Polyvagal Theory Series — Three-Episode Arc
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Okay. If you have been in any trauma-informed clinical space in the last 10 years, you've almost certainly heard about polyvagal theory. You've heard about the ventral vagal state, possibly even ventral vagal shutdown, or the window of tolerance. Neuroception. The social engagement system, you may have used these frameworks with clients.
You may have been trained in them. You may have built an entire clinical orientation around them. And then maybe recently you heard that 39 scientists publish a paper calling polyvagal theory, scientifically untenable. And you thought, like me, wait, what? And that was my reaction too, because I think for a lot of clinicians, this landed somewhere between confusing and destabilizing.
Is this everything I've been doing wrong? Do I need to throw out the whole framework, right? The answer is no, but the conversation's worth having, carefully honest, honestly, and without either defending the [00:03:00] theory or reflexively dismissing it because the headline was alarming, and that's what the series is for, and that's what the training is for in April.
Welcome to the Rewired 360 Podcast. I'm Kathy Couch, LCSW, fellow in Anology, and your. EMDR, consultant and trainer. This is the first of three episodes on the Polyvagal Theory debate today, what actually happened, what each side argued, and what the word untenable actually means when scientists use it. So let's start with what actually happened, because I think the headline got ahead of the content for most people.
In 2023, a group of 39 researchers, neuroscientists, physiologists, cardiologists, also evolutionary biologists, published a critique of the polyvagal theory in a peer reviewed. Forum, the lead author was David Grossman, and the paper was subsequently updated and referenced in a 2026 exchange in clinical neuropsychiatry, where Porges then also published his [00:04:00] response.
So the signatories were not fringe critics. Several had spent their careers studying the vagus nerve and autonomic physiology. I'm not a physiologist. But I know how clients' nervous systems are important in trauma therapy, and so they're applying rigorous scientific standards to neuro inad claims.
Now, some of this here, just caveat, I'm a therapist. I'm not trained physiologist or neuropsychiatrist, but what exactly are they critiquing? Because when we read the summary, it seems like the argument was pretty specific, not like they were saying the whole theory was useless. So this is where. The straw man question becomes important.
The critique is targeted, so it's not a critique of the clinical utility of the polyvagal informed frameworks. It's not a critique of the idea that safety and neuroception matter or that co-regulation is real, or that the nervous system has multiple states. It's a critique of specific neuro anatomy. Its neuro anatomical claims about the vagus nerve [00:05:00] and specifically about what about those claims mean for how we interpret a physiological signal called respiratory sinus arrhythmia.
The critique is not about whether safety and co-regulation matters. It's about whether this specific anatomy polyvagal theory describes actually works the way the theory claims. So here's the short version. Polyvagal theory proposes that the autonomic nervous system is organized around three circuits, and those circuits evolved in a phylo sequence.
And the oldest shared with reptiles is the unmyelinated dorsal vagal branch, and that's associated with shutdown and immobilization. So the sympathetic system handles fight and flight. And the most recently evolved unique to mammals, is the myelinated ventral vagal branch, which supports social engagement, safety, and what Porges refers to as a social engagement system.
And the theory also proposes that heart rate variability [00:06:00] scientifically a rhythmic pattern called respiratory sinus arrhythmia is a reliable marker of this ventral vagal activity. So higher RSA. Means more ventral vagal regulation, lower it means threat activation or shutdown. That's super important here and the critics are saying that last part doesn't hold up anatomically.
So essentially, yes, Grossman and colleagues argue that the cardiac vagal pathways porges described as anatomically distinct and hierarchically organized. Are not separable in the way that the theory requires, and the myelinated and unmyelinated vagal fibers protecting, projecting to the heart rate. Myelinated vagal fibers projecting to the heart are they contend not as clearly defined as the theory assumes.
And if those pathways are not clearly differentiated, then RSA cannot serve as that selective index of ventral vagal activity that the clinical model depends on. [00:07:00] So they challenged also this evolutionary narrative, this specific claim that the three circuits emerged in a phylo sequence. That maps onto the hierarchy that Polyvagal theory describes.
So what did Porches say? He argued that the critics mischaracterized his claims and that they were critiquing a version of the theory also that's more rigid than what he proposed. And he maintained that his use of the RSA is a clinical heuristic, which is a like a theory or a, like a framework is defensible, even if the precise anatomy is not fully resolved because.
He said that the integrative clinical value of the framework should be weighed alongside the specific empirical disputes. What does that mean? You're critiquing a version of my theory I didn't write, and the critic's response is, the version clinicians are using is the one we critiqued. So there's this idea of, porges said, the scientists essentially [00:08:00] are saying it doesn't work that way.
There's more to it than what you propose. Porges is saying this is a clinical heuristic, a framework, and the scientists come back and said this is the version that the clinicians are using, and that's what we critique. That seems like the crux of it. Whether the critics are engaging with the actual theory or with how it's been applied in simplified clinical training, we don't know.
It is, and I think it's genuinely unresolved. There's a version of the polyvagal theory that Porges articulated in the academic literature with considerable nuance about what the claims are and are not there is a version that most clinicians encountered in training, often several steps removed from that primary literature, simplified for practical application or discussion in client context, and sometimes presented as settled neuro neuroanatomy rather than a working model.
So basically facts rather than something with. Some flexibility, [00:09:00] nuance, or deviation, essentially, and the critics aren't wrong, that the clinical field is sometimes overclaimed. These things, or a therapist may have interpreted it in a certain way, but porous is not wrong. That some of the critiques target a more rigid version of the theory than he intended.
Both things are true simultaneously. If you wanna approach this from a. Very DBT model two things can be true, and that complexity is exactly why this conversation belongs in a clinical education context. Because how I've been teaching the framework to clinicians is part of what the debate is about. So it's partly about the science and partly how it's been.
Communicated construed and taught, which is where I come in. So the second part, how clinical frameworks get translated from research to practice is super important. It's a pedagogical problem as much as a scientific one, which is why I think this series belongs right here in a podcast that's been talking all spring about how clinicians [00:10:00] learn and how training design shapes what we believe.
Before we close, we're gonna look at understanding what RSA actually is because we've mentioned it a few times and we wanna make sure it lands clearly and it, we wanna keep it very plain. Respiratory sinus arrhythmia is basically a natural rhythm.
Our heart rate tracks with our breathing. Okay, so when we inhale, our heart rate speeds up slightly. When we exhale, it slows down that fluctuation of variability. Tied to breath is RSA. Okay, so it's measurable. It's been studied for decades, and it's used as a marker of autonomic RET regulation. Okay? Respiratory sinus arrhythmia, respiratory breathe in through nose arrhythmia heart rate. Polyvagal theory argues that RSA is specifically driven by the myelinated ventral vagal branch, the mammalian [00:11:00] social engagement circuit. So the higher the RSA is, it's interpreted as evidence of more ventral vagal activity and lower.
As evidence that the system has shifted toward threat or shutdown. So critics say that the neuroanatomy does not support that level of specificity. So they're not saying correlation is what they're talking about, or are they saying causation? We don't know. And the RSA can't be attributed selectively to that ventral vagal circuit in the way the theory.
Requires, that is the technical center of the debate. So it's not cause and effect. It may be correlation but not causation. And that's what this episode two is about is going deeper into what RSA tells us, what each side says about its interpretation and what the clinical implications are for how we talk about nervous system states with clients.
And that [00:12:00] episode drops April. That episode drops this Saturday, March 28th.
That episode drops Thursday, April 2nd, and. Before we close, I wanna name one thing directly. The goal of this series is not to tell you whether polyvagal is right or wrong. It's not to prove causation. It's not to prove correlation. The goal is just really to give you enough of a foundation in the actual debate that you can hold it with appropriate sophistication and discussion with colleagues rather than with either defensive certainty or unnecessary alarm.
So here is what both papers agree on, safety matters. Co-regulation is real. The nervous system state shapes what's possible in the clinical encounter, and those things aren't in dispute. So you can continue to talk about those. You can continue to educate and psychoeducation on those. The debate is about really specific [00:13:00] mechanistic story underneath all of them, and clinicians can keep doing our excellent nervous system, trauma informed work while that story's being refined.
And it's an important thing to land with. And if you want a full clinical breakdown, all three episodes of primary literature and the structured framework for applying this to your practice, join us April 21st for the Live CE webinar at CE Go, which will be in the show notes. It's one N-B-C-C-C up CE hour $39, and we'll see you there.
Episode two drops on April 2nd. I'm Kathy Couch and thanks for being here. Take care.
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