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Mindfulness and Meditation Practices
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Polyvagal theory, developed by Stephen Porges, is one of the most clinically relevant models of the nervous system. Porges delineates the evolution of the nervous system for one’s safety and protection. The dorsal vagal (DV) system, the unmyelinated branch of the 10th cranial vagus nerve, is the most primitive system. It is responsible for the freeze response when one is threatened with little chance for escape. The next evolutionary step is the sympathetic nervous system (SNS), the fight/flight approach to danger. The newest development in the nervous system is the ventral vagal system (VV), the myelinated ventral branch of our vagus nerve, which allows one to be calm and connected. Interestingly, the ventral vagus is only found in mammals and serves the purpose of helping find safety in alliance with others. The ventral vagal system is neuroprotective and energy efficient, acting as a neural brake by inhibiting the nervous system from going into fight, flight, or freeze states unless it is necessary. The vagus nerve mediates a brain–heart connection, which provides information about the autonomic nervous system, stress levels, and health through heart rate variability (Evans et al., 2013). Respiratory sinus arrhythmia tracks changes in heart rate associated with breath patterns (Sahar et al., 2001).
A mindfulness relationship-based model to support maternal mental health and the mother-baby relationship in pregnancy and beyond birth
Published in Antonella Sansone, Cultivating Mindfulness to Raise Children Who Thrive, 2020
The wisdom and evidence gathered in this book support a prenatal and perinatal mindfulness relationship-based (PMRB) approach as a comprehensive model of care that offers a promising opportunity to deliver a collaborative service that supports conception, pregnancy and early parenting, as well as infant development and health outcomes. This may occur through a sustainable and cost-effective strategy that legitimises the study of age-old collective and wisdom-based practices, such as mindfulness meditation, breathing techniques, yoga and other methods that cause shifts in the autonomic/visceral state and emotional experiences. Such a strategy is supported by polyvagal theory, which indicates physiological mind-brain-viscera communication as the royal road to affect-regulation and invites a radical shift in therapeutic approaches to a number of psychopathological states, such as anxiety, depression and trauma-related dysfunctions (Porges, 2011). These new approaches would invite pregnant mothers to cultivate interpersonal rhythms with their prenate and infants, to nurture their age-old capacity to use their voices, facial expressions and touch to regulate their babies’ sensorimotor, visceral and emotional experiences and develop a profound connection that prepares parent and infant for bonding after birth.
Heart and soul: the feeling body
Published in Anthony Korner, Communicative Exchange, Psychotherapy and the Resonant Self, 2020
The Polyvagal Theory (PVT), developed by Stephen Porges, is one of two major current psycho-physiological theories of autonomic function (Appelhans & Luecken, 2006). It relates autonomic flexibility in social interaction to a division of the vagal nerve providing fine-grained regulation of metabolic and emotional response (ibid.). The theory is based upon an evolutionary understanding of the development of the ANS with emphasis on mammalian patterns of social engagement, whereas the other major theory takes a dynamical systems perspective with emphasis on the role of the central autonomic network (ibid.). The PVT entails a significant revision of the understanding of emotional life, away from a focus on sympathetic arousal and towards recognition of the regulation of feeling and metabolism in everyday social life, mediated by the evolutionarily recent, myelinated division of the vagus nerve. Effectively it also provides a model linking brain to both body and environment allowing an understanding of the brain as a complex interface for reciprocal interaction with the environment rather than as a central control system.
Implicitly Regulating the Stress of Oppression: Re-establishing Safety in Intercultural Practice
Published in Smith College Studies in Social Work, 2018
With the human mammal, regulation and dysregulation of arousal occur mostly in the context of social relationships. The dysregulation of arousal (hyperarousal and hypoarousal) from threats to safety in the social world impacts an individual’s capacity to use social relationships to effectively manage the dysregulation. Porges (2001, 2004) expands our understanding of the ANS arousal system and proposes the polyvagal theory to highlight the importance of social behaviors to regulate arousal states. The polyvagal theory has been widely used by a number of varied approaches as a guide to treat overwhelming and dysregulated states. In addition to Levine’s (2010) somatic experiencing drawing on this theory, polyvagal theory is a central orienting theory of Ogden’s sensorimotor psychotherapy (Ogden, Minton, Pain, & Siegel, 2006) and one of the foundational theories supporting van der Kolk’s use of yoga to regulate core arousal states and increase sense of safety in the body (van der Kolk, 2006), as well as a number of lesser known approaches (Quillman, 2013; Stanley, 2016). Polyvagal theory provides the clinicians with an understanding of the nervous system and how interventions directly impact the nervous system.
Reading the Child Within: How Bibliotherapy Can Help the Victim of Child Sexual Abuse
Published in Journal of Child Sexual Abuse, 2020
Agnes Wohl, Gregory W. Kirschen
It is well-documented that autonomic nervous system dysregulation can occur subsequent to sexual trauma (Keeshin, Strawn, Out, Granger, & Putnam, 2014; Lorenz, Harte, & Meston, 2015). In particular, the polyvagal theory posits that when the brain processes emotionally-salient stimuli (whether externally- or internally-driven), it outputs this information to the cranial nerves, including the vagus nerve, which in turn influences heart rate, breathing, and muscle tone in the pharynx and larynx (Porges, 2009). Examples of this can be observed in the breath of the patient. Shallow breathing is an observable defensive state, while mouth breathing is generally associated with hyperarousal. One of the goals of therapy is to assist the patient in maintaining him/herself within the window of tolerance of emotions, imagery, five sense perception and physical sensations. When a patient is dysregulated in this way, his/her cognition is “off-line.” The therapist must utilize creative tactics in order to help the patient deal with the material yet stay within this window. The clinician hopes in using this gentle therapy approach to expand the window of tolerance by creating the empathetic, attuned environment, and by selecting the correct picture book that is tailored to the specific patient, with a grounding story. Bibliotherapy is also quite adaptable and can be used to complement or enhance other forms of therapy. Table 1 provides a list of several examples of books that we recommend for other therapists and clinicians interested in incorporating bibliotherapy into their practice for victims of child sexual abuse.
Allostatic load and mental health: a latent class analysis of physiological dysregulation
Published in Stress, 2021
Porges (1995, 2001) introduced Polyvagal Theory as a means of explaining the relationship between parasympathetic nervous system functioning and behavior. Specifically, respiratory sinus arrhythmia (i.e. high-frequency heart rate variability) is utilized as a measure of parasympathetic nervous system functioning, often referred to as vagal tone (Porges, 1995, 2001). While certain fundamental components and assumptions of Polyvagal Theory as they relate to human evolution have been disputed (see Grossman & Taylor, 2007), parasympathetic nervous system functioning as operationalized by measures of heart rate variability (HRV) continues to be an area of intense and diverse research. In a systematic review and meta-analysis of 150 case-control and treatment studies, Alvares et al. (2016) found that HRV among individuals with psychiatric disorders was statistically significantly lower than controls without psychiatric disorders. In addition, while each of the other subgroups (mood disorder, anxiety disorder, and substance dependence) were statistically significantly different from the control group, individuals with psychotic disorders had the largest effect size (Hedges g = −0.952, 95% CI −1.105, −0.800, p < 0.00). Brown et al. (2018) completed two meta-analyses, one of clinical trials and the other of community studies, to assess the association between HRV and depression among older adults and found that decreased HRV was associated with increased levels of depression. Specifically, low-frequency HRV, but not high-frequency HRV, was associated with depression. In all, the current state of research suggests that a more nuanced conceptualization and operationalization of parasympathetic nervous system functioning may be necessary to better understand this system’s role in mental health outcomes.