The Polyvagal Theory - Stephen W. Porges

Fascinating. Will you be commenting further on the link with polyvagal theory?

I am still working my way through the book The Polyvagal Theory. It is absorbing, but the dense language has a hypnotic effect and I sometimes find myself dozing off and dropping the book! So progress is slow. I have not read all of Political Ponerology yet, but now that I have worked out a way to read books printed in 10 point type, I plan to finish it next. It might even be interesting to alternate between the two.

I often hear media reports of what science is discovering about behavior and "the brain" using various scanning techniques. The reports, if not the research itself, seem to focus almost exclusively on brain function without regard to what is happening elsewhere in the body. Polyvagal theory on the other hand seems to offer a different view in which many common behaviors, particularly social behaviors, are governed at least in part by other parts of the nervous system. It makes so much sense, and it seems to offer a physical basis for certain critical instincts.

The picture is even more complex than that but I am not quite ready to put what I am reading into words. At this point I would only say that different kinds of behavior may be interlinked with each other, and what happens depends upon what general mode the system is currently in. With practice, one can self-observe those modes or observe them in others and understand what happens to behavior.
 
Reading the Polyvagal Theory is definitely a heavy task. I don't think I've read a book that technical since my college days. It would have been helpful if he had included a glossary of terms.

But I can definitely see it how shows we are on the right path with EE. The breathing works with our whole system not just the frontal, "newer" brain. We can work on bringing emotions to the surface that are hidden within us, often much deeper than the thinking part of the brain. Cleaning the whole machine!

Mac
 
I finally understood what instinctive substratum means. The polyvagal theory clarifies a lot of ponerology! :)
 
Galaxia2002 said:
I finally understood what instinctive substratum means. The polyvagal theory clarifies a lot of ponerology! :)

You and me both!
 
I have been reading the book Willful Blindness by Margaret Heffernan. She presents an interesting survey of the different forms that "not seeing" can take. She doesn't say a lot about pathology, let alone ponerology, and she certainly doesn't go into neurophysiology, but I still find it useful to shine some more light on these common destructive behaviors.

While much "willful blindness" might be attributed to the effects of ponerization, I sense that some of what happens relates to internal mechanisms not unlike those described by polyvagal theory. Some of it might even involve the same mechanisms.

There is something that can lead us to shut off our higher level and socially-oriented thinking when we are focused on a task, a theme that comes up repeatedly in the book. I am thinking that this may represent new and old (phylogentically speaking) adaptations where the new system promoting pro-social behavior will, under some common circumstances, yield to an older "survival" system that does not care what happens to anyone else.

If such a mechanism exists, it might provide rather easy to access for exploiting and controling humans. I will keep an eye open for clues as I continue to read The Polyvagal Theory.

By the way, the author doesn't claim that we have no control over what happens, and my own experiences bear out what she does say. It is vital to question, and to not just let your mind run on automatic.
 
Psyche said:
I thought that this draft on basic brain anatomy would clarify some of the words mentioned in the book:


This is an excellent tutorial Psyche! This not only increases our understanding of the brain, but will help immensely those of us in teaching situations!

Jefferson
 
I'm about halfway through PVT. It's gets a bit easier as I become more familiar with his terms and his writing style.

Fascinating, how complex and important the vagal system is. In calmer moments it produces homeostasis. In response to environmental demands that cause stress it acts as a brake slowing heart rate and easing respiration producing a relaxed but vigilant state. That is, when it is working as it should.

Sometimes stress so overwhelms us that the emergency "fight or flight" system is on all the time. If this goes on too long our system reverts to more primitive "freeze" state which can be very dangerous even fatal.

This is where EE comes in. We can intervene in the stress process by stimulating the vagal nerve system through pipe breathing "applying the brakes" to keep stress under control.

Am I getting it? :)

Mac
 
Mac said:
Am I getting it? :)

I think you are on the right track.

Reading Chapter 18, Reciprocal Influences on Affect, Porges talks about how structures of primitive immobilization system are used for fulfilling social needs.

[quote author=Polyvagal Theory pg 275]
However, several aspects of mammalian social behavior require immobilization, but do so in the absence of life threat. In these contexts an immobilization without fear is required. Immobilization without fear is accomplished by co-opting the structures that regulate immobilization in response to life threat to serve a broad range of social needs, including reproduction, nursing, and pair-bonding. The area of the periaqueductal gray that coordinates immobility as a primitive defense system has been modified in mammals to serve their intimate social needs.
[/quote]

A deep state of relaxation with immobilization of the physical body happens sometimes with meditative techniques. It has been quite common with EE/POTS in my experience. I think such a state may also be related neuroanatomically with what Porges is talking about here.

Interestingly, here is what Peter Levine says in "In An Unspoken Voice" regarding the relationship between trauma and spirituality.

[quote author=In An Unspoken Voice]
In both the Buddhist and Taoist traditions, four pathways are said to lead to spiritual awakening. The first is death. The second route to freedom from unnecessary human suffering can come from many years of austere meditative contemplation. The third gateway to liberation is through special forms of (tantric) sexual ecstacy. And the fourth portal is said, by these traditions, to be trauma. Death, meditation, sex and trauma, in serving as great portals, share a common element. They are all potential catalysts for profound surrender.
[/quote]

In Lost Christianity, Needleman talked about true prayer as a state of being open to higher energies - seems connected with the theme of deep relaxation without fear. Hypnosis also seems to be related to the same theme. So it seems that the human capacity to immobilize and enter a deep state of relaxation without fear opens up connections to energies which are normally inaccessible. This state can be guided with a conscious intent to align specifically with STO energies and this is what the EE/POTS combination is achieving. Maybe it is self-evident - but I thought I would mention it nonetheless.
 
Mac said:
This is where EE comes in. We can intervene in the stress process by stimulating the vagal nerve system through pipe breathing "applying the brakes" to keep stress under control.

Am I getting it? :)

Mac

I bet you do! This book is so important that I'm writing a synthesis about it for EE practitioners or for those who wish to review what was explained in the book in simpler terms. It is really amazing to read the polyvagal theory and realize how and why EE is so incredibly effective, but also how EE is also literally the best tool that helps us to do the Work. :)
 
obyvatel said:
This state can be guided with a conscious intent to align specifically with STO energies and this is what the EE/POTS combination is achieving. Maybe it is self-evident - but I thought I would mention it nonetheless.

It's definitely worth mentioning it! The possibilities and ramifications of EE are truly amazing as evidenced by all those who practice it and by the polyvagal theory as well.
 
obyvatel said:
So it seems that the human capacity to immobilize and enter a deep state of relaxation without fear opens up connections to energies which are normally inaccessible. This state can be guided with a conscious intent to align specifically with STO energies and this is what the EE/POTS combination is achieving. Maybe it is self-evident - but I thought I would mention it nonetheless.

Wow! Polyvagel immobilization can connect the higher emotional center? The self-other relationship functions of the emotional center can access the higher realms when in a state of immobilization. It this what you see, obyvatel? I read the same material, but these connections did not occur to me. Perhaps it is time to redouble my efforts with EE/POTS.

Edit: I just watched Love Code: The Chemistry of Intimacy. It is a roundtable discussion with Stephanie Brown, Sue Carter, Elaine Hatfield, Dolores Malaspina, and Stephen Porges. The discussion touches many topics related to the Polyvagel Theory, particularly the role of oxytocin and vasopressin in controlling the human immobilization response and the affect on human pair bonding. It is wonderful to watch the participants interact, especially Sue Carter and Stephen Porges who have been partners in life and work for decades.
 
go2 said:
obyvatel said:
So it seems that the human capacity to immobilize and enter a deep state of relaxation without fear opens up connections to energies which are normally inaccessible. This state can be guided with a conscious intent to align specifically with STO energies and this is what the EE/POTS combination is achieving. Maybe it is self-evident - but I thought I would mention it nonetheless.

Wow! Polyvagel immobilization can connect the higher emotional center? The self-other relationship functions of the emotional center can access the higher realms when in a state of immobilization. It this what you see, obyvatel?

I think there is correlating information to indicate that the human capacity to immobilize in a relaxed conscious state without fear opens one up to energies not normally accessed. Higher emotional center access perhaps happens by the same process but there are other options too. From what we know about sex (another instance of this type of polyvagal immobilization) - that the human body dowses similar to a dead body after sex and the energy is said to drain straight to 4D STS - that certain techniques (tantric) are promoted as means of spiritual enlightenment - seems another option with a different flavor. Hypnosis could fall under the category of polyvagal immobilization too - at least that is my current thinking. In hypnosis we can access information in the subconscious, including past lives which seems to indicate we are accessing the level of soul consciousness .

In general it seems that in polyvagal immobilization, the motor and intellectual centers are (or can be) rendered quiet. This opens up the possibility of either the lower emotional center connecting with the higher emotional center and/or the sexual center working with its natural energy. Thus the portals to higher consciousness (both STS and STO) open up. This could give us a possible limited taste of what things could be like if our lower centers were already equilibrated and working properly . I say a limited taste as we need to put the motor and intellectual centers to sleep and make do with what our atrophied emotional center can for accessing this state today while if through Work, we can develop and make the lower centers work properly, we could be open to higher consciousness with our full set of faculties. At least that is my current understanding which may or may not be accurate.
 
obyvatel said:
In general it seems that in polyvagal immobilization, the motor and intellectual centers are (or can be) rendered quiet. This opens up the possibility of either the lower emotional center connecting with the higher emotional center and/or the sexual center working with its natural energy. Thus the portals to higher consciousness (both STS and STO) open up. This could give us a possible limited taste of what things could be like if our lower centers were already equilibrated and working properly . I say a limited taste as we need to put the motor and intellectual centers to sleep and make do with what our atrophied emotional center can for accessing this state today while if through Work, we can develop and make the lower centers work properly, we could be open to higher consciousness with our full set of faculties. At least that is my current understanding which may or may not be accurate.

Very interesting the way you put it. And actually, "physical" data supports this. During bio-energetic breathing exercises, a different EEG pattern with theta slow wave pattern called post-reinforcement synchronization (PRS) occurs which is associated with a dreamy “edge of sleep” state. Kind of like a "hypnotic" state. You're not awake, you're not asleep. It has been observed that there is appearance of normally suppressed images and emotions, and reduced cortical excitability. The “edge of sleep” state has been useful in allowing suppressed emotional content to emerge. It is suggested that withdrawal of brain stem and normal thalamocortical regulatory influences leads to relative cortical disinhibition. This is kind of what you suggest when you say that motor and intellectual centers are rendered quiet.

When done within the context of EE, doing 3 stage breathing before, it allows suppressed emotion, cognitions, and trauma memories to be evoked while providing a status of calmness and relaxation that reduces the risk of retraumatization. This is why we should never skip 3-stage breathing if we are going to do beatha. Pipe breathing allows to process things in a safer environment since it stimulates our smart vagus nerve, helping us regulate better our emotions. In the end, it helps to change the relationship of your hemispheres, as well as that between the cortical and sub-cortical regions.

There is a balance of the activity between the cortical and subcortical regions. It is a synchronization of neurological elements in the body, thalamus, limbic system and cortex. In other words, there is a balance between the thinking, emotional and motor/instinctive brains where the centers of the vagus are. EE, within the context of the polyvagal theory, allows to access parts of our brains and re-balance them that would otherwise take ages to do.

Upwards and onwards :)
 
Ark found a book entitled "Biology of Kundalini" that is a mish-mash of a lot of things, but has a summary of polyvagal theory that might be useful:

POLYVAGAL THEORY

The researchers at Howard Hughes medical Institute, led by Bruce Lahn have found evidence that the pressure of natural selection has lead to dramatic changes in two genes known to control brain size in humans. Brain size or intelligence is naturally selected for in evolution for obvious survival reasons, and larger brains require more oxygen. Although the brain represents only 2% of the body weight, it receives 15% of the cardiac output, 20% of total body oxygen consumption, and 25% of total body glucose utilization. The larger the brain, the greater the demand of oxygen and hence the more sophisticated the nervous system needed to provide that oxygen… the evolutionary payoff for larger brain size of course being survival. As a natural extension of mammalian evolution we can see that the human neocortex was an inevitable consequence of evolutionary pressure.

{This makes even more sense when one considers the "Aquatic Ape" theory. Taking in lots of oxygen for diving would have been crucial.}

According to the Poly-Vagal Theory during evolution the mammalian nervous system developed two vagal systems. Built onto the relic of amphibians and reptiles is an evolutionary modification unique to mammals. Looking at the history of evolution Poly-Vagal Theory notes the importance of the need for oxygen in evolving the mammalian nervous system.

During evolution as the mammalian nervous system got more complex than its amphibian and reptilian brothers, there was a greater demand for oxygen. Porges says that it was this need for extra oxygen that may have provided the evolutionary pressure leading to the development of the highly adaptive and sophisticated autonomic nervous system found in mammals; and that behaviors such as orienting, attention, emotion and stress are by-products of the evolutionary pressure to optimize oxygen resources.

The Polyvagal Theory addresses the relative roles of the vagus nerve in energy conservation and survival. In Stephen Porges’s Polyvagal Theory he uses the term Polyvagal to distinguish between the two main branches of the vagus nerve:

1: The Vegetative Vagus—originates in the dorsal motor nucleus (DMNX), descends visceral efferent fibers {Conducted or conducting outward or away from something} regulating smooth and cardiac muscle and is associated with passive reflexive regulation of visceral functions: peristalsis of the GI tract, sweating, lungs, diaphragm, stomach. At the heart it is connected to stretch receptors of the aortic arch and chemoreceptors of the aortic bodies and is responsible for heart rate, dilation of blood vessels and blood pressure. The output from the dorsal motor nucleus does not convey a respiratory rhythm.

The most primitive function of the vagal complex is the freeze response, which is dependent on the unmyelinated vagus that is part of the reptilian system.

2: The Smart Vagus—which originates in the medullary source of the nucleus ambiguus (NA), serving efferent fibers regulating the somatic muscles of speech and eating: the larynx, pharynx, and esophagus. The ventral vagal complex (including NA) related to processes associated with attention, motion, emotion and communication. The functional output of the NA-vagus on the heart is part of a common neuronal network producing a cardiorespiratory rhythm. The most evolutionary recent component—the communication system functions through the new-mammalian or myelinated vagus that regulates the heart and the bronchi to promote calm and self-soothing states.

In mammals the two vagal systems are neuroanatomically distinct, have different origins, and are programmed with different response strategies and may respond in a contradictory manner. Thus Porges attributes various medical disorders to competition between DMNX and NA originating fibers. The different vagi may have oppositional outputs to the same target organ. The vagus is a complex of neural pathways originating in several areas of the brainstem. The vagus nerve consists of afferent {Conducting or conducted inward or toward something} and efferent parasympathetic (acetylcholine) fibers that run from the brainstem (medulla oblongata) down to the traverse colon and urinary organs; providing both motor and sensory parasympathetic activation for everything from the neck to the G spot. Efferent fibers originate primarily in two medullary nuclei (NA, DMNX).

The vagus is not solely an efferent or motor pathway, at least 80% of the vagal fibers are afferent; that is they conduct impulses from the periphery of the body to the brainstem.

According to the Polyvagal Theory the growth of the autonomic nervous system evolves through three stages:

1. Freeze—First a primitive unmyelinated visceral vagus that fosters digestion and responds to threat by depressing metabolic activity eg: freeze response.

2. Fight-or-flight—The mobilization or fight-or-flight is dependent on the functioning of the sympathetic nervous system; increasing metabolic output and inhibiting the visceral vagus to foster mobilization behaviors necessary for fight-or-flight.

3. Communication—The third stage, the mammalian myelinated vagus, can rapidly regulate cardiac output to align with the environment and is associated with cranial nerves that regulate sociability via facial expression and vocalization.

Stephen Porges points out the phylogentic hierarchy of response to challenge: “The hierarchy emphasizes that the newer “circuits” inhibit the older ones. We use the newest circuit to promote calm states, to self-soothe and engage. When this doesn’t work, we use the sympathetic-adrenal system to mobilize for flight and flight behaviors. And when that doesn’t work, we use a very old vagal system, the freeze or shutdown system.”

Stephen Porges suggests that the true freeze response is dangerous to mammals. For example, high tone in the dorsal motor nucleus vagal system maybe lethal in mammals through an overdose of the immobility response . Whereas high tone from the NA-vagal system maybe beneficial in adaptive significance of mammalian affective processes including courting, sexual arousal, copulation, and the establishment of enduring social bonds. In the development of enduring pairbounds the mammalian vagus communicates safety and trust, via oxytocin and vasopressin, between the hypothalamus and the medullary source nuclei of the viscera vagus.

Porges suggests that we use our higher cognitive processes to calm the stress response and establish effective connections with others by using our facial muscles, making eye contact, modulating our voice and listening to others. In this way we increase the influence of the myelinated vagus, which calms us and turns off the stress response and makes us more metabolically efficient. He says the social neural circuit supports our health through its calming influences on the heart and lungs and its reduction of HPA axis activation.

The vagus is asymmetrical with the left and right sides performing different tasks, with the right vagus most active in the regulation of the heart.

Primary emotions are related to autonomic functioning since they are often survival related, they must be integrated into the regulation of the heart and lungs. Emotions have a right limbic bias, as does the brainstem medullary structures controlling visceral function. Only when the environment is perceived as “safe” is there cortical regulation of the visceral pathways, because while under threat, cortical control of brainstem structures would compromise the individual’s ability to mobilize. Therefore when stressed or in danger, cortical control of brainstem is “inhibited” and the brainstem structures are “disinhibited” to allow the sympathetic nervous system to efficiently increase metabolic output.

Stimulation of the ascending fibers of the vagus releases norepinephrine into the amygdala strengthening memory storage in regions of the brain that regulate arousal, memory and feeling responses to emotionally laden stimuli. These ascending fibers is how the peripheral epinephrine from the adrenals released into the blood during the fight-or-flight response activates the release of norepinephrine in the limbic system sharpening memory of the events.

Since the adrenal hormone epinephrine cannot cross the blood brain barrier it activates the vagus nerve, which in turn stimulates neurons in the brainstem known as the “Nucleus of the Solitary Tract (NTS). This third medullary nucleus, located near DMNX, is the terminus of many of the afferent pathways traveling through the vagus from peripheral organs.

Vagus afferent sensory fibers carrying information to the brain from the head, neck, thorax, and abdomen relay information to the NTS. These NTS neurons release norepinephrine into the memory processing areas such as the amygdala and hippocampus to activate long term memory storage of emotionally laden events. This explains why vagus nerve stimulation was found to improve memory consolidation of recent events. Researchers found that by microinjecting the NTS with either GABA agonists or glutamate antagonists, they thereby increased GABA or decreased glutamate in the NTS and this blocked seizures.

Stephen W. Porges, Ph.D. found that he could improve autism by stimulating the newer structures and prompting the social engagement system with the use of acoustic sessions using frequencies associated with the human voice. Check out Stephen Porges’s fabulous papers on the web.

VIVA LA VAGUS

Vagus Nerve Stimulation (VNS) is now being used for depression, seizures and eating disorders. Although the precise mode of action of VNS is not known, researchers suggest that VNS increases seizure threshold by causing widespread release of GABA and Glycine in the brain. Reported changes in blood flow in the cerebellum, thalamus and cortex might activate inhibitory structures in the brain reducing seizure kindling. One VNS study showed mean seizure frequency to decrease by 25%. Altered synaptic activities at sites of persisting VNS-induced cerebral blood flow changes may reflect antiseizure actions.

Depression affects some 340 million people worldwide and there is a correlation between depression and the likelihood of developing seizures. VNS increases cognitive skills reflecting a reduction in depression. Areas of the brain that are affected by Vagus Nerve Stimulation include the medulla, cerebellum, parabrachial nucleus, locus ceruleus, hypothalamus, thalamus, amygdala, hippocampus and cingulated gyrus. Noradrenergic and/or serotonergic deficits, may contribute to predisposition to some epilepsies and depressions. Evidence suggests that vagus nerve stimulation exerts at least some of its anticonvulsant and antidepressant effects through its capacity to increase noradrenaline and serotonin transmission. The vagus is responsible for keeping the larynx open for breathing and also feeds the lungs and diaphragm. Deep breathing stimulates the vagus nerve bringing balance between the parasympathetic and sympathetic nervous systems.

Since a VNS device and its surgical implantation will run at nearly $30,000 it’s an expensive treatment for seizure, compulsiveness and depression…breathing however does a similar job of activating the vagus nerve and it’s free. The sense of contraction and pain in the core of ones torso and neck during the heating phase prior to popping is obviously the vagus nerve making a valiant effort to counter the revving up of the pituitary-adrenal-axis, and the sympathetic nervous system. The vagus is trying to keep the emotional-memory arousal faculties of the body repressed; hence we feel this conflict as a persistent tension in our core for up to 2 years prior to awakening.

Besides breathing it is also possible to stimulate the vagus into relaxing the body-core by turning the minds eye into ones center and actively warming and purposefully letting the area go. All thoughts, emotions and phenomena are drawn into ones core as though one is an atomic karmic disposal unit. We could call this practice Melting In The Core—turning the minds eye into actively stimulating the vagus nerve into relaxing the viscera. This alleviates depression, increases coherency, lucidity, makes for a more vibrant personality and improves health and well-being.

Scientists are investigating the existence of non-genital orgasms suggesting a more pervasive orgasmic process and its role in neuroendocrine and psychological health. There are vaginocervical sensory pathways to the brain that can produce the absence of pain without loss of consciousness (analgesia), release oxytocin, and bypass the spinal cord via the vagus nerve. That is a paraplegic woman can still have cervical and G spot orgasms because the vagina is fed by the vagus nerve while the clitoris by nerves that come out of the spine. This gives weight to the necessity of sexual intercourse for maintaining healthy balance of the nervous system. Also there might be something to the validity of having sex during an awakening to help the parasympathetic nervous system to maintain its own. Orgasm has been described as a mini-seizure of the limbic system and tends to release or lessen deep limbic activity. Dr Amen noticed that depression, sadness, feelings of hopelessness, and automatic negative thoughts correlate with a hyperactive limbic area. The supplements that seem to help limbic hyperactivity best are DL-phenylalanine (DLPA), L-tyrosine, and S-Adenosyl-Methionine (SAMe).

I find it fascinating that the parasympathetic off-switch vagus turns on activating neurotransmitters in the emotional memory systems...obviously this is a big factor in the reward/punishment building of our response system. One of the contributors to the tenacity of PTSD as well no doubt, and you know they give norepinephrine blockers to trauma victims to block the vividness of their memory. Because stimulation of the vagus nerve activates the memory centers in the brain it is apparent that sex would be good for improving memory ability. Since memory is primary to our sense of meaning and to cognition in general, it is apparent that sex has the potential of improving intelligence and quality of life through improved brain function and freedom from depression. The counter argument to this is that the endorphins produced during sex would reduce mental alertness.

Retraining the Vagus—Lie flat on your stomach with your head to one side. Progressively relax your jaw by imagining it dropping down toward your feet. Feel the sense of your tongue dropping into your belly. You will notice that this stimulates breathing, for you get the sense of oxygen hunger. Obviously a tight jaw is tied into the neural circuits for the suspension of breath and shallow breathing. Repeating this exercise and making this more jaw-contraction more conscious will help to retrain the medulla and vagus toward deeper breathing and change the set point of the nervous system toward greater relaxation.

Mechanism of the Freeze—Animal hypnosis, catalepsy, tonic immobility or the freeze response, is an inborn defensive behavior characterized by a temporary quiescencent state of profound and reversible motor inhibition elicited by danger. Cholinergic stimulation of the dorsal periaqueductal gray matter (PAG) decreases the duration of the Tonic Immobility episodes, while stimulation of the ventrolateral region increases it - lesions of the ventrolateral PAG can greatly reduce conditioned freezing. PAG is the midbrain grey matter that is located around the cerebral aqueduct within the midbrain. It plays a role in the descending modulation of pain, in the ascending pain and temperature fibers. Neurons of the PAG are excited by endorphins (endogenous opioid neurotransmitters) to produce analgesia. Stimulation of the periaqueductal gray matter of the midbrain activates enkephalin releasing neurons that project to the raphe nuclei in the brainstem. Some animal studies indicate that alterations in the levels of cerebral serotonin modulate the analgesic effect of the dorsal periaqueductal gray matter (PAG) stimulation. The EEG activity in animal studies of tonic immobility was characterized by low voltage fast activity. Tonic immobility was always preceded by long bursts of both cortical and amygdaloid alpha range EEG activity which characterized an “awake-alertfixation” state of behavior. This alpha activity may be a necessary but not sufficient condition for the onset of tonic immobility.
 
There was an interview with Stephen Porges about The Polyvagal Theory for Treating Trauma, it includes stuff from the book and it is very interesting. It is available here:

http://stephenporges.com/images/stephen%20porges%20interview%20nicabm.pdf

Contents
What Practitioners Need to Know about Trauma and the Nervous System ..... 3
How the Polyvagal Theory Refnes Our Understanding of Trauma ........... 5
Autonomic Nervous Systems ..................................... 8
Neuroception - Detection Without Awareness ........................ 10
Triggering PTSD............................................. 12
The Role of Social Engagement and Attachment ...................... 13
What Do Autism and Trauma Have in Common? ...................... 14
Treatment of Autism Disorders .................................. 17
A Listening Project - Theory and Treatment ......................... 21
 

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