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Shifting Between Survival Modes: Understanding Trauma Through Polyvagal Theory

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The Polyvagal Theory, developed by Stephen Porges to explain the autonomic nervous system’s relationship with social connectedness, security perception, and threat responses, provides a neurophysiological framework. Polyvagal Theory proposes that the autonomic nervous system, specifically the vagus nerve, regulates an individual’s health and behavior. Unlike previous theories, Polyvagal Theory emphasizes that the individual’s need for security stems from intrinsic physiological states and provides comprehensive explanations for the physiological and psychological states underlying behaviors and challenges related to well-being and mental health (Schore, 2024). On the other hand, from an innovative perspective, the Polyvagal Theory offered a new paradigm for understanding posttraumatic physiological regulation by suggesting that the autonomic nervous system responds to threats and dangers through three functional subsystems (Porges, 2007). According to the theory, there is a hierarchical organization between the ventral vagal complex (social engagement), the sympathetic system (fight or flight), and the dorsal vagal complex (freezing). Porges (2001) suggests that these systems determine how the individual responds to safety or threat. To learn more about Polyvagal theory and these functional subsystems, we cover these terms in detail in our “The Science of Safety & Social Connection: Polyvagal Theory” article.

According to Polyvagal theory, Individuals who have experienced trauma often have difficulties in making functional transitions between these systems, and their nervous systems may lose their functionality and remain in a state of chronic dysregulation. These trauma-induced conditions not only cause psychological symptoms but also impair emotion regulation skills, body awareness, and the ability to relate to others. By explaining these physiological responses, Polyvagal Theory contributes both to understanding trauma and to appropriately targeting therapeutic interventions. In this therapy sketch, the relationship between Polyvagal Theory and trauma will be examined; the effects of trauma on the nervous system will be discussed, and how the theory provides a roadmap for the treatment of trauma-related psychopathologies will be addressed.

What is Trauma?

Trauma can be defined as a single or repeated event that deeply disturbs or threatens a person’s sense of safety. These experiences can have long-term negative effects on someone’s emotional, physical, mental, and social well-being and daily functioning. Traumatic events can range from experiencing bullying, mobbing, or relational problems to neglect, abuse, natural disasters, or wars (Trauma-Informed Care Implementation Resource Center, 2022). Driven by its magnitude, trauma is classified as little T (it can also be named as small or micro traumas) and big T (it can also be named as large traumas) in trauma resources (Straussne and  Calnan, 2014). 

  • Big T: This type of traumatic event includes significant life events that are rarer but affect individuals catastrophically. Big T traumas are significant events that leave a person with immense distress, hopelessness, and feelings of no control. The examples of big T traumas are sexual or physical assaults, car accidents, natural disasters, war, and terrorism. Also, the Big T trauma encompasses complex traumas involving long-term exposure to repeated traumatic experiences such as neglect. 
  • Little T: This type of traumatic event includes life events that impact individuals’ daily life functioning and lead to difficulties in emotional regulation, a sense of safety, and overall well-being. Similar to big T traumas,  little T traumas also cause feelings of hopelessness and a lack of control. However, the difference is that little traumas tend to be emotional wounds rather than life-threatening or physical wounds. Examples of little T traumas are divorce, bullying, financial difficulties, and interpersonal conflict.

Regardless of the magnitude, trauma is a widespread experience. According to the National Center of PTSD,  approximately 5 out of every 100 adults in the United States are affected by PTSD (2023). Traumatic events affect a person’s functionality by disrupting cognitive functioning, impairing judgment, reducing awareness, heightening vigilance, and leading to dysfunctional coping behaviors.

If the impact of the traumatic event (regardless of small or big T) continues over time and starts to impair the daily functioning of the person, it may be defined as Post Traumatic Stress Disorder (PTSD) according to the American Psychiatric Association (APA) (APA, 2013).  Here are more detailed symptoms for PTSD: 

  • Exposure to a traumatic event: Exposure to a traumatic event consists not only of living the traumatic event directly. Seeing the traumatic event happen to other people, Learning that the event happened to someone close to the person, and continuous exposure to the details of the traumatic event also initiate the occurrence of the PTSD symptoms.  
  • Excessive alertness: As mentioned above, trauma can cause a person to feel on edge. In PTSD, it can turn to excessive startle response, difficulty concentrating, inability to sleep due to frequent awakenings, irritability, and tantrums. 
  • Unintentional re-experiencing of the traumatic event: In PTSD, the person might experience frequent or involuntary recall of the event, intrusive memories about it, nightmares about the trauma, flashbacks, which means that the person feels the event like it is happening again.  
  • Avoidance behaviors: In PTSD, the person persistently avoids stimuli such as places, people, or situations, or thoughts, or emotions related to the traumatic event.
  • Changes in emotion and cognition: PTSD affects the emotional and cognitive domains of the person negatively. Emotionally, a traumatic event can lead to strong emotions such as guilt, shame, fear, or emotional detachment. Cognitively, it causes negative beliefs about themselves, others, and the world around them. Additionally, the person can experience difficulties in remembering important aspects of trauma. 

According to APA, the symptoms need to cause significant impairment in the person’s social, occupational, or other areas of functioning for at least a month and not be explained by any other conditions, such as medication, medical condition, or substance use (APA, 2013).  

Trauma and Its Effect on the Nervous System

Going beyond the diagnosis, we can say that the primary impact of trauma is that it affects the person’s view of the world. It involves the “just world” belief that we believe the world is a fair place to live. This is a cognitive bias that we have to feel safe, and the traumatic experience disrupts this point of view. That means the world is no longer secure, and consequently, our body becomes alert (Furnham, 2003). Further explaining, the nervous system does not behave in a way that would be considered normal functioning, and symptoms manifest when it is stuck in a fight/flight/freeze situation, or several of them. Here are examples of what a traumatized nervous system might look like:

  • Excessive alertness: You may feel constantly on edge, as if something bad could happen at any moment. This heightened awareness can make it hard to relax or feel safe.
  • Prolonged and persistent feeling of fatigue: You may feel tired all the time, even after sleeping or resting. This exhaustion often comes from the excessive alertness of your nervous system.
  • Disruptions in daily life: You may avoid everyday activities or responsibilities that once felt normal. When the nervous system remains in a prolonged threat, even routine tasks can feel overwhelming, unsafe, or emotionally exhausting.
  • Often feeling numb: You may also struggle to experience emotions like joy, sadness, or anger. This emotional numbness can occur when your nervous system enters a “freeze” state in response to trauma. 
  • Feeling disconnected from other people: You may feel distant from loved ones or even yourself. You may feel like you are observing life from the outside rather than living it. This can be triggered when the brain perceives an ongoing threat or emotional overwhelm. 

This is where polyvagal theory comes into play and explains this kind of somatic or emotional reaction, followed by exposure to a traumatic event. Let’s further explain trauma symptoms using polyvagal theory. 

The Connection Between Polyvagal Theory and Trauma

Polyvagal Theory helps to map, monitor, and reconstruct the nervous systems of individuals who have experienced trauma. Porges’ theory provides a new perspective to the literature on trauma and recovery, and offers a physiological explanation for the experiences of trauma survivors. But before we look at how Polyvagal Theory explains the trauma, let’s look closer at Polyvagal Theory’s key concept. According to the theory, the nervous system has three different states. The first one is the ventral vagal state (relaxed state), which is associated with safety and connection; the second is the sympathetic state (mobilized state) related to the fight or flight response; and the last is the dorsal vagal state (immobilized state) associated with freeze mode when facing a threat. Another key concept in this theory is neuroception, which means that our body’s unconscious ability to detect danger and safety shifts between the states (relaxed, mobilized, and immobilized) according to detection. Another critical point of Polyvagal Theory is that it describes the connection between an individual’s nervous system and their social behavior. The focus here is on how secure the individual feels about being involved in life. The premise of Polyvagal Theory is somatic healing through bodily work to create a secure connection with others, which is called co-regulation. 

Trauma in the Context of Polyvagal Theory 

According to Polyvagal Theory, the symptoms of trauma and PTSD can be seen as the product of a reorganized nervous system that develops during extreme threat exposures. The Polyvagal Theory emphasizes the autonomic nervous system as a critical component in trauma. When a traumatic event occurs and the shock or trauma is left untreated, there is a possibility that the nervous system will not heal, and this can be life-threatening for the individual (Porges, 2022).

  • Dysregulated Neuroception: Exposure to trauma leads neuroception to become dysregulated. Neuroception focuses more on identifying danger cues and further assesses neutral or safety cues as threatening. This excessive alertness and misinterpretation of the environmental cues causes a shift between sympathetic (mobilized states) and dorsal vagal (immobilized states) states, which are known as survival modes, to be prolonged. 
  • Shift between Mobilization to Immobilization: Polyvagal Theory also explains why some victims of abuse or violence do not flee or resist. Their nervous systems switch from a fight-or-flight sympathetic response to a dorsal vagal reaction, such as numbing or immobilization, for survival. The nervous system of the trauma survivor is stuck in the sympathetic (mobilized state) or dorsal vagal states (immobilized state), without returning to the ventral state. One of the goals of Polyvagal-Informed therapy is to guide the client back to the ventral vagal state, thus ensuring their safety (Muller, 2022).
  • Stuck Mobilized State: Individuals with unhealed trauma who are stuck in the sympathetic state (mobilized state) may carry stories of fear, anxiety, insecurity, worry, while those who reside in the dorsal vagal state may have stories of loneliness, numbness, and disconnection. When survivors heal from trauma and reside in the ventral vagal state (relaxed state), they can let go of these stories and become more harmonious and connected with others around them (Muller, 2022).
  • Utilizing Coregulation to Restore Safety: As mentioned above, trauma exposure endangers the person’s sense of safety. Polyvagal Theory teaches to activate the social nervous system to inhibit the individual’s defense system consciously. This teaching allows the individual to recover from trauma symptoms and experience a deeply nourishing sense of safety. 

Let’s see how Polyvagal Theory works in trauma treatment with specific techniques and interventions!

How Polyvagal Theory Works with Trauma in Therapy Space?

Polyvagal-Informed therapy can be used to support traumatized individuals to feel safe in their own bodies, to regulate their emotions better, and to learn to improve their overall health. Trauma and chronic stress can affect the physical body in myriad ways, including high levels of stress hormones, increased heart rate, weakened immune system, digestive problems, dysfunctional organs, insomnia, muscle tension, and pain. Working with the body can give us access to nervous system functions that cannot be accessed or retrained through cognitive therapy alone. The way a traumatized individual’s nervous system regulates itself can be disrupted. Individuals who feel in a constant state of ‘’fight or flight’’ may develop long-term mental health problems if this is not addressed. Polyvagal-Informed Therapy guides trauma healing by helping the individual to understand how the trauma has affected their body and mind. In addition, it helps to promote a sense of self-compassion. 

  • Somatic Experiencing: One practice that can be used to treat many different conditions, but is particularly effective in treating trauma, is an intervention called somatic experiencing. The aim of somatic experiencing is to release trauma stored in the body. This is done through tools such as focusing on body awareness and grounding (Payne et. al., 2015).

Somatic therapy is known as a body-oriented therapeutic approach to trauma treatment, based on the idea that both the body and the nervous system are systemically affected and changed by trauma, as the effects of trauma remain ‘’locked’’ in the individual’s body. Trauma-informed somatic therapy releases emotions trapped in the individual’s mind, allows them to move through their nervous system processes, and brings awareness to the body through appropriate breathing techniques, dance, and muscle balancing exercises.

  • Listening Therapies: Most people instinctively raise their pitch and modulate their voice when talking to babies or animals. This is because highly modulated vocalizations activate the middle ear muscles and then send feedback to the brain, activating the social engagement system. When the social engagement system works well, individuals feel safe. Porges said, ‘’Listening is a portal to trigger the entire social engagement system.’’ Therefore, integrating Polyvagal Theory into listening therapies for trauma treatment is presented as an uniquely valuable method (Warren, 2022).
  • Music Therapy: It regulates vagus nerve function in two main ways: by stimulating the middle ear muscles (when listening) and by forcing a long, slow exhalation (when singing). If you are singing in a group, you are stimulating your vagus nerve in a third way, using your social interaction system. This is why Polyvagal-Informed Therapy uses music therapy as a tool to address the treatment of trauma in individuals (Warren, 2022).
  • Working with Social Engagement System in Therapy: When individuals play, the social engagement system regulates the sympathetic nervous system. This is why play therapy is so important for people whose pathology results from feeling insecure and for those who have problems with social engagement. Social interaction makes individuals feel safe while at the same time reducing the overreaction of the sympathetic nervous system. Polyvagal-Informed Therapy incorporates play into trauma treatment practices to capitalize on the benefits of the social engagement network and improve the well-being of individuals in this way (Warren, 2022).

Takeaways:

  • The Polyvagal Theory, developed by Stephen Porges to explain the autonomic nervous system’s relationship with social connectedness, security perception, and threat responses, provides a neurophysiological framework.
  • Polyvagal Theory helps to map, monitor, and reconstruct the nervous systems of individuals who have experienced trauma. 
  • According to Polyvagal Theory, trauma exposure leads neuroception to misinterpret environmental cues, switching from a fight-or-flight sympathetic response to a dorsal vagal reaction, such as numbing or immobilization, for survival, and endangers the sense of safety. 
  • Polyvagal-Informed therapy can be used to support traumatized individuals to feel safe in their own bodies, to regulate their emotions better, and to learn to improve their overall health with somatic experiencing, music therapy techniques, and working with social engagement systems.

References

  1. What is Trauma? – Trauma-Informed Care Implementation Resource Center. (2022, July 8). Trauma-Informed Care Implementation Resource Center. https://www.traumainformedcare.chcs.org/what-is-trauma/
  2. Straussner, S.L.A., Calnan, A.J. Trauma Through the Life Cycle: A Review of Current Literature. Clin Soc Work J 42, 323–335 (2014). https://doi.org/10.1007/s10615-014-0496-z
  3. U.S. Department of Veterans Affairs. (2023). How common is PTSD in adults? National Center for PTSD. https://www.ptsd.va.gov/understand/common/common_adults.asp
  4. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Edition). Washington, DC: American Psychiatric Association.
  5. Furnham, A. (2003). Belief in a just world: Research progress over the past decade. Personality and individual differences, 34(5), 795-817.
  6. Porges, S. W. (2022). Polyvagal theory: A science of safety. Frontiers in integrative neuroscience, 16, 871227.
  7. Porges, S. W. (2007). The polyvagal perspective. Biological Psychology, 74(2), 116–143. https://doi.org/10.1016/j.biopsycho.2006.06.009 
  8. Porges, S. W. (2001). The polyvagal theory: Phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42(2), 123–146. https://doi.org/10.1016/S0167-8760(01)00162-3 
  9. Schore, A. (n.d.-b). What is Polyvagal Theory? | Polyvagal Institute. https://www.polyvagalinstitute.org/whatispolyvagaltheory 
  10. Muller, R. T., PhD. (2022, June 9). This theory highlights the nervous system’s importance in how we perceive trauma. Psychology Today. https://www.psychologytoday.com/us/blog/talking-about-trauma/202206/polyvagal-theory-approach-understanding-trauma 
  11. Pyramid Healthcare. (2023b, June 9). 6 Principles of Harm Reduction for Veterans. Pyramid Healthcare. https://www.pyramid-healthcare.com/blog/2023/06/09/treating-trauma-with-polyvagal-theory/ 
  12. Porges, S. W. (2022). Polyvagal Theory: A Science of Safety. Frontiers in Integrative Neuroscience, 16. https://doi.org/10.3389/fnint.2022.871227 
  13. Warren, S. (2022b, February 21). Using polyvagal theory in clinical practice. Somatic Movement Center. https://somaticmovementcenter.com/polyvagal-theory-therapy/ 
  14. Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015, February 4). Somatic experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316402/ 

While our physical offices are located in South Loop and Lakeview neighborhoods in Chicago, Illinois for in-person sessions, we also welcome and serve clients for online therapy from anywhere in Illinois and Washington, D.C. Clients from the Chicagoland area may choose in-office or online therapy and usually commute from surrounding areas such as River North, West Loop, Gold Coast, Old Town, Lincoln Park, Lake View, Rogers Park, Logan Square, Pilsen, Bridgeport, Little Village, Bronzeville, South Shore, Hyde Park, Back of the Yards, Wicker Park, Bucktown and many more.  

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This page is also part of the Roamers Therapy Glossary; a collection of mental-health related definitions that are written by our therapists.

While our offices are currently located at the South Loop neighborhood of Downtown Chicago, Illinois, we also welcome and serve clients for online therapy from anywhere in Illinois and Washington, D.C. Clients from the Chicagoland area may choose in-office or online therapy and usually commute from surrounding areas such as River North, West Loop, Gold Coast, Old Town, Lincoln Park, Lake View, Rogers Park, Logan Square, Pilsen, Bridgeport, Little Village, Bronzeville, South Shore, Hyde Park, Back of the Yards, Wicker Park, Bucktown and many more. You can visit our contact page to access detailed information on our office location.