The Practices of the Healthcare Athlete is a polyvagal informed paradigm to promote health, wellbeing, and sustainable high performance amongst healthcare professionals.
For the final article of 2022, an overview of this year’s content will be provided. For those who have followed along over the year, this will hopefully summarize the most pertinent points. For those who may be new to this series, this will serve as an overview of the content and philosophy. Please check out the archive for all the articles of this past year. If you have suggestions for future topics, please leave them in the comments.
The Practices of the Healthcare Athlete consist of mind-based and body-based skills and strategies that all serve to optimize human performance across all domains of life. The foundation of this paradigm is a polyvagal informed perspective as this both explains how we experience events and stimuli and provides actionable strategies to work with our neurophysiology in the pursuit of health, wellbeing, and sustainable high performance. All of the principles, skills, and strategies are evidence-driven and real-world tested. Many of these concepts are currently integrated into the daily routines of the highest level competitive athletes who are looking for every conceivable competitive advantage and have chosen to include these skills and strategies for exactly that reason: to give them the best chance of performing at their highest level when it matters most. These principles can be applied to any, and all, aspects of life and provide each of us with the same potential to be at our best when it matters most.
The unique aspect to The Practices of the Healthcare Athlete is that these strategies provide the most comprehensive basis from which to work with our physiology to optimize our health, wellbeing, and sustainable high performance. Through the understanding of the function of our nervous system from a polyvagal perspective, it is possible to understand why we experience internal and external events in the manner that we do and how we can best use various mind-based and body-based skills and strategies to optimize our physiology towards being at our best. Without this understanding or training these particular skills, we continuously take the chance whether or not we are implementing strategies which will be optimally effective.
Our nervous system functions in the fashion described by Polyvagal Theory whether or not we choose to recognize and work with it. By trying to ‘override’ our nervous system we do not provide the best possible opportunity to orient our physiology in alignment with our goals and passion and, thereby, do not provide the greatest opportunity to be at our best. While it may be possible to work against our physiology and be successful for a limited period of time, this is not sustainable and, typically, is not as joyful or fulfilling as we may hope it to be. While there may be a measure of success over a defined period of time, there is a better, more joyful, and more sustainable paradigm.
The foundation of The Practices of the Healthcare Athlete is Polyvagal Theory. This theory was first described by Stephen Porges, PhD in the mid-1990’s and describes the branches and function of our autonomic nervous system. At the core of our experience lies our autonomic nervous system. It is continuously scanning our internal and external environments in order to identify cues of safety and connection and, on the other hand, cues of uncertainty, risk, and threat. On the basis of the balance of these identified cues, three primary physiological states are defined with blended states between each. This process is termed neuroception and it is instantaneously and continuously occurring beneath our conscious awareness.
The physiological states determined through the process of neuroception and described within Polyvagal Theory are able to be placed on a performance hierarchy with the ventral vagal state at the top of the hierarchy, followed by the sympathetic state and, at the bottom, the dorsal vagal shutdown state. While each state is adaptive in certain circumstances and suboptimal in others, the preferred state for human performance is the blended ventral vagal-sympathetic state. Under optimal circumstances, this state is reached through release of the vagal brake, thereby providing controlled mobilization in contrast to the less controllable activation provided by full activation of the sympathetic nervous system.
Another core element of Polyvagal Theory is the concept of the physiological state as the intervening variable. Essentially this refers to the function by which our current physiological state can determine, through neuroception, how we interpret the cues present in our internal and external environments. For example, the same stimulus can be determined to be a cue of safety when in a ventral vagal state, but is neurocepted as a cue of risk while in a sympathetic state. This understanding allows us to appreciate how we can respond and react completely differently to the same situation at different times, on the basis of our physiological state.
While there is significant benefit to understanding our physiology from a polyvagal perspective, the truly transformational aspect to the theory is the actionable strategies which are derived from an understanding of the principles. This allows us to develop skills that enhance our ability to identify our physiological state and shift our state towards that which is better aligned with our current situation and goals. By implementing this paradigm, we are able to leverage our physiology towards states which are more conducive to our current activities rather than trying to ‘override’ our physiology.
In order to develop this ability, deliberate and intentional practice is essential. Without such practice, it is highly unlikely that we will be able to access whatever knowledge we may have when we encounter high consequence situations and our physiology shifts accordingly. It is precisely during these situations that we want to be able to best manage our physiology and, in order to do so, it is imperative that we train the various mind-based and body-based skills during times of lower demand. The well established principles underlying deliberate practice and habit formation are instrumental in this regard. It is also important that we develop as many different skills as possible as it is often the case that certain skills may be effective in specific situations while other skills are needed in different circumstances.
The polyvagal informed paradigm of The Practices of the Healthcare Athlete provides a physiologically adaptive and compatible approach to pursuing health, wellbeing, and sustainable high performance. This perspective is much needed within the healthcare system given the inherent high demand nature of the profession and the necessity to perform at a high level on a consistent basis over an extended period of time. While athletes have a limited career duration, healthcare professionals practice over a career that can span decades.
Currently, there is much discussion related to burnout amongst healthcare professionals. This issue is of paramount importance. Many, if not most, paradigms addressing this issue however focus only on burnout: how to identify it, how to manage it, and how to prevent it. Unfortunately, there is significantly less discussion regarding promotion of health and wellbeing, without which there is no possibility of high performance. In addition, there is little emphasis on directly improving other domains of life. The focus remains on burnout.
The paradigm provided through The Practices of the Healthcare Athlete extends beyond the issue of burnout, while still very much addressing it. This perspective not only applies to those who have or are currently experiencing burnout, but to all healthcare professionals. This paradigm seeks to not only manage and prevent burnout but to improve the health, wellbeing, and sustainable high performance of all healthcare professionals. This pursuit allows all healthcare professionals to be at their best in all aspects of life as well as to help others do the same. This extends far beyond the important issue of burnout. In essence, this paradigm adheres to the saying of “a rising tide floats all boats”.