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A polyvagal informed paradigm can lead to a more biologically comprehensive understanding of the principles involved in promoting health, wellbeing, longevity, and healthspan.
The primary focus within healthcare, ideally, is the promotion of health and wellbeing. The current typical Western medical paradigm, however, is frequently oriented more towards treatment and management of injury, illness, and disease than the optimization of health and wellbeing. There is little question that promotion of health and wellbeing, while maintaining the ability to treat illness, disease, and injury is the preferred framework. In order for humans to sustainably be at their best in any and all aspects of life, health and wellbeing are necessary elements. A related field within healthcare is the study of longevity and healthspan which promote living longer and with greater quality of life, respectively.
There is increasing discussion regarding the importance of promoting health and wellbeing, as well as considering longevity and healthspan. Much of this conversation, however, does not integrate a polyvagal informed perspective. This paradigm is important to include in the discussion, if not to form the basis of the entire emerging considerations of health and wellbeing. The reason for this is that Polyvagal Theory provides the explanation of the fundamental pathway through which skills and strategies to improve health and wellbeing function. Moreover, while there may be a multitude of such recommendations, most, if not all, exert their benefit through the foundational impact on increasing and/or sustaining ventral vagal activation.
From the polyvagal perspective, ventral vagal stabilization is necessary for the promotion of recovery and restoration, as well as establishment of homeostasis. This applies to our physiology as well as to our psychology. Due to this function, it is necessary that we, as humans, obtain sufficient ventral vagal activation if we are to promote our health and wellbeing in a sustainable fashion. While we are able to function in sympathetic and dorsal vagal states, without the ability to sufficiently recover back to a ventral vagal state, we are susceptible to a number of mental and physical ailments. These include increased risk of anxiety and depression, cardiovascular conditions, altered immune function, and chronic inflammation. In fact, chronic inflammation has been implicated as a factor in the development of numerous chronic diseases. In addition, we consume far greater metabolic resources when attempting to function within sympathetic and dorsal vagal states, making these states less optimal for being at our best over an extended duration of time.
In addition to the necessary role of ventral vagal activation in homeostasis, recovery, and restoration, it also provides the foundation upon which the frequently discussed skills and strategies to promote health and wellbeing are based. Many of these topics include sleep, exercise, nutrition, and mindset training. As described previously, the fundamental mechanism through which these important strategies exert their impact on health and wellbeing can be viewed, through the polyvagal lens, as enhancing ventral vagal activation and stability. The polyvagal informed perspective provides the foundation upon which the principles of health promotion, longevity, and healthspan are able to optimally function. As examples, sleep deprivation leads towards sympathetic and dorsal vagal states, regular exercise and movement promote a ventral vagal state, malnourishment also promotes sympathetic and dorsal vagal states, and many, if not all, of us have had the experience, if only temporarily, of the resulting sympathetic and dorsal vagal biological states when our mindset tends towards greater anxiety or depression.
These fundamental functions of our nervous system, as explained by Polyvagal Theory, demonstrate how this perspective provides a comprehensive understanding of our biology. The principles that emerge through Polyvagal Theory allow for a deeper recognition of the means by which our physiology and psychology function together as a single biological entity, rather than two separate aspects. In addition to the unified function of our mind and body, there is two-way traffic between the two; each influences and affects the other.
Without incorporating the polyvagal informed perspective into the considerations of promoting health and wellbeing, it becomes easy to lose sight of the integrated and comprehensive nature of our biology. It also becomes much simpler to focus on specific details, such as use of specific supplements and optimizing micronutrient levels, exercise routines, and particular tasks which must be accomplished throughout the day in order to promote health and wellbeing. When one considers this important objective from a polyvagal informed perspective, namely the understanding that the ultimate goal is the enhancement of ventral vagal stabilization, it becomes possible to simplify the endeavor of promoting health and wellbeing. It is also feasible to do this in a manner specific to the individual, building upon what each person may need specifically to optimize ventral vagal stabilization. This paradigm permits the opportunity to access this foundational pathway through the numerous polyvagal informed skills and strategies that allow for increased ventral vagal activation. Rather than having to adhere to a rigid routine or protocol, we can more adaptively and flexibly implement a wide variety of skills and strategies in alignment with our biology, values, goals, and philosophy.
The above discussion is not intended to diminish the importance of the details of the discussed skills and strategies within the promotion of health, wellbeing, longevity, and healthspan. Quite to the contrary, this understanding is presented to provide a more complete appreciation of the mechanism by which these principles exert their effect and to allow each individual the opportunity and means by which to promote these goals for themselves in a manner that is specific to each individual. Many of the commonly described aspects of promoting health and wellbeing are non-negotiable regarding their necessity, however the means by which they may be integrated frequently need to be tailored to the individual. For example, while it is well established that human adults require between seven and nine hours of sleep per night, the exact amount is individual specific. A similar consideration regarding an individualized approach to each of the skills and strategies is relevant and facilitated through a polyvagal informed paradigm.
The importance of the polyvagal informed perspective is several-fold, not the least of which being that even if the principles of health and wellbeing promotion, longevity, and healthspan are accomplished, there remains the need to enhance the ability to regulate the nervous system. This is not a feature of the typical skills and strategies discussed amongst experts within the longevity, healthspan, and health promotion fields. Without such an ability, the maximal impact of these strategies is limited for the rationale discussed above.
When the above discussion is considered within the healthcare system, there are several implications which emerge. Given the negative health effects of a lack of ventral vagal stabilization, incorporation of polyvagal informed perspectives within the healthcare system and its promotion of health and wellbeing would likely lead to a substantial improvement across the entire population. The benefits which would emerge would likely include an increase in the extent to which people feel better and are more able to live in alignment with their values and pursue their goals. In addition, there would likely be a decrease in the prevalence of many common chronic diseases. Another important aspect to consider when applying a polyvagal informed paradigm within the healthcare system is the impact upon patients receiving care for illnesses, injuries, or diseases, including those recovering from surgeries and other procedures. In such circumstances, the inherent nature of the situation would likely lead towards sympathetic and/or dorsal vagal states within these individuals. As described above, a ventral vagal state is necessary for recovery and restoration. This discordance between the optimal and actual biological states is not conducive to restoring and improving health. If healthcare professionals were to integrate a polyvagal informed paradigm within the context of patient care, there would likely be substantial improvements in the outcomes following such care.
By incorporating a polyvagal informed perspective, it becomes easier to understand how best to promote health, wellbeing, longevity, and healthspan. Furthermore, and perhaps more importantly, the pursuit of these important goals becomes more achievable and sustainable when viewed from this paradigm. This understanding is at the core of the polyvagal informed Practices of the Healthcare Athlete.
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REFERENCES
Allison, M. The Play Zone: A Neurophysiological Approach to our Highest Performance. https://theplayzone.com.
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.
