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Therapy Show

Apr 13, 2020

Deb Dana is a Licensed Clinical Social Worker and a leading expert in the field of using polyvagal theory in therapy. Ms. Dana is a consultant for the Traumatic Stress Research Consortium in the Kinsey Institute which is focused on using the lens of Polyvagal Theory to understand and resolve the impact of trauma. She is the author of the book The Polyvagal Theory in Therapy, co-edited with Stephen Porges Clinical Applications of The Polyvagal Theory, and I encourage everyone to read her new book Polyvagal Exercises for Safety and Connection which will be released in April 2020 and can be pre-ordered on

Polyvagal Theory, developed by Dr. Stephen Porges and translated into a therapy framework by Deb Dana, LCSW, identifies a biological order of human response that is active in all human experience. We come into the world wired to connect and with our first breath we embark on a quest to feel safe in our bodies, in our environments, and in our relationships with others. The autonomic nervous system, working below awareness and far away from our conscious control, is our personal surveillance system, always on guard, asking the question “Is this safe?” Its goal is to protect us by sensing safety and risk, listening moment by moment to what is happening in and around our bodies and in the connections we have to others.  

Dr. Porges, understanding that this is not awareness that comes with perception, coined the term neuroception to describe the way our autonomic nervous system scans for cues of safety, danger, and life-threat without involving the thinking parts of our brain. Because we humans are meaning-making beings, what begins as the wordless experiencing of neuroception drives the creation of a story that shapes our daily living.

The autonomic nervous system is made up of two main branches, the sympathetic and the parasympathetic, and responds to signals and sensations via three pathways, each with a characteristic pattern of response. Through each of these pathways, we react “in service of survival.” The sympathetic branch is found in the middle part of the spinal cord and represents the pathway that prepares us for action. It responds to cues of danger and triggers the release of adrenaline, which fuels the fight-or-flight response. In the parasympathetic branch, the remaining two pathways are found in a nerve called the vagus. Vagus, meaning “wanderer,” is aptly named. 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.

Dr. Porges identified a hierarchy of response built into our autonomic nervous system and anchored in the evolutionary development of our species. The origin of the dorsal vagal 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. A sense (neuroception) of danger can trigger us out of this state and backwards on the evolutionary timeline into the sympathetic branch. 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.

Polyvagal Therapy on

Disclaimer: The information shared in this podcast is not a substitute for getting help from a mental health professional.