Polyvagal Theory in Therapy

A Primer

PTSDSTRESSPOLYVAGAL THEORYNEUROSCIENCENEUROPSYCHOTHERAPY

Emil Barna

11/8/20246 min read

Ever wondered why some days you feel calm and connected, while on others you feel defensive, shut down, or checked out? These responses aren’t random; they’re your body’s way of managing safety and survival.

Polyvagal Theory was developed by Dr. Stephen Porges in the early 90s to help explain why your nervous system responds the way it does. (Check out the infographic above for a more complete visual, and at the end for a simpler representation and a kids-friendly version—if you want these copies in a high-res PDF, just reach out and I'll send them through)

So, let's sink our teeth into what this theory is and how it applies to your therapy!

Nervous System States

Your nervous comprises your brain, spinal cord, and the nerves that come out of the spinal cord and the base of the brain (i.e., cranial nerves). Why's this important? Well, your brain is the CEO of everything that happens in your life, in and around you. So let's think about in greater depth using Polyvagal Theory as our base. Polyvagal Theory describes three main states that our nervous system shifts through:

  1. Safety and Connection (Ventral Vagal) – You feel safe and engaged.

  2. Fight-or-Flight (Sympathetic) – You’re in survival mode, ready to take action or defend yourself.

  3. Shutdown (Dorsal Vagal) – You're overwhelmed and disconnected.


Let’s explore each in detail.

Ventral Vagal State – "Window of Tolerance" (The Green Zone)

The ventral vagal state describes a pathway that originates in the brainstem (through the vagus nerve) and connects to your facial muscles, vocal cords, heart, and lungs. It helps you be social and calm by regulating your heart rate and helping you relax.

In the ventral vagal state, you're in your “Window of Tolerance.” This is where you feel safe and connected, handling stresses without getting overwhelmed. You feel curious and compassionate, focused and aware.

This state activates the parasympathetic nervous system (part of the nervous system that helps you slow things down, like a parachute), giving you a sense of well-being. In this state, you've got access to your prefrontal cortex—the part of your brain responsible for logical thinking, planning, and empathy. You feel safe, at ease, can think about consequences, and are open to new experiences and challenges.

Sympathetic Nervous System – "Fight-or-Flight" (The Red Zone)

When you feel threatened or stressed, your body shifts into 'the red zone.' This state, known as hyperarousal, is often called the "fight-or-flight" response. Your body's on high alert, ready to protect you by either fighting off a threat or running away from it.

In this state, your sympathoadrenal system kicks in, releasing epinephrine (adrenaline) and activating the HPA axis (hypothalamic-pituitary-adrenal) in the brain, which releases cortisol. These hormones prepare your body for action, which is useful in genuinely dangerous situations. Adrenaline is good to get you going in the short-term, but if it isn't effective at keeping you safe, cortisol takes over and stays in your system for longer. You can only run off adrenaline for so long—cortisol, however, can be in your blood for ages. This is what we refer to as 'chronic stress.'

Signs you’re in the sympathetic fight-or-flight state include a racing heart, rapid breathing, feeling defensive or anxious or angry, having racing thoughts and difficulty focusing, and the urge to run away or act out. In this state, you’re more likely to say, “I don’t care,” as your brain and body focus only on survival. You can't connect or reason. Why would you want to? You're trying to stay alive! All this is useful when you actually need to react quickly to a threat, but when it’s a reaction to daily stress (like another email!), it feels overwhelming and even destructive.

Dorsal Vagal State – "Shutdown" (The Blue Zone)

When stress feels overwhelming, your body might switch over into dorsal vagal mode. This state (also known as hypoarousal, dissociation, or “shutdown”) is your body’s way of conserving energy when it feels there’s no way to escape or fight. It's also the system that makes you faint when needed.

When you're in this state, you feel disconnected or dissociated, numb and exhausted, or even simply out of it. Physically, you feel heavy and tired and slow. Your body is pushing a button to try help—after all, what it detect is a life-threat. Signs you’re in the dorsal vagal state include feeling numb or blank, extremely fatigued or shut down, unemotional or checked out. You feel like you just need to give up. It feels safer to shut down that way, especially when overwhelmed. This response is common in situations of prolonged stress or trauma, where escape or action just isn’t possible.

Hybrid States: "Freeze," "Please/Appease," and "Play"

Interestingly, Polyvagal Theory also describes something we can call hybrid states, where two pathways are active at the same time, leading to complex responses:

  1. Freeze (Sympathetic + Dorsal Vagal) describes a state where you’re frozen, feel tense, are unable to move or react. This is common in situations where you want to escape but feel trapped. Physically, you might hold your breath, feel unable to speak, or feel a sense of being “stuck.”

  2. Please/Appease (Sympathetic + Ventral Vagal) describes a response that combines fight-or-flight with social engagement. Inside you feel annoyed, disinterested, unsafe, or stressed, but externally you try to be bubbly and engaging. You feel like you're wearing a mask. This can lead to actions like people-pleasing or peacekeeping. You might try to make others happy or avoid conflict, even if it means sacrificing your own needs.

  3. Play (Ventral Vagal + Sympathetic) describes a positive hybrid state where you feel energised, safe, and connected. You crave fun and humour and excitement, all in a safe and accepting environment.


Moving Through These States (The Yellow Zone)

The process of moving between these states is natural. Sometimes we "see red," other times we "feel blue," and still others we're feeling cool, calm, and collected. When we move through these phases, we can think of it like going into the 'Yellow Zone'—we haven't completely ticked over, but we're on the verge to.

These yellow zones (let's call them 'zones of dysregulation') represent your nervous system moving out calm and into choppy waters. You feel uneasy and disconnected and edgy—all signs that your system is becoming dysregulated. Think of this state as a tipping point: If stress continues, you might shift into hyperarousal (red) or hypoarousal (blue).

Learning to recognise and understand these states empowers you. Knowing when you’re in a dysregulated can lead you back to your 'green zone,' where you feel safe, connected, and able to tackle challenges.

Practical Ways to Return to Your Window of Tolerance

Here are a few strategies that can help you move back toward a ventral vagal state:

  1. Breathing Exercises: Deep, slow breaths help activate your nervous system and signal safety in the brain (check out this page for a huge list of evidence-based breathing interventions).

  2. Grounding: Focus on what's going on around you and your physical sensations. Press your feet into the ground. Name 3 things you see. Describe one of these things in detail. Listen to the sounds around you. Isolate one and listen deeply. Take a breath. Bring yourself into the present moment and reconnect with your surroundings.

  3. Movement: Gentle stretching, yoga, or even walking can help release built-up tension and restore a sense of calm.

  4. Reconnect: Social connection activates the ventral vagal system. Spending time with supportive friends or family can help you feel safe and engaged.

  5. Self-Compassion: Acknowledge emotions without judgment. Know one part of you feels one way while another might feel something else (check out this post for more on 'parts therapy'). Take space. Regroup. Recognising and accepting your responses can help calm your nervous system.


To Sum Up...

Polyvagal Theory gives us a powerful framework for understanding why we are the way we are. Sure, it's a theory—a great biological, neuroscientific, neuroanatomical theory—so there may be arguments for and against it; but I've noticed is that just like the theory of biological evolution gave us a great way of understanding the diversity around us, Polyvagal Theory gives us an awesome way of understanding the science of safety and threat. By learning about the different states of our nervous system and how they show up in our emotions and physical sensations, you have greater autonomy and can learn to work with our body’s natural responses. You understand, without shame, that your body is doing the best it can to survive. It's trying to protect you. It's trying to help. Recognising these states—and knowing how to return to balance—helps you take back control, feel more connected, and have more resilience in the face of life’s challenges.

Next time you feel anxious, defensive, shut down, or perfectly calm, pause and notice which state you're in. Remember, these responses are your body’s way of keeping you safe. Understanding and honouring them is the first step to navigating life with greater awareness and ease.