1.5.0
The Third Polyvagal Circle
The Third Polyvagal Circle (Broader Network of Influence) extends to therapists, lay supporters, publishing houses, and organizations propagating PVT through books, workshops, and online content. This includes institutions like NICABM (National Institute for the Clinical Application of Behavioral Medicine), ISC (International Society for the Study of Trauma and Dissociation), Open Hearts, and various publishers. Their involvement has facilitated the commercial and widespread dissemination of the theory.
1.5.1
The Desperate Attempt to Describe Polyvagal Theory and the Vagus Nerve
Heads and tails
Typing polyvagal or vagal nerve into the Amazon search box in any language will bring up many publications. Some are written by medical doctors, osteopaths, or psychologists, and some by non-academic self-publishing authors. We observe a particular pattern when we review the popular literature on the vagal nerve. Either they celebrate the ventral part in a classical polyvagal way — and present a distorted view of the dorsal part — or they describe the “dorsal” in a realistic scientific way but forget to tell the ventral part.
On the one hand, PVT adherents describe the dual origin of the vagal parasympathetic system (ventral and dorsal) and the three-layer polyvagal model (ventral, sympathetic, dorsal) but ignore the beneficial properties of the DVC.
On the other hand, authors who don't cite the PVT (e.g., Activate Your Vagus Nerve, Habib, 2022) offer a thorough and accurate description of the dorsal parasympathetic. They acknowledge the critical role of the DVC in regulating metabolic functions (e.g., digestion and appetite) and the immune system, providing a comprehensive understanding of this aspect of the vagal nerve. However, they don't discuss the ventral branch of the vagal nerve, leaving a gap in their knowledge.
Between these two poles, we can find authors like Hasler (2020) who correctly describe the dorsal vagal functions and explain the complete PVT in the same book. However, the 'expert' is not aware of the contradictions in the literature, which calls for a more critical and analytical approach to understanding the vagal nerve.
Finally, Hintringer (2021) places the dorsal vagal branch in the “social engagement” section, describing how both vagal efferent branches go from the cranial to the sacral levels in the service of the “smart vagal”.
Heads or Tails? So many authors forget a part of the fish. To find a complete description of the parasympathetic system (“orthovagal”), we must refer to professional experts, such as Neuhuber and Berthoud (in the following chapter).
Self-publishing authors
Today, the self-publishing world is full of books on the PVT. Here two examples:
The Polyvagal Theory by Robert Bright (2019) on Amazon. Bright says: «The Polyvagal Theory has raised the level of credibility of a variety of physical and mental practices, bringing a scientific rationale to what previously thought to be anecdotal or suggestive results.» p. 6.
The Polyvagal Theory by Aynan Jav (2020) on Amazon. Both self-published books offer a concise introduction to the Polyvagal Theory, but with some caveats. The descriptions of the three levels are not always accurate, and at times, they can be confusing. This underscores the importance of seeking reliable sources when delving into the Polyvagal Theory.
1.5.2
International Literature on the Polyvagal Theory and the Vagus Nerve
Searching on the shelves of European bookstores — or Amazon — for books quoting the PVT, the Vagal Nerve, or the Triune Brain, we will find several bestsellers we presented above which have been abundantly translated, sometimes into dozens of languages: e.g., Levine, van der Kolk, Ogden, but also Dana, Rosenberg, Maté. In Europe, we also have publications in Dutch, French, German, and Italian, which don’t have been translated into English.
French
Psychothérapie de la dissociation et du trauma (Smith, 2021) presents contributions of diverse French authors, along with a chapter by Suzette Boon and van der Hart. Although the book is not especially PVT-oriented, it contains two critical contributions. In the first one, Laurence Carluer, a French neurologist, extensively describes the triune brain and the PVT and explains dissociation by an excess of “cortico-limbic” inhibition. In a chapter about Somatic Experience, Michel Schittecattle, a Belgian psychiatrist, describes the “many hundreds million-years-old reptilian freezing reaction. Later, he uses the verb “neurocept” to describe the behavior of a patient.
In Évaluer et prendre en charge le trouble dissociatif de l'identité (Binet, 2022), a similar collection of articles, we find a similar contribution of Carluer. We shouldn’t be surprised, as the Smith and Binet are founder members of the Association Francophone du Trauma et de la Dissociation (AFTD). In the (free) bibliography of the site, among 14 publications, we find books by Porges, Dana, and van der Kolk.
In C’est quoi, la TPV? (2023)(= What is PVT?), François Bonnal, a French osteopath, writes an enthusiastic book about the PVT. He even proposes to optimize the “polyvagal tonus.” Neuroception is the eleventh sense.
Eric Marlien Le système nerveux autonome, de la théorie polyvagal au développement psychosomatique (2018), (The autonomic nervous system, from the PVT to the psychosomatic development) is largely similar to the book of Rosenberg (2017). It has been written for osteopaths, and for a larger public.
In Guérir des traumatismes avec le Brainspotting (= Healing the trauma with Brainspotting), Zaczyk (2019) integrates many concepts of the PVT. Tonic immobility is presented as simultaneous sympathetic and parasympathetic activation. The window of tolerance is described as the middle space between the hyperactive sympathetic space and the hypoactive dorsal space (dissociative helplessness, suicidal or mutilating plans). Later the author introduces the triune brain. The reptilian brain includes the entire brain stem and the cerebellum.
Dutch
There are few original Dutch publications, as most Dutch-speaking people are good English readers. Luc Swinnen, a Belgian medical doctor specializing in stress management, has recently written two books about the activation of the vagal nerve (2021) and the PVT (2023).
German
The author of Der Vagusnerv. Unser innerer Therapeut (Hintringer, 2021) is an osteopath and trauma therapist. After an exhaustive presentation of the PVT, she proposes diverse exercises, including trunk rotations, taping the toes together, and self-caressing.
In Das Vagus Training (Fischer, 2021) the author similarly introduces the PVT and recommends breathing, smelling, and visual exercises. She even suggests specific exercises for the tongue and the “limbic system.” The latter is “the radar of the middle brain. It constantly scans its surroundings for danger signals so that it can react in time. Life in the big city keeps it constantly on its toes.» (our translation). A specific gesture composed by the two hands on the forehead should bring the limbic system in balance.
In Die Darm-Hirn Connection (Hasler, 2020), the author offers a hybridized version of the PVT, starting with a long chapter presenting the PVT. Later, he makes a glowing portrait of what biologists call the dorsal vagal functions (e.g., metabolic regulator and anti-inflammatory), unaware of how the two descriptions are incompatible.
Italian
The interest in the vagal nerve is marked in Italy. It may be the fruit of the work of the ICS.
Fabio Petri, Nervo Vago
Emilio Lucchesi,
Allegra De Laurenti.
Michelle Necchi, the vagal nerve (Nervo Vago) and (Teoria Polyvagale).
Marcella Zaffiro (Il Codice del Nervo Vago)
Luca Nardoni (Nervo Vago)(2020).
I didn’t find original publications in Spanish or Portuguese.
1.5.3
Polyvagal Informed Therapists
In Our Polyvagal World: How Safety and Trauma Change Us (Porges, 2023, p. 114), Porges reports an ongoing survey of approximately 1,000 trauma therapists. "This survey found that therapists ranked “polyvagal-informed information” as the single most useful and most used category of trauma treatment, with some 65% of the surveyed trauma therapists self-describing their practice as “polyvagal-informed.” It's hardly surprising that a survey for which Porges presumably used the opinions of his loyal newsletter subscribers as a database would yield such positive feedback. However, the PVT is everywhere, offering an easy solution for all practitioners looking for a backup to their work (e.g., psychotraumatology, bodywork, energy psychology, etc.).
Some professional groups are more susceptible to recruitment: EMDR, EFT, Somatic Experiencing, Logosynthesis (Energy Freedom Techniques), and body-centered therapies. In a newsletter of the ACEP (Energy Psychology), the president praises the EFT as being polyvagal “informed!”
Interestingly, some groups of therapists have stayed immune until now. But the PVT — as the psychoanalysis in the last century — can apply to nearly every psychological and mental domain.
Mindfulness. John Kabat-Zinn has a solid scientific base. He wrote an approving foreword to van der Kolk's book (2014), but that's about it. He doesn't need to be converted. But Porges has also tried to get his foot in the door (e.g., Lucas, Porges, et al., 2018).
Yoga. In Yoga Therapy and Polyvagal Theory (Sullivan, Porges, et al., 2018), Porges tries the same.
Hypnosis. In the last three decades, hypnosis has benefited enormously from neuroimaging. It is now possible to follow exactly what happens during hypnotic induction. Hypnosis is also more about the cingulate cortex and less about the brainstem. Moreover, hypnotists and their clients don't fear immobility and shutdown. On the contrary,
they seek blissful paralysis, detachment, and peace– hypnotic dissociation is positive and doesn’t the artificial “ventral add.” But PVT is looking for a place there, too. (e.g., PVT in hypnotherapeutic sessions).
1.5.4
Body-centered Therapists Love the Polyvagal Theory
Interest in body-centered therapies didn't begin with Levine, Ogden, and van der Kolk. In addition to Messmer's wild experiments, Wilhelm Reich (1897-1957), a student of Freud, began to place the body at the center of therapeutic work. In vegetotherapy, he encouraged patients to breathe deeply and release physical tension. It was designed to break down muscular rigidity, which he believed was associated with repressed emotions. Reich developed the concepts of character armor (chronic tension) and orgone energy (life energy).
In the 1970s, Federico Navarro (vegetotherapy), Alexander Lowen (bioenergy), and Gerda Boyesen (biodynamic massage) developed many techniques based on Reich's work. The Esalen Institute was also a center for new experiments. Hakomi (Ron Kurz), craniosacral therapy, yoga therapy, or Feldenkrais techniques are just a few of the many techniques that have emerged in the last fifty years. Because psychoanalysis couldn't provide a theoretical framework for all these practices, practitioners lacked theories to support their work. It was all about their credibility — most didn't have an academic background or formal training (as doctors and psychologists do). When Porges began publishing, it didn't take long for the body-centered therapist community to recognize the tremendous benefits of PVT–a cutting-edge scientific terminology and a popular narrative that any Harry Potter fan could understand — save us from the reptilians!
Porges has often expressed surprise that this sizeable non-academic audience is interested in his work. Maybe an author's “mysterious, impenetrable jargon” (Shiller, 2019, p. 4) makes him viral! Peter Levine, Bessel van der Kolk, and Norman Doidge are the experts in catchy short stories — “I know a woman, who, …” while Porges tells very complicated stories. His protagonists are “The Ventral,” “The Sympathetic,” and “The Dorsal,” and it's exciting!
Porges created the label “informed” (for Polyvagal Theory informed), which therapists (body-oriented or talk therapists) can add to their qualifications like a farmer adds an “organic” stamp to his apples. Anyone who takes online training — or not, since the label is not protected — can define their work as “informed.” Robert Schwarz has repeatedly praised EFT (Emotional Freedom Techniques) as “informed” in the ACEP newsletters. Being “informed” seems to become a statement of faith and belonging to a polyvagal community.
In his new book (Porges, 2023), Porges says, “We are conducting an ongoing survey of approximately 1,000 trauma therapists. This survey found that therapists ranked 'polyvagal-informed information' as the most useful and used category of trauma treatment, with about 65% of trauma therapists surveyed describing their practice as 'polyvagal-informed." This is interesting, but Porges doesn't explain how he found these trauma therapists. Perhaps it was through the Institute's newsletters.
1.5.5
How Did the Polyvagal Theory Find Its Place in the Psychotraumatology Market?
Professional non-profit organizations
ISSTD (International Society for the Study of Stress and Dissociation)
ESTD (European Society for Trauma and Dissociation) The European Society for Trauma and Dissociation (ESTD) was founded in the Netherlands in April 2006 by specialists in the diagnosis and treatment of trauma-related disorders, particularly complex dissociative disorders. Presently, 17 European countries are represented.
AFTD (Association Francophone du Traumatisme et de la Dissociation). Created in 2015, this association counts over 500 French-speaking members specializing in trauma and dissociation. It offers a more polyvagal-friendly complement to the ESTD.
The last group – ISTSS The International Society for Traumatic Stress Studies — generally seems unconcerned by the PVT.
In the spring of 2019, the Polyvagal members were happy to participate in the annual ISSTD conference in New York. Porges was invited to give one of the keynote speeches. As usual, the "cheerleaders" were there. At the end of the presentation, a small group of attendees suddenly stood up and pulled the rest of the seated crowd along with them — a standing ovation. As much as we like cheerleaders on a football field, they have no place at a psychotraumatology conference. It's a bad omen because it confirms how quickly emotions can overtake facts, even in an academic context. Meanwhile, most polyvagal advocates have migrated to the polyvagal-friendly platforms NIBCAM and ISC (see below).
Profit-oriented groups
The Polyvagal Theory creates big sales. Two groups, NICABM in the USA and ISC in Europe, have fully integrated it into their programs. They provide polyvagal-friendly presenters with opportunities to deliver workshops live or online, promoting the Polyvagal Theory and contributing to its spread.
1.5.6
NICABM: a Savory Business
Combining her commitment to mind/body medicine with a business model since 1989, Ruth Buczynski, PhD is founder and president of the NICABM (National Institute for the Clinical Application of Behavioral Medicine). She has brought innovative training and professional development programs to health and mental health care practitioners worldwide. She didn’t meet Stephen Porges randomly. Both have long been interested in Behavioral Neuroscience.
In the USA today, NICABM is, with the ISSTD and the ISTSS, the most significant player in the market of psychotraumatology teaching. While the ISSTD targets highly specialized experts and therapists in dissociative disorders, the NIBCAM serves a broader crowd of therapists less interested in the subtle intellectual meanders of structural dissociation. NIBCAM’s marketing is intensive, with high-paced newsletters and last-minute training discounts.
Bessel van der Kolk, Daniel J. Siegel, Deb Dana, Janina Fisher, Pat Ogden, Peter Levine, Ronald D. Siegel, Ruth Lanius, and Stephen Porges.
Norman Doidge has recently been recruited to promote a co-authored article, How Loves Rewires The Brain. But first, you must «enter your name and email below to get instant access to: How Love Rewires the Brain (…) By submitting this form, you agree to receive messages from NICABM. We deeply respect your privacy and we’ll never share your email address with anyone (and you can easily unsubscribe at any time). » Happy marketing!
1.5.7
Institute of Cognitive Science (ISC)
Founded in 2005 by Alessandro Carmelita and Valeria Idini in Sassari (Italy) the Training Center offers professional training in psychology and neuroscience. Since 2014, the ISC has organized webinars, courses, and events on an international basis.
Below is a short (incomplete) list of the most renowned trainers and presenters:
Alessandro Carmelita, Antonio Damasio, Benedetto Farina, Christine Courtois, Daniel J. Siegel, David Grand, Deb Dana, Diana Fosha, Edward Tronik, Ellert R.S. Nijenhuis, Jan Winhall, Janina Fisher, Jonathan Baylin, Kathy Steele, Marina Cirio, Mary Jo Barett, Onno Van Der Hart, Pat Ogden, Peter Fonagy, Peter Levine, Rachel Yehuda, Roger Solomon, Ronald D. Siegel, Ruth Lanius, Stephen Porges, Bessel van der Kolk, and Suzette A. Boon.
You may recognize different names that also appear on the list of the NIBCAM: Bessel van der Kolk, Daniel J. Siegel, Deb Dana, Janina Fisher, Pat Ogden, Peter Levine, Ronald D. Siegel, Ruth Lanius, oe Stephen Porges.
Mindful Interbeing Mirror Therapy
Alessandro Carmelita and Marina Cirio have developed the «Mindful Interbeing Mirror Therapy» which — as the authors describe — integrates many tools, e.g., Polyvagal Theory, Sensorimotor Psychotherapy, and Attachment Theory.
1.5.8
Who Prints the Polyvagal Books?
There is little to tell about the press houses, although they are crucial in successfully spreading the PVT. Those houses have their own strategies, agendas, and secrets. In the last chapter, though, we have seen how Norton & Company has chosen to support the publication of polyvagal-friendly literature.
1.5.9
The Polyvagal Theory in Graphics and Videos
YouTube offers dozens of tutorials about the PVT. E.g., Polyvagal Informed Embodied Mindfulness: An Online Program
Open Heart Assets
This online shop creates graphics to explain different psychological concepts (e.g., Polyvagal Theory and Trauma Bundle for about 40 US$). With good intentions, they popularize polyvagal concepts, making them easy to understand.
The NIBCAM site also proposes infographics and illustrations about PVT, MacLean, and more.
Graphics
Recently, the NICABM started integrating «structural dissociation» into its list of products. Here is an illustration of dissociation. According to this graphic, the emotional right hemisphere contains the traumatized child part, while the logical left brain represents the rational, grounded self. This teaching poster is misleading. Neuroscientists don’t stop saying that the left-right-hemispheres-theory (logical vs. creative) is outdated (read The New Executive Brain: Frontal Lobes in a Complex World by Goldberg, 2009). Moreover, Structural Dissociation is not about anatomic localization.
Another graphic of NICABM illustrates the Triune Brain. Instead of representing the three structures nesting each other (like a Russian babushka doll), it presents three parts topping each other. Poor MacLean! By the way, Barrett’s book (2017, p. 82) contains the same error. Moral of the story: keep an eye on your designers.
1.5.10
The Committed Community of Fans
Clients, patients, and their relatives, or simply readers: a broad mass of "interested persons" who contribute significantly to the spread of PVT. Clients and their families share their experiences with the Listening Project or polyvagal practices. Fans express themselves on Amazon's reader pages or on Facebook.
If you browse the Internet, you will find numerous pages of enthusiastic supporters of the PVT. Some are therapists, some are not. I leave it to you to find the sites. Here are two examples:
Evolution of a Theory: Polyvagal is Not Dead by Traumageek
Reviews of The Pocket Guide to the Polyvagal Theory by Nancy Eichhorn
«I am, admittedly and unabashedly, enthusiastic about Stephen Porges’ work. I’ve attended his workshops, learned his process for measuring heart rate variability as an indicator of vagal tone, interviewed him for several articles published in this magazine, and have read his books and articles.”
More articles on medium.com under “polyvagal.”
>> next chapter The Casual Polyvagal Supporters