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A significant element in implementing a polyvagal informed perspective is the substantial benefit it provides to those around us. This can be particularly true in the healthcare setting.
Within the paradigm of a polyvagal informed practice, mind-based and body-based skills are implemented with the primary purpose of increasing ventral vagal activation and stabilization. When we have sufficient ventral vagal tone, we are regulated. This state provides a sense of safety, connection, and belonging to our nervous system, which then allows for emergence of numerous traits across all aspects of our physiology and psychology. It is within this state, or at least with an element of this state, that we are optimally able to promote health, wellbeing, and sustainable high performance. In addition, when we are regulated in ventral vagal stability, we provide cues of safety and connection to those around us. Conversely, when we are dysregulated and are in either a sympathetic or dorsal vagal state, we provide cues of uncertainty, risk, and threat to those around us.
As has been described in previous articles, the cues we emit to those around us emerge from our underlying biological state. If we are in a sympathetic or dorsal vagal state, we are not able to genuinely provide cues of safety and connection to others until we are able to return to some degree of ventral vagal stabilization. Our attempts to provide cues of safety and connection from a sympathetic or dorsal vagal state will likely be neurocepted by others as inauthentic and received as cues of uncertainty, risk, or threat.
While it may be clear from previous articles that we are best able to pursue health, wellbeing, and sustainable high performance for ourselves while in a state with ventral vagal stabilization, the same is also true for all those around us. As described above, we are able to emit cues of safety and connection to others when we are grounded in a ventral vagal activated state and, in so doing, allow others to neurocept these cues and assist their regulation through ventral vagal activation. This process is termed co-regulation. We can then infer that dependent upon the cues we are emitting, which emerge from our biological state, we are either co-regulating those around us or we are providing cues of uncertainty, risk, and threat which may lead to dysregulation for those around us.
The implication of the discussion above is that integration of a polyvagal-informed perspective is not limited to benefitting ourselves. There is also a strong benefit provided to those around us when we are able to effectively anchor in ventral vagal stability. This can promote a similar biological state amongst those around us, thereby allowing those individuals to better pursue their own health, wellbeing, and sustainable high performance. There are significant implications of this understanding for healthcare professionals within the healthcare system.
It is clear to all healthcare professionals that even under the most ideal of circumstances, the profession is that of a high demand culture. Not only are all healthcare professionals working at a high volume over an extended duration of time, but the decisions and actions of these professionals can, and frequently do, have a profound impact on the patients they are treating. Given the nature of even the best healthcare culture, it is likely that there is a higher baseline level of sympathetic activation than would be desired. This can lead to negative impacts on the health, wellbeing, and ability to sustainably perform at a high level amongst healthcare professionals. While there are many considerations that are relevant and important within this discussion of the culture of the healthcare system and how to improve it, one factor that can be readily implemented in order to ameliorate the situation is the ability of healthcare professionals to self-regulate and co-regulate those around them. While this is definitely not a cure for the current status of the system, it would provide significant benefit and is available to all of us.
Another important consideration related to co-regulation is the impact this would have on the patients being treated. It is reasonable to infer that patients and their families within any healthcare setting may be experiencing elements of sympathetic or dorsal vagal states, depending on the nature of their condition. The very existence of an injury, illness, or condition that is being treated or from which we are recovering will likely mobilize our nervous system towards a sympathetic state and, in the case, of more serious and life-threatening conditions towards a dorsal vagal state. This is very understandable. As has been discussed previously, however, it is a ventral vagal activated state that is needed for recovery and restoration. Given this reality of a discordance between the biological states being experienced by patients and the preferred state for their recovery, it becomes important that every effort is provided to assist patients shift their state towards a ventral vagal activated state.
There are many plausible considerations which would improve ventral vagal activation amongst patients. While many may be outside the direct control of healthcare professionals, one element is firmly within our control. As can be appreciated from the above discussion, all of us as humans are either emitting cues of safety and connection or cues of uncertainty, risk, and threat. If we provide cues of safety and connection to others, then we can assist them to reach ventral vagal activated states. Following this rationale, it then becomes important for healthcare professionals to co-regulate their patients to the greatest extent possible. While this may seem like an insurmountable task, it should be remembered that co-regulation spontaneously emerges from a ventral vagal stabilized state. As such, by self-regulating in order to promote their own health, wellbeing, and sustainable high performance there is an added and important benefit to all healthcare professionals, namely the emergence of co-regulation for their patients.
As is hopefully appreciated from the above discussion, the implementation of the polyvagal informed Practices of the Healthcare Athlete can be seen as not only benefiting the individual healthcare professional, but through the natural emergence of co-regulation of all those around us, we can positively impact colleagues and patients as well. Through the intentional and deliberate development of these skills and strategies, we can each have an immediate and profound impact on ourselves as well as all those around us.
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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.
