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The Polyvagal Theory of Trauma

“Trauma is a pervasive fact of modern life,” Peter Levine wrote in his 1997 book Waking The Tiger: Healing Trauma. “Most of us have been traumatized, not just soldiers or victims of abuse or attack. Both the sources and consequences of trauma are wide-ranging and often hidden from our awareness.” 

For Levine, the key to healing trauma “is in our physiology.” In Waking The Tiger, Levine writes that “traumatic symptoms are not caused by the ‘triggering’ event itself. They stem from the frozen residue of energy that has not been resolved and discharged; this residue remains trapped in the nervous system where it can wreak havoc on our bodies and spirits.” 

In a nutshell, this is the “Polyvagal Theory,” a collection of evolutionary, neuroscientific, and psychological constructs about the vagus nerve’s role in emotion regulation, social connection, and fear response, introduced in 1994 by American psychologist and neuroscientist Stephen Porges.

Polyvagal Theory takes its name from the vagus, a cranial nerve that forms the primary component of the parasympathetic nervous system. The traditional view of the autonomic nervous system presents a two-part system: the sympathetic nervous system, which is primarily activating (“fight or flight”), and the parasympathetic nervous system, which supports health, growth, and restoration (“rest and digest”). Polyvagal Theory identifies a third type of nervous system response: the “social engagement system,” a hybrid state of activation and calming that plays a role in our ability to engage socially—or not.

The three branches represent different evolutionary stages. “Dr. Porges identified a hierarchy of response built into our autonomous nervous system and anchored in the evolutionary development of our species,” wrote Deb Dana, LCSW, in The Polyvagal Theory in Therapy. “The origin of the dorsal pathway of the parasympathetic branch and its immobilization response lies with our ancient vertebrate ancestors and is the oldest pathway. The sympathetic branch and its pattern of mobilization, was next to develop. The most recent addition, the ventral vagal pathway of the parasympathetic branch brings patterns of social engagement that are unique to mammals. When we are firmly grounded in our ventral vagal pathway, we feel safe and connected, calm and social.” 

Polyvagal Theory postulates that trauma can send us backward and down that evolutionary pathway.

“A sense (neuroception) of danger can trigger us out of this state and backwards on the evolutionary timeline into the sympathetic branch,” wrote Dana. “Here we are mobilized to respond and take action. Taking action can help us return to the safe and social state. It is when we feel as though we are trapped and can’t escape the danger that the dorsal vagal pathway pulls us all the way back to our evolutionary beginnings. In this state, we are immobilized. We shut down to survive. From here, it is a long way back to feeling safe and social and a painful path to follow.” 

Because trauma plays out in the nervous system, this is the place in the human body that holds the key to healing trauma. “The nervous system holds the recipe for the end of suffering,” explained Taruno Steffensen, a practitioner in addiction and trauma recovery in a recent webinar. “We just need to help the person to get out of their own way and let the nervous system finish and do what it was designed to do. This holds true no matter what the trauma.” Steffensen recently joined a New Paradigm Recovery group session as a facilitator and lent insight and counsel. 

In Waking The Tiger, Levine described a breakthrough he had with a patient called Nancy, who suffered from immobilizing panic attacks. During a therapy session, Levine inadvertently provoked Nancy’s nervous system into overcoming her paralysis by telling her to envision escaping from a large tiger. This allowed her to regain motion and remember a previously hidden traumatic childhood experience. Without being aware of it, Nancy’s autonomous nervous system had replayed the childhood trauma over and over again—with devastating consequences. 

“The autonomic nervous system tries again and again to finish something that happened weeks, months, or even years ago,” Steffensen told his webinar audience. “The body, brain, and nervous system keep acting and behaving as if what happened to us keeps happening over and over again—and it feels really real.”

Levine developed a method for treating trauma known as “somatic experiencing.” The primary goal of SE is to modify the trauma-related stress response through bottom-up processing. The client’s attention is directed toward internal sensations rather than cognitive or emotional experiences.

Somatic Experiencing “facilitates the completion of self-protective motor responses and the release of thwarted survival energy bound in the body, thus addressing the root cause of trauma symptoms.” Clients are gently guided to develop increasing tolerance for difficult bodily sensations and suppressed emotions. “The somatic experience model is grounded in the belief that every single one of us is an organic being with an innate tendency toward wholeness,” Steffensen said. 

Unresolved trauma is a major driver of substance use disorder. Many people whose bodies, brains, and nervous systems keep reliving the same traumatic experience attempt to mitigate their emotional pain with maladaptive behaviors, including self-medication with drugs and alcohol. 

Instead of resolving the trauma, the substance use and any resulting addiction will quickly exacerbate the situation by piling on additional trauma. Addiction is a complex, intricate condition requiring comprehensive treatment that addresses all the needs of the patient. Treating substance misuse in isolation typically does not yield good results. Because the causes of behavioral health disorders are so varied and nuanced, understanding the issues every client and family system experiences is crucial to achieving successful clinical outcomes. 

Identifying and treating trauma as an underlying complicating factor in addictive disorders and co-occurring mental health conditions is a normal part of the New Paradigm Recovery process. New Paradigm Recovery’s clinicians are experienced in detecting the symptoms of unresolved trauma and offer expert trauma treatment, including traumatic experiencing, EMDR, and other evidence-based methods. Because living with people experiencing active substance use and mental health disorders can cause trauma, the New Paradigm Team works with client family members. Addressing trauma affecting other family members or identifying relational issues that may be causing recurring trauma in clients is vital to helping people find recovery and make home environments safer and more supportive. The process of healing trauma and finding solutions to reduce retraumatization can significantly improve the quality of life for all affected family members.

Resolving the effects of trauma can take time. Clients and their loved ones often need to feel strong trust in clinicians to reveal traumatic experiences. Developing this rapport can take time. Because New Paradigm Recovery offers intensive outpatient and outpatient levels of care, traumatic experiences or issues related to them that are found during intensive outpatient may be addressed over time during outpatient treatment, which can extend as long as clients need this level of care. In many cases, clients transitioning from New Paradigm’s intensive outpatient to outpatient levels of care can continue seeing the same primary therapist with whom they have already built a strong therapeutic rapport. 

Learn more about New Paradigm Recovery by speaking confidentially with an informed team member at (703) 214-5888.

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