The Polyvagal Theory - Stephen W. Porges

Here are some videos by a therapist - Deb Dana - who uses polyvagal theory in her practice where she uses touch to help map what is going on in the Autonomic Nervous System - identifying triggers, what she calls 'glimmers' and also resources. In this therapy she acknowledges 'states' instead of stories. In the second video, she mentions that stories often buffer the client while talking about states can help them open up and stay engaged. It's not necessary to physically touch the client to do this mapping process if the client can't tolerate that - rather they can use a map and work the way through the map eg. 'what would happen if I were to put my hand on your back'.


This second video goes into more detail about the Autonomic Nervous System and the maps that she uses.


The above video mentions Dana's book -


Here's the Amazon blurb.
The polyvagal theory presented in client-friendly language.


This book offers therapists an integrated approach to adding a polyvagal foundation to their work with clients. With clear explanations of the organizing principles of Polyvagal Theory, this complex theory is translated into clinician and client-friendly language. Using a unique autonomic mapping process along with worksheets designed to effectively track autonomic response patterns, this book presents practical ways to work with clients' experiences of connection. Through exercises that have been specifically created to engage the regulating capacities of the ventral vagal system, therapists are given tools to help clients reshape their autonomic nervous systems.


Adding a polyvagal perspective to clinical practice draws the autonomic nervous system directly into the work of therapy, helping clients re-pattern their nervous systems, build capacities for regulation, and create autonomic pathways of safety and connection. With chapters that build confidence in understanding Polyvagal Theory, chapters that introduce worksheets for mapping, tracking, and practices for re-patterning, as well as a series of autonomic meditations, this book offers therapists a guide to practicing polyvagal-informed therapy.
 
Here's an overview of the sections of Deb Dana's book mentioned above:

Section I: “Befriending the Nervous System”, introduces the science of connection and creates basic fluency in the language of Polyvagal Theory. These chapters present the essential elements of Polyvagal Theory, building a solid foundation of knowledge and setting the stage for work with the clinical applications presented in the remainder of the book.

Section II, “Mapping the Nervous System,” focuses on learning to recognize patterns of response. The worksheets presented in these chapters crate the ability to predicably identify individual placement along the autonomic hierarchy.

Section III, “Navigating the Nervous System,
builds on the newly gained expertise in identifying autonomic states and adds the next steps in the process: learning to track response patterns, recognize triggers, and identify regulating resources. A variety of “attending” practices are presented to support a new way of attuning to patters of action, disconnection, and engagement.

Section IV, “Shaping the Nervous System,” explores the use of passive and active pathways to tone the autonomic nervous system and reshape it toward increased flexibility of response. These chapters offer ways to engage the regulating capacities of the ventral vagal system through both in-the-moment interventions and practices that begin to shift the system toward finding safety in connection.
 
From Deb Dana's Book mentioned above and the section on mapping the nervous system:

The goal of autonomic mapping is for clients to illustrate their experience of the world from the three states of activation - safety, danger, and life threat - by detailing body responses, beliefs, emotions, and behaviours. With map making, clients begin to recognise their individual profiles of engagement and activation, the first step toward creating a somatic sense of safety and stabilisation.
[...]
Mapping brings both left-and right-brain capacities together, first inviting an embodied sense of the autonomic state (right hemisphere bias) and then adding language to the experience (left hemisphere bias). The three maps of the mapping sequence become practical representations of a clients autonomic nervous system at work. These maps help to guide clinical work. Because reshaping patterns of engagement is supported from a ventral vagal state and inhibited from states of sympathetic or dorsal vagal response, identifying a client's autonomic state is an important part of the therapy process.

Maps are powerful tools that help clients create a habit of knowing where they are on the autonomic hierarchy.
[...]
Being able to see states of dysregulation on an autonomic map brings the understanding it's not that someone is unwilling to be present, but rather they are neurobiologically unable to be present. Maps also bring awareness to moments of autonomic intimacy; the sweetness of shared moments of ventral vagal attunement.

Mapping builds a habit of autonomic awareness. The basic mapping sequence is comprised of three maps: The Personal Profile Map, the Triggers and Glimmers Map, and the Regulating Resources Map.

Map 1, the Personal Profile Map, is the foundational map exploring the question, "Where am I?" With this map, clients identify their placement on the autonomic hierarchy. T his map creates the basic skills necessary for recognising autonomic states. With the Personal Profile Map, clients describe their somatic, thinking, feeling and acting landmarks for each state.

Map 2 is the Triggers and Glimmers Map. This map helps clients begin to answer the essential question, "What bought me here?". Triggers are identified as sympathetic and dorsal vagal provocations, while glimmers are the moments the ventral vagal system lights up. It is important to recognise both, and in working with trauma survivors, therapists can get caught in the loop of focusing on dysregulation. Because the brain has a built-in negativity bias, it is necessary to bring attention to the micro-moments of safe connection or clients will move right past them and won't reap the benefits of those flashes of autonomic regulation.

Map 3, the Regulating Resources Map, is the final map in the sequence addressing the question, "How do I find my way to ventral vagal regulation?". We have the potential, and need, for both individual and interactive regulation and this map is designed to identify resources in both categories. In response to the ways life experiences have shaped their autonomic nervous systems, clients have a tendency to relay more on one than another. The Regulating Resources Map brings attention to the presence and absence of individual and interactive resources and to the process of building new regulating pathways.

The foundation of each of the maps is a ladder with the three different autonomic states detailed on it:


30730

LIFE ON THE LADDER


From the moment you
came into this world,
a ladder was placed in
front of you that you
might transcend it.

-RUMI
[...]
On these maps, the ladder is divided into thirds. Each section represents an autonomic state (ventral vagal the top third, sympathetic the middle, and dorsal vagal the bottom third) and encompasses several rungs to illustrate that there is a range of responses within each state and a progression that happens when moving between the states. The three maps use polyvagal terms to label the autonomic states: ventral vagal (safe, social); sympathetic (mobilised, fight, flight); dorsal vagal (immobilised, collapsed).

When familiar with each of the states the author encourages clients to make up their own names for each of the states.

To be continued.....I'll share more details about each of the three maps.
 
THE PERSONAL PROFILE MAP

The Personal Profile Map offers clients a way to enter into autonomic awareness and bring perception to the wordless experience of neuroception. Once clients have created their map, it becomes an anchor they can return to with the orienting question, "Where am I on my map?" The structure of this mapping experience is designed to maintain a "critical mass" of ventral vagal energy so clients can safely activate sympathetic and dorsal vagal states, be with each state but not hijacked by it, and intentionally shift between states. Therapists support their clients in safely moving between autonomic states by bringing their own ventral vagal energy to the process of co-regulation.

Each individual should probably decide whether they can do this process on their own or whether it's best practiced with a therapist. Elsewhere in the book the author states that the ventral vagal state - being a social and connected state, is also one where an individual can co-regulate other nervous systems, so if you don't think you can get into a ventral vagal state on your own, it's probably wise not to try these exercises.

Even though the client is the one making the map, it is a dyadic process. Because transitioning between states is difficult for many clients and can lead to extended periods of dysregulation, it's important for therapists to send autonomic cues of safety, creating a shared experience of befriending.

COMPLETING THE PERSONAL PROFILE MAP.

Begin with a blank Personal Profile Map (I've attached a template) and coloured markers. The map can be drawn in pen or pencil, but my preference is to add colour to the mapping process. Colour is one of the first ways we learn to distinguish objects, and studies show colours evoke physiological arousal and psychological effects (Yoto, Katsuura, Iwananga, & Shimomura, 2007). Working with markers takes adolescents and adults out of their ordinary habits, interrupting ingrained patterns of using pens, pencils, or typing. Offering coloured markers brings clients' attention to the ways map making is more than a top-down cognitive exercise and invites them to move into a different way of experiencing. For children, who are not yet immersed in the grown-up ways of working, crayons and markers are still linked to creativity.
[...]
...choose the coloured markers that represent that autonomic state with the question, "What colour are you drawn to as you prepare to map sympathetic danger, dorsal vagal life- threat, and ventral vagal safety?" This is an opportunity to practice making an autonomically informed choice by tuning in to the information communicated from the autonomic state rather than listening to a cognitive story about colour.
[....]
During the map-making process, each state will be activated as it is mapped making it essential to end by completing the ventral vagal "safe and social" section as this is the autonomic state you want your clients to actively experience at the end of the exercise. Begin by completing the sympathetic section and then move to the dorsal vagal section. The shift from sympathetic to dorsal vagal is a move down the autonomic hierarchy and for most clients this is a familiar pathway. After the dorsal vagal section, finish the map by filling in the ventral vagal section. The transition from dorsal vagal back into ventral vagal is more challenging and requires going through sympathetic mobilisation. To support the return to ventral vagal regulation, you can guide your client with use of a breath to begin a return of energy (a sigh is often a sign of the system seeking regulation); offer cues the Social Engagement System watches for (warm tone of voice, eye gaze, perhaps leaning in a bit using proximity to signal connection); and nee the sequence of leaving dorsal vagal collapse, mobilising through the sympathetic nervous system, and coming into ventral vagal connection.

Mapping a state involves activating and then documenting the qualities of that state. When bringing sympathetic and dorsal vagal states to embodied aliveness for the purpose of mapping, help your client titrate the experience with just enough of a flavour, or taste, of the state for it to be accessible for mapping. For the ventral vagal state, invite your client to experience "filling from their core to their skin" creating a fully embodied and alive experience. Ask your client to sense their embodied experience (neuroception) and then bring that experience to awareness (cortical perception). Invite your client's attention to thoughts, feelings, body responses, and behaviours: "For each state, fill in the section by writing what it feels like, looks like, sounds like. What happens in your body? What do you do? What do you feel? What do you think and say?"

[...]

To give some examples to assist in that process, here are the introductions I often use for each phase.

Sympathetic nervous system:
Remember a time when you felt the sense of sympathetic mobilising energy moving through you. You might feel a sense of too much energy flooding your system, a sense of unease, perhaps even a sense of being overwhelmed. You might think one more thing will put me over the edge! And now let just enough of it into your mind and body to get. flavour of it, and then begin to map it.

Dorsal vagal:
Think of a time when you felt the dorsal vagal sense of disconnect, a sense of collapse. There's not enough energy to run your system. If you were in a room full of people, it might feel as if there was a Plexiglass shield between you and them - you could see them but couldn't reach them. It might feel like depression. It's hard to find hope. Just let a tiny bit into your mind and body. Just enough to get a taste of it. And now begin to map it.

Ventral vagal:
Think of a time when you felt the flow of ventral vagal energy. The sense that everything is okay, not wonderful or perfect but okay. The world is safe enough, and you can move through it with ease. Bring this moment to life and let it fill you....from your core to your skin. And when it's fully alive, begin to map that.

As your client fills in their map, have them notice how their sleep, relationship to food, and use of substances is affected in each section.

When your client finishes each section, ask them to complete the two sentences, "I am....." and "The world is......" These two sentences identify the core beliefs at work in each state, and, although not new realisations, clients often recognise them in new ways.

At the completion of the mapping exercise, ask your client to share each section with you following the same order in which the map was created: sympathetic to dorsal vagal ending in ventral vagal.

[...]

Get to know the body, behaviour, and belief landmarks they have identified. In this process, you and your client can sense the shifts, noticing together difficulty or flexibility in moving between states. This is a time of ventral vagal connection as you remain curious and compassionate and actively engage your client in co-regulation.

Some clients struggle to find a moment of ventral vagal regulation. They may believe that ventral vagal energy is missing in their nervous system. One client told me she was convinced her vagus was broken! The present-moment attuned connection between you and your client can be the source of safe social engagement that brings the ventral vagal state alive for mapping. You might ask, "In this moment, between us, in this safe space, what is your autonomic nervous system telling you?" Connection with a pet is another way to find a moment of ventral vagal safety. A loving connection with an animal predictably brings a ventral vagal response. Research with dogs and the owners has shown that an elevated human heart rate is regulated when an owner is reunited with their dog (Beetz, Uvnas-Moberg, Julius, & Kotrschal, 2012). Experiences in nature also bring the ventral vagal state alive. A person's relationship with nature has been shown to have important effects an well-being (Nisbet, Zelenski, & Murphy, 2011); time in the natural environment reduces stress (as measured cortisol levels) and affects psychological health positively (Ewert, Klaunig, Wang, & Chang, 2016). When relationships have been a source of dysregulation, nature can be a pathway to finding a ventral vagal moment to map.

Using the Personal Profile map help your client consider which state they most often use to navigate daily living. An alarmed, hyper vigilant sympathetic response or a dulled, nonreactive dorsal vagal response? For some clients the border between ventral vagal and sympathetic responding is their familiar spot. Without sympathetic vigilance, they feel unsafe. For other clients, the flavour of dorsal vagal disconnection is their accustomed place. For many clients, the starting point is "dipping a toe" in ventral vagal energy and getting used to the state of safety that their nervous system has not had access to. A client's place on their autonomic ladder helps guide your session. In a sympathetic or vagal state their autonomic nervous system stays locked in story of survival while a ventral vagal state brings connection and opens the system to the possibility of change. Once your client can map their autonomic states, together you can assess safety and risk from an autonomic perspective. Nearing the end of a session, the question "Where are you on your map?" is a reliable gauge for exploring what would be helpful for your client as they transition back into the world beyond the safety of the therapy session.

Sometimes clients act from a simple desire to do something, sometimes their actions are prompted by and unmet need, ad knowing where they are on their map offers useful information. Take the question to engage or not to engage? Remembering that state drives story, a decision to engage might be a ventral vagal-inspired desire to be in connection with someone or might be a sympathetically driven need not to be alone. One brings a story of friendship and reciprocity, the other a story of the relentless search for connection. On the other side of that question, a decision to not engage might again be a ventral vagal experience of finding delight in an evening of reading and a story of self-care or a dorsal vagal experience of despair with an accompanying story of being a misfit.
[....]
Clients get to know themselves through map making. In the process of creating their Personal Profile map, clients learn to turn toward their experiences without judgement and see their dysregulation as an attempt at protection and their need for connection as a common human need.

I have attached a copy of the Personal Profile map template.
 

Attachments

THE TRIGGERS AND GLIMMERS MAP

Many of the systems embedded in our communities - schools and workplaces in particular - have been develop without regard for the role of the autonomic nervous system in guiding engagement and disengagement in everyday experience and as a result are insensitive to individual autonomic needs for safety. In social settings, a "one-size-fits-all" approach has become the norm. Behaviours identified as conforming are considered proper and are expected. In the struggle to fit in, we may feel the presence of cues of danger and the absence of cues of safety. When the autonomic survival response overrides the abilities of the Social Engagement System, engaging with others in co-regulation is impossible. Without an autonomic lens, people whose underlying state prevents them from fitting into the accepted model are judged as misfits and criticised from a belief that they could modify their behaviours if they wanted to. Insensitive systems reinforce autonomic dysregulation through blame that engenders shame. It becomes a story about who and not how or why.

The second mapping tool is the Triggers and Glimmers Map. This map brings attention to moments of activation and moments of regulation. We identify triggers as cues of danger that activate sympathetic and dorsal vagal defences and glimmers as cues of safety arising from a ventral vagal state of health, growth, and restoration. Our survival depends on accurate recognition of both helpful and hurtful experiences. Remembering that it is not enough to remove cues of danger but that we must also sense cues of safety, this map-making exercise brings attention to a client's experiences in each of the three autonomic states. The second map in the series is designed to help clients learn what activates specific state shifts and begin to consider that their autonomic experiences might be reliably anticipated. With a sense of predictability, clients no longer feel they are simply at the mercy of the Fates. This map helps make sense of what our clients often think "just happens". When clients understand there are precipitating factors (causes) for each state, they can then begin to recognise their movement in and out of states (effects). Effects depend on causes (Rim, Hansen, & Trope, 2013), and exploring "why" brings a bit of observer energy that makes it easier to then look at the autonomic state.

TRIGGERS

Identification of triggers is a way to begin to move out of the self-critical story of "who I am" into curiosity about "how I respond." In this mapping exercise, triggers are identified and linked to an autonomic state. Triggers occur when the vagal brake is not able to relax, reengage, and maintain ventral vagal regulation. Triggers are a result of a neural challenge that is too big for the flexibility of the system. They bring a neuroception of danger or life-threat, and the autonomic nervous system activates a survival response. These cues of danger prompt either a sympathetic mobilisation or a dorsal vagal shut down.

GLIMMERS

The ventral vagal system guide our experience of glimmers. The neuroception of safety creates the possibility of relaxing into a moment of connection to self, to others, or to the environment. Cues of safety bring glimmers that are often sensed into micro-moments of ventral vagal activation. Glimmers can help calm a nervous system in survival mode and bring a return of autonomic regulation. The research of Kok and colleagues (2013) found that even though the experience of a positive emotion is brief, it can build enduring resources. Bringing attention to these small moments moves the system toward a tipping point, and multiple micro-moments may become significant enough to create an autonomic shift.

COMPLETING THE TRIGGERS AND GLIMMERS MAP

The Triggers and Glimmers Map (template attached below) uses the same ladder template as the Personal Profile Map adding the 'glimmers' label to the ventral vagal section and the 'triggers' label to the sympathetic and dorsal vagal sections. This second map in the mapping sequence follows the Personal Profile Map, building on a client's beginning understanding of their experience in each of the three autonomic states. This map-making exercise brings clients' attention to what happens in their bodies, in the environment, and in relationships that sets autonomic state shifts in motion. Triggers and glimmers are the concrete events that move clients up and down the autonomic ladder. The question "What brings me here?" is the prompt that begins the exploration. Clients often first notice the "headlines" and then can be helped to name the "tangibles"

Dorsal Vagal Headline: feeling unwanted

-
Tangibles: when my friends plan a date and don't ask me to join them; when my coworkers are having a conversation and don't notice me

Sympathetic Nervous System Headline: feeling disrespected

-
Tangibles: when my friend turns away from me during a conversation; when my partner interrupts me.

Ventral Vagal Headline: feeling seen

-
Tangibles: when the store clerk looks at me and smiles; when my coworker asks me how my day is going

It is important to move from identifying the broad headlines to defining the specific events that care the headlines. Describing the specific factors that create entry into a state is necessary in order to understand how to predict, manage, or re-create state shifts.

Some clients like to have their Personal Profile Map to refer to. Others will simply use recent experiences as a guide to the process. As with the Personal Profile Map exercise, clients again are offered coloured markers to use. Work with the triggers first. Because it is experiences of distress that bring our clients to therapy, the triggers are usually easily accessible. Ask your clients to identify which of the survival states (dorsal, vagal or sympathetic - I think the author means to mention just dorsal and sympathetic here as the ventral vagal is associated with glimmers) is easiest for them to name their triggers and start there. Map that state and then the other. Once sympathetic and dorsal vagal triggers have been mapped, move to exploration of glimmers. As your clients complete each section of the map, ask them to share that section with you. Keeping the focus on one state at a time helps clients become clear about what takes them into each state and see the distinctions between the states. A client may struggle with any one of the states on this map because of their individual autonomic profile. If either sympathetic mobilisation or dorsal vagal collapse is an unfamiliar state, identification of the associated triggers will be more difficult. Clients often find recognition of glimmers to be the most challenging part of this map-making exercise and feel encouraged when they discover that glimmers are in fact bought to life by specific incidents. Bringing attention to glimmers is not negating of the suffering our clients experience with triggers. Triggers and glimmers are one of the both/and experiences that therapy strives to foster. A strengths-based perspective reminds us that well-being is not simply the absence of problems but also the presence of strengths. We used to think of well-being as the absence of disease and disorder. More and more, we are recognising that well-being goes beyond the lack of disease and just as importantly includes positive social and emotional functioning. From an autonomic perspective, Polyvagal Theory identifies the link between physiological and psychological well-being and identifies the need for both resolution of cues of danger and recognition of cues of safety. In completing the Triggers and Glimmers Map, clients are supported in exploring their full autonomic experience.

The Triggers and Glimmers Map helps clients identify their sympathetic and dorsal vagal sensitivities and ventral vagal strengths from a stance of curiosity. Autonomic response is felt in how intense or nuanced moments of activation or ease feel, how long they last, and how often they appear. Considering the ration of triggers to glimmers is another way to observe responses and note the impact on daily living. Change over time in each of these markers (frequent, intensity, duration, ratio) is a measure of movement along the autonomic continuum of sensitivity to resilience.
 

Attachments

THE REGULATING RESOURCES MAP

The Regulating Resources Map is the final map in the basic mapping sequence. Having mapped the experience of each autonomic state (Personal Profile Map) and identified the cues of danger and safety that prompt activation of each state (Triggers and Glimmers Map), clients work with this final map in the series to gain awareness of their patterns of regulation. The Regulating Resources Map is designed to help clients identify individual and interactive actions that move them out of dorsal vagal and sympathetic states and actions that maintain a ventral vagal state. In this map-making process, clients continue to get to know their autonomic profile as they discover both the presence and absence of individual and interactive resources in each autonomic state.

LEARNING ABOUT REGULATION

We come into the world with a need to co-regulate to survive. Babies and their mothers engage each other in reciprocal regulation, a baby naturally turning toward their mother and their mother responding, together co-creating a physiological and psychological state (Apicella et al., 2013). This interactive experience tones the baby's nervous system beginning the creation of their individual neural profile. When the expected and common moments of rupture happen, a regulated and attuned mother notices, makes a repair, and the baby experiences safety in the interactive regulation. An example of this is a mother who is playing with her baby and turns away to interact with her older child. The baby feels the loss of connection and signals distress (vocalises, reaches out, cries). The mother recognises her baby's dysregulation and returns her attention through her eye gaze and prosodic voice. Tronick and Reck (2009) demonstrated that moments of misattunement, or interactive mismatch, do not necessarily unfavourably impact attachment; rather, it is when ruptures happen and are not repaired that the baby begins to carry a negative expectation into the future interactions. In the example above, if the mother doesn't recognise her baby's distress or if she responds with anger to her baby's demand for connection, the necessary repair does not happen. If a mother is chronically dysregulated, her ability to offer interactive regulation is affected, and her baby's autonomic nervous system moves into protective mode, no longer seeking the safety of co-regulation. For this baby, survival now depends on self-regulation.

The ability for self-regulation should optimally be built on the foundation of interactive regulation. A baby begins to learn to self-regulate from the interactive regulation in the attuned mother and baby dyad. This ability to self-regulate continues to develop throughout childhood supported by social engagement with autonomically regulated others. "The capacity to fully experience ones feelings, particularly when they are intense and/or painful, is greatly enhanced by being able to do so together with a supportive, empathetic, and emotionally present other" (Fosha, 2001, p. 229). As the capacity for self-regulation increases, when reactions happen, regulation and recover follows. When we are supported by a nervous system that can engage with both interactive and individual streams of regulation, safe and flexible navigation of the experiences of daily living is possible.

Research into social connection shows a downward trend in connection and a rise in isolation and loneliness (Seppala, Roosomado, & Doty, 2013). Without reliable people to interact with, we turn to our self-regulatory skills and the opportunity for interactive regulation and creating autonomic well-being through connection to others is lost. When we feel lonely, we also feel unsafe (Cacioppo & Cacioppo, 2014), and loneliness activates the survival systems of the autonomic nervous system.

Through the Social Engagement System, we use our eyes, our voice, and movement of our face and head to send and receive signals of safety and to reach out for and offer connection. When we use devices for communication, the important nonverbal elements conveyed in tone of voice, facial expression, and body language are often lost. As we rely more on online conversations to communicate, there are fewer opportunities to exercise our social engagement circuitry. Sherry Turtle, director of the MIT Initiative on Technology and Self, said: "Face-to-face conversation is the most human and humanising thing we do" (2015, p. 3).

A history of mistuned caregiving and unprepared relationship ruptures shapes the autonomic nervous system toward protection and away from connection. Social isolation and the perception of social disconnection can lead to a lack of interactive resources. Both experience become a story of aloneness. A chronic neuroeption of danger or life-threat that is triggered in response to being in connection with others makes using interactive resources difficult. With a nervous system that dysregulates when social engagement is offered, a client will likely initially find interactive regulation too great a neural challenge. For some clients, the first interactive regulation resource may simply be sitting in a place where people are present (mall, coffee shop, movie), and feeling the presence of others from a safe distance.

When exploring resources to move from a dorsal vagal or sympathetic response, it is important to remember the energy states involved in each. In dorsal vagal collapse, the autonomic nervous system has entered a state of "conservation" where there is not enough energy moving in the system to support regulation. To begin to recover, a gentle return of energy is needed. The resource can't bring too big of a shift in energy or it will feel dangerous and push the system further into disconnection. In a state of sympathetic mobilisation, too much energy is flooding the system. To move from here, the resource has to bring a way to safely discharge energy.

Some actions may be a resource for each of the autonomic states when utilised with just a slight difference. Movement is an example of this. Humans are built to move. Movement was essential to survival (Owen et al., 2010) and is a fundamental resource for regulation. Through a polyvagal perspective, we understand that movement is key feature of sympathetic activation, is missing in dorsal vagal collapse, and is a natural part of the ventral vagal state of connection. As a resource to shift the immobilisation of the dorsal vagal state, movements can be small or can even simply be sensed (imagined rather than enacted, bringing the motor cortex alive). In the sympathetic state the intensity of movement needs to be shaped, and in the ventral vagal state movement can be savoured. Using walking as an example, in dorsal vagal the movement might be small, slow-motion steps (or imagined steps); in sympathetic a fast-paced run; and in ventral vagal a refreshing restorative walk or hike.

COMPLETING THE REGULATING RESOURCES MAP

The Regulating Resources Map (template attached) uses the same ladder template as the other maps in the series with the addition of a centre line to divide the map into the two categories of regulation: interactive regulation (Things I can do with others) and self-regulation (Things I can do on my own). The sympathetic and dorsal vagal sections are labeled "What moves me out of here" and the ventral vagal section is labeled "What helps me stay here?" As with the Triggers and Glimmers Map, it doesn't make a difference whether a client begins with the sympathetic or dorsal vagal section. Have your client start in the state that is most familiar to them and fill in their self and interactive resources for that state. Then to the same for the other survival state. Finish by filling in the ventral vagal section.

Like the other maps in this sequence, coloured markers are used, but for this map invite your client to choose two colours for each state: one for individual resources and one for interactive resources. The picture this creates colourfully illustrates abundance and scarcity. With a clear picture of their present options, clients can begin to look at effectiveness and outcomes and explore where, and how, to add resources.

The Regulating Resources Map is a work in progress as your clients continue to create resources that lead them back into a ventral vagal state and exercise their vagal brake. The map becomes part of the therapy process with a focus on bringing balance to individual and interactive resources, creating resources where they are absent, and shaping resources toward actions that effectively bring a return to ventral vagal safety. This map is designed to draw your clients' awareness to the resources they already use and to the areas in which resources are scarce.

Clients are often surprised, and can be distressed, to see the variety of ways they engage in attempts to regulate. Merriam-Webster's defines a resource as "something to which one has recourse in difficulty" and "a possibility of relief or recovery." When your clients are autonomically dysregulated and experiencing and adaptive survival response, turning toward an action that brings the possibility of relief is powerful.

While the resource might not be a response that is health giving, it is an attempt to resolve the pain of the present state of autonomic reaction. Food and substances are common examples of resources that your clients may turn to and may eventually want to change their relationship with. Understanding the autonomic need to ensure survival, clients can be helped to see their "resource responses" without shame.

Clients can also be surprised to notice an absence of resources for a particular state or a scarcity of resources in the individual or interactive category. It's important to remind clients that their autonomic nervous system has been toned by their past and is being returned in the present. They will create new resources in the process of brining balance to their system, using the information from their map to guide this process.

For your clients, just as important as identification of what moves them out of dorsal vagal or sympathetic dysregulation is identification of the resources that maintain their ventral vagal state of connection. If your clients struggle with this portion of the map, looking at previously identified glimmers can prompt recognition of regulating pathways. Because clients come to therapy in states of dysregulation, they may think they have no resources for this section of the map. Some clients will be relieved to find several resources, while others will be dismayed to see how few they have. Over the course of therapy, all of your clients will build numerous resources and find just the right amount of interactive and individual resource to fit their unique autonomic needs.
 

Attachments

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This subject is really taking off and is discussed in the most recent MindMatters show interview with Susannah Hays:

MindMatters: Susannah Hays Interview: Polyvagal Theory, Gurdjieff and the Evolution of Man

In recent years researchers like Stephen Porges have brought a newfound understanding of the body's all-important polyvagal system to greater and deeper awareness. The tenth cranial nerve, or vagus nerve, has a great impact on the health of major organs (including the brain), and even direct impact on a human being's 'higher' functioning. Interestingly however, is the historic fact that the wandering nerve has also been the subject of research and speculation for hundreds of years, among the scientists of the West - as well as the mystics of the East.

This week on MindMatters we discuss a new development in research that seeks to bring together these seemingly separate subjects with Susannah Hays, MFA PhD. In her doctoral thesis and subsequent paper 'Nature as Discourse: Transdisciplinarity and Vagus Nerve Function,' Dr. Hays lays out not only the historical precedent for polyvagal system research, but also what the great teacher and mystic Gurdjieff may have been seeking to do with his exercises - and where a broader look at all of this information may be leading us towards. Join us as Dr. Hays takes us on a transdisciplinary journey through Gurdjieff, polyvagal theory and more.


 
The Pocket Guide to the Polyvagal Theory is supposed to be an easier to understand version of the book and I liked it.
 
This is a short (8-9 minutes) video about how our autonomic nervous system impacts our health. It's titled "Trauma and the Nervous System: A Polyvagal Perspetive".

This video was developed to give a basic introduction and overview of how trauma and chronic stress affects our nervous system and how those effects impact our health and well-being. Much of the content is based on the groundbreaking work of Stephen Porges and his Polyvagal Theory and inspired and informed by the work of thought leaders Deb Dana, Vincent Felitti, Robert Anda, Gabor Mate, Dan Siegel, Robert Scaer, Peter Levine, Steve Hoskinson, Allan Schore, Laurence Heller, Bessel van der Kolk, Bruce Perry, Diane Poole-Heller, Wilhelm Reich, Hans Selye, Walter Hess, Walter Cannon and John Hughlings Jackson.
 
This subject is really taking off uand is discussed in the most recent MindMatters show interview with Susannah Hays:

MindMatters: Susannah Hays Interview: Polyvagal Theory, Gurdjieff and the Evolution of Man




During the interview Harrison (I think) asks the question about whether having the scientific understanding of what and how the vagus system works would contribute to the efficacy of practices that stimulate vagus tone.
I would like to mention the work of Pain Psychologist Beth Darnell from Stanford University. Her and her team have developed a simple evidence based chronic pain intervention that does exactly this, it combines neuroscience with relaxation practice. The intervention has ingredients of pain neuroscience education,psychological skills training, and relaxation practice which reduces pain and serves to enhance learning. The intervention is an easily accessible two hour work shop called Empowered Relief.
It is generally offered for free to participants who are also given the 20minute relaxation sound file that comprises of a guided relaxation exercise to binaural beats in the background.
The results from the effectiveness studies are very positive and further publications are currently under peer review to be published this year. The beauty about ER is that it is accessible to people who may not ever have thought to engage in this type of practice.
I have recently completed my instructor training for this workshop and will be starting to provide this over video conferencing. Beths goal is to get as many instructors schooled as possible to make this simple evidence based intervention available for everyone with chronic pain who needs it.
I was impressed with Beth Darnell and her sincere passion for her research and desire to help people in pain. Many here in this forum will be very familiar with relaxation and meditation etc but there’s huge numbers of people in pain who need guidance on how they may be able to help themselves.
 
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Porges has released a neat gadget called Televagal.

- a pulse wave is collected from the pixels of the face with a high definition camera.
- the physiological signal is deconstructed into neural metrics and neural indices.
- neural indices are synthesised into traffic lights reflecting level of nervous system activation.
- live feedback is given by colour changes in a lamp.

Demonstration of its use in a session.
 
Here's an interview with Deb Dana where she does a demo session using PT in therapeutic practice. She covers some of the blended states, e.g. meditation is a blended state of dorsal vagal and ventral vagal. After helping the client to anchor in ventral vagal, they explore both sympathetic vagal and dorsal vagal taking ventral vagal with them to show how blending the states modifies them.

They also address working with shame.

 

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