Polyvagal Theory in Integrative Counselling for Trauma

24Sep

by Laura Hendry

Polyvagal theory has become influential in the world of trauma therapy, giving counsellors new ways to understand and help people who have experienced trauma. Created by Dr Stephen Porges in the 1990s, this theory helps us see how our body’s automatic responses can shape our feelings of safety, our ability to connect with others, and our overall well-being. In this blog, we’ll look at how polyvagal theory is used in counselling, focusing on the fight, flight, and freeze responses, as well as new research on more complex patterns in our body’s reactions.

At its heart, polyvagal theory says our body’s stress response is more complicated than just “fight-or-flight” or “rest-and-digest.” According to the theory, there are three main ways our body can react to danger or safety. One helps us feel calm and able to connect with others, another gets us ready to confront or run from trouble (fight or flight), and the last makes us shut down or freeze when things feel overwhelming. These responses developed over time to help us survive in different situations.

When someone goes through trauma, their body can become stuck in these survival modes. The “fight” response prepares us to stand up to danger. If that’s not possible, the “flight” response gets us ready to run away. If escape isn’t possible either, our body may “freeze” — we might feel numb or disconnected, like we’re shutting down. For people who’ve experienced trauma, these reactions can show up long after the original danger has passed, often without warning.

Counsellors are trained to spot these patterns in their clients. By using ideas from polyvagal theory, they help people feel safer and teach ways to calm their nervous system, such as deep breathing, grounding exercises, or connecting with others in a safe setting.

Recent studies show that our body’s reactions aren’t always so simple. Sometimes, people feel mixed reactions at the same time — like feeling numb and restless, or shut down but also on edge. These blended reactions are common for people with complex trauma or PTSD.

Understanding these mixed states helps counsellors offer better support. Instead of seeing people’s reactions as only one thing or another, therapists can recognise that feelings can overlap and change, and they can adjust their help to match what someone is really feeling in the moment.

Integrative counselling uses different techniques based on each person’s needs. A polyvagal approach might include mindfulness, gentle movement, or body-focused therapies, all with the goal of helping people feel safe and more in control of their bodies and emotions.

Research shows just how important it is for therapists to help clients feel safe, both emotionally and physically. When people feel truly safe, they can begin to heal from trauma, reduce anxiety, and start to reconnect with others and themselves.

  • Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological foundations of emotions, attachment, communication, self-regulation. New York: W. W. Norton & Company.
  • Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. New York: W. W. Norton & Company.
  • Dana, D. (2018). The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation. New York: W. W. Norton & Company.
  • Schauer, M., & Elbert, T. (2010). Dissociation following traumatic stress: Etiology and treatment. Journal of Psychology, 218(2), 109–127.

As our knowledge grows, integrative counselling is leading the way in using polyvagal theory to help people move from just surviving to truly living—supporting recovery, connection, and hope.

Self-Destruction as Self-Protection

01Jul

Frequently, the question posed is ‘Why the behaviour?’. However, as suggested by Dr Gabor Mate, perhaps the more pressing question is ‘Why the pain?’  (2018).

Self-destructive behaviour is an often misunderstood issue that profoundly impacts both the individual and those close to them.  Where current standard treatment approaches focus on thought and behaviour patterns in the ‘here and now’, there is growing evidence to support therapeutic interventions which explore the root causes of the behaviours.

Renowned trauma specialist, Dr Janina Fisher explains that each incident of destructive behaviour results in short term relief from psychological pain, followed by a ‘rebound effect’ which may include negative social consequences, traumatic exposure or reinforcing experiences.  This increases the likelihood that the same destructive behaviours will be stimulated again (2024).

Consultant Psychiatrist, Dr Frank Corrigan explains that destructive behaviours are an attempt to regulate a dysregulated nervous system (2010).  A cycle of re-traumatising self-destructive responses is set in motion and since the individual likely develops a tolerance to the addictive behaviour, increased or more intense attempts to self-regulate are needed to achieve some relief. 

Dr Janina Fisher explains that, despite the best efforts of health professionals, successful treatment of destructive coping behaviours is extremely challenging because the fear of their underlying pain is much greater than the fear of the risks involved in their behaviours (2024).

Self-destructive behaviours are self-protective strategies offering a sense of safety and a way to cope and regulate through deep, often unconscious pain. 

Although challenging thought and behaviour patterns is one aspect of successful therapy, it is not enough. 

I believe that much of the work is possible only as a stable therapeutic relationship begins to be established.  It is important to find a counsellor who feels like a ‘good fit’ for you.  Who can sit with you in your pain and honour the protections that have helped you survive whilst offering safety, compassion and care.  In this way, you can work together to uncover the underlying thread of pain, processing and establishing a new level of safety within and finding new, safer ways to regulate your system. 

The Window of Tolerance

01Mar

When we are within our own window of tolerance, we are present and alert.  We can engage with others and respond in a calm and considered manner, with skills to self soothe and regulate our emotional state.

However, when we are dysregulated, we are pushed out of our window of tolerance into either hyper-arousal or hypo-arousal.

Hyper-arousal is a state of excessive energy.  You are likely to feel a heightened sense of anxiety, which may make you highly sensitive and reactive.  The fight or flight responses are activated and you may experience symptoms such as:

anxiety, panic, fear, hypervigilance, angry outbursts, sleep problems and difficulty concentrating.

Hypo-arousal, in contrast, is a state of very low energy as a result of the freeze response.  You may experience:

numbness, lack of energy, inability to think or respond, reduced physical movement, low appetite, excessive tiredness and difficulty processing thoughts and emotions.

For people who have experienced trauma or cumulative toxic stresses, their window of tolerance can become very narrow.  Consequently, they will often find themselves in either hyper-arousal (fight or flight) or hypo-arousal (freeze) state.

As dysregulation feels incredibly uncomfortable, we unconsciously develop protective defences to bring us back within our Window of Tolerance.  Unfortunately, they can become very problematic when, later in life they end up causing us harm.

For example, as it is intolerable for a child to believe their caregivers are ‘bad’, they internalise the ‘badness’ and develop the belief that they are ‘bad’.  When this decision has been made early in life and reinforced through cumulative experiences, it is likely that they will carry this belief and defence into adult life.  Although it helped them survive childhood, it no longer serves in the same way in adulthood.

Counselling which focuses on processing trauma and painful memories without being flooded or overwhelmed helps to widen the window of tolerance; the client sees that those defences they created are parts of them created to survive but are not helpful or necessary now.  

Thoughts on Anxiety…

15Feb

Written by Mairi Henderson

Anxiety is hugely prevalent in society today. Over the last couple of years, with all the uncertainty of COVID, lockdowns and associated issues, more people of all ages have been seeking help to deal with anxiety.

The nervous system is a bit like a smoke alarm.  It is supposed to be there in case of emergencies, it is part of us, and when it’s doing its job properly, it’s good and it’s healthy.

The problem arises when our nervous system becomes over-sensitive and perceives threat and danger everywhere. When this happens, our alarm system goes off, flooding our bodies with stress hormones, and causing all the horrible physical feelings associated with anxiety.

In her book, ‘Atlas of the Heart’, Brene Brown explains that, unlike fear, which is a response to current threat, anxiety is linked to the future.  Research has revealed that there is a link between intolerance to uncertainty and anxiety.  It is common and natural to want to have control over what may happen.  However, unfortunately we never really have control over the future and this striving often exacerbates symptoms. 

Once the cycle of anxious thoughts, feelings and physical symptoms has started, it’s impossible to stop it using “mind over matter”.  You cannot think your way out of anxiety once it is there.  It is in our bodies and that’s where we must start to break its cycle.

Living with chronic illness…

10Feb

Written by Mairi Henderson

For many people, living with a chronic illness such as chronic fatigue syndrome (CFS) can be an anxious and frustrating experience. Fatigue, widespread pain, digestive problems, and disordered sleep are just some of the more common symptoms.  Dealing with these daily can be very isolating, and for some sufferers, this may lead to low mood, depression and/or anxiety.  Unfortunately, this is often a vicious cycle, with each component exacerbating the other.

 In his book ‘The Body Says No’, Dr Gabor Mate writes about the mind-body connection:

“The body will always find a way to communicate its needs. Whether we pay attention or not.”

Talking about your worries and frustrations and exploring new ways to cope with the limitations the condition brings, can help make it more manageable.

CBT, a type of therapy which works by interrupting the negative cycle of thoughts, physical feelings emotions and actions, and breaking down overwhelming problems into smaller, more manageable chunks, can be particularly effective.

 Mindfulness, a practice which helps reduce stress and anxiety by focusing on being in the present moment, can also be very useful as it helps the body to be in a naturally more healing state.