Using the Polyvagal Theory to Heal from Trauma

Written by: Stephen W. Porges, PhD and Seth Porges


Published on: September 21, 2023

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Stephen W. Porges, PhD, is a psychologist and neuroscientist, and his son, Seth Porges, is a journalist and filmmaker. The excerpt below is from their new book, Our Polyvagal World: How Safety and Trauma Change Us, which is available for preorder now.

Every single one of us enjoys (or, as is often the case, suffers through) a wide range of bodily experiences and feelings. There are times when we feel social and lively, energized and aggressive, or perhaps paralyzed into immobilization. We feel good and we feel bad. We feel fulfilled and we feel empty. We feel a lot.

These feelings are all universal, and largely adaptive. They are not innately “bad” but, rather, exist within us to serve specific functions that evolved to help us survive and hopefully return to a state of safety.

But for those of us who suffer from trauma, specific bodily feelings can become deeply tied to our trauma. While feeling defensive or angry is never fun, healthy individuals can often move on from such feelings without too much difficulty. For those who suffer from trauma, simply feeling a certain feeling (whether it’s defensiveness, anger, or anything else—even feelings we largely view as “positive”) can act as a painful trigger that can cause massive disruption and massive pain.

  1. Seth Porges and Stephen W. Porges
    Our Polyvagal World
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How the Polyvagal Theory Helps Transform Triggers

This is why, with the polyvagal theory as a guide, Deb Dana, LCSW—clinical adviser to the Traumatic Stress Research Consortium and my coeditor on the book Clinical Applications of the Polyvagal Theory—reframes her therapy sessions so that she focuses not on the traumatic event but rather on the bodily feelings associated with it.

This is a major shift. The goal of talk therapy is often to create an explanation for why a patient feels the way they do.

The goal of polyvagal-informed therapists such as Dana is to shift that question from “why” we feel the way we do to “how.”

The point is to understand our own feelings and decouple them from the trauma. In essence: Have patients get used to these universal bodily feelings so that they become less disruptive. We all feel bad feelings, just as we all feel good ones. The problem for traumatized individuals is that those bad feelings can overwhelm the ability to simply go about living.

Steps to Uncoupling Feelings from Trauma

The first step in this process is to create awareness of our bodily state, free from any narrative of it being “good” or “bad.” Instead, Dana has her patients approach these states from a place of curiosity and exploration: “This is a bodily feeling. It is not a good one or a bad one. But it is one I am feeling and this is what it feels like.”

Without this sense of awareness, we often create narratives around our negative feelings that involve blame. We blame ourselves or those close to us for making us feel bad. A loved one or the environment we’re in may inadvertently trigger us, which can lead our body and brain to believe that the person or thing is the problem. This creates real interpersonal problems and no shortage of conflict. It can also cause a bias toward negativity in all our interactions, as we look for somebody to blame for our own bad feelings.

Blame is a coping strategy. But as a coping strategy, it is both easy to fall back on and highly ineffective. A patient who is fully aware of their bodily feelings can experience these feelings outside the context of blame and, hopefully, understand what may actually be triggering them.

With awareness as a beginning, the next step is to help patients develop the ability to move in and out of these feelings and states without getting stuck in them. Life improves when patients can experience these feelings without having massive state disruptions. Moving in and out of and controlling these states and feelings can occur through mechanisms such as breath and movement. A patient who has mastered these skills is better able to navigate through their own, often painful, bodily feelings like a ship seeking safe harbor while deftly moving past obstacles without crashing. This sort of therapy works as a progressive exercise (or “ladder,” as Dana frames it) aimed at allowing patients to become aware of their own bodily feelings, and to slowly remove these feelings from the context of pain and trauma. Patients are encouraged to “feel” feelings that they associate with trauma in short—but increasingly lengthy—bursts, and in a safe environment. If they go too far, Dana pulls them back.

Eventually, patients get used to these feelings as just feelings, and not as triggers for trauma. When this happens, these feelings lose their disruptive power. We can acknowledge them, honor them, feel them, appreciate them. But then also move on from them.

Excerpted from Our Polyvagal World: How Safety and Trauma Change Us by Stephen W. Porges and Seth Porges. Copyright © 2023 by Stephen W. Porges and Seth Porges. Illustrations © 2023 by Regan Desautels and Alexis Cruz Gómez. Used with permission of the publisher, Norton Professional Books, a division of W. W. Norton & Company, Inc. All rights reserved.