This one was published in 2017. Rosenberg is a craniosacral therapist and Rolfer, and a longtime friend of Stephen Porges (years ago Rosenberg fixed up a chronic problem with Porges's vertebral discs in mere seconds). His book explores how his practice has evolved and been informed by polyvagal theory. He includes a series of simple exercises he has developed to bring one into a state of ventral vagus nerve activation, and chapters focusing on some specific conditions he thinks are tied to vagal dysfunction, reporting success in his own practice with them, for example, COPD, hiatal hernia, shoulder/neck pain, migraines, forward head posture, anxiety/panic attacks, phobias, antisocial behavior and domestic violence, PTSD, depression, bipolar disorder, ADHD, and autism.
While he deals extensively with those specific conditions, he points out that vagal dysfunction involves a whole 'hydra' of symptoms and syndromes, from chronic physical tensions, emotional issues, heart and lung problems, visceral-organ dysfunctions, immune-system problems, behavioral problems, interpersonal issues, cognitive issues, etc. Getting out of states of dorsal vagal activity or spinal sympathetic activity alone is often enough to kill the hydra.
Before sharing some specifics, I'll highlight some of what I consider the pros and cons of the book. It is an easy-to-read introduction to polyvagal theory (much easier than Porges's book). But that might be a downside for others, because it is very repetitive. If you get it the first time, the repetitions might be annoying. (The book is 220 pages, but could probably be shorter.) But the explanations are all there, the exercises well described, and probably anyone reading will learn a thing or two from it, in addition to the exercises. So, getting into some of that...
Rosenberg points out that it's not just the vagus nerve that's important for health (physical, emotional and mental): it's intimately tied with other cranial nerves, and dysfunction in one often shows up in others. CN V, VII, IX, X (the vagus), and XI are all important and described in the book. He says he treats IX, X, and XI as if they were one nerve. Some of his exercises are designed to make use of those connections, i.e., stimulating one nerve has the effect of also stimulating ventral vagus activation.
A couple notes on dorsal vagal activation:
He argues that just as there is a physiological component to anxiety (spinal sympathetic activation), so too with depression: chronic dorsal vagal activation.
Rosenberg developed 2 basic tests to see if there is dysfunction in vagal nerve activation. One is to look at the uvula while saying "Ah, ah, ah" (short pulses of sound, not a long "Ahhhh" as you would do for a doctor). If the movement of the uvula and arches to either side is asymmetric, chances are you are not in a ventral state. (One arch will raise higher than the other, uvula will move more to one side as opposed to straight up.) He always tests this way before and after a treatment (in addition to making other observations, like of facial expressions, pulse during in- and outbreath, etc.). The other test is the relative tension in the upper trapezius. A gentle squeeze of this muscle above the shoulder on each side should show if one side is more tense than the other. He says he has found a 100% correlation between these two tests. The exercises should result in a symmetric uvula and trapezius, signs of ventral vagal activation.
For COPD, he often finds the breathing problems associated with a shortened esophagus caused by a hiatal hernia, in addition to ventral vagal dysfunction. He gives a self-massage exercise that can fix such a hernia (essentially a gentle push on the stomach that stimulates the esophagus to lengthen and the stomach to drop). In addition to the basic exercise (see below), this is often enough to fix symptoms, even if lung scans still show problems. (Hiatal hernias are often a hidden problem associated with ADHD in children, too.)
For shoulder/neck pain, the culprits are CN XI, the trapezius, and sternocleidomastoid muscles (or the levator scapulae, if the pain while turning the head is experienced on the same side you're turning it - in this case the treatment is massage of the supraspinatus). For the SCM, the exercise is to lie on your stomach, lift your upper body by supporting with your elbows/lower arms, arch your back so your head is straight up like a baby, then turn your head as far as you can to each side for 30-60 seconds.
For migraines he gives some diagrams of effective trigger points on the trapezius and SCM muscles, showing the four forms migraines tend to take and which trigger points apply to each pattern of migraine.
A few other random things I found interesting:
-"Light stroking of the face often calms us and helps us out of a state of stress." (Cranial nerves V and VII innervate the skin and muscles of the face.)
-Importance of body awareness: "Awareness of our body can help us avoid getting carried away by emotions that can lead to faulty neuroception." (i.e., our 'sixth sense' of the threat or safety of our environment.)
-raising our eyebrows, opening the eyes wide "improves our sensory intake and helps us be more present to what is happening around us."
If anyone has any questions, I can go into more detail - this is just a very basic summary. But probably the most important exercise is what he calls the "basic exercise." It's very simple and has the effect of activating the ventral vagus and aligning the atlas and axis vertebrae. Here's a video demonstration:
He gets all his clients to do this one and reports that it's quite effective on its own or combined with the other exercises (about 7 are included in Part Two of the book, with some variations) and massage/body work.
The book:
While he deals extensively with those specific conditions, he points out that vagal dysfunction involves a whole 'hydra' of symptoms and syndromes, from chronic physical tensions, emotional issues, heart and lung problems, visceral-organ dysfunctions, immune-system problems, behavioral problems, interpersonal issues, cognitive issues, etc. Getting out of states of dorsal vagal activity or spinal sympathetic activity alone is often enough to kill the hydra.
Before sharing some specifics, I'll highlight some of what I consider the pros and cons of the book. It is an easy-to-read introduction to polyvagal theory (much easier than Porges's book). But that might be a downside for others, because it is very repetitive. If you get it the first time, the repetitions might be annoying. (The book is 220 pages, but could probably be shorter.) But the explanations are all there, the exercises well described, and probably anyone reading will learn a thing or two from it, in addition to the exercises. So, getting into some of that...
Rosenberg points out that it's not just the vagus nerve that's important for health (physical, emotional and mental): it's intimately tied with other cranial nerves, and dysfunction in one often shows up in others. CN V, VII, IX, X (the vagus), and XI are all important and described in the book. He says he treats IX, X, and XI as if they were one nerve. Some of his exercises are designed to make use of those connections, i.e., stimulating one nerve has the effect of also stimulating ventral vagus activation.
A couple notes on dorsal vagal activation:
There are other commonly observable signs when we are in a state of shock or shutdown: The face loses its color and appears lifeless and unresponsive; the facial expression is unchanging and facial muscles sag. The voice also lacks prosody (melodic expressiveness); it is flat and without melody. The eyes appear dull and lifeless - there is no sparkle.
He argues that just as there is a physiological component to anxiety (spinal sympathetic activation), so too with depression: chronic dorsal vagal activation.
Rosenberg developed 2 basic tests to see if there is dysfunction in vagal nerve activation. One is to look at the uvula while saying "Ah, ah, ah" (short pulses of sound, not a long "Ahhhh" as you would do for a doctor). If the movement of the uvula and arches to either side is asymmetric, chances are you are not in a ventral state. (One arch will raise higher than the other, uvula will move more to one side as opposed to straight up.) He always tests this way before and after a treatment (in addition to making other observations, like of facial expressions, pulse during in- and outbreath, etc.). The other test is the relative tension in the upper trapezius. A gentle squeeze of this muscle above the shoulder on each side should show if one side is more tense than the other. He says he has found a 100% correlation between these two tests. The exercises should result in a symmetric uvula and trapezius, signs of ventral vagal activation.
For COPD, he often finds the breathing problems associated with a shortened esophagus caused by a hiatal hernia, in addition to ventral vagal dysfunction. He gives a self-massage exercise that can fix such a hernia (essentially a gentle push on the stomach that stimulates the esophagus to lengthen and the stomach to drop). In addition to the basic exercise (see below), this is often enough to fix symptoms, even if lung scans still show problems. (Hiatal hernias are often a hidden problem associated with ADHD in children, too.)
For shoulder/neck pain, the culprits are CN XI, the trapezius, and sternocleidomastoid muscles (or the levator scapulae, if the pain while turning the head is experienced on the same side you're turning it - in this case the treatment is massage of the supraspinatus). For the SCM, the exercise is to lie on your stomach, lift your upper body by supporting with your elbows/lower arms, arch your back so your head is straight up like a baby, then turn your head as far as you can to each side for 30-60 seconds.
For migraines he gives some diagrams of effective trigger points on the trapezius and SCM muscles, showing the four forms migraines tend to take and which trigger points apply to each pattern of migraine.
A few other random things I found interesting:
-"Light stroking of the face often calms us and helps us out of a state of stress." (Cranial nerves V and VII innervate the skin and muscles of the face.)
-Importance of body awareness: "Awareness of our body can help us avoid getting carried away by emotions that can lead to faulty neuroception." (i.e., our 'sixth sense' of the threat or safety of our environment.)
-raising our eyebrows, opening the eyes wide "improves our sensory intake and helps us be more present to what is happening around us."
If anyone has any questions, I can go into more detail - this is just a very basic summary. But probably the most important exercise is what he calls the "basic exercise." It's very simple and has the effect of activating the ventral vagus and aligning the atlas and axis vertebrae. Here's a video demonstration:
He gets all his clients to do this one and reports that it's quite effective on its own or combined with the other exercises (about 7 are included in Part Two of the book, with some variations) and massage/body work.
The book:
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