Modern Wisdom｜Polyvagal Theory: Why You Feel So Anxious All The Time - Dr Stephen Porges

You've authored more than 400 peer reviewed scientific papers and literally created polyvagal theory.

It's sort of rare that you get to ask Mike Tyson about how to throw a jab or the founder of a really impactful theory about what it means.

So I guess, how do you describe polyvagal theory to someone who isn't familiar with it?

It's really quite simple.

It's that our underlying physiological state affects how we perceive the world, how we interact with others, and how receptacle we are to others engaging us.

So in a sense, we kind of got dropped into a world where we think that all our behaviors are intentional and

But we don't acknowledge that some days we feel basically quite constrained and some days we feel very energetic and engaging.

The bottom line is that we have to start paying attention to our own underlying physiological state because it will help us navigate through a very complex world.

So we're responsive in that way to the local ecology, kind of like a plant.

We are a plant in a way, exactly.

We're detecting signals just like plants.

We're responding.

The difference is that with our great intelligence, we think it's all our – we caused it all.

We create narratives of control when in reality we're being swept away by

By the challenges of the environment in which we are in and when we feel swept away and overwhelmed

At that point we start acknowledging things but we don't acknowledge it until it really gets over over a certain threshold

Why is that adaptive

Why have we evolved to have that dynamic

Because the world was a dynamically changing place.

That's as simple as that.

But we've lost some of the, I would say, innate and intuitive skill sets.

And that's being aware of when our body loses that resilience.

And instead, we're trained by our culture to say, you can do it.

It's like...

It's like, I mean, that's a quote from the Waterboy, if you don't remember that movie.

But the issue is we live in a world in which everyone thinks we can suppress our feelings or we can get over something when in reality, our body is just percolating and broadcasting signals to our awareness.

And now we're being told,

Don't pay attention.

I understand why.

And this is a pivot in the world of nonfiction communication, personal development, self-growth that I've been really fascinated by.

Forget your feelings, just work harder.

Approach

I understand why because maybe for a lot of people they're too at the mercy of their feelings

They actually could do with a little bit more agency they could do with

I can do it

We're in a meritocracy and we want to uphold people but as you say it's denying the real dynamic that we are a system that is interacting with our environment

There are certain things that you're skimming across the top of because implicit in what you're saying is you have some idea of what being a successful human being is.

And what I'm saying is our markers of success may be somewhat confounded.

Because part of being a successful person is feeling good about being a person.

And part of the motivation for working is to, in a sense, get over those feelings of inadequacy.

So we get kind of twisted and tricked by all this.

And the other part is that we don't truly acknowledge it as we numb our body out or don't listen to it.

We're literally turning off neurophysiological feedback loops.

A feedback loop is the part of us that monitors our functioning.

And a part of us that now creates the motor actions.

And so in a way, we are destroying our own bodies.

And those who work hard acknowledge that.

They said, I'm stressed out, I burn out.

But there's a physiology to that, and that is in part, we're not listening to our body.

That's so wonderful.

You're so right.

How many people are chasing success to give themselves the sensation of feeling good, but in the pursuit of achieving the success, they have denied themselves of the feeling of being good?

Yeah.

Now, as you say that, listen to what you said.

And there's a secularity there.

And then you accumulate.

And listen, you're in Austin.

So you're in the midst of a lot of what is now the success track.

A patient zero.

Yeah, yeah, yeah.

This is ground zero right here.

Yeah.

And the issue is, yeah, acquisition, wealth, influence, these are wonderful things, but wonderful things for what?

So how do you leverage that successes of acquisition, of respect, and accumulation to become more, to do more, to be better?

You know, in a sense, what are our goals in life?

And this is kind of a complicated and very personal question.

So are our goals acquisition or are our goals growth?

A curiosity, learning, or are goals benevolent and compassionate?

No, we can set our goals, but they're not merely the here and now.

We as a species like to do things that are different.

We like exploration.

We like curiosity.

We like humor.

Hmm.

And we like to meet people as well, which is part of that whole bit.

So you could accumulate resources without having, in a sense, a type of curiosity that enables our nervous systems to thrive.

So in a way, the manual for living a good life

Has been mistranslated.

Can we use that term?

So brilliant.

So great.

Okay, what was the actual problem that you were trying to solve in 1994?

What didn't fight or flight, rest and digest?

What didn't that explain?

Well, it gets, okay, there are different levels.

So you're sitting across from me, at least metaphorically, and you're asking me those questions, but there is really decades before that as well.

Like, who was I?

What were the types of questions that I personally was asking?

I was asking myself.

What was going on basically behind the smiles of people?

What was going on in their mind?

What was going on?

What were they feeling?

I was asking different level questions, not levels of what were your scores on your test or how fast was your reaction time?

I was kind of more interested in what was going on inside of them.

And it didn't have really an area of science.

Science was really very mechanistic, so behaviorism was big, and then you don't, so behaviorism was to explain everything

Certain types of physiological conditioning was to explain everything.

And then the other part, what was going on in the mind, like psychoanalysis, mental health, that was something else totally independent of the body.

So the issue then was if something's bothering you, just sit on it.

Don't let it percolate.

There was no understanding that the way we feel was anything other than optional.

Until something catastrophic happens in people's lives, like loss of a loved one or a severe injury or, let's say, a traumatic event where someone is raped or mugged on the street and suddenly

Everything is different in the world, and what used to be comforting and engaging is no longer there.

Or what happened to me was I got pneumonia.

And I had been extremely a social individual.

And this was when I was a tenured, actually, I was probably a full professor at that time.

And the issue was, I basically...

No longer could be around crowds of people that start to bother me.

My threshold, and you see this after COVID for many people, they are dealing with chronic illness and they have words like chronic fatigue syndrome and people are literally marginalized when they say they have that.

Come on, get back into the flow.

Everybody gets tired as they get older.

Everyone's a little bit underslept.

Yeah, or fatigued.

But those who suffer really get very upset because they're being dismissed.

And they're trying to explain to you that they had a body that listened to them, and now their body doesn't.

And that's the interesting part that I started to ask, why doesn't your body respond?

What was going on?

But let's get back to your question, going back to 1995.

I was starting to do work in intensive care units with preterm babies.

And I was building this in a sense of vagal related theory about parasympathetic nervous system was very important.

I was basically trying to describe the other side

Of the world, the other side of stress.

What are the systems that calm you down?

Where does, let's say, even meditative aspects, where do these insights, what state supports that?

And so you had fight and flight and stress, and then you had this parasympathetic, this wonderful system that was a rest and restore system.

And that was kind of an interesting model until I worked in a neonatal intensive care unit.

Where you have these preterm babies, and of course they have a fight-flight response frequently to high heart rates and tachycardia.

But you know what their defensive systems were?

Shutting down a lot of this vagal slowing heart rate, but so slow that it could actually compromise their ability to get oxygen to the brain.

And I couldn't quite understand what I later called the vagal paradox.

How could this same nerve, which was really associated with basically good states, health, growth, and restoration, how could it kill you?

In a sense, how could a good...

In fact, a neonatologist wrote to me after I wrote a paper in a journal and said,

Maybe too much of a good thing is bad.

And that was the way most people think.

Too much of a good, it shuts down.

And I said, that doesn't make any sense.

That's not how systems are, in a sense, evolved or wired.

And I started to get deep into the anatomy and then into the evolution.

Basically, it was called phylogeny, where you look at

Species changes in autonomic regulation.

And then there was something that became very mammalian, something of which we are mammals, and we start to have a very different type of autonomic nervous system, a nervous system that enabled us to be safe in proximity of another.

So was breeding cues, you know, when mothers talk to their babies?

Or if you have pets, do you have a pet, a dog or a cat?

No, I am on the cusp of getting a dog, but not yet.

Okay.

Well, you have friends at least.

I treat them like dogs sometimes actually, so that probably works.

True, but you probably don't.

This is the secret of it.

The way people treat their dogs, they use very melodic, prosodic voices.

It's the way that mothers talk to their babies.

And that's when I started to realize that we as mammals have a whole collection of, let's call it a behavioral repertoire, of broadcasting signals of safety to others, and those seem to affect their physiology.

And so that's where this whole story started was trying to identify what was uniquely mammalian and using the preterm baby as this window of an opportunity to see a system that was not fully developed.

And I could see it coming on board.

Can you just give me the adaptive explanation for those three states as you conceived them?

Sure.

Everything is adaptive in the model.

Nothing is wrong.

Nothing is bad.

Nothing is pathological.

They're adaptive in certain contexts.

So in a sense, we have, because the system basically for vertebrates, and those are all the species of backbones,

As they evolved into amphibia and then basically mammals and reptiles broke off at the same time and had basically parallel evolutionary pathways.

The mammal had a very unique pathway.

Because it needed to nurse.

It needed the parent to take care of it.

And it also, when it matured, when it was born, it needed to be taken care of.

Now the other species laid their eggs and walked away.

So what happened was that you had a very special need to survive for this type of vertebrate, which we are part of, mammals.

And they needed to broadcast their underlying physiological state.

In their vocalizations, in their facial expressivity.

They needed to broadcast to signal.

Everything's about now signaling.

And other species didn't need that because they could just survive.

They could scamper off and survive.

So you needed this new signaling system.

And ironically, what that signaling system did was enabled social behavior to act positively on our physiology.

So that's why I asked if you had a dog.

And when you have a dog, you realize that the dog's engagement to you and the way you vocalize with the dog is going to be a great regulator of both your physiological states.

And that made us uniquely mammalian.

And that's why dogs and humans, or if you look, can you see my cat?

Yes, yeah, we will be able to.

Yeah, so the cat back there loves for me to talk to her.

And if I don't talk to her, she will talk to me.

And that's her broadcasting that she is there and she wants this comforting back.

So let's go through the three.

The old vertebrates had a very primitive autonomic nervous system, the system that regulated your organs, and that's fine.

It had basically a primitive vagal system, and it had a bunch of chemicals like adrenaline or chemicals like that in the body.

So it could mobilize and had a neural system of calming.

That neural system was not merely acting on the organs.

It was also reflecting what the organs were doing.

And this becomes really critical here.

It's that we tend to focus on the brain neural regulation of the organs when most of the neural traffic is the body sending signals to the brain.

And that's what our culture has said, forget it.

Yeah, just don't attend to it.

So the Vegas initially was fine when we were in, we could rest and restore with it.

In peaceful comfort but when we had a fight flight mobilization we interfered with that rest and restore but what happened now with mammals they had a very let's say nuanced

That became a vagal system that enabled social engagement, enabled even mobilization without fear.

And we call that play and dance.

And we didn't merely have to be immobilized and intimate

To, in a sense, have this physiological calming.

We could be interactive.

So the mammal basically had not only a fight-flight system, and not only a older dorsal, the back of the brain's that vagal system that regulate your organs,

But also had this newer ventral vagal that was locked to our voice and the muscles of our face and head.

Basically, we were broadcasting that visceral state, and we were, in a sense, encouraging others to co-regulate with us to come closer.

Yeah.

So the whole, in a sense, in Austin, where you're seeing startup businesses and all this, the question always will become the degree of cooperation within a workplace.

And as we become more and more remote,

That type of the social cues become more and more separate from the actual interaction.

So the mammal had this remarkable system that enabled it or us to control our fight flight and actually co-op it as play.

And to control our immobilization to support our health growth and restoration by being safe in the arms of another.

And to also signal that we needed help, that we needed care, that we needed support.

Yes, signaling is the magic word here.

We are a nervous system that is looking for signals, signals literally of safety and connection.

And what you really were saying is, so if you go and meet someone and you engage them and have a drink with them,

You make face-to-face contact.

You smile with them.

And you start now creating almost a template of what that person is like.

You start, it says, inferring, is that a person you would like to spend more time with?

Or do you look at your watch or your phone and say, I got to go?

And you're picking up all those signals, and those signals are really signals of whether that person is accessible to you, and are you accessible to that person?

Or are you defensive?

Does that person, in a sense, make you feel uneasy?

You want to get out of there.

And you may have those same feelings doing podcasts and say, wow, is the hour almost up?

Or what am I going to talk about?

Or can I move on?

Yeah, you say that we come into this world with a quest to be safe.

Yeah.

Why?

Because we can't survive by ourselves.

So, I mean, there's a function to all this.

So it's not like it makes it unimportant because it's pragmatic.

It's just how we evolve.

We didn't evolve as an independent, self-controlled or self-contained system.

We needed others in our world.

Mm-hmm.

And for many, especially those who survive trauma, people have great difficulty moving into their worlds or they have difficulty moving to others.

So they often gravitate to horses or dogs or cats.

They want some type of co-regulation from a social mammal.

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What does feeling safe actually mean?

It means basically we can.

OK, so let me flip it on you.

What does feeling stress mean to you?

High heart rate, sweating, tightness in the body, ruminating thoughts, intrusive thoughts, concern, lack of creativity.

Lack of ability to access your capacities.

Yes, yes, constrained capacity.

Right.

So now let's flip it and say, when do I feel I have options to access my capacities?

When do I feel exploratory?

When do I feel expansive?

There are basically two different physiological states.

One supports our physiology of health growth and restoration, and one is very constrained and is costly to us.

And we know that.

We call it burnout or exhaustion.

And we also know that there are benefits.

So safety really is the child of a physiology that is homeostatic.

This is taking care of itself.

That's why when we start to block the feedback loops, because when we talk about homeostatic or the body regulating itself, it has to assess itself and act on itself.

So it's a feedback loop.

But if we numb our own feelings, those feedback loops become less effective.

What's the most powerful force of safety in the human world?

Let's reframe it.

What are the most powerful signals of faith?

You could identify them.

That would be maybe a smiling face, a voice that's prosodic.

Prosodic voices, melodic voices are powerful.

And just ask that crying baby who feels isolated, out of control, and how rapidly that baby will calm down if the mother has a good engagement, good voice.

In fact, we actually did research on this where you kind of like disrupt the baby, and then you talk to the baby and see what happens.

And if the mother's voices were more melodic, the baby's heart rate dropped almost immediately.

The mother engaged without a melodic voice.

No way.

Yeah.

So when you get your dog, you can try this all out.

Yeah, I will do.

I would say if you had a child or if you have a spouse or a partner, you can try it out as well.

Yeah, child soon cometh.

I need a little bit more time on that one.

Okay, so to sort of recap where we're at, is it right to say that your position is...

Our ability to connect with others is fundamentally a biological state and not just a psychological choice.

Feeling safe enables curiosity and empathy and social engagement.

Yeah, I think that's quite accurate.

I would kind of reframe one word.

I would say our capacity to.

Which is not necessarily our ability, so our capacity.

To connect with others.

Yeah.

And so part of, I view my goal in life is to navigate in the, let's say, complex world that has lots of signals so that my capacities can be expressed.

So if I'm in a world that is too aggressive, too noisy, too overwhelming, I can't access my capacities.

Why do some people never truly feel safe even when objectively everything's fine?

I think that's the greatest.

That was the question that got me going because I said, you know, we use this word safety.

And it's not like there's a metal detector.

That's not going to make me feel safe.

It's something different.

And it's because our culture sees threat and the removal of threat as obviously being safety.

It's not.

Safety requires signals, just like threat.

So it's not like take away the signals of threat and everything's fine.

No, you can take them away, but we really, really want signals of safety.

And they will be, you know, watch children playing.

And actually, you think that, like, when we mobilize this fight-flight system,

When you watch children running in play, they're still smiling.

And when you look at them, you feel good.

But if you see children running from a school or something else,

Your body gets a totally different response to that signal because the faces are telling you everything.

So that was the part that really got me going.

This is now we're in the 1990s because the nerves that control the face, the smile, nerves that control the intonation of her voice

Were linked to how that mammalian vagus was working.

So as the mammalian vagus was really sending signals of calming, it was triggering social engagement.

So it was like, this is the broadcasting part of what we can see physiologically.

And the mammal, social mammal, when it evolved, it literally gave a window to that underlying physiology.

So we know by people's voices and faces whether they're safe to come to.

Do some people just naturally in terms of disposition before conditioning

Do some people require a different dose of signaling in order to feel safe?

I've read a little about HSPs, highly sensitive people.

I'm trying to think about how much of personality and how much of safety is really nervous system state and how much do people differ in terms of what it is?

We could actually kind of build a model and say, before we think that it's a locked-in temperament or a personality, maybe it's a physiological state that got retuned and got locked into this more defensive mode.

And so let's kind of look at things optimistically.

The interesting thing or one of the interesting things you're bringing up is that if a person has a history of not having safe individuals in that person's history,

When someone tries to engage them, even with prosodic voices and those signals, they may actually react adversely to it.

Especially if there's a real abusive trauma history.

And you can actually read what's going on in their nervous system.

The nervous system is getting triggered and it hears that voice, that face, and it goes,

Then the body starts feeling those feelings inside the body and those feelings for healthy, I say healthy is not the right word, for a typical nervous system are feelings you feel good.

But if those feelings of feeling good are associated with being abused, what happens?

So you get the feeling, and then the brain remembers, says, been there, this is what happened to me, I'm out of the room.

Surgical interjection, that feels a little bit...

Uh, Skinnerian that feels a little behaviorist-y that we have this stimulus response.

What is it that we have associated?

Is that fair?

Is that fair for me to sort of add that little bit of a twist to how the conditionings occur?

So, so we have in the sense of reflex, which is no cognitions necessary, uh,

And you talk to me or I talk to you or you talk to your dog, and the dog just kind of relaxes.

That's a reflex.

It's not an awareness.

Now, the body responds.

And so you have that feeling.

That's an awareness.

Now that awareness becomes conscious, and then you can associate that with good and bad things.

So there are two different parts of this sequence.

One, my nervous system has a propensity to react.

I can't change it.

That's who we are.

We can get triggered.

It's like,

And this reason I have a smile is that my wife used to say to me, you should be above it.

And I say, I'm human.

I get triggered.

We all get triggered.

And so the real issue is being triggered is not the real issue.

The issue is what happens when you get triggered.

And when you get triggered, your body shifts state.

And what is your awareness of that state?

So when you get aware that your body's shifted state, what do you do?

Do you scream at the other person across the table from you?

Or do you say, wow, I got, people are gonna say, think you're weird, but you say, oh, wow, I must've been triggered.

Where did that come from?

Very few people have the patience

To stop getting in the way of that physiological shift.

They want to create the narrative to get out of there.

What's interesting, you used the example of when you got pneumonia and preferred to be around smaller groups of people, didn't want as much social stimulus.

That...

That shows just how adaptive, not only across time, human evolution, adapting to the environment, creating these different capacities and signaling that means that it's more likely that you'll survive, but even within a single organism's lifespan.

Your system had adapted to see an old stimulus in a new light.

Yeah, yeah.

That's who we are.

We're a flexible species.

And the problem is that when we have things like pneumonia or chronic fatigue or long COVID, that flexibility gets reduced.

And that tends to be a shock to many of us when it happens.

And the up part of it is that there's pathways of rehabilitation.

There are ways in which you can seal the system to slowly gain confidence in itself again.

It feels...

I need to break the fourth wall a little bit for a second, so bear with me.

It feels very...

Timely to be speaking to you.

So you probably won't be aware of this, but a lot of the audience will.

I released a health vlog about nine months ago or so tracking a journey that I'd been on from long COVID, chronic fatigue, Lyme, CMV, EBV,

I lived in a house that had mold with every different polymorphism that you don't want in order to have mold toxicity, heavy metal, like just this laundry list of challenges.

It had meant that I was tired at seven o'clock at night every night.

It meant that no matter how much I slept, I never felt recovered.

I had...

I hated the smell of standing water.

I couldn't stand silence, but I also couldn't stand music.

It's this real sort of big mess.

We get to the back end of last year and I'd made some good progress.

I'd improved all while doing this, right?

Bits of the brain that are associated with word recall, working memory, being in a good mood, all of those were the ones that were being slammed while I was trying to...

Put on a good show and be a professional for a few million people a week and to try and do this well.

So that felt like a big tension.

I go and do a tilt table test in February.

I failed my tilt table test.

Or succeeded, depending on how you looked at it.

11 minutes, full vasovagal syncope, fainted, heart stopped for five seconds.

So for the people that don't know, this is a test for autonomic

Flexibility autonomic response

They strap you onto a table you've got blood pressure cuffs everywhere heart rate sensors on your feet on your hands there's an iv in case you faint and need to come back around

And after you've laid down and done some breathing exercises they raise you up to sort of 70 degrees and they see how your body responds

There's something about that 70 degree angle that um

That your body doesn't like it.

And after five minutes,

I felt a little sweaty.

I felt a little uncomfortable.

I started to feel a little bit sick, but I've done a lot of meditation, a lot of breath work.

And I was like, right, okay, well, this is the time to apply some of your meditation and breath work.

You're not allowed to move at all.

You can't wiggle your toes even a bit.

You can't move your calves.

You're on this special bed.

You're all strapped in, not moving.

Because they don't want you to help your circulation to get a fully valid test.

So I start breathing through it and it gets a little better.

And then it gets quite a bit worse.

And then my vision starts to go blurry.

It's nine minutes in.

And then I start to sweat and it's 10 minutes in.

And then the next thing that I knew...

I was flat on the bed and the nurse had come over me, this small Filipino nurse that was a really lovely guy.

He came over me and the first sentence that came out of his mouth after I sort of came back around was, okay, so your heart stopped?

Your heart's, no worries, buddy.

Your heart stopped.

I was like, hey, dude.

If I've just passed out, okay, I don't want the first words out of your mouth when I come back around to be your heart stop.

Anyway, all of this together, I've got about as...

Strong of a personal investment in your work and in the world of nervous system regulation as I think I could.

This has been unbelievably personal to me over the last two years and specifically the last nine months.

And you're catching me today

This week coming up, I'm going away on my first ever meditation retreat for seven days.

And a big part of the motivation for that has been to try and get my autonomic system back in check to be gentle with myself.

So anyway, I just appreciated you opening up about your case with the pneumonia thing because it felt like it gave me license to talk about this thing.

You have license to talk to me about anything.

So the interesting part is, first of all, it's a slow journey back.

I thought we could just throw a switch.

I had optimism about these things as well.

Basically, listen to your body.

It is telling you things.

I will tell you a similar story when I was getting a heart checkup.

They basically put AIV in me, and the IV started to get loose.

And so I started to tell them, I'd say, twiddle it, and I wanted to do vasovagal syncope as well.

And they then looked at me and they said, what are you scared of?

I said, I'm not scared.

You're basically tweaking with my bowel receptors.

Basically, you're playing with the blood pressure receptors, but they don't think of it in that way.

So they see this autonomia, which is what they're looking for.

Actually, for many of the people who fail those tests, they have a broad, let's say, array of symptoms, and they tend to be treated by the medical community as if there's nothing wrong with them, and yet these symptoms keep coming out.

What I'm saying to you is be patient.

Your nervous system is on a recovery track.

And long COVID is the story that I want to tell you is a metaphor for you to think about.

You survived a pathogen.

You had COVID, and COVID is, for some people, lethal, as you know.

And the other part is that when our body wins the war, kills the pathogen, it doesn't always inform the entire nervous system.

You know what my Filipino friend said to me?

He said, this is what I do.

I'm a technician for the tilt table test.

And prior to COVID, I would maybe do between three and five of these a month.

And now I do between three and five of these a day.

Wow.

I think long COVID or the consequence of the pandemic have been so underestimated.

I've just completed a study on long COVID.

I was part of an interesting government-funded project basically doing it remotely.

And basically the intervention was vagal nerve stimulator, which was developed by a colleague of mine.

And another intervention, a sound intervention that I had developed with basically it's called sonic augmentation technology.

It's a new stuff that I've developed with a colleague called Anthony Gorey.

And what it does, first of all, the vagal nerve stimulator, you know what it does.

It's sending a signal to the vagus and it's basically trying to tell the vagus that everything is okay in your body

And if it tells you that, then it may start connecting to the organism's body and you feel better.

So it's a signaling system.

It's not regulating the motor part of the vein.

It's just sending a signal in.

The sound does the same type thing.

It basically sends signals of literally that you're floating in a rhythmic sea.

It's just like think of the tilt table, but not like that.

Think of it as rocking, slow.

More like a cradle than a tilt table.

Yes.

We all have that visual image like babies coming away and floating in space, but no fear of falling off.

Basically, the sounds had the same effectiveness.

As the vagal nerve stimulator.

It was very profound in terms of what it did over a four-week period.

And so basically we had massive effects on all, basically all the parameters we had

Were measuring, they were all questionnaires and symptom arrays.

There were no blood samples, but symptom arrays of how people felt.

And whether they had fatigue, and whether they were anxious or depressed.

And basically, all the indicators improved in a very, let's say, powerful way, which provided the whole model, whether it's a vagal nerve stimulator or the sound, is that if you know what the signal profile is that your nervous system is looking for,

You can do that.

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Why would it be the case that a dysregulated nervous system...

Would cause people to feel more anxious, people to feel more depressed, them to have lower energy, them to be, why would this huge suite of things occur?

First of all, let's tap you on the back and give you a congratulation for observing and calling out that it is a suite of systems that are effective.

It's not one.

It's not really is.

Just tired, not just sad.

You're not just distracted.

It's not just you have poor sleep.

It's not that your gut isn't working.

It's not that you have tachycardia.

It's everything about your autonomic nervous system's regulation.

So it's a regulatory disorder, and we have difficulty in, I would say we, I'm talking about modern medicine, in seeing a system and seeing the system and its function.

The system is dysregulated.

It's not coordinated in the way that it should.

And we were picking up on it.

And so the issue is, yes, and I'll give you a word that fits in with all this.

Your body's in a chronic state of defense.

It's as simple as that.

It's like you killed the pathogen.

But that information, the success of that war, didn't retune how your nervous system worked.

So it's still prepared for war.

Oh, you're locked into this price.

Oh, that's interesting.

So in the same way as a traumatic emotional event or physical event, a traumatic pathogenic event...

Yeah.

It's all the same.

But the difference is when something has occurred consciously, people can talk back to, well, I got into that car crash.

So getting into cars, it makes sense that that would make me feel nervous now.

The same thing we don't draw because it's below the conscious threshold.

We don't draw the same analogy to-

Because we're numb to our body.

We don't have the language.

So our narrative isn't saying, look, it doesn't matter what was a car wreck or a pathogen or whether someone humiliated me in public.

It doesn't matter, my body reacted to it as if I was going to die.

And this is what bodies do when they think they're going, they don't think, when all the signals are that death is imminent.

So I actually gave a couple of recent talks that I call sentinel trauma.

And that is, how does the body react to the single events of mortal threat?

And I'm actually saying that COVID can be a mortal threat to the nervous system.

And that's the consequence.

It gets hardened as a response pattern.

And you're living through it.

I would say optimistically, you're doing well.

And even your curiosity, so where you're going with it is, and you're going to end up on that journey about understanding about

The body's own feedback loops and how they got challenged.

And that's exactly what they're assessing in the tilt table test.

They're assessing whether the feedback loop is working on your blood pressure, meaning your vascular bed, the vagus, the sympathetics.

And, you know, blood flow.

Now I will tell you one of my exercises every morning.

Yes.

I have a backswing, basically a tilt table in the basement.

Yeah.

Ever see when the back swings?

So it tilts down like that and you can go upwards like that.

Like an inversion table?

Yeah, yeah.

It doesn't go under.

I can't rotate, but I can go like 70 degrees down, 70 degrees up.

Yep, yep, yep.

I have seen that.

Why?

I'm challenging my down receptors.

I'm doing a neural exercise on them every morning.

How long are you doing that for?

First of all, I tilt downward and do basically sit-ups and basically about 10, 5 minutes or so of exercises in the inverted position.

Then I do tilts on each breath, 30 of them.

They're quite rapid.

You would pass out.

Yeah, I bet I would.

Yeah.

But I'm not passing out.

Look, I'm 81.

So it's not like what I'm saying is I'm trying to stay here for a while.

And if I were totally sedentary, my body may think it's too old to do those things.

Hmm.

How fascinating.

Okay.

I think this is important to get into.

Across all of your research, what interventions have you found to be most impactful for improving autonomic function?

Okay, so first of all, if we go back, we're going to go back into the 90s.

I actually was playing around with a tilt table.

I had a motor on it where I rocked people up 21 degrees and then back down to horizontal.

It took seven seconds up, so one, two, three, four, five, six.

So you can start feeling that it's kind of like a very nice rocking, even slower than what you're doing, much slower.

And suddenly, no one wanted to get off the table.

That was the first.

So the research showed that I could entrain rhythms associated with literally vascular bed activity.

I could actually get into that system and exercise those.

But the subjective response, how people felt, was to me the most interesting part of it.

No one wanted to get off the table.

Yeah.

And I never forgot that.

And that's when I started to develop the acoustic one.

I was mimicking what the tilting was doing.

So the issue is that the acoustic interventions, I've developed two of them.

One has been used by a few 100,000 people now, it's called the Safe and Sound Protocol.

What it does is basically mimic the acoustic features of a mother's voice.

So it's broadcasting calmness and engagement.

And they're finding that it works quite well with pediatric populations.

But the trauma population, people have used it with other therapies.

And it's been intertwined with EMDR therapy.

And with various cognitive behavioral therapy and all forms of it, in a sense, to make the client more accessible to the therapy.

So what it's doing is priming a system to be more connected with the therapist.

So what I'm doing, and then the new one I developed, which is called

Sonic Augmentation Technology and the intervention was called Rest and Restore Protocol.

And that was dealing really with visualized basically floating in a wonderful sea without having any need to connect.

You feel so safe.

You don't have to look for someone.

You don't have to listen.

You're just there.

Basically, I called it stealth meditation.

Meditation's too hard, okay?

And the issue is if you deal with meditation for traumatized individuals, they run out of the room.

Because that immobilization now is a signal to the nervous system of vulnerability.

Fascinating.

So, okay, you've managed to isolate frequencies of a mother's voice.

I think it's like 1500 to 3500 hertz.

Is that right?

You read.

Well, yes.

What can I say?

I do my research.

Also, obviously, like, unbelievably personally invested in getting this right.

And that's why layering it into music, making the connection, that's enough to signal safety cues to the nervous system.

Yeah, but it's actually even broader.

So anything, it's like 500 to 3,000 will be fine or...

Basically, it enables the frequency.

Actually, all mammals, even little mice-like animals, they vocalize in a certain area of the auditory spectrum that is very similar if you looked at their full spectrum.

So dogs, cats, and horses overlap with our spectrum.

A band of social communication.

So you can calm a dog or a horse or a cat by talking to them.

Is that part of the reason that we have.

Yes.

Collaborated and partnered with those animals.

So that's so fucking cool.

Okay.

So part of the reason that humans, cats and cats, dogs, and horses.

Yeah.

Have bonded so well is that our frequency of calm when vocalized is in a similar range to the one that they use.

Absolutely.

That is so cool.

It's totally amazing.

And it's so interesting to watch how people talk to their pets.

It's like they have a manual.

Have you ever seen a video, a short video of a golden retriever

And there's two hands down in front of it.

It's on a couch somewhere.

And the golden retriever is going from dad to mum.

And with dad, the golden retriever is used to play fighting.

So he bares his teeth and sort of pretend bites at the hand as he's putting the hand down.

And then when he goes to mum, he just rests his chin on the top of a hand.

But the dog does it...

Two seconds, two seconds, two seconds, two seconds, bite, rest, bite, rest, bite, rest.

And I just thought that was, it's so funny.

It's so funny how quickly adaptive that is to be able to have that.

Listen, my cat does something similar.

My cat likes to mouth me, my hands, not my wife's.

It's the same.

Okay, so if this is the case, right, and safety cues can be cued through...

Auditory input, why not just play this music all the time?

If it's that simple, why not just play the music permanently?

Okay, interesting.

So I had that idea and I decided to play it in a preschool to see what would happen.

I was playing in the preschool, and guess what?

The kids were talking to each other.

They were gravitating near the speakers, and they were very socialized.

I played the same music without the algorithm working.

Modulating it the way I wanted.

They were very solitary and I played other music and nothing happened.

The part was that our nervous system recognizes it.

But here is the problem, and this is a massive problem.

And I thought that we're just there sitting there waiting for love sounds and sounds of connection to occur.

And wouldn't the world be so much nicer?

I forgot that if you come out of a traumatized environment, someone who is

Broadcasting those same frequencies is a predator to their nervous system.

Huh.

So their own history retunes them and keeps them out of social settings.

And again, in the world that we both live in, we know people who have had very bad relationships.

And we also know that they talk about finding the right person, but you know after meeting them, there will never be a right person.

Because their nervous system is not broadcasting signals of accessibility.

That's interesting.

Okay, so what about vagus nerve stimulators?

That's something else that you mentioned earlier on.

How much is real and how much is bunk with regards to that?

Oh, I mean, number one, it's real.

The question is for what and what reason do you want to use it?

A lot of people want to use these things because they think it's a simple way out.

That they can change the context of their life by stimulating a nerve.

And the answer is the nervous system is smart.

If you stimulate the system to be calm and accessible and you abuse it, the nervous system will cut off that feedback.

It will just adjust.

So terms like hacking the nervous system is not the right concept.

You want to make the nervous system available, and then you want to exercise it to expand its range and increase its flexibility.

What does exercise it, expand its range, increase its flexibility look like?

For me, it's like challenge it and let it calm down, challenge it again.

It's like my oscillating tilt in the morning.

I'm challenging the system.

So one might say this is stressing the system, but it's exercise if I allow it to recover.

So the issue is I'm aware that if I stress the system, it's going to pull off its inhibitory or slowing up aspect, so the heart rate will go up.

But then my heart rate will come back down and now I can do it again.

It's like saying to people who have high heart rate and they're concerned about exercising, their system has been retuned and they're locked into a fight flight.

And if they now try to exercise, they can get into a syncope situation where the body just can't adjust, it can't give anything else more out, and it just will shut down.

So we have a real problem in how we conceptualize even our own physiology.

So it's not only our heart rate level, it's the neural regulation of our heart rate.

And that's where heart rate variability.

Actually, what you don't know is that in the 60s, I was the first person to quantify heart rate variability.

That's something that I do know because I did my reading.

That was your first paper, right?

1969?

Yeah.

Right, but here's the real, you're on my good list.

So the real issue is I'm extraordinarily disappointed in the area of heart rate variability.

Because what I was working on was once I observed a phenomenon, the question was, what is causing it?

What were the underlying mechanisms?

What was I really measuring?

And if I can measure it better, in a sense, get closer to the neural innervation, then the measurement would have much greater and better generalization, more useful.

And what happened is that it went back to very descriptive.

So, like, I have a Fitbit...

And the Fitbit is just giving me measures of variance, which is a descriptive statistic.

I've worked on this for decades to develop technologies to pull out the specific vagal influence in the heart rate activity.

And that's basically swept under the carpet.

Speaking of that, what do you make of resonance breathing?

Well, there's something very interesting there.

Well, first of all, when we start understanding that the brainstem's respiratory rhythm is not just affecting heart rate, but affects other things, we start getting into this notion of what would be called resonance.

I have a very simplistic view of it.

I think...

A lot of people think that, a lot.

So the theory is really that there's individual differences in what your resonant frequency is.

I don't think it's that tailored that neatly.

I think our bodies like certain slower rhythmicities.

And that's even like with the music I was really working on.

I don't think it has to be that specifically designed.

And with resonant frequency, they were going at 0.1 hertz or 10 seconds.

I think the body wants to gravitate slower.

It wants to go to like...

Which is really what I was tilting people at.

Actually, I think it wanted to be moved out of our normal breathing frequency.

It wants a different experience.

It wants a frequency that is closer to our normal vascular oscillation.

And breathing tends to be quite a bit faster.

I did a bunch of assessments.

I love this product.

It's called Ohm, Ohm.Health.

And it's a HRV resonance breathing lamp.

And you grab this thing.

Anyway, my frequency is 4.5 breaths a minute.

It's 4.5.

That's good.

That's where I get the highest...

Oscillation between top and bottom.

That's where mine is.

Okay, so vagal nerve stimulators, good, but being used in the right context.

Resonant breathing, interesting and may also play a good role.

Also good, but remember what you were doing, you were doing a lot of interoception with your resonant breathing.

You were not only looking at what the numbers are, you were assessing what was optimal and how you felt.

How I felt.

So you were really closing the loop of the sensory part with the motor aspects.

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I guess that's a really good question.

So there's a ton of different interventions, humming, chanting, a variety of other interventions that we could use.

But

How much of what we're trying to do requires some relational aspect between us and another person?

Because there's the...

Physiological intervention, vagus nerve stimulator, using a tilt table up and down, breathing at a particular rate, but then that perhaps stresses and then relaxes or relaxes and opens up tolerance for your nervous system.

In that window, is that important beyond just the interoception thing to say, hey, and now I'm going to start to relate to the world around me, like a social exposure therapy or nervous system exposure therapy within that newly calmed window?

Yeah, well, that's exactly how the safe and sound protocol is being used in clinical interventions.

It's not being used by itself.

It's being used to make the client more accessible to the intervention, which may be the therapist herself or himself is maybe what the actual stimulus may make the therapist more effective.

So you're engendering a state which is one of calm.

Would it be fair to say sort of a broader flexibility within the nervous system for a little while?

Absolutely.

You're creating a window.

Yep, of tolerance.

And then in that newly expanded window that's going to exist for a little time, you're going to expose yourself to some interventions.

And then once that's closed off, the goal is to increase that window of tolerance from state to trait.

Yeah, well, this is exactly what several therapists are using the safe and sound protocol with, with extraordinarily sensitive people.

So go back to your initial interest, which is on hypersensitive people, which is something you brought up.

They found, or some of them found, that just listening for, let's say, a few seconds or a

Has had effect but they tend to react

They found that if they start to expand over days how much they listen to they're creating in a sense with a tool they're opening up the window for longer and longer periods

Yep yep okay uh why do singing and humming and chanting karma so much

It's a very easy answer.

It's because they're recruiting.

I could actually say, why does eating or ingestion calm us?

You have enough resources

To sit down and have this food that suggests that there's not a threat.

Also, it's a reinforcement that there's calories, so you're not in starvation mode.

No, too smart.

You have to go back there.

That's a problem I have all the time, Stephen.

It really is.

Well, you're building your narrative.

When all you needed to be was a simple observer, and that is you watch a baby suckling.

And what you realize is that the nerves and the neuromuscular control of sex while in breathing, that coordination, are the same of social expressivity.

It's the same thing.

So we're, in a sense, using the same neural system

When we ingest than when we are interacting with others.

And this becomes really, in some of my talks, I say we try to share ingestion, but not digestion.

And digestion is a private matter.

It's a dorsal vagus.

Ingestion is the ventral vagus, which is our social engagement system.

So we say, let's get together and have something to eat.

That's a social act.

And in fact, if we start tracking the history of society, ingestive practices or rituals literally are part of the history of community.

You know what's interesting?

I had a communication expert, a guy called Chase Hughes on the show a couple of weeks ago.

And he deals in microexpressions and body language and some interesting things.

And he had one insight around...

People who are feeling anxious and unsafe.

He says that they tend to keep the inside of their arms in close.

They don't want that brachial vein to be exposed.

But one of the other things as I was got him to break down a killer.

Who was being sentenced, this guy that had done some pretty heinous crimes.

And he highlighted that as the...

Sentence was being given to him and the judge was reading out what he'd done and sort of giving him his dressing down.

He was there and his tongue came out just a tiny little bit, licked his lips and then pushed back in.

And I said, what's going on there?

And he said, well, it's a vanity thing.

Moistening the lips makes you look better.

But also as a baby...

Who is pre-verbal, the first no that you have is

Because it's pushing whatever is in your mouth, maybe a nipple, out of your mouth.

And he had that as a human's first no.

And I have no idea if it's true, but I thought it was really cool.

All these things can be true, but there are other parsimonious strategies.

If you're getting a sentence...

Do you think your mouth will be drier than if you're getting an award?

So it can be really the body's dehydration at that.

The adaptive reaction is to kind of re-lubricate your orifice.

I think- Re-lubricate your orifice indeed, yes.

Yeah, okay.

That's another point because-

Anyway, another time.

Let's go to this bit.

For me, I basically talk about this is accessibility when the arms pull out.

Okay, that's showing the ventral side.

And like with my cat, my cat loves to do that.

That's not a normal posture for a cat.

But she loves because she likes her belly to be rubbed.

She wouldn't be doing that if she was underneath a foreign parked car out on the street.

Or a stranger.

But this is really, we hold in, we protect the ventral side.

So the issue of the evolutionary history is the ventral side is a side of vulnerability to injury.

And it becomes how we protect ourselves versus not.

So part of the bracing, symbolic, if I were to sit like this, you'd have a different interpretation than if I were like this.

What's the biggest myth about anxiety from your perspective?

Anxiety is the body being in a defensive state.

Simple as that.

We don't need the word anxiety.

We don't even need many of the words that we associate as emotion.

The characteristics of anxiety are we're mobilized.

Why are we mobilized?

Now, what people like to say, I'm mobilized because I have to get something done.

But what we notice is that, quote, anxious people, it doesn't matter if they get it done.

If they get it done, they're still anxious.

So that's just the narrative of how they are explaining their feelings.

So the myth about anxiety is that it's outside of us.

When it really is, we're really broadcasting our physiological state.

I guess a lot of people may feel, and obviously very self-serving, they go through periods of life where new

Lower tolerance periods, lower tolerance abilities with regards to how much stress they can put up with, how much energy they've got, their startle response, their level of ambient anxiety, their capacity to deal with stress and change and uncertainty and ambiguity and stuff where that gets constrained.

Yeah.

What's the difference between somebody who gets locked in from that situation and somebody who ends up bouncing back?

And how much resilience can be re-inherited after it's potentially been damaged?

Okay, so you're living through a recovery phase post-long COVID.

So you know exactly that your range of resilience is different than what it was pre-COVID.

Correct.

But you also know that it's getting greater than it was immediately after COVID or during COVID.

So you have a trajectory that you can assess.

So the part of it is that we tend to think that if we're not flexible, we're not trying hard enough.

And the issue is we have to understand what it is that is implementing the constraint on us.

Our nervous system wants to blame something outside of us.

It tries to blame, let's say, colleagues or bosses or spouses or, let's say, fiscal demands or political issues.

It tries to create a whole set of other issues to externalize feelings that are really being generated inside our body.

I'm not saying that the external ones aren't real.

They are real.

But the issue is it's not that they're not real or not that they are real.

It's how we deal with them.

So we can't solve the problems.

We can't navigate in the complex world.

If our body's in a state of defense.

So what I've been working on is this whole idea of what optimizes our ability to utilize or gives us the access to our capacities.

And that should be really the real question we should be asking.

Not what is your capacity, but what gives us access to our capacities.

So what you experienced and are experiencing is that the capacities that you know that you have were being compromised.

And that

Creates a conundrum.

You don't understand why or how you want it to be fixed.

And the answer is the nervous system is really broadcasting a message that those capacities are not accessible.

It's not that they haven't been taken away, but they're just not accessible.

So the real question is what enables them to be accessible.

And that's where we move into the concept that our physiological state, how we start the conversation, our physiological state is really giving the boundary conditions of permission for these capacities to be expressed.

But the problem is when it's giving us constraints, how do we reverse that?

That's part of our whole dialogue and that is, it's all going to end up with signaling the nervous system that it's basically okay to come out and play again.

It's almost like, is it safe enough to come outside?

It's like a horror movie.

Our nervous system wants to be reassured.

And this is difficult because we do not know the signals.

Our culture is horrible with signaling our nervous system.

Just think about the traumatic events of schools with mass shootings.

And the solution is give guns to teachers and principals and put metal detectors everywhere.

What is that doing to the nervous system of these children?

I mean, it's not like metal detectors aren't useful and having someone with a gun may be very adaptive in complex situations, but those are profound signals to a developing nervous system.

It's so interesting how because people's nervous system states aren't anywhere near as visible as pretty much anything else.

If you had dirty drinking water and that impacted the way that a child's digestion worked, or if you had loud music and it was obvious how distracted they were, if you can see stimulus and response quite easily-

The fact that the pushback against that intervention would be quite obvious.

What we don't see, for instance, like, are humans built to see assassinations live streamed on X, you know, within minutes of it happening, posted around the world?

Are we supposed to watch movies and car crashes and, you know...

Well, you know the answers.

You know the answers.

Of course.

But the question is, you start with a very interesting and very important question, and that is if our nervous systems were visible.

And I'm saying they are to much more of an extent than you think.

Because people's faces broadcast, their voices broadcast, their muscle tension broadcast.

Can you explain what a low tolerance nervous system expressing person and a high tolerance nervous system expressing person, how would they show up differently?

Okay.

First of all, the face would be flat and you've seen flat faces, especially the upper part of the face.

The lower part, you have much more control, and so you can make false smiles.

But the upper part tells you really truthful emotions or feelings.

The other one is intonation.

And again, this is from your seat as a podcaster when you're –

Interviewee has a monotone voice or a high-pitched voice.

It doesn't show any flexibility.

It's just broadcasting to your ear and to your body anxiety.

So they're broadcasting their physiological state.

And I think when you brought up your question about anxiety, it's a rhetorical question.

If you spend time with someone who's highly anxious, there's no doubt that your body is feeling their anxiety.

And what are you detecting?

What are the things that you feel?

You basically say, I don't want to be around this person.

You make a gullible statement and you try to distance yourself.

You haven't really, it says, gave the simple answer.

The physiological state that that person is in is broadcasting that state to me and it's bleeding all over me.

Yep.

And so what it does is it changes our responsibility in the world that we are in.

We feel as a species that we can say whatever we want.

It doesn't matter how we say things.

It's what we say is important.

And I'm saying it's how we say it becomes as important or more important.

Yeah.

How we utilize this wonderful apparatus of vocalization.

Okay.

How do you advise people to increase their window of tolerance and build safety practically?

Then we talked about a variety of interventions.

What's something that's high compliance, high impact?

Well, you actually brought up things that people are doing.

They're working on breath.

I would say when they do breath, they start really working on their own internal feelings of the breath.

So they're helping the feedback loops become more enhanced.

I think, you know, like resonance breathing is powerful.

Yoga breathing is powerful.

I think part of what's missing, again, even in the world of, let's say, elite athletes and exercises, people are not saying as you exercise, go into the exercise and feel your body responding to it.

So we put on the television while we're on treadmills.

We don't take the exercise as a moment of zen.

Why is that important?

Why is it important to feel the thing that's happening?

Why is it not enough to just do the thing?

Ah, this is where the nervous system comes in.

If we're not feeling it, we're in a sense down-regulating the feedback loop of the feelings of the sensory information coming in.

We're dampening the sensory information.

And I don't think we appreciate the, I would say, the power of what sensory information does to our brain.

And so even like with the concept of the vagus, which has a lot of press, 80% of the fibers of the vagus are sending sensory information to the brain.

80%.

It's an internal surveillance system of our body.

Our body craves that information.

So are you suggesting that the...

Because 80% is going Vegas up and only 20% is going brain through Vegas down,

That by paying more attention to the breath as you're doing resonance breathing,

To the sounds as you're doing safe and sound protocol,

To your body as you're exercising, playing and dancing, that you're...

Opening up the aperture inside of your mind to pay attention to that 80% that's coming back up.

I'm saying it's not even paying attention.

It's allowing the feedback loops to complete themselves.

This is all metaphoric, by the way.

There is absolutely, as far as I know, no research on this, but it is, in a sense, the whole...

I would say underlying or implicit theory behind meditative work, meditative breath, that is that we can literally travel, or body scans where people literally try to travel within their body, that it may sound like it's kind of weird or woo-woo, but think about what you're doing.

You're allowing the neural circuits

To send information into areas of your brain that have a degree of awareness, and then to act on that, or allow, I would say act on it may merely be

To be more patient and more reduce your own muscle tone.

So we think of activity as skeletal motor, but some of our activity is visceral motor.

Our organs and cranial motor, like the muscles of our face,

Is we have to start to appreciate these different sources of motor systems in our body.

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How important do you think metabolic support is to provide a window of tolerance to somatic interventions?

In terms of mitochondria, that?

Yeah, yeah, yeah.

Oh, I think, okay, now we start talking personal information.

So I had...

Um, let's say I had radiation and I had prostate cancer and I had treatments and the treatments really wiped me out and they wiped me out so much that I couldn't walk up a flight of steps.

And I, you know, I just was gone.

And, um,

In fact, we went to Greece and I couldn't even go to the banquet.

My wife was talking at a conference.

And the conference was on physiology of stress.

She's an endocrinologist.

By the way, she's the person who discovered the link between oxytocin and social behavior.

Sue Carter, that's my wife.

So she basically talked to the organizer, who was a very famous stress physiologist, and said, what's the matter with Steve?

You know, Steve wasn't going to come.

And so he said, it sounds like mitochondria.

Okay.

And then we talked to someone else, and we got the answer.

The answer was there are supplements available.

That kind of signaled the mitochondria to come out and play again.

And the one I took was called L-carnitine.

It's over-the-counter.

And I was now, I couldn't even walk a flight of steps or walk to my office.

I took that, and the next day I did two miles on an elliptical.

So it was a switch change, and actually it may be helpful to you as you recover from long COVID.

So what it is doing is signaling the mitochondria and the ATP production.

It's basically saying, come out and be productive again.

Right.

So could it be the case that you could be doing the work from a... Yeah, you would be metabolically incapable of the work having any impact.

Bingo.

Yeah.

And the issue is you need certain resources.

So you need the nerves have to communicate.

And there's another thing.

About like neurotransmitters are part of that, and we haven't discussed that at all.

But I will tell you that for, I'll say decades, I've been taking lecithin, which has a phosphatidylcholine, a precursor for acetylcholine.

Because acetylcholine is used in vagal nerve transmission and a lot of other neurotransmission, and fish oil.

So I've been taking a lot of precursors that are useful in neurotransmission.

I'm interested in...

The sort of journey or what happens if someone goes from having this narrow window of tolerance to regaining safety again?

Why is it that the nervous system seems to oscillate between hypo arousal and to hyper arousal?

Okay.

What you have, and actually I got an email from a physician from the UK who says, the letters start, I have a client who's suffering from the polyvagal syndrome, which I had no idea what he meant, but I read through it.

And what it really was exactly what you're saying, moving from hyper to hypo.

And being poorly regulated in between.

That's because access to that ventral vagus is not there.

So the system goes in one direction and then goes in the other.

When you have the ventral vagus, it's kind of like a choreographer.

It enables us to repurpose fight-flight into play, repurpose immobilization into intimacy and restoration.

So it's like this social net that's over us.

And when it's there, these other components really basically serve our needs.

But when that's gone, we are basically functioning like...

In a way, almost decorticated animals.

It's like we're down and we don't have this master regulator.

So we're a regulated system.

Oh, yeah, you're just much more at the mercy of everything flip-flopping from one side to the other.

An element that I wasn't aware of

But there's a paradoxical relaxation and startle response where the nervous system interprets parasympathetic states as threats.

So as people start to relax...

As they start to get below the window of tolerance on the bottom end, their system sees that as a threat and bounces them out the top.

Why would that be the case?

In a system that needs more relaxation, why would it bounce you out the top?

This is what we talked about.

The interception of that calm state is now associated with vulnerability and injury.

Right.

So it's, in a sense, our higher brain structures sabotage us.

So the lower brain says, relax, you need it.

The higher brain says, can't relax in this environment.

It's to is prioritize this threat.

Hmm.

And I guess this is where the safe and sound protocol would come in.

Slowly, slowly with those who have that type of history.

I would say the greatest surprise to me on this interesting journey was that the safe and sound could be a trigger for people.

Meaning it could create defensiveness.

And I had no concept of that in my theoretical model.

So how does something that only is broadcasting signals of safety or calmness, how can it be responded to?

And then you start asking the question,

Who are the people responding?

What are their clinical symptoms?

What's their history?

And then it becomes a script.

The script is that they were injured by, let's say, a biological parent.

And so the vulnerability to signals that are in our DNA become signals now of threat.

Why does tinnitus often show up in highly activated people?

What is it about the ear that's got, I know some of your research has gone into the ear territory.

Yeah, the issue with tinnitus, tinnitus is just, let's use it, it's not a very descriptive diagnosis.

So the history of tinnitus is that people thought it was, in a sense, in the ear.

And they actually did such things as aggressive surgeries and removed the entire internal ear structures

The tinnitus was still there.

God, you would be really annoyed if you had your ear structure removed and you were still hearing ringing in your head.

That's right, because it was now the solution to that is basically it's on the auditory cortex, that type of tinnitus.

And the solution now is actually they put a stimulator on the auditory cortex to scramble those sounds.

So that's one type of tinnitus.

I have tinnitus or had it, and I have something called an acoustic or vestibular neuroma.

It's a nonmalignant tumor on the vestibular branch of the auditory nerve.

And it was discovered because I started to get severe tinnitus.

It was like...

Hearing sounds of being in the kitchen and people throwing dishes, it was not a calming humming, it was a lot.

And then I actually, okay, so two issues on that.

The medical community, this is 2002,

Said there's only one solution, and that is you need to have surgery.

I said, well, what will that do?

They said, we're going to have to cut this out, the tumor, and you'll be able to have hearing.

However, you're going to lose hearing, which is really the consequence of the surgery.

And

You know, I'm not your average or your normal patient.

So I went and did my literature search and I started to read.

The publications were not giving me any information, but the conference papers, which are done before publications, start to tell me about what would be called watch and wait.

And they basically said, look, a lot of people don't get surgery, nothing happens.

They live.

So it's not gonna kill you.

And if it grows big, then you, which is extraordinarily rare,

Now, what I found out was that when I was, quote, stressed, the tinnitus would bother me.

Okay, this is where your question is to focus on.

And in fact, this is now 25 years ago or 20 years ago.

Now in Miami, visiting my father and grandparents.

And I'm driving across a railroad track.

And on the tracks, as I go to the tracks, the dentist is going on and off, on and off.

Okay, so there was a physical component, and what I was dealing with was in the literature, when I read the material, there was an inflammatory component to the expression of the tumor.

So I started to take high doses of fish oil, and the tinnitus disappeared.

Fish oil has an anti-inflammatory.

So what I'm saying is that what I was getting, my temperativeness was due to the actual nerve being inflamed.

And I could control that.

With fish oil.

So I was very fortunate.

And now I don't even know that I have tinnitus.

Why would it be the case that a dysregulated or a lower tolerance system would worsen tinnitus?

Why is that?

Well, because inflammation is part of that defensive system.

Okay.

Yeah.

Okay.

So let's go back.

Rewind the tape.

And we're talking about clusters of symptoms that are together.

Inflammation is one of them.

So the whole family of things happen.

It's not merely your heart rate gets up, your regulation of heart rate and sweating.

The inflammatory component is there as well.

Yeah, that makes complete sense.

I'm interested in the link between the vagal nerve and the gut microbiome.

What do you make of that connection?

Well...

Just remember that 80% of the vagal fibers are afferent and where's the vagus going is in your gut.

It's really monitoring your gut.

And I would think most of or many of the vagal afferents are really gut receptors.

Why would that be the case?

Just because digestion is really important?

Yeah, it's not digestion.

It's toxins.

And the other thing, you have to think about what your gut is.

It's a farm.

It's a farm for molecules that your body needs.

Think of it that way.

You're raising all kinds of things in your gut.

The flora of your gut is complex.

Mm-hmm.

So basically, I've actually been doing, the past decade, quite a bit of work in gastroenterology and was showing that most, a lot of these syndromes within GI, which,

Is also another one of these disciplines where it's very hard to document pathophysiology with the symptoms, that the autonomic nervous system is highly dysregulated in many of the individuals who have gut problems, including chronic vomiting syndromes and symptoms like that.

What direction is that going from?

Is that low tolerance nervous system giving you bad gut?

Is that bad gut giving you low tolerance nervous system?

What do you make of the gut biomes effect on the nervous system?

Okay, you need to do some resident breathing now and realize that when we talk about a system, it's bidirectional.

Is really sending up signal, and we know we can influence by how we feel.

So we know our gut reacts to things happening in our environment.

And we know if we have a stomach ache, really, our capacity has become very, very limited.

So we know that the sensations from the gut can disrupt our daily life,

And we also know that our daily life can disrupt how our gut works.

Now we start talking about what it is to be having a system.

Another thing that tends to be missing from our own narratives of explaining how our body works.

Is there a sex difference in how nervous systems operate?

Well, for decades I've tried to neglect that question.

My wife has always informed me that there are sex differences.

The answer is probably.

I mean, I think we can say that there are some basic mechanics that are in a way asexual and that systems work the same way.

But there are different demands on, let's say, different sex as a subspecies, different demands on women than on men and at different times of their lives.

So there's a time course that's going to be different.

I think it's so understudied.

Because most of the research on health has been done on males, because females had more variability, and especially when it comes to clinical trials, variability kills you in clinical trials, because people wanted cause and effect relationships.

I think what I'm interested in around the sort of sex difference for nervous systems is...

Male socialization, antisocial behavior situations, loneliness, stuff like that, certainly seems to show up in men more than in women for a variety of reasons.

I'm wondering whether male socialization is partly a nervous system challenge.

Uniquely?

I don't know.

I mean, I haven't thought of it that way.

I keep thinking of our socialization process of males and females and the history of humanity, which was different social circuits for men and for women, historically.

And the issue and also the notion of birthing and how that was really a communal event.

Uh, I'm actually more interested now in the other part of the lifespan.

And that is how poorly we as a species are doing with end of life.

Um,

Which is not really discussed or worked on.

And so I'm getting very interested in palliative medicine and with a desire that we have tools to enable us to literally smile and wave goodbye at the end of our

Duration here uh as opposed to trying to preserve life and make people fearful of the dying process

It's interesting yeah i mean think about it because uh how many how many uh episodes have you had interviews on 1150 maybe okay

How many have talked about palliative care end of life

Less than 10.

Yeah.

And we're all going to die, right?

I think.

And it just gives you a glimpse into how we are so unprepared for the, in a sense, the whole life, the passage.

Yeah, I think it makes at least a little sense about why, especially around nervous system, people understand that something which impacts you at the beginning

Lays the foundation and can be an echo which is heard throughout the remainder of the journey

We don't talk about grandparent trauma

We talk about childhood trauma because the trauma doesn't tend to move backward in time

It tends to move forward in time

So I understand why it feels like investing in an early stage startup as opposed to a company that's very mature because

Well, how much more is there to go?

But you're right.

I mean, like everybody is going to pass away.

And the fact that we haven't looked at palliative care with the same level of scrutiny.

Even compassion.

Let's use the word compassion.

Well, it's the one type of discrimination which is still almost universally accepted is ageism.

Right.

Like it's the one thing that you're never going to get pulled up for.

You can say on a daytime TV show, you can say on a comedy show, you can shout it at somebody that cuts you off on the street.

Has anybody ever stepped in and said, hey, hey.

Don't talk about his age like that, man.

Like no one's stepped in to do that.

People have said it about race, about sexuality, about gender, like all of these different things.

Ageism is this one that Arthur Brooks told me this.

This is the one that's through the cracks.

Is not very accommodating for people who are getting frail.

Well, you are spinning yourself upside down a couple of times every morning.

I'm doing fine.

I was going to say, the frailness thing, I wouldn't... No, but the issue is, when you're doing fine is when you should be exploring the future, is really what I'm saying.

Yeah.

Just going back to the...

Sex differences thing you've said that co-regulation is is the biological basis of love that we literally regulate each other's nervous systems

What do you think are the implications when a man has never experienced consistent co-regulation like potentially especially from a father um

I think we can see that in, let's say, the politics of today, so that our culture is not...

Okay, so there's a lot of...

Okay, the consequence of what we're really saying is the experience of being vulnerable is part of the experience of having relationships.

And if we can't cope with our own vulnerabilities, then we have difficulty navigating the world we're in.

And I think there's times when

Uh, being bold or being impervious to, or not acknowledging vulnerability serves us well, but there's also other periods where it basically locks us out of community.

And, uh,

I'm kind of watching this because, to me, the script of life is becoming, I think, what you were saying about things that happen early in life, we can see it moving on.

I think that script is now, to my mind or my eyes and my ears, become quite predictable.

You know, it's like saying I can see the consequences and the issue is it doesn't fit with my view when I was young.

My view was, A, we can all be who or whatever we want to be.

I was quite an idealist and I basically felt that options that I could do

Everyone else could do.

I didn't have an appreciation of, let's say, the permissiveness that was given to me through my, you know, through whatever.

Lineage I had or the opportunities I had, I didn't see them as special.

And I didn't see the skill set or the insights as special.

And I think part of what, because we're trained in a sense to have a type of humility.

What I'm saying is that the concept of really being compassionate and benevolent

Is really an understanding that others don't have what we have.

It's such a good point.

I had a conversation with a friend in Bali earlier this year.

I mean, I'm explaining to him about this journey that I've been on.

I've spent...

Two years trying to piece myself back together after mold, Lyme, EBV, CMV, long COVID-y stuff.

And then just as I've got myself to where I felt I'd made really great progress, this dysautonomia kicks in.

And now I've got this new fight and I'm...

So I'm irritated.

I'm tired.

I'm agitated of having to do this.

I'm starting to get apathetic.

I'm like, I'm just constantly having to be strong and having to show up.

And I'm even trying hard at not trying hard.

I'm trying hard at being empathetic.

I'm trying hard at doing this stuff.

You gave me this big, long voice note in response.

And I think it speaks to what you're saying.

And he said, I don't know of a single person

Who has fully and truly understood humanity without going through a long period where they didn't know if they were ever going to get better.

He said, this is the difference between just having a hard time and having a life-changing difficulty that you face.

Because in one of them, everyone's been through a hard time.

Everyone's lost a job, everyone's lost a parent, everyone's lost a whatever.

But the difference he said is not knowing whether or not you'll get better.

And that, that is so true that now, when I look around,

I've got more compassion for people who are ill.

I've got more compassion for people who are struggling with addictions.

I've got more compassion for people who are seemingly annoying.

Even stuff that you think is elective.

Everybody's got compassion for somebody that was born disabled.

Everybody's got compassion for someone that was abused as a child.

But what about that person who just never seems to stop, is never able to stop talking about themselves and their accomplishments?

And I'm like, I see so much more now.

Hey,

Something's happened at some point in this person's past.

Either something's happened to them or they were born and this is something that they are the predisposition, right?

They didn't get to choose either of these things.

Like, fuck, like, as annoying as you are, I should give you a lot of compassion.

And that has been...

That's been born out of this experience the last two years of really trying to sort of grapple and battle with this thing.

That's been the biggest takeaway, humility and more compassion.

Yeah, Chris, as I listen and hear the array of vulnerabilities that have hit you, to me, they're all the same.

Even the hypersensitivities, the sensitivity to mold, the system does not have resilience.

That's what you're saying.

Now, this is where the beautiful big cortex is useful.

So we evaluate, okay, my system does not have resilience.

I can move my system into places where it's going to be less vulnerable.

Now, what does that mean?

It means different things to different people.

It's all based upon whether your daily demands like doing podcasts are nourishing to you at this stage of your recovery or they're not.

And I think that becomes the first question to ask yourself.

I mean, I'm just talking to you as a person, not as a therapist, but as the observer.

And I think that's really the first question that you really have to come to grips with because that is, in a sense, containing you is the work.

And this is what you do, this is how you define yourself.

And the question is, if you didn't have that to define yourself, how's your body going to feel?

So the issue is you can't deal with the vulnerability of the disease entity that has invaded you

Unless you can deal with how you can feel without the container that may now be contributing to the expression of the symptoms.

Dependent on whether it feels nourishing or sapping.

That's right.

Very interesting.

One thing I haven't mentioned, what do you make of stellate ganglion blocks?

What do you make of SGBs?

Yeah, well, so Eugene Lipoff, who I know quite well, is really one of the originators of that.

And I'm very, okay, from my view, it's turning, okay, it is actually something that we alluded to implicitly.

If your sympathetics are now overextended,

You're going to be locked in fight, flight, and you're going to continue to do that.

And if you downregulate them, the parasympathetic calming has an opportunity to express itself.

That's what I think is happening.

The stomach anglia is actually dampening that whole limb of the sympathetic sufficiently that the parasympathetic vagus can start to express itself.

Okay, but...

The utility of it has been really in terms of the world of trauma or PTSD, as far as I can tell.

And PTSD is manifest in different ways.

There are people who are locked into a state of fight-flight.

And I think that's really the great toolkit to help treat it.

But there are those who are kind of locked into a shutting down, withdraw, and immobilization.

And I'm not sure if that's going to be helpful for that group.

Yeah, that's interesting.

I've seen some research that says deeply traumatized baby mice require three generations to get back to a normal nervous system state.

Do you feel like that's true for humans?

You're asking what I call...

Okay, so they

Talk about intergenerational trauma.

I like to use the word transgenerational because I think the country where we live, and I imagine the UK as well, historically, is a transgenerationally traumatized environment.

And what it doesn't, okay, you don't have to assume that it's epigenetic, so the genes have been modified and transmitted

All you need to think about is what is the culture?

So think of the UK and the private or the boarding schools and basically stripping kids from childhood and then making this the elite.

Yeah, this is...

And totally- These are the trendsetters moving forward culturally.

Yeah, or they were the leaders.

So I met a, actually became a friend.

He's written a book called the, basically about the damaged elite of the UK because they become the prime ministers and all these other people.

And he's really saying their bodies are locked into states of defense

So their ability to be compassionate is quite compromised.

Oh, that's so fascinating.

And then you're in an environment which probably makes that worse.

It rewards a stoic stiff upper lipness.

I am not affected by this.

I'm a safe pair of hands to drive this organization forward.

Or even the bit about the English view of sexuality, do it for the queen.

I've never pulled that one out.

If the line was, it will be over in a few minutes, just don't worry about it.

Yeah think of think of queen and country and just keep going yeah yeah yeah it's it's not one of love and engagement and connection it's something else duty it's closer to duty yeah right okay um

Obviously, you've been working on this theory for a long time and it's unbelievably influential.

What are the strongest criticisms of polyvagal theory in your opinion?

Which criticisms do you think are fairest?

Okay, so my view is this is quite a trigger to me because the criticisms are not of the theory.

The criticisms have been misrepresentations of the theory.

And so I don't mind criticism because they will improve articulation of what this is.

Every criticism that I've seen

Has been really a misrepresentation of what the theory said.

And really, what you have are people who think they know what the theory is and who are making statements.

And I...

I'm interested, what are the most common misconceptions when criticisms are being lodged then?

They don't understand the evolution of the vagal system.

The fact that the nucleus where the vagus comes from in the ventral vagus is an older nucleus long before mammals is fine, but it didn't have cardioinhibitor fibers until mammals had it.

So they don't understand the distinction between an anatomical structure and its actual components neurophysiologically.

They basically don't understand that polyvagal theory was never about the nerve.

It was about the organization of this integrated brainstem system.

They just don't understand what it's about.

And what does that lead them to wrongly conclude?

What are the implications of not understanding that?

What's the criticism that's levied because of that error?

Oh, well, they say it's not based on physiology.

And what they've done is misrepresent every point of it.

And they may quote accurate physiology, but it's not relevant to what the theory actually states.

In fact, I created AAI, Polyvagal Scholar, and it has one basic rule.

You have to have fidelity to the theory.

And I have not gotten a criticism that it doesn't basically kick out because the theory has not been accurately represented.

In a sense, the theory has evolved over decades with more clarification

And I'm just finishing two papers.

One is on an architecture of the theory, but it's not of the Vegas.

It's of this whole mammalian organizational system that enables us to

Co-regulate, it enables our social behavior now to impact on our health and physiology.

And they miss all that.

They get stuck into something that doesn't exist.

And this has been going on for almost 30 years.

So it's like, you know, I basically have said this, read the papers.

And if you can't read them, you know, don't tell people that

You have I mean it's like but I will also say that it's double edged the more people criticize it the more lights that are shining on it

It's like it's not unknown.

And it's really interesting because the clinical world, which really gave it traction, it works for them.

The interesting part is the neuroscience world is too, let's say, siloed to understand the organizing principles of it.

So it's kind of like...

Ahead of its time or pulling things together because it requires an understanding of the interaction of too many components.

So you can't criticize the theory based upon the vagus.

You can't criticize it based upon any single pathway because it's not about that.

And by criticizing on it, you're not understanding what the theory is stating.

So,

I'm actually extraordinarily confident that time is – I may not be here, but it will survive me by far.

And the issue is because what I am now writing about is giving people a toolkit to understand what the theory is so they don't get pulled into, let's say –

False arguments.

What I would say if someone criticizes, show my one basic statement.

Show me in the literature where I made that statement.

Simple as that.

And I mean, that's all I'm asking.

And the bottom line is it doesn't really matter to me if you want to argue with me.

It matters to me if you represent my work accurately.

That's my...

I'm going to use your statement when somebody misquotes me on the internet as well.

Yeah.

Well, see, that's the world you're in.

And to me, the internet world and the social media world is so vulnerable because people can say anything.

Hmm.

But they can also say that you've said anything, which is the false accusation equivalent.

All right.

We spent an entire episode talking about when people's nervous systems are too dysregulated, too sensitive, a window of tolerance which is too constrained.

Can a person's nervous system be too safe?

Lead to risk aversion, lack of ambition, inability to tolerate challenge, like the pacification of people.

Is there such a thing as too safe?

Okay, so what I see, I wouldn't...

My interpretation was, what if a nervous system feels too safe?

Does that make them too vulnerable?

See, I'm actually going to the other side.

Yeah, yeah, yeah, yeah.

And I actually was very concerned about that.

I was actually thinking that that was a possibility.

And the issue is, so it's like, if I feel safe, am I going to not detect signals of danger?

That was my concern.

And I basically, I feel much better after pondering this for quite a few years, that our nervous system, the healthy nervous system that has the capacity to

To connect and to basically love and share and trust is usually the nervous system that can detect threat as well.

So it's like we're talking about a well-regulated system that enables this co-regulation to occur tends to be the same system that can adjust and navigate to this complex world.

World unreal steven porges

Ladies and gentlemen steven you're so great uh i've got

I have a million more things i want to talk about about relating about child rearing about uh pediatrics and stuff but we can we can save that for another time

Um i just really i really appreciate you

I really appreciate you giving me uh

And everybody a language with which to experience or to understand the way that we experience the world.

I've been on the front lines of this, so to speak, with my own sort of priorities over the last two years or so.

I've come to basically believe that

Our nervous system, we are our nervous systems when it comes to the way that we interact with the world around us.

And it's the single most influential thing in terms of how we experience the world and how the world experiences us.

So giving us language and insights about how to navigate that and understand it is awesome.

So I just wanted to give you your flowers there.

Well, thank you, Chris.

And my summary of what you just said is that you're polyvagal informed.

I mean, that's when you see the world through the way that you described it.

That's what the theory was for.

It's for us to understand that the nervous system, or what I'm basically saying, our physiological state, is really...

A major component of our behavior and who we are and our feelings.

In my world, that's the world of academia would be polyvagal informed.

In my world of the internet and degenerate culture, it would be polyvagal pilled, but will allow us to do one or the other.

Stephen Porges, ladies and gentlemen, Stephen, you're great.

I appreciate you and I can't wait to speak to you again soon.

Well, thank you, Chris.

Thank you very much.

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[多迷走神经理论：生理状态如何重塑我们对安全、连接与成功的认知]-[Polyvagal Theory: Why You Feel So Anxious All The Time - Dr Stephen Porges - #1128]

📋 Summary

多迷走神经理论：生理状态如何重塑我们对安全、连接与成功的认知

被误译的人生手册：成功与生理状态的错位

进化的三重奏：从生存到社会参与

重建安全感：信号而非消除威胁

结语：从能力到可及性

🎯Key Sentences

📝Key Phrases

📖 Transcript

[多迷走神经理论：生理状态如何重塑我们对安全、连接与成功的认知]-[Polyvagal Theory: Why You Feel So Anxious All The Time - Dr Stephen Porges - #1128]

📋 Summary

多迷走神经理论：生理状态如何重塑我们对安全、连接与成功的认知

被误译的人生手册：成功与生理状态的错位

进化的三重奏：从生存到社会参与

重建安全感：信号而非消除威胁

结语：从能力到可及性

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