By Tanner Murtagh, MSW, RSW
At our clinic we utilize Polyvagal Theory to support clients in reducing their chronic pain or symptoms. In this post we’ll explore Polyvagal Theory, providing education on the nervous system, and how this relates to neuroplastic pain and symptoms.
Hierarchy of the Autonomic Nervous System
In our autonomic nervous system, we have a hierarchy of responses. We shift between three systems, depending on cues of safety or danger1.
The two branches that make up our autonomic nervous system are called the parasympathetic and the sympathetic. Our nervous system responds to sensations and signals through three systems, the Ventral Vagal, Sympathetic, & Dorsal Vagal1,2.
The Parasympathetic Branch
First let’s look at the parasympathetic branch. This branch consists of the vagus nerve, which is the 10th cranial nerve and the longest of the cranial nerves3. The vagus nerve facilitates bi-directional communication between the brain and body.
“From the brain stem at the base of the skull, the vagus travels in two directions: downward through the lungs, heart, diaphragm, and stomach and upward to connect with nerves in the neck, throat, eyes, and ears.”1
80% of the communication in the vagus nerve is afferent/sensory, delivering messages from the body to the brain3. This means that 80% of our messages of safety or danger come from the body and organs. This tells us that the state of the body is very influential in our thinking and beliefs.
Only 20% of the communication in the vagus nerve is efferent/motor, delivering messages from the brain to the body3. This means only 20% of messages of safety or danger come directly from the brain. This is why focusing somatically on the body is so important in healing trauma, chronic pain, and chronic symptoms. Safety starts in the body!
The vagus nerve is split into two parts: ventral vagal and dorsal vagal.
The Ventral Vagal system “responds to cues of safety”, leading to feeling safe, socially connected, and socially engaged1. When we are in ventral vagal, our social engagement system comes online and we look to socially connect with others2.
Dorsal Vagal system “responds to cues of extreme danger” causing us to disconnect, dissociate, feel numb, and protect ourselves by going into a state of shutdown and collapse1,2.
The Sympathetic Branch
Now let’s discuss the sympathetic branch, which is found in the mid-section of the spinal cord1. The sympathetic pathway mobilizes us and prepares us to take action. In response to internal and external cues of danger, the sympathetic branch triggers our fight or flight response1. However, the sympathetic nervous system is more than just fight or flight. It also gives us energy when we need it, allowing us to experience excitement and passion.
The autonomic nervous system shifts between ventral vagal, sympathetic, and dorsal vagal depending on cues of safety or danger1,2. When we sense cues of safety, the ventral vagal system is activated and we feel connected, safe, social, and calm1,2. When we sense danger, the sympathetic system becomes activated, and we shift to mobilize, take action, fight, or flee1,2. Often taking action can help us move back towards a social and safe state within the ventral vagal system. But if the level of danger is too much to handle and we feel trapped, the dorsal vagal system becomes activated and we shift to shut down and collapse to survive1,2.
Trauma, the Nervous System, and Chronic Pain and Symptoms
Trauma causes dysregulation in our autonomic nervous system, resulting chronic activation of our sympathetic and/or dorsal vagal system3. Our survival/defence states may be frequently triggered, moving us into fight, flight, freeze, or immobilization with fear5. We may feel reactive, and it can become difficult to regulate or co-regulate our nervous system, because “Trauma replaces patterns of connection with patterns of protection.”3 Trauma is closely associated with chronic pain and symptoms for this reason. When our brain and nervous system are chronically functioning in a state of danger, it increases the likelihood that danger signals of chronic pain or symptoms will be produced6.
Systems of the Nervous System and Their Effects on Chronic Pain and Symptoms
Let’s take a closer look at how the three systems within our autonomic nervous system can influence chronic pain or symptoms, for better and worse.
As you can see, when we are stuck in the sympathetic or dorsal vagal systems, chronic pain and symptoms can develop. However, by learning to shift our nervous system back into the ventral vagal system, where we feel safe and connected, our pain and symptoms can reduce or dissipate.
At our clinic we incorporate Polyvagal Theory and somatic practices to support clients in shifting toward the ventral vagal system, where they feel safer and more connected. This leads to the reduction of neuroplastic pain and symptoms.
Book a free 20-minute consultation with one of our therapists today.
Dana, D. (2018). The polyvagal theory in therapy: Engaging the rhythm of regulation. WW Norton & Co.
Porges, S. W. (2019) Clinical Applications of the Polyvagal Theory.
Dana, D. (2019). 2-Day Workshop: Polyvagal Theory Informed Trauma Assessment and Interventions
Porges, S. W. (2022). Autonomic state: A neurophysiological platform for feelings, emotions, and social engagement. Trauma Research Consortium, Kinsey Institute, Indiana University Bloomington and Department of Psychiatry, University of North Carolina Chapel Hill, USA.
Kozlowska, K., Walker, P., McLean, L., & Carrive, P. (2015). Fear and the Defense Cascade: Clinical Implications and Management. Harvard review of psychiatry, 23(4), 263–287. https://doi.org/10.1097/HRP.0000000000000065
Pain Reprocessing Therapy Center (2021). Pain reprocessing therapy training.
