Alex Klassen, MSW, RSW & Tanner Murtagh, MSW, RSW

Understanding the state of your nervous system is essential when healing from chronic pain and symptoms.

Pain and symptoms are signals of danger the brain generates to alert and protect us¹. This means better understanding and guiding our nervous system from a state of danger to safety can reduce symptom flare-ups and intensity. This post explains polyvagal theory, helping you recognize the different states of your nervous system so you can better articulate and respond to your daily needs.

Polyvagal Overview

Our nervous system is designed to shift between different states, which help us live our daily life by responding to challenges, reacting to dangers, connecting with others, and resting. We shift states depending on cues of safety or danger detected in our bodies, relationships or evironments². The three systems are called Ventral Vagal, Sympathetic, & Dorsal Vagal^2,3.

The sympathetic branch of our nervous system is found in the mid-section of the spinal cord². The purpose of the sympathetic system it to mobilize us with energy, preparing us to respond to challenges or dangers. The sympathetic response increases energy and activation felt in our nervous system, while the parasympathetic response decreases this energy and helps us return to a calmer resting state.

The vagus nerve is also very important in our nervous system functioning. As the 10th cranial nerve and the longest of the cranial nerves, the vagus nerve facilitates bi-directional communication between the brain and body⁴. “From the brain stem at the base of the skull, the vagus travels in two directions: downward through the lungs, heart, diaphragm, and stomach and upward to connect with nerves in the neck, throat, eyes, and ears.”²

80% of the communication in the vagus nerve is bottom-up, delivering messages from the body to the brain⁴. This means 80% of our messages of safety or danger come from the body and organs. This tells us that the state of the body and nervous system is very influential in how we think and what we believe.

Only 20% of the communication in the vagus nerve is top down, delivering messages from the brain to the body⁴. This means only 20% of messages of safety or danger come directly from thoughts or beliefs in the brain. This explains why changing thoughts about our pain and symptoms is helpful, but it’s not he only way to create safety and heal. Focusing somatically and regulating the nervous system with body-focused practices is very important in healing trauma and symptoms; safety starts in the body.

Ventral Vagal – The Safe State

The nervous system shifts into a ventral vagal state when it senses “cues of safety”. This leads to feeling calmness and balance in our body and thinking². When we are in a ventral vagal state, our social engagement system comes online and we can connect with others³. When we spend more time in the ventral vagal state, our pain and symptoms tend to reduce because our mind and body feel safer.

When researchers and programs talk about “toning the vagus nerve” or having  “high vagal tone”, they are referring to a nervous system that has a easier time shifting into a safe, ventral vagal state. The good news is, vagal tone ca be improved through somatic practices and making healthy changes to your thinking, lifestyle, and relationships!

The Sympathetic System – Fight of Flight

In response to internal or external cues of challenge or danger, the sympathetic branch triggers our fight or flight response². It's in this activation that we'll feel excited, nervous, anxious, worried, frustrated, tense, angry, etc. Often, taking action during a sympathethic response to a threat can help us move back towards a safer ventral vagal state.

It's also very important to note, the sympathetic nervous system is more than just fight or flight! It also gives us energy when we need it, allowing us to experience excitement, play and passion. Imagine you’re playing soccer. You might feel a bit of nervous and excited (sympathetic) energy as you step out on the field, but if you also feel confident, present and connected to your teammates, your sympathetic activation would be blended with ventral vagal energy. Sympathetic activation provides the energy to play, compete, and have fun! But you can also imagine how the sympathetic activation may tip into dysregulation during your game, and you would move into fight or flight. You could become overwhelmed, scared or angry with yourself or others, and feel unable to compose yourself and perform at your best. In this scenario, you’d be experiencing high sympathetic activation with reduced ventral vagal safety.

We’ll encourage you to think about the blended state of sympathetic + ventral vagal, because it isn’t just found in sports – this blended state is necessary within all play and passion, including our hobbies, relationships, and work.

The Dorsal Vagal System - Freeze/Shutdown

The dorsal Vagal system causes us to feel fatigued, depressed, burnt out, numb, or dissociated because our nervous system is trying to protect us by shifting us into a state of freeze/shutdown^2,3. If the level of danger we feel is too much to handle and we feel trapped, the dorsal vagal system takes over from the sympathetic system, leading to shut down and collapse^2,3. Sometimes dorsal vagal shutdown follows prolonged activation of the sympathetic (fight/flight) system; the body can’t handle this intensity any longer and begins to shut us down with feelings of fatigue, depression, etc. Dorsal vagal states may also be triggered during extreme physical or emotional danger, causing us to freeze and feel unable to respond.

Like the sympathetic system, the dorsal vagal state is more than just freeze/shutdown! A blended state of dorsal vagal + ventral vagal energy helps us engage in stillness and intimacy.  Building a sense of safety with downtime and rest (especially when sleep, fatigue or depression has felt dangerous for us in the past) is essential in healing. Intimacy through close connection, like cuddling with a partner or pet, or sexual contact, also occurs in a blended state of dorsal vagal + ventral vagal function. Healing from chronic pain and symptoms often involves regaining safety with a blended state of stillness and intimacy.

In A Perfect World

If life was smooth and easy, we would never shift too far into the sympathetic and dorsal vagal systems. We would always have enough of a blend of ventral vagal energy to feel safe, present, and connected to others. When we’re energized, we’d feel safely playful and passionate. When we’re lower in energy, we’d feel safely still and intimate. But of course, in a human life it's normal to become dysregulated in a high sympathetic (fight/flight) state, or dorsal vagal (freeze/shutdown) state. Remember, it’s normal to feel dysregulated sometimes! Mammals are designed for this.

Concerns arise when we chronically function in a state of too much sympathetic and/or dorsal vagal dysregulation. Chronic dysregulation can lead to the generation of many different symptoms, including chronic pain, fatigue, dizziness, tinnitus, insomnia and stomach issues, and cognitive issues with worry, negative thinking, or relationship difficulties.

There are many reasons our nervous system may be functioning in a state of chronic dysregulation. Dangerous social factors like unhealthy relationships, isolation, workplace stresses, or broader oppression may be impacting us. High-intensity living habits like perfectionism, people-pleasing, or workaholism can continually shift us into danger. Trauma in the past, within the medical system, or arising from our pain/symptoms can over-sensitize the nervous system. Negative thoughts and beliefs about our bodies or selves may also cause to nervous system dysregulation. Or we may feel a great deal of danger living and moving inside our body, leading to further dysregulation in a feedback loop.

Because nervous system safety is complex and you are unique, your ways of re-establishing safety will also be complex and unique! This is why we created the Somatic Safety Method course. Our comprehensive course is designed to address the multiple causes of danger that dysregulate the nervous system, offering education, strategies, and somatic practices to restore safety in your body and mind. Remember, more safety = less pain/symptoms.

References

1. Gordon, A., Ziv, A. (2021). The way out: A revolutionary, scientifically proven approach to healing chronic pain. Sony/ATV Music Publishing LLC

2. Dana, D. (2018). The polyvagal theory in therapy: Engaging the rhythm of regulation. WW Norton & Co

3. Porges, S. W. (2019) Clinical Applications of the Polyvagal Theory.

4. Dana, D. (2019). 2-Day Workshop: Polyvagal Theory Informed Trauma Assessment and Interventions

5. Porges, S. W. (2022). Autonomic state: A neurophysiological platform for feelings, emotions, and social engagement. Trauma Research Consortium, Kinsey Institute, Indiana University Bloomington and Department of Psychiatry, University of North Carolina Chapel Hill, USA.

6. Kozlowska, K., Walker, P., McLean, L., & Carrive, P. (2015). Fear and the Defense Cascade: Clinical Implications and Management. Harvard review of psychiatry, 23(4), 263–287. https://doi.org/10.1097/HRP.0000000000000065

7. Pain Reprocessing Therapy Center (2021). Pain reprocessing therapy training.