Book Review: ‘The Polyvagal Theory’ by Stephen Porges

Book cover Polyvagal Theory

Porges’ book is an essential step in advancing his ideas, but written for a highly technical scientific audience.

The Polyvagal Theory, by Stephen Porges
Porges has just published a long-awaited book version of his revolutionary ideas. This book is highly technical and combines many of his articles from scientific journals. Overall I am a bit disappointed as the main points are obscured by the highly technical language. I am hoping for a book entitled, “Polyvagal Theory for Dummies,” but this is not it.

The main points of the Polyvagal Theory are:

  1. The autonomic nervous system is much more important than is commonly acknowledged, and its care and safeguarding should be a primary objective throughout health and education institutions.
  2. In addition to being under-appreciated, the autonomic nervous system is misunderstood: (a) There are three branches, not two; (b) The branches are sequential, not purely reciprocal; and (c) The newest branch– social autonomic nervous system– trumps the other two– sympathetic and parasympathetic– in stress responses.
  3. Characterization of the sympathetic (“Fight or Flight”) and parasympathetic (“Rest and Rebuild”) is also a misunderstanding in that these terms are mixing sympathetic’s stress response with parasympathetic’s normal functioning. It would be much better to describe these in similarities! Here are the missing pieces: Sympathetic normal functioning is “Mobilization, etc.” and parasympathetic stress response is “freeze, etc..”
  4. Van der Kolk’s and Levine’s assertions (to the effect that trauma impact depends on how much betrayal was involved and how early the overwhelming event happened) is deeply confirmed by Porges. Re-establishment of social nervous system functioning and sympathetic’s defensive responses should be pre-eminent in all health care endeavors.
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