Ask Me Anything #1

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Discussing and responding to commonly asked questions regarding polyvagal informed coaching for healthcare professionals can be informative for all of us.  

Polyvagal informed coaching for healthcare professionals is not a common niche within the coaching domain at this time, although it promises to provide significant advantages.  There are commonly asked questions which provide the opportunity to discuss important principles.  The opinions and responses to these questions can be informative for us all.  This article marks the start of a new installment in this overall series.  This is the first Ask Me Anything segment and for the initial article is based upon commonly asked questions amongst healthcare professionals.  Future Ask Me Anything articles will draw upon questions from readers of these articles!  Please submit questions in the comments and they will be answered in future articles.  The frequency of these articles will depend upon the number of questions posed. 

Why do you utilize a polyvagal informed paradigm? 

Polyvagal theory was first introduced by Stephen Porges, PhD in the mid-1990’s.  From my perspective it is a truly groundbreaking and game changing theory.  Ultimately, it is the most biologically based and comprehensive paradigm to inform skills and strategies that we can employ to be at our best in any, and all, domains of life.  There are two main considerations as to why I view this theory as the preeminent foundation for promoting health, wellbeing, and sustainable high performance.

Firstly, it provides the most comprehensive explanation of the structure and processes of our nervous system, specifically the autonomic branches, and how it functions to interpret the cues and stimuli we experience within ourselves, with others, and with our surroundings.  This provides a more complete understanding regarding how we process information and subsequently use it to respond to stimuli.  This information allows us to not only better understand the foundation and basis for our experience but also predict how specific stimuli under specific circumstances will lead to particular responses.  

While the first aspect of Polyvagal Theory is, in and of itself, significant, from my perspective the even more empowering aspect is the framework it provides to allow for the development of skills and strategies to better manage our autonomic nervous system responses in the pursuit of our goals and objectives.  This framework is actionable and consistent across all domains of life.  

In essence, Polyvagal Theory provides the biological link between the mind-based and body-based skills and strategies that are commonly discussed in the pursuit of health, wellbeing, and sustainable high performance.  This link provides a unifying understanding of how our psychological and physiological aspects interact and function within a single being.  

This framework informs numerous skills and strategies, both mind-based and body-based, that can then be used to leverage our biology towards accomplishing our goals and objectives.  The importance of this wide array of skills and strategies cannot be overstated since certain skills will be more useful for some individuals and others for other individuals and even within the same individual, different skills and strategies may be more effective at different times.

How does Polyvagal Theory apply to the promotion of sustainable high performance?

This is an important topic to address.  After Dr. Porges first described Polyvagal Theory, it was initially integrated into the management of traumatic mental health conditions.  The main application of the theory was within this domain for several years.  Recently, Michael Allison, a friend and mentor, was the first to my knowledge to apply the theory within the realm of human performance.  His insights and work form the foundation for the understanding and application of Polyvagal Theory within the realm of human performance.

Intuitively, the principles of Polyvagal Theory would be expected to apply to any, and all, human domains.  This is because the theory is first, and foremost, and explanation of our biology as it pertains to the autonomic nervous system which governs our initial interpretation of the cues and stimuli we encounter and initiates our response.  Michael’s work, in part, provides numerous illustrations of the physiological states amongst top-tier professional athletes, particularly tennis players.  These examples are important because they clearly demonstrate the principles and shifts in physiology in response to cues and stimuli.  This supports the application of Polyvagal Theory within the realm of human performance. 

In addition to this significant understanding, Michael’s case examples also demonstrate that even amongst athletes who train all aspects of their physical and psychological skills, the shift in physiological state in response to cues in the internal and external environment will occur.  This provides evidence that training the mind-based and body-based skills and strategies outside of a polyvagal informed paradigm will have its limitations.  Indeed, even a polyvagal informed training paradigm will not fully prevent these shifts in physiological state because we are all human and will eventually, especially in the domain of high performance, experience cues and stimuli that will overwhelm our available resources, skills, and strategies.  However, the polyvagal informed paradigm provides a preferred response to such situations through the application of non-judgmental acknowledgement of our biological state in conjunction with implementation of a wide array of skills and strategies to shift our biological state towards one that is more conducive to accomplishing our present goals and objectives.  It should be noted that my use of the terminology of biological state is intended to denote the unified acknowledgement of psychological and physiological states as a single entity.

These sports examples are particularly informative of these principles because the athletes are highly visible.  We are able to directly observe their physical manifestations of the various biological states. We can then appreciate the immediate and direct impact of these state shifts on their performance.  This more completely informs the understanding that neither the mind-based nor the body-based paradigm in isolation is optimally effective.  If it were, then we wouldn’t observe these biological state shifts and consequent impact on performance amongst these highly trained athletes.  Rather, these examples demonstrate the importance, benefit, and need for the polyvagal informed paradigm which unifies our physiology and psychology.

From my perspective, in day to day life, strong psychological skills may be sufficient on their own to optimize our performance.  However, we will eventually experience cues and stimuli that will overwhelm these mind-based skills and they will not be optimally effective in these situations.  This scenario is particularly prone to occur in the domain of high performance because we are regularly pushing our limits in the pursuit of being at our best.  In order for the mind-based skills to be optimally effective, they are dependent upon our brain’s executive functions and prefrontal cortical activity.  This reflects the cognitive component of these skills.  When our biological state shifts into a sympathetic or dorsal vagal state, the function of our prefrontal cortex is substantially reduced, thereby reducing the effectiveness of skills and strategies dependent upon such function.  For example, if we are well trained in the mindset skills of reframing and disputing our thoughts, narratives, and beliefs but find ourselves in a sympathetic or dorsal vagal state with associated reduced prefrontal cortical activity, we are not able to maximally utilize these skills.  In this situation, we simply do not have access to the required cognitive capacity.  In contrast, by first utilizing body-based skills to shift away from a sympathetic or dorsal vagal state, we can increase ventral vagal activation thereby allowing prefrontal cortical activity to be more effective and, consequently, restoring the benefit of these mind-based skills.

Which skills and strategies are most important to develop?

As can be appreciated from the above discussion, the most effective and optimal skills and strategies are individual and situation specific.  That said, there is one foundational skill and one additional skill which are particularly important and effective across a large range of circumstances.  The ideal situation is for each individual to discover what is most effective for them through practice and experimentation with the various skills.

The foundational skill is awareness.  This provides the ability to identify our biological state which is the first and necessary step in the polyvagal informed paradigm.  We are not able to effectively and appropriately shift our state if we are not first able to identify our current state.  This is best developed through training and improving our awareness.  This can be accomplished through formal and informal mindfulness practice as well as clearly identifying our individual specific features of each of the biological states and the blended states.

The additional skill which is most powerful for most people and applicable across the greatest number of situations is breathwork.  By identifying our breathing patterns and mechanics we can obtain substantial insight into our biological state.  In addition, we can use these patterns to effectively and rapidly shift our biological state.  Breathing has a direct and rapid impact on our autonomic nervous system which explains its effectiveness as a foundational skill.  As a result, the appropriate breathing pattern employed at the correct time can assist our ability to shift from any biological state to the subsequent state in our attempt to self-regulate and regain ventral vagal activation.  An intentional and deliberate breathwork training practice is needed to optimally utilize this skill.

It is hoped that the above discussion and response to common questions encountered in polyvagal informed coaching of healthcare professionals will be instructive and create additional interest in these topics and the application of these principles.  Of course these concepts apply to all of us, not just healthcare professionals, because we are all human and our biology functions through the same structures and processes.  Through understanding the principles of Polyvagal Theory and the application of the framework informed by the theory, we are better able to pursue health, wellbeing, and sustainable high performance.  This is the specific paradigm of The Practices of the Healthcare Athlete.  Please include any questions in the comments so that they can be addressed in future installments of Ask Me Anything.

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REFERENCES

Allison, M.  The Play Zone:  A Neurophysiological Approach to our Highest Performance.  https://theplayzone.com.

Allison M.  How Our Feelings of Safety Guide Our Behavior.  Looking at the World Through a Polyvagal Lens.  Psychol Today, May 30, 2022; https://www.psychologytoday.com/us/blog/polyvagal-perspectives/202205/how-our-feelings-safety-guide-our-behavior

Porges, SW.  The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, Self-Regulation.  New York: W.W. Norton & Company; 2011.

Porges, SW.  Presidential Address, 1994.  Orienting in a Defensive World: Mammalian Modifications of our Evolutionary Heritage.  A Polyvagal Thoery.  Psychophysiol 1995; 32: 301-318.

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