11/10/21 The Covid-19 Pandemic is a Paradoxical Challenge to Our Nervous System: A Polyvagal Perspective — Stephen Porges
I’m a big fan of Polyvagal Theory (PVT)for one big reason: It’s our clearest window into human nature. According to PVT the biggest driver of human behavior is whether we feel safe and connected or threatened and stressed. Unfortunately many times PVT is explained in a way which assumes you already know a lot about stress, coregulation, and other relevant topics.
Most of us don’t have that knowledge.
I want to take a different approach. I’m going to use Stephen Porges’ article on PVT and Covid-19 to explain the top concepts a lay person can learn from Polyvagal Theory.
Photo by Josh Calabrese on Unsplash
First, we are fundamentally relational.
[T]his capacity to cooperate [is what] enabled the earliest mammalian species to survive in a hostile world dominated by physically larger and potentially aggressive reptiles…
If you were to roll the clock back 100,000 years and survey all the animals on planet earth you wouldn’t bet on humans. We’re not that fast. We’re not that strong. And we’re not born with instincts. We have to take the long way around and learn just about everything.
So how did we survive? It wasn’t our brains. It was our ability to cooperate.
We’re the best, because we’re the best at working together.
Second, our brains and bodies are connected.
Functionally, the brain and visceral organs are connected by neural pathways that send signals from the brain to our visceral organs and from the visceral organs to the brain. Thus, threat reactions through definable and measurable pathways may have predictable effects on our mental and physical health.
Our brains and bodies are connected and our brains make changes to our bodies. For instance I once heard a doctor talk about a patient whose lungs had calcified due to stress. Her body had been stressed for so long that her heart rate was always elevated, which lead to more blood pressure in her arteries, which means her arteries had to harden to take the additional pressure, and the hardening over time lead to calcification of her lungs.
This also means our bodies send information back to our brains, changing what our brains think. For instance if I drink coffee the caffeine makes my body jittery and spikes my heart rate, which makes me more irritable. My body has changed my mind. The psychology is dependent on the physiology and the physiology is dependent on the psychology. The mind influences the body and the body the mind.
The contemporary conceptualization of bidirectional communication between visceral organs and the brain is rooted in the work of Walter Hess. In 1949 Hess was awarded the Nobel Prize in Physiology/Medicine …The first sentence of his Nobel Prize speech… states that “A recognized fact which goes back to the earliest times is that every living organism is not the sum of a multitude of unitary processes, but is, by virtue of interrelationships and of higher and lower levels of control, an unbroken unity.”
Third, our bodies are always scanning for threat.
Our bodies, without our awareness, are always looking for cues of safety or cues of danger. This process of constantly scanning, even when we don’t know it, is called neuroception.
Fourth, Neuroception puts us into one of three modes.
Our neuroception puts us in one of three modes. If we find cues of safety we go into “connection mode.” In “connection mode” we do two things. First we connect to others well. Second our body’s resources go towards health, growth, and restoration. This means connection mode is the best mode for when we’re sick because our bodies are prioritizing healing.
However, sometimes we find cues of threat. This is our “fight/flight mode.” Fight/flight mode is good because it’s protective, but it isn’t social. In fight/flight we prioritize protection over connection. Also in fight/flight mode our bodies divert resources away from healing. Ideally we’re able to shift out of fight/flight mode when the threat has passed.
Sometimes the threat is so big we think we’re going to die. This is our “Freeze mode.” Signs of this mode are fainting, freezing, dissociation, and feelings of hopeless. This is our bodies way of defending ourselves from the pain of dying. But it cost us a lot. It’s really hard for us to shift out of Freeze mode once we go into it.
Fifth, our mode is displayed on our face.
[T]hrough common brainstem structures coordinates the striated muscles of the face and head with the vagal regulation of the viscera originating in a brainstem region known as nucleus ambiguus.
How do you know what mode someone is in? It’s written over their face. Do they look angry or scared? They’re in fight/flight mode. Are they flat? Then you know they’re in freeze mode. Do they smile with a crinkle in their eyes? They are in connection mode.
Sixth, mental and medical problems occur because we’re stuck in one mode.
Mode dictates much about our physical and emotional health. For instance if a friend reveals they suffer from anxiety, that means they are chronically stuck in flight mode and can’t shift out of it. Or let’s say a co-worker is always irritable, well they’re stuck in fight mode. Or let’s say you’re struggling with depression and can’t get out of bed. You’re stuck in Freeze mode. All are conditions for which you could see a counselor or get medication.
It’s also about your physiology. Someone with chronically high blood pressure is probably stuck in “Fight/Flight.” Someone with Chronic Fatigue or Chronic Pain is probably stuck in Freeze.
Seventh, connection shifts us from one mode to the next.
Thus, the optimally resilient individual has opportunities to co-regulate physiological state with a safe and trusted other. Ideally, this “other” person projects positive cues regarding their autonomic state through prosodic voice, warm welcoming facial expressions, and gestures of accessibility. From an evolutionary perspective the integration of the neural regulation of the viscera with the regulations of the striated muscles of the face and head enable visceral state to be projected in vocalizations and facial expressions. This also allows vocalizations and facial expressions, modulated by autonomic states, to serve as cues of safety
If being stuck in a mode is harmful to our bodies and minds how do we change? Our ability to feel connected and safe is the control lever. Kids give us a great example of this. The other day my youngest fell, knocked his head, and started crying. I went over, picked him up, and held him. He cried for a few more minutes, then got really quiet and relaxed on me, and then asked to get down and keep on playing. His ability to connect with me is what allowed him to make the shift.
Photo by Kelly Sikkema on Unsplash
Clinical implications
It seems to me that the implication are vast for human nature. One of the big ones is that maybe humans are prey animals. I mean if we’re always scanning our environment for threat. That sounds more like prey than predators to me. As one author says:
Horses are powerful, magnificent creatures, but they don’t see themselves that way; in their inner life they feel vulnerable. They are, after all, prey animals like elk and deer, who developed their view of the world and their survival skills on the plains of North America and Europe, running from large animals trying to eat them. In the late Pleistocene, the plains were hunting grounds for huge lions bigger than an African lion, several types of cheetahs, terrible giant ground sloths, dire wolves, voracious short-faced bears, and a host of other high-octane predators. Horses learned their nervous ways in a very rough playground; there’s a whole lot of “flight” in their “fight or flight” response…
Predators hunt under cover of darkness; from the horse’s point of view, nighttime calls for high vigilance. Come morning we often need to settle them down before we attempt a ride, so we groom them and do some “ground work.” At some point in their connection with us — once they’re feeling safe and secure — they let out this wonderful sigh. Out of those big nostrils comes a big, deep, long breath. Their muscles relax; their heads lower. They have switched off hypervigilant mode. I love it when they do that; you’re looking for that sigh when you’re working with horses. We humans do that sigh, too, when we feel settled and in a good place.
We are big.
We are powerful.
We are smart.
And we are always looking for the next threat.
A lot of the bad behavior we see is not from bad people but frightened people. Of course, we can’t allow bad behavior, but the first step in changing bad behavior is seeing where it comes from. People are scared. We still think we’re prey. We need to connect to others. If we can’t connect we get sick.
-Fin-
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