The Vagus Nerve, Polyvagal Theory and Hypnotherapy
DSFH, HPD; Reg CNHC, AfSFH, MNCH, ABNLP, ABH, IARTT; CTAA, BA Hons (London), PGCE (Cantab)
Hypnotherapist, Jane Pendry, explains how the vagus nerve, and our modern understanding of neuroscience, helps to explain the transformational power of hypnosis in this easy-to-read summary of Stephen Porges’ Polyvagal Theory.
Why does Polyvagal Theory matter?
Polyvagal Theory
The Polyvagal Theory explains how our entire nervous system works, and how and why Solution Focused Hypnotherapy and somatic healing are so effective for anxiety-related conditions, and resolving trauma.
Understanding how the nervous system works signposts us to the most effective, safe, drug-free paths to healing.
The vagus nerve is the longest cranial nerve and accounts for around 85% of the functioning of our parasympathetic nervous system.
What is the vagus nerve?
The vagus nerve is the longest cranial nerve. It links our brain to all our key organs.
This long, meandering nerve - a pair of nerves actually - is the main driver of our parasympathetic nervous system, and it strives to keep us calm and regulated.
The vagus nerve starts in the medulla oblongata - in the brainstem - where the brain and spinal cord connect. It meanders down the spinal column and carries sensory fibres that link with parasympathetic control of our major organs including the digestive tract.
How it functions is at the core of Polyvagal Theory.
Rapid transformations
As a Solution Focused Hypnotherapist, I can testify to the rapid transformations of many of my clients. The rapid positive change hypnosis can facilitate, can largely be put down to the efficient functioning of the vagus nerve, and the plasticity of the brain.
When healing takes longer
Sometimes there are complicating factors, where recovery can take a little longer. Understanding the vagus nerve and Polyvagal Theory is also the key to helping clients with more complex, deeper rooted issues to recover.
Hypnotherapy - toning the vagus nerve
Genetics, trauma, environmental stressors, hormones, diet and chemical imbalances can all impact the functioning of our vagus nerve. Hypnotherapy helps to tone and strengthen the vagus nerve, and retrains our bodies and minds to help us resolve even the most complex issues.
Our Unique Nervous Systems
Each person’s nervous system is different. Much of our innate resilience is down to a healthy functioning vagus nerve.
A Formula 1 driver has a highly efficient nervous system, with reaction times estimated to be 3 times faster than the average person.
Someone who has experienced enduring trauma, or who has a developmental delay, may be overwhelmed quite easily.
Luckily, we can tone our vagus nerve, and strengthen our parasympathetic nervous system (much like we can train our mind and our muscles).
Hypnosis is one way we can tone the vagus nerve; not to the extent we become racing drivers of course. We can, however, increase our resilience and capacity for stress, reduce our anxiety and become generally calmer and more in control.
The Autonomic Nervous System
To understand Polyvagal Theory let’s start with the autonomic nervous system or ANS.
We know the autonomic nervous system regulates the internal organs in the body without us being consciously aware. We breathe. Our heart beats. We produce hormones. Our blood circulates.
All until our nervous system is disrupted.
When our system is working as it should, we are barely aware of the sensations in our body. We just feel ‘normal’ and would struggle to describe what’s happening in our body.
Photo (c) Hannah Thomas Licensed from @ wombtoworldart
Our Sympathetic Nervous System
The sympathetic nervous system drives the ‘fight or flight’ response.
The amygdala - the body’s alarm
The amygdala - a tiny organ situated at the top of the brain stem - acts like an alarm system in the body. When we face a threat – real or imagined – the amygdala acts like an alarm sending signals to other parts of the brain. The body goes in to battle; or we run away.
The hypothalamus - our hormone pump
The hypothalamus pumps out stress hormones - adrenaline, cortisol, noradrenaline - to help us take action. We act fast.
What the vagus nerve does next
When pushed into fight or flight, the vagus nerve, to a greater or lesser extent, becomes less active.
Although our heart pumps vigorously to get enough oxygen to our muscles to help us run from, or fight, the real or imagined ‘predator’ or threat, the functioning of our digestive organs slows down.
This is a partial immobilisation response. Our throat constricts, our eyes can become blurry, we feel clammy, our stomach ‘drops’, we produce more bile, and we want to empty our bladder and bowels (presumably to lighten us as we face the fight).
When the threat has passed
When the threat has passed, our brain sends signals through the vagus nerve that we can now stand down, and rest. Our body returns to normal. We experience relief.
The Parasympathetic Nervous System
When the parasympathetic nervous system is dominant, we are in the ‘rest and digest’ state. We are calm, in control and ready to connect with others.
The structure of the vagus nerve
The vagus nerve is primarily responsible for the functioning of our parasympathetic nervous system. The vagus nerve consists of a pair of nerves wandering around your brain, and down your spine.
Connected nerves, like tributaries from a river, reach out to all our major organs. These nerves spread out to the muscles of the eyes, and to the throat, heart, lungs, stomach, bowels, and bladder.
Helping us return to calm
When the vagus nerve is ‘toned’ and functioning well, our bodily systems function well and we can return to a calm relaxed state much faster.
Dr Porges’ Polyvagal Theory
When we talked about the sympathetic nervous and parasympathetic nervous systems in the past, the emphasis was always on the motor pathways of both systems travelling down to the organs. One way traffic.
Who is Dr Stephen Porges?
Expert on developmental psychophysiology and behavioural neuroscience, Dr Stephen Porges, developed The Polyvagal Theory from his experiments with the vagus nerve. Porges observed bi-directional communications from the brain down to the organs; and from the organs back up to the brain.
Two-way traffic!
Porges deduced that motor pathways govern communication from the brain to the organs; and sensory pathways communicate sensory information from the organs to the brain.
Evolution of the ANS
Porges’ Polyvagal Theory also describes how our autonomic nervous system evolved. As mammals evolved from reptiles, our autonomic nervous system developed to help us defend ourselves from a variety of threats, and to co-regulate and connect with other mammals and each other.
The Parasympathetic Nervous System and Sympathetic Nervous System Phoco (c) Adobe. Licensed.
The Third Nervous System
The traditional model of the nervous system was then a two-part ‘antagonistic’ system where the two systems – sympathetic and parasympathetic - have opposing actions and balance each other out.
• More activation of the sympathetic nervous system signals a flight or fight response – agitated and active
• Activation of the parasympathetic nervous system signals the ‘feed and breed’ response - calm and connected.
The social engagement system
Porges added a third nervous system response called the social engagement system where activation and calming operations adapt and change as a result of nerve influences through the vagus nerve.
Hypnotherapy and Solution Focused approaches help the sympathetic nervous system to stand down; and help activate, stimulate, strengthen and tone the parasympathetic nervous system. The result is an improved social engagement system.
When we are immobilised or shut down, or in fight or flight mode (aggressive, stressed or anxious) we know from experience this directly affects our ability to engage and connect with others. By addressing the physiological root cause of our dysregulation, we find our social engagement system operates well and we create a virtuous cycle of connection, interaction and emotional support.
What is the Vagus Nerve?
The vagus nerve, the 10th cranial nerve, is the main information highway, responsible for 85% of the functioning of our parasympathetic nervous system.
The wandering nerve
In Latin, the vagus nerve means the ‘wandering nerve’. It is, by far, the longest cranial nerve, meandering from the front of the brain and down the spine to our tailbone.
Controlling key functions
The vagus nerve helps to control our autonomic (automatic) nervous system functions: breathing, heart variability, hormones, digestion, and even sweating, In addition, the vagus nerve plays a key role in stimulating saliva production, regulating blood pressure, and plays a part in producing tears.
According to Polyvagal Theory the vagus nerve has two different motor pathways that travel through the vagus nerve: the dorsal (back) vagus and vagal (front) vagus branches.
The Ventral Vagus
The ventral vagus is the area of the brainstem involved in regulating the heart, bronchi in the lungs, face and head muscles, the larynx, pharynx and neck. In short, all the organs above the diaphragm.
Responding to cues of safety
The ventral vagus nerve responds to cues of safety.
When we feel physically safe, calm, socially or emotionally connected, the ventral vagus nerve is dominant. Ventral vagus activity does not involve chemical reactions and can happen in milliseconds.
Feeling ‘normal’
The resulting social engagement system is a kind of playful communication which we experience when we feel psychologically safe. When we are in this state, we are barely aware of the functioning of our body because it just feels ‘normal’.
What is the Dorsal Vagus?
The dorsal branch of the vagus nerve affects organs below the diaphragm. It is located in the brainstem, and integrates and coordinates sensory information received from the lungs, heart, digestive organs, bowel, reproductive organs and circulatory systems.
Shut down, freeze and faint
The shut down, freeze or faint response operates through the dorsal branch of the vagus nerve. This reaction includes muscles feeling tired or weak, and light-headedness much like mild flu when we are stressed.
At the other extreme, the body and mind can shut-down completely when we are faced with an overwhelming, or enduring threat.
Photo (c) of the Polyvagal Institute 2023
Three Evolutionary Stages
In his Polyvagal Theory, Stephen Porges describes three evolutionary stages involved in the development of the autonomic nervous system. He describes a hierarchy of responses.
Immobilisation
Extreme danger resulting in being frozen in fear, numb or shutdown and is associated with the dorsal vagus nerve. This oldest evolutionary pathway helps us survive.
Mobilisation
The nervous system response linked to our sympathetic nervous system helps us mobilise in the face of potential danger. This pathway evolved next.
Relaxed - Social Engagement
The ventral (front) side of the vagus nerve, which largely governs the activity of the parasympathetic nervous system, responds to cues of safety and connection, allowing us to feel anchored, safe, engaged, calm and connected. This pathway evolved most recently.
When our vagus nerve is operating well, we are able to move away from immobilisation, and mobilisation, and towards social engagement when the threat has passed. To do that effectively we need good vagal tone.
What is Good Vagal Tone?
Good vagal tone is associated with physical and mental wellbeing. When stimulated to work well for us, the vagus nerve releases a neurotransmitter called acetylcholine. This in turn, is experienced as increased focus and a sense of wellbeing and calm and improves:
• Heart health: heart rate variability improves which increases resilience to stress
• Emotional regulation: we become more emotionally resilient
• Improved digestion: nutrients are better absorbed, gut health improves
• Inflammation reduces: risk of inflammatory conditionsreduces and immunity improves.
Neural connections can be broken and forged to change our thinking, our reactions, our habits and our behaviours. Photo (c) Adobe Licensed
What Impacts our Vagal Tone?
When we are locked in a state of self-defense, or we are chronically engaged with ever-present threats. We don’t connect with others. The systems designed to keep us safe become maladapted.
Often long after threats have gone, and when we recognise perceived threats are no longer dangerous or life-threatening, we can continue to stay locked in fight or flight, or stuck in immobilisation.
When we feel stuck
This is one reason why clients can become stuck. The body has developed an adaptive self-defence state, and becomes locked into experiencing intense physiological symptoms, sometimes without negative thoughts or obvious reasons.
Understanding how the vagus nerve operates helps us explain how conditions like persistent generalised anxiety, complex phobias, obsessive compulsive disorder (OCD), complex trauma and PTSD can become embedded.
Neural connections can change
Neural connections in the brain, can be broken and forged throughout our lifetime. That is largely how we change our thinking, our reactions, our habits and our behaviours through hypnosis. Our brain remains largely plastic throughout our lifetime, with our universe of neurons being forged, lost, connected and disconnected. That’s how we can change our thoughts, habits, behaviours, reactions and interactions.
How thoughts impact our body
Over time, intense stress impacts many of our organs and the functioning of the vagus nerve, leading to long term physical and mental health issues. However, reducing stress and learning to manage anxiety helps us keep our body and mind in working order.
Hypnosis helps us take control of our thoughts, improve the functioning of our vagus nerve, and can help us resolve trauma stuck in the body leading to improved health outcomes.
What we think does have a direct impact on how we feel.
When we are anxious (often because of our thoughts) our brain sends messages through the vagus nerve from the brain to the gut - often called the gut-brain axis - which can cause nausea and uncomfortable sensations in the tummy. Our thoughts, therefore, can impact our gut health.
Conversely, there is a body of research that shows that hypnosis can calm visceral nerves in the gut, improve symptoms of IBS and even slightly alter the gut microbiome (the balance of good and bad bacteria in the gut).
Triggers
We know that changing our thoughts alone does not always change our body’s reactions and responses, which have taken on a life of their own!
With trauma we talk about triggers. When something quite random, or unexpected, creates an instant, intense emotional response that seems out of proportion to the event, we talk about being triggered. Without any conscious thought at all, our body responds with fear or terror, shaking and a rapid heart rate. We can be triggered by all sorts of things - a button, a loud noise, a cuff-link or a word.
According to Stephen Porges, we have become mobilised. Even though there is no actual physical threat in the moment.
Reducing shame and powerlessness
Understanding the vagus nerve therefore can be helpful for clients struggling to understand their trauma responses, reduces their sense of shame and powerlessness, and gives them hope. We now know that traditional talking therapies are rarely helpful with trauma - especially complex trauma - and patients or clients end up feeling worthless or hopeless when these approaches don’t work
Working with the vagus nerve and neuroscience leads can lead to more rapid progress, helping clients stay committed to the Solution Focused Hypnotherapy process.
The Plasticity of the Nervous System
People who have experienced enduring trauma, high anxiety or Obsessive Compulsive Disorder (OCD) have shifted their nervous system into or a state of hyper-vigilance.
The past is in the present
With trauma, the past is in the present. It’s not thoughts about the trauma that create the response. The response happens automatically. The body has taken over. It is wired to react to anything that resembles the original trauma or traumas (usually experienced in childhood).
Hypnosis calming the nervous system
For this reason, it can be a battle to get some clients to change their thinking. By calming the nervous system (through hypnosis for example) it’s easier for clients carrying trauma to access their minds (primitive and conscious) and to help them change the thoughts or memories that feed the fears.
More sessions, more patience, more time
For some clients, it may take more time for them to learn to ‘stand down’ and relax at all. These are the clients that need more sessions, more patience, and more time.
The alpha brain wave state of hypnosis helps to calm the mind, and heal many of the signs and symptoms of trauma. Photo (c) Adobe licensed
Impact of Trauma
Some time ago a fellow therapist told one of my clients that because she had been with me for 6 months (on and off) for a complex issue, that I could not be a very good therapist!
Dealing with trauma
On reflection I realised that I had chosen to work with some of the most complex issues because of my own history of recovering from complex trauma, phobias and anxiety. This is not what hypnotherapists typically do.
Another experienced hypnotherapist told me that Solution Focused Hypnotherapy is not suitable as a therapy for trauma. I whole-heartedly disagree. Although I understand why people shy away from the responsibility.
Trauma is an adaptation
Trauma is not a disorder. It’s an adaptation that happens because of the functioning of the vagus nerve and nervous system in the face of extreme stress and threat. Trauma is actually a very normal and common state and hypnotherapy with a qualified, accredited and insured hypnotherapist can be hugely helpful in helping clients resolve past traumas and learn to feel safe in their own bodies.
Solution Focused Hypnotherapy
Solution Focused Hypnotherapy works brilliantly well with the unconscious and unconscious mind and the body and is suitable for almost everyone who does not have a diagnosed psychiatric medical condition involving psychosis.
Working with Neurodivergence
Vagal tone might explain why some clients respond to our methods with ease and speed, and some work with us over a much longer period. It may take clients some time to be able to access moments of anxiety and to break down internal resistance.
For neurodivergent, traumatised or highly dysregulated clients, I adapt my language to opens up the possibility of relaxation and safety for example: “You may find yourself experiencing moments of relaxation. There are no wrong feelings. You are retraining your body to feel safe. That might happen all now, or next week. You will know when you are ready.”
It is likely that neurodivergent clients will always need to manage external stressors, but Solution Focused Hypnotherapy gives these clients so much more autonomy and agency to find their own solutions, and helps to strengthen their nervous systems to make life more comfortable.
How Polyvagal Theory Benefits Clients
The brain is plastic and continues to change and forge new neural connections throughout our lives Photo (c) Adobe
By including the vagus nerve in the initial consultation we can explore whether our clients are experiencing ‘fight or flight’, or ‘immobilisation’ or a stuck state of hyper-vigilence, which may take more time. Solution Focused Hypnotherapy is about helping clients to find their way into safety, where they can change the way they think and react to stressors.
Incremental steps
Some clients need smaller incremental steps. Some require some adjustments - checking there are no trauma triggers in scripts and using more permissive language. Longer inductions can be helpful too.
If your therapist is not experienced at dealing with high levels of immobilisation or hyper-alert anxiety, please know that the limitation is theirs, not yours.
One cardinal rule is that we must never shame clients by saying something like ‘I can fix you’ (it implies they are broken), or ‘Why have you been in therapy so long?’ (something is wrong with you).
By understanding the hierarchy of response, and the operation of the vagus nerve, and with the Solution Focused focus that gives clients back their personal agency, helps take away clients’ shame and opens the door to healing.
Sticking to the process of Solution Focused Hypnotherapy, holding the space and believing in your client’s capacity to heal, moves clients towards healing.
No one therapist will be the whole answer for complex issues. Look for therapists who work with humility and respect, and help you explore the right path of healing for you.
Solution Focused Hypnotherapy and the Vagus Nerve
Solution Focused Hypnotherapy helps to deactivate our sympathetic nervous system fight or flight response.
SFH also activates and strengthens our parasympathetic nervous system response through by toning the vagus nerve. That’s a message of hope, even the most distressed, overwhelmed and traumatised.
Jane Pendry is a Solution Focused Hypnotherapist who works extensively with more complex issues that she has recovered from herself, including complex trauma, phobias and anxiety. She specialises in emetophobia, complex phobias and trauma.
References:
National Library of Medicine (USA): Intestinal Microbiome in Irritable Bowel Syndrome before and after Gut-Directed Hypnotherapy
*Neuroanatomy, Parasympathetic Nervous System
The Somatic Movement Centre: What is Polyvagal Theory
Positive Psychology: Five Differences between Mindfulness and Meditation
https://positivepsychology.com/differences-between-mindfulness-meditation/
Hypnosis Training Academy: What Does The Vagus Nerve Do? Discover How To Naturally Stimulate The “Communication Superhighway” Linking The Conscious & Unconscious
Very Well Mind: Polyvagal Theory: How Our Vagus Nerve Controls Responses to our Environment. By
Click on links for all authors and medical editors, and full articles for further reading.
Jane Pendry
Sense-Ability Solution Focused Hypnotherapy
Jane@sense-ability.co.uk
+44 (0) 8843 813 833