Polyvagal Theory, an Introduction
The 1% Chance explores themes of hope, wellness and discovery in the context of MND / ALS. This article is for informational purposes only and does not construe medical advice. The author is not a healthcare professional. Please consult a healthcare professional about your own healthcare needs.
Transcript
Well, hello! Welcome to the 1% Chance, exploring themes of hope and wellness in MND slash ALS. My name's Graham Dargie, I was diagnosed with MND in 2023 and my mission is to stay as well as I can in every way that I can.
Living with MND / ALS throws up an overwhelming array of physical challenges but it could be argued that the mental and emotional obstacles are just as great. When I first learned about polyvagal theory (PVT), it helped me understand how stressful lifestyles directly connect to ill health. It also gave me a practical toolkit for managing my emotional state, which has a knock-on effect for my overall wellness.
PVT teaches us that many of our actions are generated below the level of conscious awareness by the autonomic nervous system (ANS). An animal-instinct designed to keep us alive, these are autonomic decisions that move in patterns of self-protection. In other words, our ANS acts on our behalf, keeping us safe in the world by interpreting situations more quickly than our brain can consciously read them.
PVT shows us that our ANS has three main states: safe (ventral), fight or flight (sympathetic), and shut down (dorsal). To help us survive, our ANS subconsciously scans our environment for signs of either threat or connection. When we find a place of safety, we can engage in bonding behaviour (ventral). When we feel unsafe or threatened, we shift gears and prepare to fight or flee (sympathetic). When we feel that we can no longer fight or flee our way out of the threat, we enter a shut-down state where we want to give up or disappear (dorsal). In practice, the states are a continuum, with hybrid states that cross over between ventral, sympathetic, and dorsal.
As we navigate our day, our ANS reads our environment with our body and emotions responding differently according to each state. When we feel safe, we have a normal heart rate and muscle tone, and we feel relaxed, engaged, curious, creative, and hopeful. When we shift to a fight or flight state, our body increases production of stress hormones like noradrenaline, which increases heart rate, blood pressure, and muscle tone, while our emotions become anxious, tense, and fearful. In a dorsal state (shut-down), our heart rate, energy, and muscle tone become low, and we feel depressed, withdrawn, and hopeless. Here, stress hormone production decreases, and endorphins - a ‘feel-good’ hormone - may increase to help numb pain and facilitate immobilisation.
These biological changes are helpful, on a temporary basis, when an extra dose of adrenaline kicking-in can give us extra fuel to evade a predator or fight off an enemy. As part of this threat response, some non-essential functions like tissue repair, and cell regeneration are temporarily suppressed while energy is diverted to deal with the immediate threat. Our ANS knows how to find its way back to safety once a threat has passed, but stressful, modern lifestyles can cause our body to move from the fight or flight response to the integrated stress response (ISR).
Whereas fight or flight helps us deal with acute threats, the ISR helps the body adapt to lower-level stresses. Long-term activation of the ISR, however, elevates cortisol, a stress hormone, which can lead to a range of health issues, including chronic inflammation, oxidative stress, protein misfolding, protein aggregation, neurodegenerative disorders, and even cell death.
I’m sure we can all relate to times when we’ve been in these three different states: they are part of the human experience. Polyvagal theory teaches us that by becoming mindfully aware of these states, we can learn to at navigate them rather than simply following where our nervous system takes us. If I can recognise the physical or mental cues in my body when I’m in a ventral state, a sympathetic state, or a dorsal state then I’m more able to notice when I’ve moved away from safety. Understanding polyvagal theory isn’t about staying in a ventral state at all times; it’s about building the flexibility to move back to ventral when we notice we’ve been nudged out of it.
We might be aware of our ‘triggers’ - the things that can quickly shift us away from feeling safe. In the context of chronic illness, the thought of an unwanted future that has unfolded before us can lead to feelings of despair that can be hard to shake off. Deb Dana, a leading expert in polyvagal theory, describes what she calls ‘glimmers’. Glimmers are prompts we can use to help move ourselves back to a ventral (safe) state; conditions where we not only feel better emotionally, but where our cells can return to functioning at their best.
Finding your own set of glimmers gives you a personalised bank of resources to draw from in difficult moments. Examples include, a comforting hug from a loved one, social engagement, (laughter, eye contact etc), mindfulness practices and breathing exercises, dance or physical movement, listening to music and acts of creativity and spending time in nature.
Understanding polyvagal theory has been a game-changer for me. It has given me the tools to recognize when my nervous system is in distress and, more importantly, how to guide it back to a place of safety. Living with MND/ALS presents daily challenges, but knowing that I have the power to influence my emotional and physiological state gives me a sense of agency in a situation that can often feel beyond my control.
Remember, this isn’t saying I can eliminate difficult emotions or stay in a ventral state at all times; it's about cultivating the skill and flexibility to return to balance when life pushes me off course. By identifying my own ‘glimmers,’ I can navigate this journey with greater resilience, hope, and self-compassion. I hope you can, too.
I stand with you.