Managing Adversity to Promote Health and Wellbeing

For the opportunity to reflect on this article and earn CE/CME credits, see the instructions below.

When we consider the promotion of health and wellbeing, it is also important to include the manner in which we manage the inevitable adversities and challenges we experience in life.

The previous article discussed the foundational framework a polyvagal informed paradigm provides for many aspects of life, including the promotion of health and wellbeing, as well as longevity and healthspan.  The emphasis of this article will expand upon those considerations by describing the contribution of a polyvagal informed perspective that is not directly addressed by the typically discussed strategies for promoting health and wellbeing.  Specifically, how we can optimize our response to the inevitable challenges and adversities that we will experience in life.

It is possible for us, as humans, to intentionally and deliberately plan and schedule our routines in order to optimize for whatever we value and set as goals, in this context it is the promotion of health and wellbeing.  We can further arrange our environment to support this pursuit.  When circumstances are unfolding how we expect, everything can run smoothly.  However, there will always be unexpected situations and adversity that is outside our plan and control.  Our response to such events is often a significant determinant of the quality of our life as well as our ability to optimally pursue health and wellbeing.

While the routines and protocols that we may establish and follow have an undisputable importance and benefit, by their very nature they are not able to directly guide us in our response to the unexpected.  While it is undeniably important to obtain and develop appropriate and sufficient external resources and support systems, these too are frequently not able to directly contribute to our response to adversity, particularly in the immediate occurrence of such situations.  By their nature, it is not possible to specifically plan for each and every one of these events.  It is also not possible to obtain sufficient resources to avoid and prevent these circumstances from eventually occurring.  When these situations do arise, they likely provide significant cues of uncertainty, risk, and, possibly, threat which is neurocepted and then leads towards mobilization in sympathetic states or shutdown and collapse in dorsal vagal states.  When this occurs, it is very difficult for the routines of health and wellbeing promotion or external resources and support systems to directly assist in recovery and shifting towards a ventral vagal stabilized state.  While those factors may be contributory, ultimately the most significant determinant is our ability to identify our biological state and employ skills and strategies to shift towards a preferred state.  This is also the only strategy which is directly within our control.

There is another substantial benefit of the polyvagal informed paradigm.  This framework provides what few, if any, others do.  Through embodiment of the principles of Polyvagal Theory we are able to expand the tolerance and capacity of our nervous system to allow us to better manage unexpected situations and adversity as well as develop the ability to more efficiently identify when we dysregulate and employ well established and effective strategies to shift our state to that which we would prefer.  This ability is critically important because it is inevitable in life that we will dysregulate and shift towards sympathetic and dorsal vagal states.  It is impossible to prevent or avoid this from occurring.  It is the nature of life and the human experience.  What matters most is our ability to restore our stability and regulation in the face of such circumstances.

It is important to emphasize that the cues which will, at some point, cause a shift in our biological state can be internal, external, or relational.  Examples of internal cues include those resulting from sleep deprivation, a physical injury, or our thoughts and emotions.  External cues may include unexpected and/or undesirable changes in our environment.  Relational cues are those which occur between us and others, such as an unanticipated critical comment or a contentious conversation.  Furthermore, it is important to note that the principle of biological state as an intervening variable will influence our neuroception such that our response and reaction to a particular situation may differ under various circumstances as well as between different individuals.

In the face of adversity and unexpected situations, the manner in which we manage the accompanying biological state shift is crucial.  The polyvagal informed lens provides the most biologically consistent and comprehensive framework with which to address such circumstances.  By virtue of being human, we will all dysregulate at one time or another.  Even with the best and most consistent routines, practices, and resources there will inevitably come a time when we will shift into sympathetic and/or dorsal vagal states in response to the cues around us.  Most likely, this will occur relatively frequently.  How we manage such a situation can be a major determinant of the quality of our life, our health and wellbeing, our relationships, and our ability to sustainably perform at a high level.  

By embodying the polyvagal informed paradigm of identifying our biological state and employing specific (and previously practiced) skills and strategies to shift our current state to one which is preferred, we are best able to manage these crucial situations.  This perspective allows us to implement a wide variety of mind-based and body-based skills dependent upon what is most effective for us in a given situation.  By developing and then utilizing a wide range of skills and strategies, we have greater flexibility and adaptability in our response to these situations. This is why the polyvagal informed lens provides the best, and most biologically comprehensive, strategy and framework.

In addition to the empowering perspective this paradigm provides on an individual level, there are further advantages to this framework in the setting of our relationships with others.  The manner in which various cues and stimuli impact us are similar to how they may affect others.  The process by which neuroception may shift our biological states is the same for all humans.  The internal and external expression of the various states is similar for each of us.  This understanding better allows us to recognize how various situations and events may impact those around us, causing a shift in their biological state, as well as how we can better adjust our states to manage our response and, thereby, co-regulate others.  This can then assist with their response.

There are few, if any, other strategies that provide as complete an understanding of how we as humans react in the face of adverse events, while providing a commensurate level of compassion for ourselves and those around us, as well as skills and strategies to help regulate ourselves and those around us.  This isn’t provided by external routines.  This can’t be fully provided by external resources or support, with the exception of others who co-regulate us, which requires those around us to implement a polyvagal informed perspective.  It is for these reasons that embodiment of this framework is an essential component to the fullest pursuit of health and wellbeing, including longevity and healthspan.

In large part due to the comprehensive nature of this paradigm, the polyvagal informed Practices of the Healthcare Athlete can provide a biologically consistent and empowering perspective to promote health, wellbeing, and sustainable high performance.  

The CE experience for this Blog Post / Article is powered by CMEfy – click here to reflect and earn credits:

This experience is powered by CMEfy – an AI-powered platform that directs learners along a pathway to capture reflections at the point of inspiration, point of care. Clinicians may earn CME/CE credit via ReflectCE, the accredited activity portal. Learn more at


Allison, M.  The Play Zone:  A Neurophysiological Approach to our Highest Performance.

Dana, D.  Anchored: How to Befriend Your Nervous System Using Polyvagal Theory.  Boulder, Colorado: Sounds True, 2021.

Porges, SW.  Polyvagal Safety: Attachment, Communication, Self-Regulation.  New York: W.W. Norton & Company; 2021.

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

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.