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Training the nervous system is necessary in order to develop the skills and strategies to implement and embody the principles of the polyvagal theory.
We are all very familiar with the need to exercise in order to train the physical attributes of our body and promote health and wellbeing. Many are also familiar with the related need to train our mind, for instance through meditation and gratitude training. Within these paradigms, it is understood that in order to realize the benefits of the desired attributes, regular and deliberate training is needed. Even when we develop a degree of proficiency with these skills, ongoing training is needed for maintenance. The most obvious example is with muscle strength following resistance training. If we do not continue our training, our muscle strength will decrease through atrophy.
While the skills and strategies based upon the principles of polyvagal theory may be less familiar to many people than the aforementioned examples, the same principle applies. In order to benefit from the understanding and framework provided by polyvagal theory, it is necessary that we undertake ongoing training to specifically develop the applied skills and strategies and maintain proficiency over time. While the particular exercises may differ, the principle of training the nervous system is no different than that described above for physical and mental skills.
Deb Dana has described that a healthy nervous system is not determined by an absence of dysregulation and associated descent on the physiological state hierarchy towards sympathetic and dorsal vagal states. Rather, the health of our nervous system is reflected by the extent to which we are able to restore regulation and stability following instances of dysregulation. In essence this describes the resilience of our nervous system in the face of cues of uncertainty, risk, and threat.
The primary goal of training the nervous system is to increase the degree of resilience in our system. This allows us to mobilize and, even, reach shutdown states in response to cues from our internal and external environments and restore our ventral vagal stability as quickly and efficiently as possible. At the level of the autonomic nervous system this involves engaging our vagal brake and improving our vagal efficiency. Dr. Stephen Porges, the originator of polyvagal theory, first described these terms and Michael Allison has subsequently applied these concepts within the domain of human performance. The vagal brake describes the ventral vagal pathways which effectively provide a connection to our heart rate through the sinoatrial node. When these pathways are activated, our heart rate slows, typically in conjunction with ventral vagal predominant states, and when these pathways are released our heart rate increases, usually in mobilized states. The particular significance of the vagal brake is that it provides the ability to reach a degree of mobilized state without a full activation of the sympathetic nervous system, thereby maintaining a greater degree of ventral vagal stabilization. Vagal efficiency refers to the ability to readily engage and release the vagal brake. With greater degrees of vagal efficiency, we are better able to shift between ventral vagal states and increased mobilization without fully entering a sympathetic state. Functionally, this affords us the benefits of mobilization without the increased risk of descending the physical state hierarchy.
The primary objective of training the nervous system is to improve our vagal efficiency through intentional and deliberate practice. This must be done within a ventral vagal state or, at minimum, with ventral vagal activation present. If training is undertaken without sufficient ventral vagal tone, there is an increased risk of becoming stuck in sympathetic and/or dorsal vagal states.
The principle underlying nervous system training it to present cues of uncertainty, risk, and even certain degrees of threat to the nervous system while there is sufficient ventral vagal activation. In response to these cues, our nervous system will mobilize, however since the training is designed to ensure the cues are not beyond our level of tolerance, we are able to recover from the mobilized state. This strengthens our vagal efficiency. Over time, we can increase the degree of uncertainty, risk, and threat while maintaining sufficient ventral vagal activation, thereby further improving vagal efficiency. The philosophy of this training is similar in nature to gradual and progressive increases in the amount of weight used in resistance training.
Effectively, we are training our nervous system to respond to increasing degrees of cues of uncertainty, risk and threat while maintaining ventral vagal tone. This allows us to mobilize our nervous system in response to the cue while maintaining an element of ventral vagal activation. This ability allows us to stay within our performance zone with a blended ventral vagal-sympathetic state. This capacity is primarily determined through vagal efficiency and as this ability is developed, we are able to be exposed to progressively more challenging situations while maintaining our physiological state within our preferred performance zone.
There are two main domains of nervous system training. We can expose our nervous system to general situations or craft specific situations. A comparison to physical skill development can, again, be helpful. If we were to consider an athlete’s training program, the general situations would be analogous to strength and stamina training while the craft specific training would be similar to the athlete’s sport specific skill development.
Within the category of general situation training, we identify and expose ourselves to scenarios that cause a degree of mobilization and then utilize polyvagal informed skills and strategies to recover back to ventral vagal stability. For example, we might engage in social situations that result in mobilization and then utilize elements of the social engagement system to restore stability. Other examples include strenuous exercise or exposure to cold, such as with whole body cryotherapy, and use of breathing to restore stability. As can be appreciated, the specific type of exposure is individual specific and must be tailored to the particular skills and abilities of the individual. Over time with continued training, these situations will likely change as will the skills and abilities.
From a craft specific perspective, a similar paradigm is employed. The only difference is that the specific situations that are chosen are determined by the particular domain in which the individual participates. An example would be a surgeon who is learning a new procedure and initially practices the procedure either on a cadaveric specimen or in an artificial training simulation. Following this training, the surgeon may perform the procedure in conjunction with an experienced surgeon prior to performing the skills independently. This progression would allow the surgeon in training to develop the necessary technical skills in a less mobilizing scenario prior to performing the same skills on a live patient.
In order to be at our best in any, and all, domains of life it is necessary to be able to expose ourselves to internal and external events that lead to mobilization of our nervous system while maintaining an element of ventral vagal activation and then recovering back to a ventral vagal state. This allows us to maintain our preferred physiological state to a greater degree in the face of progressively more challenging situations and recover back to ventral vagal stability in a more efficient fashion. The philosophy of training our nervous system described above provides this particular experience. This is necessary in order to fully embody and realize the benefits of a polyvagal informed life. This provides each of us the fullest opportunity to promote our health, wellbeing, and sustainable high performance within the paradigm of The 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. Polyvagal Exercises for Safety and Connection: 50 Client-centered Practices. New York: W.W. Norton & Company; 2020.
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.
