43: Prof. Stephen Porges - Revolutionising mental health diagnosis and treatment with Polyvagal Theory

Conventional mental health treatment manages the symptoms rather than treating root causes of mental health issues. Functional medicine psychiatry seeks to treat the root causes behind these symptoms, whether they are biochemical (hormone imbalances, gut issues, toxic load, inflammation, infections) or psycho-spiritual (adverse childhood experiences, trauma) or both. But what comes first? Do depression, anxiety, insomnia generally come from biochemical imbalances or psycho-spiritual ones? According to the legendary Professor Stephen Porges, biochemical imbalances are the downstream effects of the real root cause of all mental health issues: a dysregulated nervous system, which itself is caused by a chronic physiological state of stress (fight, flight, freeze). Interestingly, this physiological state of stress can be caused by biochemical issues (such as a toxin or a pathogen) and/or psycho-spiritual ones (such as childhood trauma). The body responds to both with the same threat reaction. 

In this interview, Professor Porges, who after years of scientific research has developed a deep understanding of the vagus nerves and their role in mental health, discusses his groundbreaking Polyvagal Theory and its implication for mental health diagnosis and treatment, as well as his latest book, “Polyvagal Safety: Attachment, Communication, Self-Regulation”. 

He shows that the syndromes we call depression, anxiety, insomnia, poor attention, irritability, exhaustion, as well as many physical health conditions, have in common a disordered response to stress, or nervous system dysregulation, which he defines as being in a chronic state of sympathetic arousal or dorsal vagal shut down, neither of which are conducive to health, growth and repair – a state facilitated instead by the social engagement system, or ventral vagal nerves. He shows that mental and physical health comes from homeostatic flexibility – the ability to go between states of fight, flight, freeze and social engagement, appropriately and with ease, and shows us how to promote this healthier state in our lives.