The polyvagal theory: new insights into adaptive reactions of the autonomic nervous system
Open accessAbstract
The polyvagal theory describes an autonomic nervous system that is influenced by the central nervous system, sensitive to afferent influences, characterized by an adaptive reactivity dependent on the phylogeny of the neural circuits, and interactive with source nuclei in the brainstem regulating the striated muscles of the face and head. The theory is dependent on accumulated knowledge describing the phylogenetic transitions in the vertebrate autonomic nervous system. Its specific focus is on the phylogenetic shift between reptiles and mammals that resulted in specific changes to the vagal pathways regulating the heart. As the source nuclei of the primary vagal efferent pathways regulating the heart shifted from the dorsal motor nucleus of the vagus in reptiles to the nucleus ambiguus in mammals, a face-heart connection evolved with emergent properties of a social engagement system that would enable social interactions to regulate visceral state.
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Neural structures involved in the Social Engagement System orchestrate the autonomic states of the interacting dyad to both broadcast and receive cues of safety that downregulate threat reactions of defense and promote accessibility and co-regulation.
“The theory elaborates that the neural structures involved in the Social Engagement System (Porges, 2009) orchestrate the autonomic states of the interacting dyad to both broadcast and receive cues of safety that downregulate threat reactions of defense and promote accessibility and co-regulation.”
From Polyvagal Theory: A Science of Safety (2022) · cites this paper as Porges, 2009
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Experimental — accuracy not yet measuredPorges' Polyvagal Theory suggests that midbrain brainstem structures can initiate vagal efferent pathways that are responsible for generating adaptive responses during fluctuations in arousal.
“This also aligns with Porges’ Polyvagal Theory, which suggests that midbrain brainstem structures can initiate vagal efferent pathways that are responsible for generating adaptive responses during fluctuations in arousal (Porges, 2009).”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Porges, 2009
The Abstract and “Three Phylogenetic Response Systems” section describe brainstem nuclei as sources of vagal efferent pathways and link vagal circuits to adaptive responses. They do not identify midbrain structures as initiating those pathways or specifically describe responses during fluctuations in arousal. Page numbers are unavailable in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredPolyvagal and neurovisceral integration theories favor slow over fast breathing due to parasympathetic activation and effects on mind and brain.
“Polyvagal [108] and neurovisceral integration [109] theories favor slow over fast breathing due to its activation of the parasympathetic nervous system and accompanying effects on the mind and brain [52].”
From Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature (2023) · cites this paper as [108]
The Summary and ‘Consistency with Jacksonian Dissolution’ sections link increased vagal influence to reduced sympathetic activity and social engagement. But the paper does not say that polyvagal theory favors slow over fast breathing or that slow breathing activates those pathways; searches for breathing rate and slow breathing found no such comparison. Page numbers were not available in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThe autonomic nervous system may provide a platform for dyadic influence on emotion.
“Given that the ANS is related to emotional expression and regulation and is implicated in social interaction, it may provide a platform for dyadic influence on emotion (Butler and Randall, 2013;Porges, 2009).”
From Physiological feelings (2019) · cites this paper as Porges, 2009
Tonic immobility refers to a shift in the stress response from arousal (mediated by the sympathetic branch) to extreme deactivation (mediated by the parasympathetic branch).
“Tonic immobility refers to a shift in the stress response from arousal (mediated by the sympathetic branch of the autonomic nervous system) to extreme deactivation (mediated by the parasympathetic branch) [135].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [135]
The polyvagal theory proposes that atypical functioning of different ANS mechanisms may be linked to difficulties in regulating socio-emotional and communication behaviours.
“an association between autonomic mechanisms, brain and emotional responses (such as facial expressions) has been proposed by the polyvagal theory (Porges, 2009), which suggests that atypical functioning of different ANS mechanisms may be linked to difficulties in regulating socio-emotional and communication behaviours.”
From Is autonomic nervous system function atypical in Attention Deficit Hyperactivity Disorder (ADHD)? A systematic review of the evidence (2020) · cites this paper as Porges, 2009
sAA responses during conflict might represent not only negative aspects of arousal, but also task engagement and emotional involvement in a positive sense.
“In fact, sAA responses during conflict might represent not only negative aspects of arousal, but also task engagement and emotional involvement in a positive sense.”
From Sex-specific effects of intranasal oxytocin on autonomic nervous system and emotional responses to couple conflict (2013) · cites this paper as Porges, 2009
The Neuroception and Summary sections discuss autonomic states, defensive responses, and social engagement, but do not address salivary alpha-amylase (sAA) responses during conflict. Searches for sAA, conflict, task engagement, and positive emotional involvement found no passage supporting the proposed interpretation. (LLM, conf=0.76)
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Sleep Medicine - Asleep or Awake?
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- Authors
- Porges, S. W.
- Affiliations
- University of Illinois Chicago (US)
- Corresponding author
- Porges, Stephen W.
- ORCID
- Porges, Stephen W.
- Venue
- Cleveland Clinic Journal of Medicine
- Publisher
- Cleveland Clinic Journal of Medicine
- Published
- 2009-02
- Volume
- 76
- Issue
- 4 suppl 2
- Pages
- S86-S90
- ISSN
- 0891-1150 (ISSN-L)
- 1939-2869
- PMC
- PMC3108032
- OpenAlex
- W2111357518
- Cited by
- 879
- References
- 21
- Citations by year
- 2026: 55 · 2025: 89 · 2024: 83 · 2023: 84 · 2022: 73 · 2021: 92 · 2020: 61 · 2019: 57 · 2018: 49 · 2017: 67 · 2016: 29 · 2015: 45 · 2014: 25 · 2013: 30 · 2012: 22
- FWCI
- 8.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cleveland Clinic Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD053570, HD 053570)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Keywords
- polyvagal theory, autonomic nervous system, vagus nerve, dorsal motor nucleus of the vagus, nucleus ambiguus, phylogenetic evolution
- MeSH terms
- Adaptation, Psychological, Autonomic Nervous System, Blood Pressure, Heart Rate, Humans, Perception, Social Behavior, Vagus Nerve
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