What to do with the myth of Polyvagal Theory

Polyvagal Theory is everywhere these days. 

Psychologists talk about it; parenting coaches talk about it; if you’re in the mental health field you’re probably referring to polyvagal theory in some way. So one would assume that there’s lots of evidence for it, right?  Well, maybe. Maybe not. 

In this episode I dig into the foundational principles of Polyvagal Theory and find that there's a lot less evidence supporting it than you might think, given how many places it's used.

So what's going on? Is it legit? Should we be using a different theory to understand our experience instead?

But all may not be lost! Maybe there are aspects of the theory that we can still use...the episode suggests a path forward on this.

Jump to highlights:
00:00 Introduction to this episode
04:05 Three defining principles of the Polyvagal Theory
09:01 The challenges in reconciling PVT’s popularity with the lack of scientific evidence supporting its core premises
21:09 Dr. Stephen Porges' 1995 paper on Polyvagal Theory (PVT) is examined, including references to Charles Darwin's support, removal of a premise, and disagreements with Dr. Paul Grossman
24:35 Dr. Stephen Porges' 2007 paper on Polyvagal Theory introduces four principles about heart regulation and the vagus nerve's role in social engagement behaviors
32:12 Dr. Doody challenges the assumptions behind Polyvagal Theory
36:34 Experts challenge Polyvagal Theory (PVT) by refuting its foundational premises, raising the need for alternative models and further evidence examination
42:05 Bloggers and experts offer mixed views on Polyvagal Theory (PVT): some argue it can adapt without changing its core, while others label it a myth
45:31 Jen evaluates the usefulness of Polyvagal Theory (PVT) considering evidence both for and against it
48:01 The existence of alternative theories to Polyvagal Theory (PVT) is a key consideration in evaluating its validity
48:35 Polyvagal Theory (PVT) is still debated, with limited evidence both for and against it, and alternative theories lacking strong support.
55:24 The cultural context and alignment between a therapist's explanation and a client's understanding are essential for therapeutic success
01:06:23 Indigenous perspectives emphasize the importance of understanding dynamic systems in place and time, which aligns with Dr. Porges' attempt to examine a broader system in polyvagal theory
01:11:55 The Safe and Sound Protocol (SSP), based on polyvagal theory (PVT), lacks substantial scientific evidence supporting its effectiveness

[pedrom]

So interesting. I personally find polyvagal theory baffling even on its own terms. There's so much talk of people being 'stuck' in defensive states, and the need to move through sympathetic, up the ladder into ventral, then in the same breath we're told that we first need to move into ventral in order to 'unstick' a defensive state! Total paradox as far as I can see. I can't make head nor tail of it.

[shinshin]

You raise some interesting points and I appreciate the level of detail. I wanted to address this comment: "surely if PVT were completely invalid, there would be an absolute dog pile of research from people anxious to disprove it." In reality, what I have heard from researchers is most could care less about PVT because to them it is so obviously wrong. They simply don't have the time for it.

[pdpUU]

Never seen your videos before but I'm thankful I came across this one - I love how you explain your thought process and approach to assessing this argument. A great illustration of critical thinking. Thank you!

[terryelizabeth]

Your analysis was very helpful to my efforts to grapple with this very same subject. I appreciate your process and conclusion.

[RalloR]

This is such and awesome exposition of the subject!!! Thank you so much for your efforts, you have even a great setup for recording! I wish this had reached more people, I think maybe the title isn't helping maybe something like Why the PVT is a myth and why that may not be that bad or something like that. My point is that it may be titled like an article and in youtube there is more to the creating curiosity (: not clickbait or anything but something that sparks that curiosity, I think in your title people that "asupport" the theory may dismiss it and even be offende, and the people that dismiss the theory may be like ikr? next video haha and you actually have so much more to offer to both camps. This is truly great (: I wil check out all youother videos.

[larseriksson]

Wow! I'm really impressed and I will definitely check out the rest of your content.

Hope you don't mind, but I'll take a shot at a question.


I would love to hear your thoughts on NLP, neurologistic language programming.
It's not scientifically proven in every aspect, but with a practical approach and a critical mind to explore it, everybody can put it to good use in a way that suits them.

You can't simply replace your senses and reactions to replicate a successful athlete for instace, if you're wanting to be good at high jumping, but keep stopping before the bar. However you can work on different aspects of your behaviour and ultimately get closer, kind of using a scientific method of researching yourself and running the change process as a project.
It's an entire world and my favorite speaker and coach is a Swedish one, named Kjell Enhager, who also has English videos.

[ericray]

3 examples of how body language is not universal:
1. In India, there are not one, but several nuanced variations of what Westerners know as “nodding”.
2. Bulgarians shake their heads for “Yes”, and nod for “No”
3. Most Asians do not gesture “Come here” the way Westerners do. They would consider that degrading - since it is reserved for animals. They wave their hand in a flapping motion towards the ground.
Also, most all cultural responses are quite different in collectivist (Asian) societies as opposed to individualistic cultures (American, British, Australian, Canadian, etc.).

[caitlin]

Thank you for all your work on this. I’ve been wondering about the legitimacy of PVT and this is exactly what I’ve been looking for

[LeahBensonTherapyTampa]

So good! Thanks. I'm always looking for good explanations of why this is a myth to send to my friends and colleagues. I'm a bit less measured than you, lol, so this is a good resource. The betrayal I felt was gigantic when I realized (after understanding Lisa Feldman Barrett's work) that PV was junk. I couldn't believe that all my teachers had been teaching me scientific myths about brain function. And though they are no longer my teachers, it irks me that they still are teaching this junk as if it's science. It's kind of infuriating, and I'm on a mission to make sure as many people as possible know it's junk science. Therapists deserve better. They deserve to know that it's a story, perhaps a useful one, but nothing more. Anyway, thanks again.

[mindofown]

Polyvagal theory bases its theory on the role of the vagus nerve, however scientists with extensive experience and knowledge about the vagus nerve have debunked Porges data and theory. Still its a very helpful model for psychotherapy.

[bitofwizdomb]

What do you think of attachment theory ?

[Neilgs]

As far as the effects of RSA (respiratory sinus arrhythmia) being questionable is simply untrue. Look at apnea, tachycardia and neurogenic bradycardia in SIDS amongst preemies born prior to 28 weeks. The protective myelinated (ventral) vagus is simply not there. There is a direct causal relationship. Much of Steve’s work is entirely borne out by human embryology.

[Neilgs]

Core affective emotions are universally hardwired, parabrachial nucleus, part of the lateral reticular formation, the periacqueductal gray, hypothalamus, etc. Seeking System/Curiosity, Panic, Sadness, Rage, Lust, , Nurturance/love, Play/Laughter. The outward various cultural expressions may subtly vary but they are identical with respect to accompanied autonomic state. If you prefer looking at animals they are the same. Lisa Barrett who you cite, the darling of cognitive neuroscience is actually fringe and doesn’t hold a candle to Mark Solmes and the father of Affective Neuroscience who actually correlated, mapped these systems empirically, Jaak Panksepp.

[lightmatter]

In regards to the coherence model you mentioned. You say didn't really show proof. I don't necessarily have any proof....but heartmath might have some good information for you.

[SusQ]

You seem to love drama. Why there is so much drama around everything these days. What comes to polyvagal theory. It has helped me a lot to control my stresslevels. I understand that medical industry hates pvt, cause people can get help without drugs through breathing and balancing autonomic nervesystem. Could it be that research doesnt get any funding because results might be harmful for medical industry 🤔

[Neilgs]

No matter how impressed you are with respect to what Taylor is saying, his assertions are NOT supported by the facts! The cardioinhibitory neuronal fibers migrated from the dorsal motor nucleus to the nucleus ambiguus forming the mammalian ventral vagal complex, which is IN FACT neuroanatomically linked and coordinated with the five cranial nerves (V, facial nerve, VII, trigeminal nerve, IX, glossopharyngeal nerve, X, Vagus nerve and XI Accessory nerve. They are connected by interneurons. This has never been disputed by any scientific peer reviewed journal.

"However, Porges is wrong that the vagal system is responsible for social interactions such as facial expression and head turning."

This is entirely inaccurate. What are the other cranial nerves? Do you know what they are? Did you know that the outer perimeter of the nucleus ambiguus is where the facial nerve forms? Do you understand that sucking, swallowing and vocalization is an integral part of calming and in normal and healthy infancy a high baseline RSA and the beginnings of social-emotional regulation/engagement? Do you understand that the striated muscles of the face, cranial nerve V innervates the ossicle chain, the small middle ear muscles, namely the stapedius muscles as well as other cranial nerves? We are talking about coordinated neuronal pathways of the cranial nerves.

However the five cranial mentioned nerves and the two visceromotor pathways (i.e., specifically the ventral vagal complex) is a fundamental part of how the fetus myelinated brain during the third trimester develops. Please take a look at Embryology. During the first six months (forgive me for repeating myself) the corticoreticular pathways begin to be transferred or re-purposed to more corticobulbar pathways with projections to other myelinated developing parts of the central nervous system. So the SAME SYSTEM (the ventral vagal complex as it further myelinates (the child acquires more agency), becomes part of social-affective reciprocal cueing with the mother (i.e., back and forth deepening affect reciprocal attachment, back and forth vocalization and play).

Of course the parasympathetic ventral vagal complex (social-engagement) sympathetic-adrenal system (fight/flight) and the dorsal motor complex (reduction of metabolic output and immobilization under threat) are phylogenetically and hierarchically ordered! All are different adaptations of one system.

I am sorry but with all due respect, it is embarrassing and patently absurd to make such a misleading and false statement about the ventral vagal complex!

[Neilgs]

For entertainment purposes only, I go back and listen once again. The reason Polyvagal theory is not falsifiable is that the science supporting it is derived from long established, well- substantiated facts in neuroanatomy, neurophysiology, neuroendocrinology and embryology.

You are very confused. "The vagal nerve is not the 'cause' of social differences." The vagus nerve is simply a conduit. It is affect -reciprocal co-regulatory engagement (i.e., neuroceptive and interoceptive cues of safety or danger) that then results in shifts in vagal regulation and cardiac tone (e.g., RSA).

Your quoting of Dr. Doody@ 1:15, (his points) are risible to the point of utter absurdity. It stands as a laughingstock on the basis of facts. 1) Mammals did not evolve from "modern reptiles" that's correct, however, they did indeed evolve from a common ancestor to both reptiles and mammals. 2) It is both tragically sad and hilarious that you believe that reptiles are social in any shape manner or form like mammals. Reptiles do not engage in nurturing their young, nursing, grooming, playing, laughing; up regulating (affective states of joy) and down regulating (affective states of sadness or crying) through social-engagement. They do not down regulate cues of threat through social play and engagement. Their dominant neuroanatomical and neurophysiological response under threat is to immobilize. They do not have at their disposal the mammalian myelinated ventral vagal complex. Because their oxygenation requirements are 500% less than the mammalian brain, they can without harm immobilize (i.e., feign death) when under life threat.

The cardioinhibitory fibers clustered and migrated from the dorsal motor nucleus to form the nucleus ambiguus and significantly coordinate and inter-neuronally link with the five cranial nerves (V, VII, IX, X and XI) to form the social-emotional autonomic nervous system (the ventral vagal complex) of mammals. We don't need to turn to phylogeny but simply our owbn human embryology to see how our physiology and associated pathways ways form.

Of course the brain was re-wired in mammals to express sociality and down-regulate defense (i.e., the migration of the cardioinhibitory fibers neuroanatomically linked and coordinated with the five cranial nerves mentioned and visceromotor pathways, sinoatrial node and bronchi forming the ventral vagal complex). That my "informed one" is a truism. It is not even in question! That is not a "just-so" story that is a phylogenetic and neuroanatomical fact! However, we do not need to turn to evolution from a-social reptiles to mammalian autonomic nervous system, we simply can look IN THE PRESENT at how the autonomic nervous system in babies develop, Embryology. They transition precisely through the same stages, dorsal motor nucleus to a myelinated ventral vagal complex.

"Heart-rate variability is not the reason we over-react in certain situations." Heart rate variability and specifically RSA is a window, a measurement of the efficiency of the vagal brake, which reflects, key word, reflects ( NOT causes) how safe, unsafe or withdrawal/shut down we feel with others and our environment. You have it backwards.

Cited in some 15, 000 peer-reviewed articles. The theory is not wrong.