healthy physically and mentally. The “building blocks” of a healthy relationship combine social engagement and social bonding, but this is disrupted for people with psychiatric, behavioral and educational problems. They have difficulty feeling safe with others.
“The first phase of co-regulation, we do it through facial expressions, gestures and the intonation of our voice. Phase two is this immobilization without fear,” Porges said. “When we deal with issues of mental health, this is where we start seeing issues — where people are unable to feel safe in the arms of another.”
Physical contact while immobilizing without fear maintains a physiological state that supports health, growth and restoration, which allows people to feel relaxed, safety and love. Phase two of co-regulation doesn’t require face-to-face interaction because voice and gestures, Porges explained.
Immobilization with fear, as opposed to “fight or flight,” has been a missing connect in psychology and psychiatry, but polyvagal theory brought it back to the forefront and forced an understanding that immobilization as a defense strategy is a last resort.
“Trauma, at the heart of everything we’re talking about today, disrupts the opportunities to engage others and help us co-regulate,” he said. “It disrupts the accessibility of that social engagement system and if you can’t get the social engagement system working, then the ability to feel safe in the arms of another doesn’t exist. Rather, trauma is triggering and optimizing the access to biobehavioral states of defense.”
When people live in a safe world, they can utilize all the systems of the body, like the system that would support shutting down and the one that would support “fight or flight”, according to Porges.
“When we incorporate social engagement with mobilization we call it playing. When we incorporate social engagement with immobilization, we call it intimacy; but, everything is predicated on the ability that the social engagement system is working,” he explained. “The human body wants to be able to turn off the defenses of the automatic nervous system and health depends on understanding and appreciating the cues that our nervous system needs to feel safe. Feeling safe provides the conditions for optimizing physical and mental health, healing and social behavior. We want to shift the agenda of treatment models away from documenting events to witnessing individuals’ experiences.”
In the future, Porges hopes the polyvagal theory will offer a way to explain different levels of dysfunction. – by Savannah Demko
References:
Porges S. Keynote Presentation. Presented at: Psych Congress; Oct. 25-28, 2018; Orlando, Fla.
Disclosure: Healio Psychiatry was unable to confirm any relevant financial disclosures at the time of publication.