“Polyvagal theory” was introduced in 1994 by Stephen Porges, director of the Brain-Body Center at the University of Illinois at Chicago. As a mental health theory, it reshaped how we view the autonomic nervous system and its role in human behaviour. The Autonomic nervous system encompasses nerve fibers transmitting information from the body toward the brain, called afferent influences and, in as simple an explanation as possible, according to polyvagal theory, branches of the vagal nerve are claimed to serve different evolutionary stress responses in mammals: the more primitive branch is said to elicit immobilization behaviors, whereas the more evolved branch is said to be linked to social communication and self-soothing behaviors.
These functions are claimed to follow a hierarchy, where the most primitive systems are activated only when the more evolved functions fail. These neural pathways regulate autonomic state and the expression of emotional and social behaviour. Thus, according to this theory, physiological state dictates the range of behaviour and psychological experience.
Given the growing discussion around polyvagal theory in therapy, we examine these questions in a dedicated seminar that sets out the recent critique alongside Porges’ response, with a focus on how this evolving debate may influence clinical reasoning and intervention.
Rethinking Depression
According to Porges, what we call depression is the cluster of emotional and cognitive symptoms that sits on top of a physiological platform in the immobilisation response. It’s a strategy meant to help us survive; the body is trying to save us. In other words, according to this theory, it follows that depression happens for a fundamentally good reason.
And that perspective, potentially, could change everything when it comes to how we view depression, our attitudes towards it and how we treat it. This mental health theory suggests that when people who are depressed learn that they are not damaged, but have a good biological system that is trying to help them survive, they begin to see themselves differently. After all, depression is notorious for feelings of hopelessness and helplessness. But if depression is an active defence strategy, people may recognise they are not quite as helpless as they thought.
Recent Polyvagal Theory Research
We were reminded of this in a recent article in Psychology Today by Alison Escalante, M.D. “For generations, we have seen depression as an illness, an unnecessary deviation from normal functioning. It’s an idea that makes sense because depression causes suffering and even death. But what if we’ve got it all wrong? What if depression is not an aberration at all, but an important part of our biological defence system?
More and more researchers across specialities are questioning our current definitions of depression. Biological anthropologists have argued that depression is an adaptive response to adversity and not a mental disorder. In October, the British Psychological Society published a new report on depression, stating that “depression is best thought of as an experience, or set of experiences, rather than as a disease”. And neuroscientists are focusing on the role of the autonomic nervous system (ANS) in depression. According to the Polyvagal Theory of the ANS, depression is part of a biological defence strategy meant to help us survive.”
Getting It Backwards
Put very simply, models like the Polyvagal Theory suggest that, as a society, we’ve got it all the wrong way around. It’s the body that detects danger and initiates a defence strategy meant to help us survive. That biological strategy is called immobilisation, and it was, or is believed to manifest in the mind and the body with a set of symptoms we have come to label as depression.
The problem with the old way of thinking is that when we think of depression as irrational suffering, we stigmatise people and potentially rob them of hope, argues Escalante. But when we change our approach and consider that depression, at least initially, happens for a good reason, we begin to lift the shame that many suffer, possibly breaking the negative cycle. This will be more than familiar to the approach taken in yoga therapy. If this way of looking at depression could be adopted by society at large, we could start to see that people with depression are courageous survivors, not damaged.
Shifting Out of Immobilisation: A Polyvagal-Informed Mental Health Theory
The article in Psychology Today explains how, if depression is the emotional expression of the immobilisation response, then the solution is to move out of that state of defence. Porges’ Polyvagal theory proposes that it is not enough to remove the threat. Rather, the nervous system has to detect robust signals of safety to bring the social state back online. And the best way to do that? Via Social connection.
Alison Escalante, M.D., argues, “One of the symptoms of depression is shame, a sense of having let other people down or being unworthy to be with them. When people are told that depression is an aberration, we are telling them that they are not part of the tribe. They are not right, they don’t belong. That’s when their shame deepens, and they avoid social connections. We have cut them off from the path that leads them out of depression. It is time that we start honouring the courage and strength of depressed people. It is time we start valuing the incredible capacity of our biology to find a way in hard times. And it is time that we stop pretending depressed people are any different from anyone else”
