Peter A. Levine draws on his broad experience as a clinician, a student of comparative brain research, a stress scientist and a keen observer of the naturalistic animal world to explain the nature and transformation of trauma in the body, brain and psyche.
The Polyvagal Theory
If animals were physically restrained and frightened, they would go into a profoundly altered state of consciousness where they were frozen and immobilized, unable to move. And it turns out that this is one of the key survival features that animals use to protect themselves from threat—in this case from extreme threat. Actually there are three basic neural energy subsystems. These three systems underpin the overall state of the nervous system as well as the correlative behaviors and emotions, leading to three defensive strategies to threat.
MY: That’s the polyvagal theory developed by Stephen Porges?
PL: Yes. These systems are orchestrated by the primitive structures in our brainstem—the upper part of the brainstem. They’re instinctive and they’re almost reflexive. The tonic immobility is the most primitive system, and it spans probably over 500 million years. It is a combination of freezing and collapsing—the muscles go limp, the person is left without any energy. The next in evolutionary development is the sympathetic nervous system, the fight-or-flight response. And this system evolved from the reptilian period which was about 300 million years ago. And its function is enhanced action, and, as I said, fight-or-flight. Finally the third and most recent system is the social engagement system, and this occurs only in mammals. Its purpose is to drive social engagement—making friends—in order to defuse the aggression or tension.
VY: So this is when we’re feeling threatened or stressed we want to talk to our friends and family?
PL: Yeah, exactly. Or if somebody’s really angry at us, we want to explain what happened so they don’t strike out at us. Obviously most people won’t strike out, but we’re still hardwired for those kinds of expectations.
VY: Most people have a general sense of the fight-or-flight, but would you just say a few words on it?
PL: Basically, in the fight-or-flight response, the objective is to get away from the source of threat. All of our muscles prepare for this escape by increasing their tension level, our heart rate and respiration increase, and our whole basic metabolic system is flooded with adrenaline. Blood is diverted to the muscles, away from the viscera.
The goal is to run away, or if we feel that we can’t escape or if we perceive that the individual that’s trying to attack us is less strong than we are, to attack them. Or if we’re cornered by a predator—in other words, if there’s no way to escape—then we’ll fight back. Now, if none of those procedures are effective, and it looks like we’re going to be killed, we go into the shock state, the tonic immobility.
Now the key is that when people get into this immobility state, they do it in a state of fear. And as they come out of the immobility state, they also enter a state of fear, and actually a state in which they are prepared for what sometimes is called rage counterattack.
MY: Can you say more about that?
PL: For example, you see a cat chasing a mouse. The cat catches the mouse and has it in its paws, and the mouse goes into this immobility response. And sometimes you’ll actually see the cat bat the mouse around a little bit until it comes out of the immobility, because it wants the chase to go on. Now, what can happen is that the mouse, when it comes out of the immobility state, goes into what is called nondirective flight. It doesn’t even look for where it can run. It just runs as fast as it can in any direction. Sometimes that’s right into the cat. Other times, it will actually attack, in a counterattack of rage.
I’ve actually seen a mouse who was captured by a cat come out of the immobility and attack the cat’s nose. The cat was so startled it remained there in that state while the mouse scurried away. When people come out of this immobility response, their potential for rage is so strong and the associated sensations are so intense that they are afraid of their own impulse to strike out and to defend themselves by killing the predator. Again, this all goes back to our animal heritage.
So the key I found was in helping people come out of this immobility response without fear. Now, with Nancy, I was lucky. If it were not for that image, I could just as easily have retraumatized her. As a matter of fact, some of the therapies that were being developed around that time frequently retraumatized people.
I think particularly of Arthur Janov’s Primal Therapy, where people would be yelling and screaming out, supposedly getting out all of their locked-in emotions, but a lot of times they were actually terrorizing themselves with the rage and then they would go back into a shutdown, and then be encouraged to “relive” another memory, and then this cycle would continue.
MY: It becomes addictive sometimes, right?
PL: That’s correct. It literally becomes addictive. And one of the reasons is that when you do these kinds of relivings, there’s a tremendous release of adrenaline. There’s also a release of endorphins, which is the brain’s internal opiate system. In animals, these endorphins allow the prey to go into a state of shock-analgesia and not feel the pain of being torn apart.
When people relive the trauma, they recreate a similar neurochemical system that occurred at the time of the trauma, the release of adrenaline and endorphins. Now, adrenaline is addictive, it is like getting a speed high. [section;And they get addicted not only to the adrenaline but to the endorphins; it’s like having a drug cocktail of amphetamines and morphine.
So when I was at Esalen I actually noticed that people would come to these groups, they would yell and scream, tear a pillow apart that was their mother or their father, and they would feel high. They would feel really great. But then when they would come back a few weeks later, they would go through exactly the same thing again. And that’s what gave me a clue to the fact that this might be addictive.
Releasing Trauma from the Body
VY: So getting back to Nancy, from what you observed and what you learned from the animals’ various responses, what was your understanding of what happened with Nancy and what you did that was actually helpful?
PL: What was helpful is that her body learned that in that time of overwhelming threat she could not defend herself. She lost all of her power. Her muscles were all tight. She was struggling to get away—this was the flight response—to get out of that, to get away from those people who were holding her down and to run out of the room and back to her parents. I mean, that’s what her body wanted to do, her body needed to do—to get out of there and get back to where she could be protected.
So what happened is all of this activation, this “energy” that was locked into her body when she was trying to escape and then was overwhelmed, was still there in a latent form. When we’re overwhelmed like that, the energy just doesn’t go away—it gets locked very deeply in the body. That’s the key. It gets locked in the muscles.
MY: And that’s the foundation of your understanding of trauma—this locking of energy?
PL: That’s right, exactly. How the energy, how this activation gets locked in the body and in the nervous system.
MY: And so your objective is to help the person release that energy?
PL: Yes, to release that energy, but also to re-channel that energy into an active response, so then the body has a response of power, of its own capacity to regulate, and the person comes out of this shutdown state into a process in which they re-own their own vital energy—we use the term “life energy.”
It’s not generally used in psychology but I think it’s a term that is profound in people’s health, that people feel that they have the energy to live their life fully, and that they have the capacity to direct this energy in powerful and productive ways.
VY: Now obviously you’re just giving a snapshot of the case and we can’t capture the depth and the nuances of it. But someone who doesn’t know about this could think it sounds a little simplistic.
This woman had a tonsillectomy decades ago, and you’re having this one session with her and somehow you’re freeing up some energy that was trapped back then. How would you respond to that?
PL: Well, it was simplistic, and of course I was to learn that one-time cures were not always the case. However, over the years I started to develop a systematic approach where the person could gradually access these energies and these body sensations—not all at once, but one little bit at a time. It’s a process that I call titration. I borrowed that term from chemistry.
The image that I use is that of mixing an acid and a base together. If you put them together, there can be an explosion. But if you take it one drop at a time, there is a little fizzle and eventually the system neutralizes. Not only does it neutralize but after you do this titration a certain number of times, you get an end result of salt and water. So instead of having these toxic substances, you have the basic building blocks of life,
I use this analogy to describe one of the techniques I use in my work with trauma patients.You’re not actually exposing the person to a trauma—you’re restoring the responses that were overwhelmed, which is what led to the trauma in the first place.You’re not actually exposing the person to a trauma—you’re restoring the responses that were overwhelmed, which is what led to the trauma in the first place.
Healthy vagal tone is noticed by a slight increase of heart rate when you inhale, and a decrease of heart rate when you exhale. Deep diaphragmatic breathing—with a long, slow exhale—is key to stimulating the vagus nerve and slowing heart rate and blood pressure, especially in times of performance anxiety. A higher vagal tone index is linked to physical and psychological well-being. A low vagal tone index is linked to inflammation, negative moods, isolation,and heart attacks.
Heart disease is the number one killer according to World Health studies. There are a few ways to improve your heart-health: Yoga, meditation, breath-work, and meditation.
Well conditioned athletes have higher vagal tone because aerobic breathing creates healthy vagal tone, which results in a lower resting heart rate. Healthy cardiac function is directly linked to stimulating the vagus nerve.
The German physiologist Otto Loewi (1921) discovered that by stimulating the vagus nerve caused a reduction in heart rate thereby triggering the release of a substance he coinedVagusstoff (German: “Vagus Substance”). The “vagus substance” was later identified as acetylcholine and became the first neurotransmitter identified by scientists.
Vagusstuff is literally a tranquilizer that you can self-administer simply by taking a few deep breaths with long exhales. You can consciously tap the power of your vagus nerve to create inner-calm on demand. This knowledge alone should be enough to reduce the fear -of-fear-itself and give you grace under pressure next time you need it.
What exactly is the vagus nerve?
The word vagus means “wandering” in Latin. The words vagabond, vague, and vagrant come from the same root. The vagus nerve is known as the wandering nerve because it has multiple branches that diverge from two thick stems rooted in the cerebellum and brainstem that wander to the lowest viscera of your abdomen touching your heart and most major organs along the way.
The vagus nerve is constantly sending sensory information about the state of the body’s organs “upstream” to your brain. In fact, 80-90% of the nerve fibers in the vagus nerve are dedicated to communicating the state of your viscera up to your brain. When people say “trust your gut” they are in many ways saying, “trust your vagus nerve.” Visceral feelings and gut-instincts are literally emotional intuitions transferred up to your brain via the vagus nerve.
As with any mind-body feedback loop, messages also travel “downstream” from your conscious mind through the vagus nerve signaling your organs to create an inner-calm so you can “rest-and-digest” during times of safety or to prepare your body for “fight-or-flight” in dangerous situations.
Your vagus nerve is the commander-in-chief when it comes to having grace under pressure. The autonomic nervous system is comprised of two polar opposite systems that create a complementary tug-of-war which allows your body to maintain homeostasis (inner-stability).
The sympathetic nervous system is geared to rev you up like the gas pedal in an automobile – it thrives on adrenaline and cortisol and is part of the fight-or-flight response. The parasympathetic nervous system is the polar opposite. The vagus nerve is command central for the function of your parasympathetic nervous system. It is geared to slow you down like the brakes on your car and uses neurotransmitters like acetylcholine and GABA to literally lower heart rate, blood pressure, and help your heart and organs slow down.
Unfortunately, the vagus nerve’s reflexive responses can backfire and turn it from comrade into saboteur. Anytime you psyche yourself out before an important event, feel intimidated, or insecure your vagus nerve interprets that you are in real danger which exacerbates these negative responses.
All of the physical symptoms of performance anxiety—racing heart, sweaty palms, dry mouth, upset stomach, shakiness—are the result of your vagus nerve disengaging. Luckily, you have the power to harness your vagus nerve and keep it engaged to create grace under pressure. By understanding the incredible power of your vagus nerve you can begin practicing ways to flex its inhibitory strength to keep you mellow in times of distress.
When you do body scan see if you can connect deeper into the energy of each of the following organs:
Heart. Abdomen, stomach, upper intestines, liver, gallbladder, kidney, pancreas, adrenal glands, spleen, middle spine behind the solar plexus.
You may have in the past experienced health problems i.e. Arthritis, gastric or duodenal ulcers, colon/intestinal problems, pancreatitis/diabetes, chronic or acute indigestion, anorexia, bulemia, liver dysfunction, hepatitis, adrenal dysfunction.
Your relation map may have been disrupted by :
Trust, fear, intimidation, low self-esteem, lack of self-confidence, loss self-respect, low-ambition, lack of courage, in ability to handle crisis, inconsistent self care, of yourself, sensitivity to criticism, fear of rejection and looking inadequate , physical appearance anxieties, an absence of strength of character.
Questions for Self-Examination
1.Do you like yourself?
2.What don’t you like and why.Are you actively working to change the things about yourself you don’t like?
3.Are you honest? Do you sometimes misrepresent the truth? Why?
4.Are you critical of others? Do you blame others as a way of protecting yourself?
5.Are you able to admit when you are wrong? Are you open to feedback from other people about yourself?
6.Do you need the approval of others? If so, why?Do you consider yourself strong or weak?
7.Are you afraid of taking care of yourself?
8.Have you been in a relationship with a person you didn’t really love, but it seemed better than being alone?
9.Do you respect yourself? Can you decide to make changes in your life and then stick to your commitment?
10.Are you afraid of responsibility? Or, do you feel responsible for everything and everyone? Are you continually wishing your life were different? If so, are you doing anything to change it, or have you resigned yourself to the situation?