How can the body become a resource for a patient who’s experienced trauma?
Polyvagal Theory helps us answer this question by explaining how people process their environment and how the body regulates itself in the face of stress and trauma.
Watch the video below as Stephen Porges, PhD shares one way to apply Polyvagal Theory when working with the body’s responses to traumatic triggers and stressful events.
How could you use Polyvagal Theory in your work with patients? Please leave a comment below.
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Dear Ruth,
I work as a counselor with kids who are incarcerated in the Juvenile Justice Detention Center in Miami and, as you know, most of these kids have been severely traumatized. They have witnessed so much violence and rage and hopelessness in their young lives and, with no emotional support to teach them how to deal with the fear and anger they are experiencing in a healthy manner, they turn to drugs to dampen the pain and to escape for awhile.
I would love to learn some skills to really help these kids.
Thank you.
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Thanks for this video. In my work with very young babies if the baby is starting to show signs of stress I ask the Mum to sing to her baby…….it works every time!!!!
I do prenatal & Birth work and cranial work.
Patricia
Very nicely written blog!!
I think the effect of a voice is highly individual. I can barely think of anything more aggravating than a soprano or tenor, whereas an alto voice or a bass baritone is like a soft velvet coat. I also find a lot of (especially American) high pitched female voices intensely irritating. Sorry! Otherwise yes, I do like what Porges has to say and I use chiefly energy psychology methods like EFT in my work. It empowers the client, because they can use the the technique at home, whereas in EMDR the client relies on the therapist.
As a singer and vocal teacher who has thought about this a lot I want to add a comment. I think I know what you mean about voices being aggravating. But in my opinion there’s a whole other story behind this. Those voices that you find irritating are trained in a certain way. They are probably trained in a way that’s very much about control and pressure. There is nothing free about them and they can even be physically unhealthy, leading to vocal fold nodules. There’s other methods of training the voice that are about freeing it, about relaxing the mucous membranes, using the resonance of cavities and gently strengthening certain muscles. And they are not about sounding like some role model, but about finding your own unique voice and learning to accept and love it as an expression of who you are. I believe that, even when we are untrained, we can feel the “pain” and stress in a voice. Some people actually are drawn to voices like that and I believe it’s because they recognize something familiar. But we can also feel the healing quality of listening to a free voice. Why high pitched voices are helpful in trauma work, that’s a different issue altogether.
I hope I was able to express what I wanted to say – English is not my mother tongue.
I’m a 65 yr old woman flower farmer Lei maker & Artist. I have been using my Enjoyment of Karaoke Singing for Fun and relaxation from everyday Stress. I Know this Polyvagal is Real in the Portal of Music when I Sing all of many Emotions come out and release from my body. I used this last Saturday, my Mother Passed from Cancer & Suffered for months I was her caregiver. I spent 3 hrs singing with others in a Karaoke Lounge my Friends own. I have used this for more than 10 yrs now. Yes it works. I was my Aunty’s caregiver for the last 5 yrs prior to her Passing last July. I’ve had 3 experiences with Shibgles attacks during now and last year and when my husband started using street drug 6 yrs ago. If I Dobt Sing I’ll surely end up in the Hospital.
Thank you and Aloha from Kona Hawaii.
yes – I agree singing can be soothing. I wish I did it as often as you do. Take care. Best Wishes.
Imparting to conversion disorder client to learn to tolerate increased heart rate and sound through the music… Ie playing three mins of a fast beat song , over time with increased sound level… Maybe learn an instrument..
Dr. Porges, I appreciate this ground breaking work on intonation. Please let me know how I can get more information on this. Sopranos always seem to calm me down more when a good female vocalist sings. I have been a music therapist in earlier years and now just full time mental health but use music quite often. I would love to be brought up to this century in an earlier field for me and augment my knowledge to incorporate into the music therapy work I do lately on a superficial level. I am enthralled by the polyvagal nerve and can believe this was the missing link needed to more advanced trauma work with client. This is so energizing to me regarding the possibilities. More, please!
Hi, I am curious about the use of music and frequencies and am wondering if one of the ways chanting works is because of the shift of information (vibrational frequency) to the brain via the middle ear.
Also, supporting or teaching people to become more aware of their reaction to triggers and then bringing in the breath to shift the HRV can be a powerful tool that can be used anywhere. This breath is being taught by HeartMath, as well as other yogic/meditation breaths that also seem to have impacts on our neurobiology.
I am curious about ways we can also shift the conversation to look more at some of the socio-political factors that impact our emotional health and a discussion of power relations and how they show up for groups of people.
Janet McGeachy, MSW, RYT-500
I like the notion of tracking sensation, as we are incorporating that in our training, beginning with the start of the workshop. The music aspect we approach a little differently, but with no scientific basis. I wonder though if the cello, with no other noise, might be doing what Porges said in the video, where he introduces the modulation to a female voice to add the lower register. Part of the reason we play what we play is that it induces a lower heart rate to begin with.
I would like to see actual testing of this hypothesis with patients and controls, if possible. Perhaps this has been done? It seems common sense that some vocals have a more soothing effect than others. To narrow this down would take work and I assume the speaker has done some of the ground work or at least has collected data on this? Thanks.
I had a client with a chronic health condition in addition to PTSD from childhood sexual abuse. This work really helped her understand her body’s reactions that also exacerbated her health condition. Part way through our work research revealed that her condition also had an affect on the heart and after scans her consultant gave her heart medication. This helped her anxiety enormously; she was feeling calmer therefore triggering less traumatic memories and also understanding her bodily reactions often came before psychological distress and not the other way around.
I have also developed a programme MY WAY CODE that will be an App and amongst other features, will be encompassing animations, music, visuals and trigger buttons to help inform and assist ppl to monitor somatic changes. We are planning this to also link with wearable devices that can track heart rates etc.
Exciting innovation using technological intervention for person centred self managed help. Would love to link in with you Ruth! @MWCSoni
With my PTSD clients I use Polyvagal theory to explain why they often feel ashamed of what happened to them when they “freeze” during an assault, an accident or natural catastrophe. When the ventral vagal nerve has us ready for fight or flight, we can be active in the case of a serious incident and we often “triumph” and survive. However, when the person instantly assesses that flight or fight are not possible the dorsal vagal nerve causes us to freeze and shut down. This is also an adaptive, but not conscious choice. By explaining this to the client and using mammalian examples of predators and prey, I explain that freezing and shutting down can also result in survival as the predator loses interest in prey that is no longer moving. This often helps the client to stop blaming and shaming themselves for not taking action in certain traumatic circumstances.
Steven Porges is a great mind! I use his concepts
such as the “vagal break” and other Polyvagal Theory
and energy psychology components
to inform my practice and provide insight to clients.
Here he is using a lot of terminology which could be
simplified to make the information more readily accessible
to all.. such as perhaps stating that lower
vocal frequencies illicit a calming response in
the listener… possibly also in the person vocalizing
a low frequency. American culture’s version would
be singing… But vocalizing has been used to calm
and as a cathartic tool by most of our ancestors.
We are now looking behind the curtain to ask how it works.
In therapy this might be used in consciously speaking
in lowered tones or playing of certain ambient frequencies
during sessions.
I think calming is also achieved by patients who create
these tones as well as hear them. (One of the reasons
full deep “OMmmmm” works so well.)
“Keening” practiced by Irish mourners may be a version of this.
Women were often hired for procession and burial to moan loudly
and lament using the listing of the genealogy of the deceased,
praise for them as well as stating the woeful condition of those left behind.
While generally carried out by one or several women,
a sympathetic “response” was often intoned by all present. I am interested
to combine these low frequencies in “tapping” or EFT work to perhaps
enhance response.
Have you thought about putting these particular valuable information video clips on YouTube for the general population, ministers, coaches, teachers, parents, and those on a self healing trajectory, etc.? These videos can be very empowering, can stimulate further searches and subject research and perhaps even stimulate book sales. I would like to be able to have some of my clients and students have access for increased awareness and empowerment. However, I am unaware of how to share these productions for future use and reference other than forwarding this email. I suppose I could individually forward my email but access would be greater if I could just provide a list of links. I know there are already YouTube clips on polyvegel theory, music to calm SNS, activate PSNS, etc. I find that many people assimilate and take action more readily when experience is accompanied by education which can normalize the situation and experience. I particularly like the sequencing In this link. Thank you both for your continued devotion and dedication to the evolution of healing.
I hope a video demonstration will be provided soon.
I do GIM that’s a technique where music becomes the therapist. In this technique the music has many functions. The results are amazing.
I must admit that I still don’t know much about tnis. I wish the video could have included a demonstration of some kind.
AS a mindfulness Educator I have discovered That mantras have a profilindstillinger calming affect ón people. It cames the hole system and turn the self companion on. So we ofren use mantras to help calming the mind and Body.
It seems to awakened the parasympaticus
Combined whit mindfulness theacing, and a theoretic understanding of what mind is ( the embodied mind) and gentile yoga strechs it often help trauma to let goe.
We’ve created a Trauma Sensitive yoga class with Music Therapy. We found the combination to be extremely helpful in vagal regulation. Thank you Stephen!
Great idea to use music therapy to dampen sympathetic activities of the nervous system that is often predominant in the traumatized clients.
This seems to explain why eastern chanting is so soothing to me and how some particular singing voices lead me to feel safe and calm. Also reading earlier about the social component of polyvagal theory has been an eye opener. Recognised my chronic tension in all social situations even though I thought I was fairly relaxed and OK. Have started to practice mindfulness and breathing in all social situations and am amazed at the amount of tensions that is leaving the body. When stress in social situations was the norm for me I labeled low stress as relaxed. I didn’t know any better. But with this small piece of information I am experiencing real relaxation in social situations. What a relief. Still a work in progress but thank you Ruh for your wonderful work in sharing this knowledge that should be taught in school.
Polyvagal Theory is the precursor to CBT, SFBT and Neurofeedback. It is an ideal way of introducing either of these modalities. By playing specific music during a session is a form of treatment and can also be introduced into sessions of mindfulness.
Paul Busuttil
It has been shown that baroque music lights up many areas of the brain and to facilitate new learning. (Its beat is said to be close to the normal heart beat.) We found in working with hyperactive and emotionally distressed children in a classroom setting that baroque music helped them regulate their behavior more effectively, helped them learn more efficiently and helped them relate better to others.
Was this facilitated through the vagus nerve? In retrospect, it might have been useful to have used baroque music as a background in my adult clinical practice.
I’d be more likely to follow through with this if there were an example of the music and what happens to a client’s heart rate when someone listens to it.
As it stands this little video seems more like an infomercial than an educational video.
Alot of my psychotherapy practice is based on what i have learned from the process of meditation_mahamudra over the past 3o years. In fact, in my book, “Butterfly on the Wrist” i clearlt spell out that one of the main functions of meditation is becoming intimately acquainted with our physiological system. A friend recently asked me to try his feedback ststem of coherence between heart and brain. Although i was very familar with knowing how to regulate my internal states by , NO EFFORT” methof of mahamudra ,it was certainly supportive to watch on the screen how i was able to regulate my internal process. I wondered how an indiviual who has no training ,even in concentration meditation can register or regualte their internal states?
thank you for the presentation.
Dr Vincent Androsiglio
Heartmath have a system for regulating internal states as well as the technology to measure HRV. Lots of information on their website: http://www.heartmath.com/
About four years ago I experienced what was diagnosed as a Vasovegal Syncope event in which my blood pressure dropped to the 90s and I became feint requiring medical attention during which the event was diagnosed. Though I was a retired person, I realized I still had stress in my life. This led me to a meditation class. The meditation class in turn led me to discover Spring Forest Qigong with Master Chunyi Lin who is an internationally recognized Qigong master. Spring Forest Qigong is unique because it is simple and focuses exclusively on healing through the opening of energy blockages within the body’s organs and energy channels. The principals come from Traditional Chinese Medicine (TCM). My study of Spring Forest Qigong meditations and practices has revolutionized my life wherein my entire orientation physically and emotionally has found peace, deeper emotional connection with self and others. I am not here advertising for Spring Forest Qigong, but just sharing my experience. as it may be of interest to this forum.
I wonder if female voices are also more tuned to A as 432hz, or if that’s what some of the modulation is about. I just met a violinist, and she said every time she naturally sang a note that she thought was an A, it was an A in a 432hz scale, and not in the 440hz (the present world standard.) A study in Germany followed mental patients who had anxiety and depression. They had one group listen daily to a cd in 432hz and the other group in 440hz. Eighteen months later, the symptoms of the group who listened to the 432 music were ameliorated whereas the symptoms of the group who listened to the 440hz music were not. If you want to see the visual, cymatic difference, look on youtube and search for 432hz vs 440hz experiments.
Thank you, Ruth!
I would like to know more about how Dr. Porges computer-alters female vocal music and see the results in action.
I guide my patients ‘back into meet themselves’ and help them ‘stand their somatic feelings’ without going to the trauma.
In my experience, the side effects of trauma is just a ‘Bad Skype Connection’.
Eva
One of the best moments in therapy was when she showed me a belly breath. Slowly in time I cam to realize that the contacting of my muscles and breath was a real response to stress, fear, and triggers. It’s taken such time to become a little more conscious of myself. Lots of stuff has helped decrease the effects, nothing anymore powerful than to sit across from my counselor and watch her do a belly breath!!
Thanks~
I use music therapy with most of my patients, and as a singer, I am interested to know more about the sound modulation and alteration techniques specifically. I have piles of evidence for the fact that sound vibration affects the brain/body, and invite any new information as we collaborate together.
thanks for the video…for someone who has PTSD for 50 years I understand some of the principles
of PTSD…my body reacts to a minor situation as if it were a major problem…I know there are inroads being made in the treatment of anxiety… have been following the research of MAPS.org…thanks once again for the video on Polyvagal Theory…will check it out
Pete – I hope you’ll also check out Energy Tapping with an experienced therapist! Noticing thoughts/events/how others feel to you, that trigger body reactions is just one part. Working with the breath (make abdominal breathing a habit by practicing daily), noticing feelings in the body, practicing mindfulness activities such as concentrative meditation mindfull walking, and peaceful movement (Tai Chi – Yoga, etc. – find the right teacher/style for you!) is key to being able to maintain (or return more quickly to) a state of harmony. Beyond that, as Dr. Porges states, music can be a powerful tool for optimizing brain function and calming over-energy aspects. I wonder how his application compares with Hemi-Sync Meta-music from the Monroe Institute and similar works which I use with my clients. I find working with Chakra stories, and Meridians/Elements in relation with the Core is the best way to stay informed and be empowered. I’m grateful Dr. Porges work!
Pete – I hope you’ll also check out Energy Tapping with an experienced therapist! Noticing thoughts/events/how others feel to you, that trigger body reactions is just one part. Working with the breath (make abdominal breathing a habit by practicing daily), noticing feelings in the body, practicing mindfulness activities such as concentrative meditation mindfull walking, and peaceful movement (Tai Chi – Yoga, etc. – find the right teacher/style for you!) is key to being able to maintain (or return more quickly to) a state of harmony. Beyond that, as Dr. Porges states, music can be a powerful tool for optimizing brain function and calming over-energy aspects. I wonder how his application compares with Hemi-Sync Meta-music from the Monroe Institute and similar works, which I use with my clients. I find working with Chakra stories, and Meridians/Elements in relation with the Core is the best way to stay informed and be empowered. I’m grateful for Dr. Porges work!
Understanding, and being aware of the body’s response to stress is so important. Heartmath (Heartmath.com, Heartmath.org) has some great tools to help increase awareness and skill at calming.
Thank you again. My aim is prevention of t trauma by working with pregnant woman through voice to build their confidence and playfulness so that baby in womb and after will have a mother who is engaged and more able to self regulate. The simplest tool is to get the mother to sing one song – a popular lullaby – every day – in a gentle voice. This song then becomes connected to the womb and mother experience and can be used in the first 6 months after birth by any carer to soothe the baby. From what Stephen said today it most likely engages the babies middle ear muscles and therefore regulates. I have seen it work and feel it is regulating for both carer and baby whoever the carer is. While singing are faces are more expressive and baby gets more feedback to engage with. Does Stephen have any recordings of the commuter altered vocals that I could listen to. Thank you
There’s just one thing I’d like to add about singing, and that is that if the mother isn’t on pitch, it could affect the baby in a negative way. I was tone deaf and my baby kept crying until I stopped singing. A close friend remembers that when she was carrying her first baby, it kicked and kicked until she stopped singing (or maybe it was playing a piano that wasn’t in tune.) Either way, both children were born with exceptional abilities to recognize music that is in tune, and are natural musicians. Should this problem emerge for any of your clients, Brain Gym(R) is an amazing tool to correct the mother’s ability to sing on pitch. They have a web site: http://www.braingym.org
As a crisis worker, when encountering a client that I observe in hyperawareness, I have a mental checklist of focuses to observe. With experience of working in an ICU/CCU, use some aspects of the fight or flight that would core from any vagal reaction. I would love to know more about Dr. Porges experiences, I know as all the training’s I’ve purchased from NICABM have made my job a delight to simply help people to a better place.
I think emotional discharge–crying, shaking, yawning, laughing, telling the story of trauma to a sympathetic listener, perhaps even meditation and yoga, certainly Feldenkrais ATMs, all lead to a lowering of stress, the return to at least a dominance of the parasympathetic nervous system and the regulation of breathing and heart rate.
Is it like playing “possum”, ?
What happens if there already
is burn out in the body?
Isn’t there a risk the parasympathetic
nervous system could lead the body to
slip into a catatonic state?
I’m not a professional.
One of the best moments in therapy was when she showed me a belly breath. Slowly in time I cam to realize that the contacting of my muscles and breath was a real response to stress, fear, and triggers. It’s taken such time to become a little more conscious of myself. Lots of stuff has helped decrease the effects, nothing anymore powerful than to sit across from my counselor and watch her do a belly breath!!
Thanks~
I am interested in this theory and was wondering if u have any ideas or resources that offer heart rate monitors or pulse monitors instead of a feedback machine? I looked into Fitbit for patients. But agency has limited budget.
My 1st feedback was a small thermometer that I held between my thumb and index finger. All I did was learn to raise the temperature. Visualize the sunlight coming into me, warming my body. The heart rate will decrease.
“The fusions of East and West cultures teach our children and families to manage distractions and prevent addictions and attachments”
Meditation helps to improve our mental health and well-being by teaching us to be mindful and manage our own behaviour and problems, including relapsing conditions, such as stress, anxiety, anger, low self -esteem, pain, addiction and depression, which can often lead to alcohol, illicit drug and medication dependency. youtu.be/f-iyR3I-ddI
I agree meditation is wonderful–the problem is that people whose nervous systems are already on overload , and disregulated due to undischarged trauma, can suddenly go into a panic attack, spiritual bypass or shutdown.
If you check out Dr Peter Levines work with shock trauma you will discover that the somatic experiencing offers the skills that can bring the nervous system and the person back to a state of calm and presence efficiently and within a short space of time.
I would like Dr. Porges to study what we call “palpitations” of the heart, and possibly even
atrial fibrilation in cases where there is no measurable pathophysiology to “back up” causation.
I would like to know the role the vagus nerve plays in these conditions.
Polyvagul Theory is interesting, am I right in thinking it helps the client get tuned in to their body and the language it speaks, so that they can understand the messages and learn how to manage them?
I find once I have explained their response to a past trauma with how fight or flight works and the way the brain pattern matches and stores fear-filled memories in the amygdala, they begin to calm down. They realised they are not going mad! Teaching them 7/11 breathing then takes them to the next level to bring the anxiety down further. My two ultimate tools are the Rewind technique and non-attachment therapy, both enable the client to gain a sense of calm control over the old memory and associate it with calm and distance. The result is no more phobia and associated anxieties. Wonderful!
What city are you providing services to?
I have always found singing to calm me and bring me into the present moment. I am not a good singer, but I will sing familiar songs or make up my own silly songs and sing them loudly! I have sung to my children when they were young and now to my grandchildren and even my cat who comes running and sits and listens like the purrrrfect audience!
It always makes me smile and shifts my energy.
The nonsensical nature of the songs I make up brings humor and lightness to the system, also creating a sense of calm.
Ruth, Thank you for all your efforts to share innovative and useful information that can inform our thinking and work with trauma. Dr. Porges has expanded our understanding of how the human nervous system work and adapts. He is inspirational in his ground breaking insights. Thank you.
THIS IS ABSOLUTELY THE WAY TO GO- SO PEOPLE CAN LEARN TO UNDERSTAND HOW WHY AND WHEN THEY REACT AND BY THIS INSIGHT AND THE TECHNOLOGICAL HELP OF SEEING THEIR HEART RATE AND NERVOUS SYSTEM RESPOND – TAKE RESPONSIBILITY AND HAVE A WAY TO CHANGE THE NERVOUS SYSTEMS RESPONSES. . THE MUSIC ART OR ALTERNATIVE THERAPY ALSO TO HELP THE HEALING PROCESS IS ALSO INVALUABLE. IN OUR FAMILY THERE HAS BEEN MUCH TRAUMA AND MENTAL ILLNESS BUT FACING UP TO THIS AND SEEING THAT IT CAN BE MANAGED NOT BEING JUDGMENTAL HAS MEANT THAT THE EPISODES HAVE BECOME NOT ONLY MANAGEABLE BUT BASICALLY EASILY MINIMIZED . fEAR AND ANXIETY FROM THOSE WHO JUDGE MAKES THE CONDITIONS MUCH WORSE. tHE STEPS AND THEORIES YOU SHOW ARE WONDERFUL WAYS TO COMBAT DIFFICULT TIMES IN LIFE AND OVERCOME OBSTACLES TO LIVING A FULL LIFE. THANKYOU
I use the awareness of bodily sensations with people presenting with anxiety and OCD and see the impact awareness and choice is making to their physiology. The idea of music => polyvagal regulation. I’d like to understand more of how it’s used, and the science behind the concept. This makes so much sense to me …
I USE A VERY SIMPLE TOOL TO REGULATE MY HEART RATE. IT WORKS ON THE SPOT, LIKE A SWITCH. I SAY THE SERENITY PAYER. HOW HAVE I COME ACROSS THIS? WHEN ONE NIGHT BEING AT AN EMERGENCY WARD AND CONNECTED TO AN ELECTROCARDIOGRAM MACHINE. I COULD SEE THE MONITOR ABOVE MY HEAD. IT WAS DRAWING WILDLY. A THOUGHT CAME TO MIND: “PIERRE SAY THE SERENITY PRAYER; IT MIGHT HELP CALM YOU DOWN.” I DID. AND IMMEDIATELY, THE LINE ON THE SCREEN FLATTEN. IT STAYED FLAT AS LONG AS I WAS SAYING THIS PRAYER. IT RETURNED TO ITS UNNERVING WAVES, WHEN NOT. I KEPT DOING THIS. EACH TIME IT WORKED. FOR WHO MIGHT NOT THE WORDS OF THIS PRAYER, HERE THEY ARE: “GOD, GRANT ME THE SERENITY TO ACCEPT THE THINGS I CANNOT CHANGE, THE COURAGE TO CHANGE THE THINGS I CAN, AND THE WISDOM TO KNOW THE DIFFERENCE.” IT TAKES 10 SECONDS TO SAY IT SLOWLY. THIS RATE IS A KEY RATE FOR BREATHING. IT IS THE SAME RATE AS AIMED FOR WHEN DOING BIOFEEDBACK AND QIGONG. SIMPLE, EASY, AND EFFICIENT!
What type of music, specifically, do you think helps people the most? Jewel, perhaps–Or, maybe Madonna Or, Christina Aguilera?
I find this Polyvagal Theory of great use personally. (No longer work with clients) I utilised this theory today whilst undergoing stressful and lengthy dental treatment. Awareness led to a sense of managing my responses well and thus a diminution of the symptoms. A deep interest in Neuroplasticity led me to strive to cure myself of Atrial Fibrillation. I developed AF in 1999, have been in sinus rhythm since Feb 2016. I remain fascinated with, and committed to, these marvellous sciences.
Sounds useful for GAD ,panic disorder and phobias .
We use Dr. Steven Porges’ Polyvagal Theory as a model to integrate over a dozen different modalities in the Vet TRIIP Integrative Immersion Process (IIP) Sessions. For more information: VetTRIIP.org