1.3.0
The First Polyvagal Circle
While searching for a system to classify Polyvagal Theory affiliations, we came across an interesting graph created by the Google Books Ngram Viewer that illustrates the growing presence of PVT in Google Books. The curve starts around 2006.
Beyond Porges and his family, we see three circles of affiliation. The first circle is before 2006 and includes the allies or encounters of the first hour: Peter Levine (late 1978), Pat Ogden (1988), Bessel van der Kolk (1999), and Robert Scaer (1996). These dates are certainly only partially correct, as these authors may have met earlier in informal ways. Apart from a joint conference around 2000 with Porges, van der Kolk, and Scaer, the Internet gives no information.
Special wood is needed to start a fire. Three writers were waiting for Porges and would take care of him: Peter Levine, Bessel van der Kolk, and Pat Ogden. Read what Porges says about them:
“Polyvagal Theory did not evolve or expand without the help and commitment of several people who have played important roles in helping me translate my ideas into a coherent theory. Unlike many of my colleagues, who treat and study trauma, trauma was not a focus of my research or part of my theoretical agenda. Without traumatologists being interested in Polyvagal Theory, there would not have been an entrée for the theory to contribute to the treatment of trauma. This entrée was due to three pioneers in traumatology: Peter Levine, Bessel van der Kolk, and Pat Ogden. (…) It was through their passion to help their clients, their commitment to learn, and their curiosity to understand the processes involved in experiencing and recovering from trauma that they embraced insights from Polyvagal Theory into their treatment models.”
Porges, Stephen W.; Porges, Seth. Our Polyvagal World: How Safety and Trauma Change Us (2023, p. 185, Kindle edition).
1.3.1
Peter Levine
Peter A. Levine, Ph.D., born in 1942, is an American psychologist. A specialist in the therapy of psychological trauma, he founded Somatic Experiencing (SE).
Levine received his Ph.D. in Medical Biophysics from the University of California at Berkeley - not an M.D. - and then worked as a stress consultant. He is the author of several international bestsellers, including
Waking the Tiger: Healing Trauma: explains how trauma affects the brain-body (1997)
Unspoken Voice (2010)
Trauma and Memory: Brain and Body in a Search for the Living Past: A Practical Guide for Understanding and Working with Traumatic Memory (2015)
Meeting Porges
In his introduction to Clinical Applications of The Polyvagal Theory (2018, XXiii), Porges writes: “My interaction with Peter began in the late 1970s when Peter's curiosity led him to call me and discuss models of homeostatic function … Through Peter, I was drawn into the somatic therapy community.
In the following pages, Levine describes how he became interested in Porges' work through an article (1975). Their first meeting took place in 1978 and was the beginning of “40 years of fraternal collaboration” (Levine).
Waking The Tiger, published in 1997, was a great success. Among the authors who praised his book are Porges and Robert Scaer. This book introduces somatic experience. It mentions the reptilian brain — with a dramatic quote from Jurassic Park — and the famous Bessel van der Kolk story about a veteran in 1980.
In an Unspoken Voice — How the Body Heals Trauma and Restores Goodness (2010) begins with laudatory comments by Onno van der Hart, Robert Scaer, and others, followed by a laudatory foreword by Gabor Maté. This time Polyvagal Theory fills chapter six, while chapter eleven focuses on MacLean's Triune Brain. He also cites J. Hughlings Jackson's concept of dissolution to support the bottom-up trauma healing process.
The Orienting Reflex and MacLean
The orienting reflex is the concept, described by Pavlov and developed by Sokolov, of a brief moment of arrest, usually marked by a slowing of the heart. Porges used it as an argument in his first Polyvagal paper in 1995. But what Levine describes is different. In his work, the orienting reflex is a reptilian motor response, echoing MacLean's concept of a rapid instinctive reflex of approach or avoidance. It is a response of surprise and curiosity that leads to a search. He states, “The instinctive brain often orients, organizes, and responds to stimuli long before we are consciously aware of them. This reflex exists in elementary life forms, such as a medusa or an amoeba, which react immediately to the slightest change in their environment.”
Mobilizing
Mobilization is an essential healing factor in Levine's work. In Porges' work, mobilization—a typical sympathetic action—belongs to regression. The truth is, the more we compare the approaches of Levine and Porges, the more we wonder how they could be so close. They probably don't even realize how different they are.
This difference is illustrated in Crash Course (2001, chapter 4) by Diane Poole Heller, a “student” of Levine. In her book, she extensively describes the role of the “reptilian brain” within the framework of the triune brain and how important it is to connect with our reptilian brain. “The sensory language – touch, taste, sound, smell, and sight appeals to the reptilian brain.” (P. 38). “It likes stories,” she adds.
In the quoted book (2010, chapter 11), Levine explains how a deficit of the instinctive brain and an over-compensating prefrontal brain may lead ADHD patients and delinquents to unadapted behaviors. Isn’t this the complete opposite of the PVT?
1.3.2
Bessel van der Kolk
Bessel van der Kolk was born in the Netherlands in 1943 and received his medical degree in Chicago in 1979. He is a psychiatrist, author, and researcher specializing in trauma and post-traumatic stress disorder (PTSD). He has made significant contributions to the understanding of the effects of trauma on the brain and body and to the development of effective treatments. Van der Kolk is the founder and medical director of the Trauma Center in Brookline, Massachusetts, and a professor of psychiatry at Boston University School of Medicine.
In 2014, Bessel van der Kolk published The Body Keeps The Score. Many top bestselling authors praised his work. “This book is a tour de force” (Kabat-Zinn), “lucid, fascinating, hard to put down” (Norman Doidge), “this compelling book” (Porges), “unsurpassed ... simply put, brilliant” (Otto van der Hart), “fascinating” (Francine Shapiro), “eloquently articulated” (Ruth Lanius), “a cutting edge offering” (Daniel Siegel), “a magnificent book” (Pat Ogden), “a masterpiece of powerful understanding” (...), “one of the most intelligent” (Jack Cornfield).
What can be said? The book is undoubtedly brilliant in its lyrical quality. It has helped an incalculable number of people (victims, their families, and friends) to understand psychotraumatology. However, I believe this book conveys many outdated concepts deeply rooted in MacLean's reptilian narrative.
Chapter 4, describing the “bottom to top brain,” presents much of the MacLean style (quoted on page 64). Van der Kolk can't avoid succumbing to the temptation of localization and the magical metaphors the public loves. The fifth chapter, pp. 76-86, presents PVT in detail.
This book is the most vivid contribution to the dissemination of Polyvagal Theory. Bessel van der Kolk is a top super-spreader (see Narrative Economics, section 3.1.4).
Few readers know that thirty years earlier, Bessel van der Kolk published The body keeps the score: memory and the evolving psychobiology of posttraumatic stress (1994). There he states that “in PTSD, the failure of declarative memory may lead to the organization of the trauma at a somatosensory level (as visual images or physical sensations) that is relatively impervious to change. (...) Animal research suggests that intense emotional memories are processed outside the hippocampally mediated memory system and are difficult to erase. Over the next thirty years, this credo led him to explore various therapeutic approaches such as yoga and neurofeedback.
It was impossible for him not to meet Peter Levine, Pat Ogden and Robert Scaer. Van der Kolk wrote the foreword for the third edition of The Body Bares the Burden (Scaer, 2014) and the foreword to The Polyvagal Theory (Porges, 2011). Porges gave him access to the Triune Brain concept.
Why does van der Kolk love PVT? For reasons I don't know, van der Kolk has long been attracted to nonverbal therapies. Porges, Levine, Ogden, and Scaer provided theoretical support.
1.3.3
Pat Ogden
Pat Ogden, a well-known author, met Porges around 1988. She developed Sensorimotor Psychotherapy, a body-oriented approach to treating trauma and attachment issues. Her work integrates attachment theory, neuroscience, cognitive strategies, and somatic techniques. She has incorporated concepts from Porges' Polyvagal Theory to explain physiological and emotional responses to trauma and to reinforce the importance of the body's role in trauma healing.
Of The Polyvagal Theory, she writes: “… Read this book and be inspired by a revolutionary perspective on the human condition… “.
However, Ogden's work is remarkably consistent with Bessel van der Kolk's research, which emphasizes the need for somatic and body-oriented therapies to facilitate trauma healing. Both Ogden and van der Kolk recognize the importance of integrating body and mind in treatment, and their work has influenced each other.
In Trauma and the Body. A sensorimotor approach to psychotherapy (Ogden, Minton, Pain, 2006), published by Norton, with a foreword by Daniel J. Siegel and van der Kolk, Ogden presents her bodywork supported by a considerable amount of theory. The book is recommended by Allan Schore, Onno van der Hart, and Christine Courtois. Pages 5-8 present the Triune Brain in detail (with a surprising quote from LeDoux, who despises MacLean). The Polyvagal Hierarchy is presented on pages 29-33. On page 97, she quotes Bergman (2004): “The increase in dorsal vagal tone has been observed in hypoxic neonates.” Bergman (2004) doesn't use the term “dorsal vagal” but quotes an article by Schore (2001), which in turn quotes an article by Porges (1997) describing how the “DVC” (dorsal vagal complex) can be lethal to mammals. Porges repeats his statement three times without argument (a possible fallacy of authority) and finally quotes Richter's (1957) article on sudden death. Richter’s article concludes that “he did not provide any physiological explanation, except to speculate that the lethal vagal effect was related to a psychological state of “hopelessness.” This cascade of distorted quotes leads to a dead end.
In Sensorimotor Psychotherapy: Interventions for Trauma and Attachment (2015), co-authored with Janine Fisher and published by Norton Company, Ogden (chapter nine) presents the Triune Brain theory. She explores “the possible effects of experience on the functioning of the three areas that make up the Triune Brain (MacLean) — neocortex, mammalian, and reptilian, which roughly correspond to cognitive, emotional, and sensorimotor (or body) processing. Learning about these “brains” can help clients better understand why they think, feel, and act the way they do and promote integration among these three levels of information processing.”
In The Pocket Guide to Sensorimotor Psychotherapy in Context (2021), with a recommendation from Bessel van Der Kolk (et al.) and some contributions from various authors (Janine Fisher et al.), Ogden further develops her concept of embodied psychotherapy and somatic narrative. This would be undoubtedly an exciting approach if only she could keep her hands off unproven theories–in our opinion.
1.3.4
Robert Scaer
Allan Shore, Louis W. Tinnin, and Peter Levine wrote a foreword to The Body Bears the Burden (Scaer, 2001). The book was republished in 2007. Bessel van der Kolk wrote the forward for the third edition (2014). Ronald Siegel gave a positive review: “In The Body Bears the Burden, Dr. Scaer boldly demystifies the profoundly debilitating impact of trauma by forcing new conceptualizations that move treatment toward an integrated biobehavioral approach, emphasizing the adaptive functions of our nervous system as it communicates, often outside awareness, between brain and body.” Porges also praises the book. Scaer is, indeed, the first author quoting the “polyvagal system” (p. 116) “helping to understand the relationship of dissociation with the basic primitive freeze response.”
On the same page, Scaer writes that the DVC “is associated with life-threatening arrhythmias and bradycardia in mammals, and perhaps its extreme expression in humans is the phenomenon of voodoo death as previously described by Cannon. This condition, as studied in animals, is associated with death by cardiac arrest, with the heart flaccid and engorged with blood (Richter, 1957), (Hofer, 1970). The extremes of vagal parasympathetic tone therefore contribute greatly to severe emotions, especially those associated with extreme terror and helplessness.”
The Trauma Spectrum (2005) (W.W. Norton & Company) begins with a foreword by Peter A. Levine. In his acknowledgments, Robert Scaer mentions Peter Levine, whom he met in 1996. In the freezing phenomenon described by Levine, he had recognized many of the symptoms of whiplash victims — his primary area of expertise.
Later in the book (p. 44), Scaer describes the “freezing response,” writing: “The perceptual experience at this moment is called dissociation. It is physiologically the same as freezing. He also describes the orienting response of motionless scanning of the environment by an alarming cue.” He quotes Porges (1995), who has suggested that the true freeze response (not just orienting) is dangerous for mammals: «The dorsal vagal complex (…) governs the dive reflex in reptiles (…) excessive influence of the dorsal vagal complex in mammals may be hazardous of life, causing cardiovascular events they may precipitate sudden death.» Scaer also describes the orienting response of motionless scanning of the environment by an alarming cue. There follows a paragraph on sudden death, referring to the work of George Engel (1971) on 170 cases, saying that helplessness and hopelessness were the critical factors in all cases. Finally, he comes to the animal model of helplessness, including the research of Seligman (1975), who supposedly “documented that blocking the parasympathetic nervous system with atropine blocks the development of learned helplessness in animals. However, there is no such reference in the book by Peterson, Maier, and Seligman {Peterson, 1993)! On the contrary, the authors refer to the dorsal raphe nucleus, also in the spinal cord, but serotoninergic and not influenced by atropine.
Robert Scaer cites Allan Schore's research on the right orbital-frontal cortex (OFC). In return, Allan Schore praises “this remarkable book” on the cover. Polyvagal arguments appear (pp. 46-47) in a lengthy description of the possible responses to threat — from the ventral vagal complex (VVC) through the sympathetic system to the dorsal vagal complex (DVC).
In summary, Scaer promotes the unproven narrative of a dangerous DVC that produces immobility and shutdown–possibly lethal for mammals.
>> to the next chapter The Second Polyvagal Circle