Reset your brain and body for a pain-free life.

Joe Tatta, PT, DPT


Optimizing Human Experiences Through the Lens of the Polyvagal Theory with Dr. Stephen Porges

Welcome back to the Healing Pain Podcast with Dr. Stephen Porges

Have you ever wondered how your heart and brain interacts and coordinates? For decades, Dr. Stephen Porges, a leading expert in developmental psychophysiology and developmental behavioral neuroscience, has been studying the connection between human behavior and physiology, specifically the vagus nerve. Dr. Porges’ work on the vagus nerve opens up new insights into the way our autonomic nervous system unconsciously mediates behaviors such social engagement, trust, and intimacy. Simply put, the simple or observable physiological measures open up windows into the nervous system for understanding human behavior. This fresh perspective and its emphasis on the link between our psychological experiences and the physical manifestations in our body is what chronic pain is all about. Learn more about what this theory means and how they can apply to health and the treatment of anxiety, depression, trauma, autism, and varuous other disorders.

This is a topic that when I first read about it, it completely knocked me off my feet and forever changed the way I looked at conditions such as stress, anxiety, trauma, and pain. If you’ve never heard of Polyvagal Theory or you’re looking to dig deeper into what Polyvagal Theory is, then our podcast is the one you’re going to want to pay close attention to. When the book The Polyvagal Theory was first published in 2011, it took the therapeutic world by storm, bringing Dr. Stephen Porges’ insights about the autonomic nervous system to a variety of clinicians interested in understanding pain, trauma, anxiety, depression, and other mental health issues. The polyvagal perspective is providing new concepts and insights for understanding human behavior and its effect on how we suffer. This fresh perspective placed an emphasis on the important link between our psychological experiences and the physical manifestations in our body and that right there is what chronic pain is all about.

Personally, I was mesmerized by Dr. Porges’ first book because as a physical therapist, I’ve taken courses such as gross anatomy where you spend months dissecting every structure in the human body including the nervous system as well as studying the physiology, but no one ever articulated the vagus nerve the way he has and the impact it can have on you at every moment of your being. Dr. Porges’ work about the vagus nerve opened up something brand-new in me and changed me as a clinician forever. As brilliant as his book was, it was quite challenging to understand unless you had a strong neurophysiology background. Almost a decade later, Dr. Porges has published book called The Pocket Guide to Polyvagal Theory. Dr. Porges is here with us to break down Polyvagal Theory so it’s simple to help you digest its foundational principles and to apply the science in a fluid manner, whether you’re a practitioner or someone looking to lead a life of less suffering.

To help you understand exactly what polyvagal theory is, Dr. Porges has been generous enough to provide us with the first chapter from his book to all of us, 100% free. All you have to do to download and access this free chapter is open up your computer and type in the URL or if you’re listening to this on your smartphone, you can simply text the word 81Download to the number 44222. In honor of Polyvagal Theory, let’s take a moment to slowly exhale, direct your awareness to the rhythm and the beat of your heart. Notice the sounds, sights and smells all around you and let’s begin this week’s interview.

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Optimizing Human Experiences Through the Lens of the Polyvagal Theory with Dr. Stephen Porges

Stephen, welcome to the Healing Pain Podcast. It’s great to have you here.

Thanks, Joe. It’s a pleasure to be on your podcast.

HPP 81 | Polyvagal Theory

Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation (Norton Series on Interpersonal Neurobiology)

I read your book many years ago called The Polyvagal Theory. We will make it as simple as possible for those who are not practitioners and want to learn what this theory means and how they can apply to the health. We’ll probably get into some of the neuroscience and the physiology behind it as well. It makes sense to frame the podcast and explain what Polyvagal Theory is, but more importantly, how did you come about studying this interesting theory that didn’t exist anywhere else?

Discoveries are not solely generated from nothing. They are built upon the history of thought, history of science, and the history of human curiosity. I always wondered why people’s behavior literally became hijacked by their physiological state. I was always interested, and this is 50 years of research about looking at what I call the intervening variable, which is physiology and how that interferes or interfaces with how we react to everything in the world, and that’s where it came from.

How many papers have published in and around this theme?

I was always in this theme, and so there were probably 300 peer-reviewed papers out there. The theme didn’t have the name Polyvagal Theory in the beginning. It was always about heart rate variability. What many people may not know is that my work was the first published peer-reviewed work quantifying heart rate variability, using it both as an individual difference and also looking at it as the response variable. I was always curious about how powerful a little measure like heart rate variability could tell you about the subject and how they would react in certain settings, even how, from a physical therapy and even a physical performance model, you can predict people’s reaction times based on the heart rate variability. The more heart rate variability, the more faster in responding and faster even in making complex decisions. It was an interesting window into how the brain and the nervous system was regulating our physiology.

It’s interesting that you began with the heart because a lot of people can start to make the connections to things like blood pressure. That’s skimming the surface of things like heart rate variability. Can you explain to us what heart rate variability means and why it pertains to the Polyvagal Theory?

We have to think in different terms. We’re so accustomed thinking in terms of levels. People tell you how fast their heart rate is. They take blood pressure and the questions is, what is your blood pressure? People aren’t thinking about these variables as being dynamically adjusting all the time. That dynamic adjustment is being done by lower brain structures. Those lower brain structures are influenced not only by your body sending signals to the brainstem, but also your cortex sending signals down to the brain stem. It’s these dynamic oscillations and changes as blatantly simple or observable physiological measures that give you windows into the nervous system. What I always was interested in is how can you get a window into the nervous system?

This was literally diametrically opposed. It was a different philosophical orientation because people are always talking about the brain. The brain was not influenced by the body, nor did the brain influence the body. The body was a mechanical thing that the brain executed specific behaviors. It’s very interesting to go through the history of what was considered a major part of the body, was it the heart or the brain, and that had been philosophically very deep. The other part is even if you go back and read Darwin in his beautiful book of The Expression of the Emotions in Man and Animals, he talks about the heart and the brain being coordinated and interacting. He doesn’t even know what the vagus is called because it didn’t have that name then. It was called the pneumogastric nerve, but it was this notion of a brain-heart connection. This is what my work has been all about.

It’s brilliant work for many practitioners across many different fields. Can you start to in essence dissect the vagus nerve for us and talk about some of those connections for us? It is a rather big nerve. Give us some of the connections. You mentioned how the vagus nerve is coming off the brainstem and interacting with our physical body and vice versa.

I would do it a little differently than an anatomical dissection. I would deal with the metaphor of what Polyvagal Theory is and how it gets manifested in the vagus. Polyvagal Theory is a name that was applied to an orientation towards the autonomic nervous system that respected both evolutionary changes to the autonomic nervous system and maturational changes. In understanding those evolutionary contributions, we start to figure out or see the autonomic nervous system as something that is changing to fit the adaptive demands of organisms as they evolved. We’re going to talk about vertebrate history. We’re going to talk about our relatives. The initial autonomic nervous system in vertebrates was basically a chemical system. Then what emerged was a vagal pathway, but that vagal pathway was, in general, an inhibitory one. If oxygen wasn’t available or food, the animal could go into a quiescent state. Shut down, we would call it in human behavior. In an animal, it was basically adapting to the limited resources. As animals evolved, they became more proactive in the environment. They evolved a sympathetic nervous system which enabled mobilization to be under the control of the nervous system. When we use the nervous system, it means brain to the autonomics. The autonomic don’t exist independent of a brain. The central area of the brain is primarily the brainstem. In the primitive vertebrates, the brain is basically a brainstem. That’s it. The sympathetic nervous system evolved. Everyone is familiar with that because we think of it as our fight-flight system, but it’s not that. It’s part of our optimistic, our energetic. It’s why people exercise, move and like things. It’s our energizing system.

HPP 81 | Polyvagal Theory

As animals evolved, they became more proactive in the environment.

It can be diverted or utilize for fight or flight. If we didn’t have that sympathetic system, we would be blobs. That now led to the traditional understanding of the autonomic nervous system as a vagal system that could conserve or shut you down. Basically, when it wasn’t shutting you down, it was supporting homeostasis and a counterbalance of an accelerating sympathetic mobilization system. It was always this concept of an autonomic balance. What was missing in that conceptualization was the fact that in mammals, the vagus started to take on a different role. It started to be a little bit different because mammals can’t take care of themselves at birth and to reproduce. They need someone around them and they often need to create groups so they can be safe to sleep and do things. They need to create trust and relationship. They can’t confuse bodily signals of threat with bodily signals of comfort and safety. There are a couple of very interesting things that now happened. In most mammals, the vagus started to evolve another branch. What it meant was you had this vagus and if you look at the embryology, you see that the area of the brainstem where the old vagus came, some of those cells start to migrate during gestation and they migrate ventrally to an area that regulates the striated muscles of the face and head.

We have a vagal system is intimately related to facial expression, intonation and vocalization, and even the muscles in our middle ear that enable us to hear. For those who are listening and watching, think about a moment that if you go into a bar, especially when you’re younger and you meet someone and you talk to that person, you can hear every word and the background noise gets filtered out. In a psychological model, people say that it’s your interest that is driving it. In a polyvagal model, your interest shifts the neural regulation of those middle ear structures as it shifts into a regulation of a part of your face, so you conveyed to the other person that you’re interested. Your voice now has intonation of interest as well, and now your ears go along with it. The middle ear start to only pick up human voice, but these is the headache price. There’s a big price for this. As we have cues of safety, we are turning off our vigilance. We’re turning off our fight-flight system.

We now have to be very aware of the context that we’re in and that lead in the way that we have civilizations, we have houses, we have buildings, we have bathrooms, we have bedrooms, we have kitchens. We have places where we can give up the vigilance so that our bodies now can be social. When they are social, they can regulate. That tells you these evolutionary stages that occurred. There’s another branch of the vagus that regulates our intonation or the prosodic or the emotional qualities of our voice. In a way, it’s a wider diameter vagal fiber. It’s thicker than the one going to the heart. They’re both myelinated and voice triggers and conveys physiological state. It’s a projector of your own physiology but it also can change your physiology. People sing and they sing to calm down, with melodic voices.

You’ve taken what can be deep physiology and you started to translate it beautifully to the human being, which is ultimately what all of us are trying to do, is trying to help people cope with their life and adapt to what they’re experiencing. It’s interesting when you start talking about things like facial expression and voice because I started to think automatically about the relationship a practitioner has with their patients. How they can affect change through maybe their body language or what they’re saying or the tone of their voice. When you talked about different parts of the vagus, one being the voice, one being facial expressions so many of us in healthcare is so focused on process and getting paperwork done that we forget about these little nuances which are important and you articulated it beautifully.

They are important because we forget about the power of top-down processes to the brainstem that regulates our physiology. We use terms like placebo or illusionary effects when those effects are often as powerful as pharmaceuticals, and the point is they’re not trivial. They’re basically the brain informing lower brainstem areas that it’s safe. The metaphor is when the body gets a sense of safety, it can then utilize homeostatic functions. It can heal itself. The other important metaphor is that most healing and health is done by the individual organism. All practitioners, whether you’re a physical therapist or a physician or even a psychiatrist, you’re a facilitator of that individual to enable that individual’s nervous to support health, growth, and restoration.

HPP 81 | Polyvagal Theory

When the body gets a sense of safety, it can then utilize homeostatic functions. It can heal itself.

One of the things that people with chronic pain are interested in is the immune system. There are people who have auto immunity, who have chronic pain. There are also people who realize that they get sick more and have colds since they have developed chronic pain. Can you talk about the influence of the vagus nerve on the immune system?

I like to talk about the autonomic nervous system as an expanded autonomic nervous system. It’s not the traditional autonomic nervous system that you may get in graduate school or medical school. I like to incorporate the immune system and the endocrine system as part of this. The areas in the brainstem that are the regulators that have autonomic system are also regulators of immune and endocrine. We can’t think of them as independent. There are also the feedback loops. The specific answer to your question is that when you have more of regulation to this mammalian myelinated vagal tone, it is a down regulator of sympathetic fight-flight reactions so it dampens sympathetic reactivity. It also works with the immune system as well. It keeps the inflammation down, and this is part of the whole issue. Fear is a defensive strategy. Think of the metaphor of fear. Fear in our autonomic nervous system promotes fight-flight. Fear in the immune system promotes a reaction. Fear in the endocrine system promotes the hormones that will support fight-flight behaviors. It feeds into it. Cortisol and epinephrine are things that our body will utilize for mobilization.

How has this type of work influenced trauma care and trauma rehabilitation? It is important to talk about it especially nowadays with so much traumatic things that happen on the news every day. They are of course important events, but they keep people in a fight or flight state for a long period of time.

What I started to do in my talks is to make statements like, “We are traumatized species.” Try to understand that trauma is part of everyone’s life. The other part that I emphasize is trauma is not the event. Trauma is the personalized reaction, the response. By treating trauma as the event, we do a disservice to those who have survived trauma. They have not witnessed. We’d say things like, “I could’ve done that. I would’ve run in and protect it. I would’ve done those things.” The answer is, we don’t know. We don’t know what we will do. Our body tries to protect us and like in Florida, the policemen couldn’t go in. It’s not that he “was a coward” like they’re saying, his body said, “You can’t go there.” If you think again about the type of weapons, our bodies don’t want to suffer that type of assault and it’s not a moral decision. It’s built into our survival mechanism as species. The perpetuation or the expansion of the Polyvagal Theory is functionally due to the warmth and a welcoming of the trauma community. I developed the theory as a scientist to stimulate research in science, into neural regulation of the autonomic nervous system.

I saw it as potentially useful in assessments for risk babies and I was working in that area for a few decades, but I had not understood trauma because like everyone, we’re all traumatized in some way. In some ways, we’re all living a dissociated life. Pain becomes one of the consequences of that dissociation. Our brain is disconnecting from the feedback from the body, which means the brain is no longer serving regulatory function to help our body heal itself and regulate, and the body screams out. That screaming out is often manifested in pain. That becomes the issues that have that have that occur. Trauma therapists welcome me because it provided explanation for immobilization behavior or death feigning and post-traumatic stress disorder. People were floating in this concept of stress. Stress equals cortisol equals mobilization equal fight-flight. That’s only one dimension. A profound defense is when our nervous system says you can’t fight or flee, you can’t get out of there, disappear, which means pretend that you’re dead, pass out. That’s a very profound last resort and that occurs often or frequently not to everyone, but to some people in terms of life threat. The reason it happens to some, and some never get out of fight-flight and they go into panic, is that it facilitates survival of our species. Some will survive by disappearing and others will survive by fighting, depending on the situation.

To lead us into pain a little bit, I want to talk about how Polyvagal Theory helps inform complicated topic, which I’ve talked about. Most of us are aware of our five senses, but the idea of interoception is something that is relatively new to people as well as practitioners. How does that come into the conversation?

The term interoception is colored by our concept of perception. It means in most people’s words, “Do I feel my body? Do I sense my heart beating?”In many situations, feeling your body is not the appropriate thing. Your brain should always be feeling your body. There are interoceptive feedback loops in which the nervous system is detecting the status of our body. Part of what seems to be happening again with trauma is that these feedback loops are turned off or at least dampened. This results in self-organizing situations which may be dissociation and then maybe other types of diseases and disorders.

How does the Polyvagal Theory start to inform the pain practitioner? What can they take away from it and say, “This is an incredible theory.” What does it mean about pain?

The Polyvagal Theory would force the pain practitioner to partition where the pain is coming from. Pain is like emotion. It’s a broad perspective. You have dental pain and that’s directly going into cranial nerves going right to your brain, but you also have thoracic pain. People who are traumatized often have pain that’s diffused and often coming from organs below the diaphragm. They have symptomatology of irritable bowel, fibromyalgia, migraines. The body is now turning off. Polyvagal Theory has a lot to say about that because it says that is the consequence of the body going into life-threat reactions. When it goes into life-threat reactions, those feedback loops that have supported health, growth, and restoration are now distorted.

Have we started to look at the different types of therapies out there and say, “This therapy addresses the vagus or this therapy addresses one part of the vagal response? How deep are we into that type of research?

I would say the first part of all therapies is the negotiation of safety with the client and in a way, that is negotiating and allowing the mammalian vagus to do its work. One of the most important attributes or aspects of treatment is the cues of trust and safety. When the cues and trust and safety occur, then the nervous system starts to shift out of defense. When it shifts out of defense, then the pliability of muscles from a physical therapy perspective, the body becomes available. Again, as a physical therapist, what you probably will see with a lot of people is hypertonicity. There’s a lot that you can read from the body. What the Polyvagal Theory gives you is almost a roadmap of understanding what those processes are. There are people who are like that and have those two, and they’re all in their diaphragm. They will come with all these gut problems and pain because the system isn’t functioning because the feedback loops have been disrupted. The direction of everything occurs because the Polyvagal Theory gives you a roadmap. It says, “If you can recruit that ventral myelinated vagal circuit, the circuit of social engagement, it creates a container for the other parts of the autonomic nervous system to go into a more traditional autonomic balance.”

HPP 81 | Polyvagal Theory

There’s a lot that you can read from the body. What the Polyvagal Theory gives you is almost a roadmap of understanding what those processes are.

The traditional model of autonomic balance, sympathetic and parasympathetic balance, resides inside the Polyvagal Theory and primarily focuses on subdiaphragmatic areas. If you create this containment of trust and safety, then these other systems can start working. There are certain manipulations that are historical and they have been a lot through breath because during slow exhalation, there’s more vagal efferent, motor activity coming down and down-regulating the sympathetic. Distension of the thorax or moving the diaphragm stimulates that system. Then there are things that physical therapists can actually do. Pelvic manipulations also provide afferent feedback to these systems, but everything, in its time and in its place, when the client is inviting to be touched and to be moved.

In your book The Polyvagal Theory, you talked about children with autism and you talked about having them rock as a way to quiet down their system and to down-regulate that vagal tone. I used to work in adult rehabilitation and people who have Parkinson’s disease would become very rigid and one of the things they respond well to these rhythmic rocking type movements and exercise.

What I was focusing on when I was thinking about that was head-to-toe movements because they would be stimulating baroreceptor, blood pressure, feedback loops, which stimulate vagal activity. If you look at people who often will do that, in a way they are performing a behavioral vagal nerve stimulation, and so as singing and so are breathing. Pelvic manipulations do that as well.

A lot of children actually develop some of these behaviors naturally and as adults, I wonder if we don’t hang on to them or they start to become not socially acceptable maybe to do it in the workplace?

What is the developmental trajectory or what are the instructions of our development trajectory? It’s to discount the intuitive feedback loops or information that the feedback loops are providing us. What we end up doing is as we no longer think about it or try to depress it, we start creating a dissociation between our body and our mind. Think of the educational system which says, “Sit still,” and think of what’s been removed out of the educational system which is recesses and organized play. If they were interspersed, you now would have all these opportunities for neural physiological state regulation to become enhanced as opposed to being viewed that you should be able to control it and we’ve done that also. Music is a good example, theater. All these things, they are involving all these muscles of the face and head.

Where would you like to see your work developed as you move into the future of Polyvagal Theory because it informs a lot of different types of care?

If you look at my credentials, I published in about fifteen different disciplines. I always try to move things into different areas. As I start to develop the Polyvagal Theory, I saw it literally as a system that would be very helpful in areas like internal medicine. Internal medicine hasn’t spent much time in its training of clinicians in emphasizing the feedback loops. It focuses on the organs. It doesn’t focus on the neural regulation of those organs. Within the internal medicine, there are all these disciplines. When the specialists talk about heart disease, kidney disease, liver disease, they’re not very attuned to the neural regulation of these organs. Even if you have a view that the disease is local to the organ, the feedback from that organ to the brainstem to the brain is conveying a lot of information. We’re getting more insightful with the interest in the microbiome. What that is saying is the gut is loaded with sensory afferents. The gut has a brain of its own. That gut is communicating with the brain on top of our shoulders. That metaphor is a similar model.

HPP 81 | Polyvagal Theory

Polyvagal Theory: The gut has a brain of its own. That gut is communicating with the brain on top of our shoulders.

As we enter into this very complex territory where trauma literally becomes the elucidator, it provides us the opportunity to understand the mechanism through the disruption of mechanism. When I talk about trauma, it’s not solely with compassion. There’s also a scientist sitting inside me and said, “I can see things that I couldn’t see unless they were turned off.”What trauma is doing to us is it’s turning off those feedback loops and allowing us to understand those functions. The example that we’re going to bring it to pain is as we change our relationship with our organs below our diaphragm and that is being that we recruit them in a immobilization defense and unlike using fight-flight, which our bodies and our nervous system evolved to move back and forth from being friendly and engaging, in running and fighting. In fact, we incorporate in something that we call play. Play is utilizing all those things. They totally regulate. We don’t have a play of shutting down. It’s a very old system and shutting down gets co-opted when we have warm and tender and trusting feelings and we call that intimacy.

We utilize the same circuits, but we are super imposing on them. This newer mammalian myelinated vagal circuit and intimacy is always preceded by use of voice, the use of gesture, the use of cues of safety that now enables the body to be open and free. As a physical therapist, you see people pulled in and what we are saying is the chest becoming welcoming. We get into the issue of pain because when the gut and all these areas have been shut down, the vagal circuit to the enteric nervous system changes its flow of information. In a way, the vagal will flow to the enteric is saying, “Everything’s fine. Do your job. Do all your self-organizing, digestion and organization,” but the vagal circuit to the enteric says, “Things are not going well.” Then the enteric gets confused so it either goes for the gut, diarrhea or constipation and what you see with irritable bowel and other disorders back and forth because it’s not having in a sense the protective auto vagal circuit. This is also linked to the afferents that are now signaling pain issues. That’s coming up now through the sympathetics. The vagus is also related to the regulation of that.

When we look at the studies on people with fibromyalgia, up to 100% of them have IBS-type symptoms and it’s a great connection to make between pain, the digestive tract and the Polyvagal Theory.

Well over 50% have a trauma history and they may not even acknowledge it. They may have dissociated so much about it. If you go within the trauma community, those symptoms almost all the time varies there. If you can see interviews or talk to people before and after a severe trauma, you see these things coming in. You start getting an understanding of these mechanisms underlying that. I’m not saying this is causal for all forms, there are going to be other pathways.

We have to keep in mind within the context of the conversation that when you have chronic pain that chronic pain can be in and of itself a trauma because that’s something that continues over a long period of time that the organism has a hard time confronting or regulating it in some way.

I was talking about pain as spontaneously emergent and you’re talking about the many people who are injured, and it’s not spontaneously emergent. It was the body’s adaptive reaction. That has profound effects on our autonomic nervous system because it puts our body into this state.

I agree. Stephen, I’d like to ask you a couple of questions, almost a rapid fire style. I’m going to ask you a question if you can give us a one word or one phrase response, that’s the best way to summarize this. Knowing that each of us, whether you’re a scientist or a clinician, the work we do of course impacts thousands of other people’s lives, but also informs our own life. How has Polyvagal Theory informed your ability to communicate with others?

It’s giving me the rules. I actually have a slide once that I called the rules of engagement. It gave me the rules of how to give public talks. It gave me the rules of how they’re being welcomed by people when you speak to them. It wasn’t to be a pontifical professor, it was to be functionally a vulnerable, authentic human being because that’s how we interact.

How has the Polyvagal Theory informed your humanity?

It’s given me a different sense of compassion and also has triggered in me this whole idea of self compassion. That is in a sense the pathway for others who are suffering. They first have to have compassion for themselves. I don’t mean that I shouldn’t have compassion for them, but it’s this notion of most people who are suffering, are suffering from a double burden. They are suffering from a burden of feeling blame and shame that’s embedded somewhere. If they had developed a sense of self-compassion, they can allow those things to occur and even be compassionate for others. It gave me a sense of that, but there’s another point. The theory said to me, “We’re not living our lives the right way.”We know too much about what it is that our bodies need to be loving, creative and engaging people. We know what we need and yet look at the world we’re in? It is very troublesome because our body screams. Our body likes safety, and safety is important.

You may have answered this last question, but I’m going to pose it anyway. How has Polyvagal Theory informed the way you love life?

It enabled me to understand others better. We all come from traditions which emphasized knowledge and information and basically say that feelings are things we control. When we start to respect these, then we have the self-compassion and the compassion for others. Then we can witness others and in doing that, we have relationships. Those relationships become healing not to other people, but also to us.

I have been talking to Dr. Stephen Porges, who is a wonderful researcher. He wrote a book called The Polyvagal Theory, but he also has two new books out. Stephen, can you share the new books you have coming out, which are great pieces of work that everyone should check out.

HPP 81 | Polyvagal Theory

Clinical Applications of the Polyvagal Theory: The Emergence of Polyvagal-Informed Therapies (Norton Series on Interpersonal Neurobiology)

There is one book that came out called The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe. It’s published by Norton. There’s another book coming out called Clinical Applications of the Polyvagal Theory: The Emergence of Polyvagal-Informed Therapies. The second book is edited and it has examples of clinicians embracing the Polyvagal Theory and using it in their disciplines.

You are a professor and you do some lecturing and teaching on the side. Tell everyone how they can learn more about you and all your work?

I have a webpage. It’s and you can go to there and it tends to list when I’m giving talks or where I’m giving them. It also lists all the books and it has a bibliography and there are other things like transcripts of interviews. It has one thing recently put up, which I would like to share, and that’s the link to a company called Integrated Listening Systems because our over twenty years ago, I started to work on a intervention that extracted from vocal music or human voice, what I thought were the essence of love and trust. It was like a mother’s lullaby. I used it on autistic children and improved their ability to reduce auditory hypersensitivities and increased social spontaneous engagement. After twenty years as a very tight researcher, I allowed it to go out and it’s being distributed by Integrated Listening systems. At this point in time, we have 550 providers now using it. Wonderful people trying unique things and the feedback from the field is like what I’ve got in my laboratory. It makes me feel very good. Basically, think of it as an acoustic vagal nerve stimulator and think of it as a trigger to what I call the social engagement system, which means it’s a calming system.

Your work is so applicable to children with developmental problems like autism to those with trauma, to those with chronic pain and oftentimes, chronic pain can start early in life for people whereas the priming of the nervous system. I want to thank Stephen Porges for being on the Healing Pain Podcast. You can find him at


About Stephen Porges

Stephen W. Porges, PhD, is Distinguished University Scientist at Indiana University, where he directs the Trauma Stress Research Consortium within the Kinsey Institute. He holds the position of Professor of Psychiatry at the University of North Carolina and Professor Emeritus at the University of Illinois at Chicago and the University of Maryland. He served as president of both the Society for Psychophysiological Research and the Federation of Associations in Behavioral & Brain Sciences and is a former recipient of a National Institute of Mental Health Research Scientist Development Award. He has published more than 250 peer-reviewed scientific papers across several disciplines including anesthesiology, biomedical engineering, critical care medicine, ergonomics, exercise physiology, gerontology, neurology, neuroscience, obstetrics, pediatrics, psychiatry, psychology, psychometrics, space medicine, and substance abuse. In 1994 he proposed the Polyvagal Theory, a theory that links the evolution of the mammalian autonomic nervous system to social behavior and emphasizes the importance of physiological state in the expression of behavioral problems and psychiatric disorders. The theory is leading to innovative treatments based on insights into the mechanisms mediating symptoms observed in several behavioral, psychiatric, and physical disorders. He is the author of The Polyvagal Theory: Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation (Norton, 2011), The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe, (Norton, 2017) and co-editor of Clinical Applications of the Polyvagal Theory: The Emergence of Polyvagal-Informed Therapies (Norton, 2018).


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Dr. Joe TattaOptimizing Human Experiences Through the Lens of the Polyvagal Theory with Dr. Stephen Porges
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  • Janice - April 7, 2018 reply

    Hi. I have had many severe traumas that I have never talked about or really acknowledged, just went into a shell. My body now is in various pain situations, some unbearable, mainly gut problems and severe pain in joints.. I know it’s related to my past, and maybe present. Can’t really cope anymore, but would love to help myself, love myself one day. Thanks for more insight into complex human suffering. Janice

    Dr. Joe Tatta - April 7, 2018 reply

    Hi Janice,
    Finding a way to soothe, care and nurture yourself is important. I recorded an entire podcast on this topic which would be an excellent place for you to start. Here is the link:

    In addition for your pain and gut issues, I suggest you begin with my book which you can purchase here:

    May you find loving-kindness to see you through this difficult time.
    Dr Joe.

  • Carol - April 7, 2018 reply

    Hi, I’m in a chronic situation of pain (diagnosed with FM) exhaustion and gut problems (diagnosed with IBS). It all started little by little, until now, when it has turned my life and body into a prision. I now wonder if It’s just a form of traumatic disorder, after a very complicated pregnancy of twins which held me in the hospital for 5 months, not knowing if me and my children would survive and facing 3 surgeries afterwards. Do you think that could be the possible cause of all these? Would It help to read the book you mention? If so, which one, the polyvagal theory or the quick guide? I don’t know if It’s just for professionals or if It has real and practical tips or steps to follow to overcome this.. Thank you

    Dr. Joe Tatta - April 7, 2018 reply

    Hi Carol, thank you for reaching out and sharing your story. It can be challenging to rebound from a traumatic pregnancy but you are doing the right thing by exploring options and educating yourself. In the podcast, I provided a link where you can read the first chapter of Dr. Porges book. Download it and read through it. If it calls to you and seems helpful then order the book. If it seems too complicated I’d suggest you begin with my book which you can purchase here:

    Please let me know if this helps and if there is another way I can support you.
    May you find peace and relief.
    Dr. Joe!

  • Carol - April 9, 2018 reply

    Thank you very much. I already have your book, not finished yet.. I´ll also read the first chapter of Dr Porges book and see if it could help. Congratulations for your work and dedication

  • Kimberly - April 19, 2018 reply

    I would just like to share that the Safe and Sound Protocol that Dr. Porges created has been LIFE CHANGING for my son! My son went from being a very emotionally dysregulated, hyperactive, impulsive and aggressive child to now what I can only describe as a typical toddler. I have been told by every professional involved in his care that I needed to be looking into residential facilities, never did any of us think we would see such a drastic change in my son. I am forever grateful for Dr. Stephen Porges’ work and more specifically the SSP!

    Dr. Joe Tatta - April 20, 2018 reply

    Hi Kimberly,
    Thank you for reaching out and sharing your story on how Dr. Porges work has helped your son!
    I’m so happy to hear how well your son is doing.
    Your recommendation will help others in their search.
    May your son continue to thrive and enjoy a rich full life!
    Dr. Joe!

  • lynette - July 26, 2018 reply

    I would like to hear a lot more about this Polyvagal Theory in connections to FEELINGS!

    Dr. Joe Tatta - September 15, 2018 reply

    Thanks! I’ll plan another podcast around this topic! Wishing you the best Lynette 🙂

    Dr. Joe Tatta - September 15, 2018 reply

    Thank you, Lynette. I love this topic too and will do another. Stay tuned by signing up for my mailing list at
    On the right-hand side of the page, you can join the mailing list.
    Wishing you the best 🙂

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