The Thinking Practitioner Podcast:

Episode 149: Bodywork through the Polyvagal Lens (with Stephen Porges)

Whitney Lowe  

Welcome to the Thinking Practitioner podcast, 

 

Til Luchau  

a podcast where we dig into the fascinating issues, conditions and quandaries in the massage and manual therapy world today. 

 

Whitney Lowe  

I'm Whitney Lowe 

 

Til Luchau  

and I'm Til Luchau. 

 

Til Luchau  

Welcome to

 

Whitney Lowe  

the Thinking Practitioner

 

Til Luchau  

The Thinking Practitioner podcast is proudly supported by ABMP, Associated Bodywork and Massage Professionals, the premier association for dedicated massage and body work practitioners like you. When you join ABMP, you're not just getting industry-leading liability insurance, you're gaining practical resources designed to support your career, from free top-tier continuing education and quick reference apps like Pocket Pathology and Five-Minute Muscles. ABMP equips you with the tools you need to succeed and grow your practice.

 

Whitney Lowe  

And ABMP is committed to elevating the profession with expert voices, fresh perspectives and invaluable insights through CE courses, the ABMP podcast and Massage and Bodywork Magazine featuring industry leaders like my co host Til and myself. Thinking Practitioner listeners like you can get exclusive savings on ABMP membership at abmp.com/thinking. So join the best and expect more from your professional association. Til, welcome back. Good to see you again, and we've got a wonderful guest with us here today.

 

Til Luchau  

You too Whitney. Today, we're speaking with Dr Steven Porges, a distinguished neuroscientist, the originator of the Polyvagal theory, and someone whose work has profoundly influenced how we understand safety, connection, and the nervous system. You might know listeners that polyvagal theory is a framework that explains why we can't heal sometimes or connect sometimes, or even think clearly when we don't feel safe. But it's a lot more than that. It's a window into how our bodies respond to each other and to the world around us. And in this conversation, I want to explore what polyvagal theory means for you bodyworkers, and how touch can support regulation and connection and how we as practitioners can become even more attuned to our clients and ourselves. Welcome. Dr Porges, Steve,

 

Stephen Porges  

Well, thank you Til, and thank you, Whitney.

 

Til Luchau  

I'm happy here. It's great to have you here, and it's I'm actually really excited to talk to you, and the irony is that I've learned so much about what happens in excitement from your work. Indirectly, I first heard about your work through John Cottingham, who is teaching in a program I coordinated at the Rolf Institute, and then later Peter Levine, who taught in the same program and learned a lot about calming and the ways that bodywork we were examining then might influence that, and how your work helped us understand that better. You did some early research with John Cottingham, if I remember right. What drew you to do research in a bodywork context, and how has that early work shaped the evolution of your thinking.

 

Stephen Porges  

Well, this is actually an interesting story. The bodywork connection actually came from Peter Levine, whom I met, actually in the 1970s and he was very intrigued with, this is long before he developed somatic experiencing.  He was very intrigued with how touch and movement and massage and actually deep manipulations, deep fascia manipulations, were changing what appeared to him to be autonomic state. So he kept engaging me. And, I was this young assistant professor in Illinois, and he was out in the west coast, and we developed a relationship, and it's been a very strong relationship. And he brought me into the Rolfing community in the late 1970s actually, probably the mid 70s, late 1970s actually would be more accurate.

 

Til Luchau  

He trained as a Rolf erand was active in office too and had a big influence on what persisted there as well. He did our show last year.

 

Stephen Porges  

Yeah, so Peter is a visionary. He's an explorer. And I pretty much, or at least was at that time, pretty much, a structured laboratory scientist, but interested in human behavior and basically opening open to learning, and I was very intrigued, and it was interesting dialectic. And actually, let's get John Cunningham into the story next, and then we'll go to I call the dialectic, and that is function and structure, which is really kind of the world that you folks come from. Whether you can change function through structure, or can you change structure through function? These become questions really that one can ask, answer or ask, and the realization is, they both are very important in the integration of what we call the human experience. Let's go to your question about John. John had been in medical school, and you probably know the story about John, he had been in medical school, and he became very frustrated with being in medical school and wanted to be a bodyworker. He wanted to study manipulation. So this is really going back to his engagement with me. I was a faculty member at that time in Champaign, Illinois, where John was living, and John basically engaged, and he knew I had an interest in, basically somatics, and start to talk to me and with his passions. Basically we got into this quid for quo. He would do manipulations on me, and I would teach him the neurophysiology, what I thought he was doing, and then encouraging. Yeah, so it was a very interesting bit. So it would be like, you know, going through the 10 sessions we we he manipulate me, then we go out for coffee for two hours and talk about it. Then next week, we do the same thing, and we start, we built a very nice relationship. He got very interested in wanting to do research in this and at that time, and actually I can give you the year now, because I developed a device that measured vagal regulation of the heart online. So that device was created in 1985 and John got use of one. He got a grant from the Fetzer Foundation to do some studying, b of  Rolfing manipulations, and I helped him really structure his research into research questions that had answers or could be answered. So we start with this simple question, "what does pelvic tilt do to autonomic regulation?" And that really was our first publication. And of course, when you til the pelvis, you are changing the sensory flow of the afferents from actually parasympathetic afferents going up the vagus. And sure enough, if you lift the pelvis up, you get more cardiac vagal tone. And what John was interested in was the angle of inclination, so he's getting into your world. So where peoples' pelvis is really tilted out of optimal range, and does it have a consequence on autonomic regulation? And so the inference of that study was yes, it should have, because you can do the acute manipulation, and now we can start inferring about more chronic positioning. The second study was the deep massage. I can't remember the number of the session that refers to within Rolfing, but it's deep abdominal massage. By the way, I, of course, went through all this myself, and this is very profound. Essentially, you feel like a little bit like jelly afterwards. The interesting part about this one is, not only does it give you an acute reaction, but it stays up for a prolonged period of time. I'm not sure if it was days or hours. I'm not sure. I can't remember, but there are two publications in a credible journal called Physical Therapy with John on this. And I believe these were probably the first scientific papers published in Rolfing, and

 

Til Luchau  

That's how I got to know them. And yeah, I'll put links to them in the show notes. That was 1988, and it was looking at people subjects with pelvic tilt and the findings that we all talked about were that not only was there a change in the pelvic angle afterwards, but there was a change in their vagal tone. That was the first thing of us had ever heard of that term. But at his guide is something you originated, yeah, and

 

Stephen Porges  

so, so it's really kind of a interesting issue, that you can change the structure, and now you're getting a change in the function. And John then went on and got a masters in biology, and then he became a physical therapist. He went to Northwestern and got a degree in physical therapy. And actually, he's been, I don't know if he's still with us. He had been ill, and I sent it, you know, I heard he had, I don't know, is he still with us? 

 

Til Luchau  

I haven't been in touch with him for many years. So, I don't know.

 

Stephen Porges  

This was about, oh, seven or eight years ago. I was actually in contact with his wife, who told me he was ill. So I wrote to him, but I didn't get a response. So, but John, when we lived in Champaign, I would say John was a close friend. You know, we'd go out for beers as well, and coffee frequently. And on the side, we talk about professional wrestling. Okay,

 

Til Luchau  

He's a wonderful guy. I learned a lot from him,

 

Whitney Lowe  

so I'm curious about this psyche, and I wasn't really familiar with his work and the things that you all had looked into there. But was there a way, when you had done that study to sort of discriminate that those results were specifically ascribed to the pelvic tilt and not just the manipulation of tissues in general? that they were having some kind of response to tissue. 

 

Stephen Porges  

This is interesting. I believe there was a hands-on type of thing as well, but they were specific to the manipulation.

 

Til Luchau  

But there was a control group that did have manipulation that was not specific

 

Whitney Lowe  

 yeah, okay,

 

Stephen Porges  

the dialog that I used to get into is actually, especially my view was very neural, very neural perspective and almost a dismissiveness over structure. It's kind of a strange world to be in, and I think my venture, or entree into the somatics got me really to put it more together, to talk about the feedback loops of where structure is actually influencing neural and this is really the start of that it's actually developed more. And as you know, I'll be talking at the fascia meeting, and actually my talk is really looking at fascia through the lens of polyvagal theory.

 

Til Luchau  

This is the Fascial Research Congress in New Orleans coming up in August.  They are an in-kind sponsor of the show, so I should make sure that I underline that.

 

Stephen Porges  

Well, it's quite remarkable that if you take the see the lens of polyvagal theory forced you to ask evolution-oriented questions because our nervous system changes a function of evolution. The termwe would use is phylogeny, as species change and when we move from different groups of species like moving from amphibia to mammals or amphibia to reptiles, these are major reorganizations or repurposing is actually better word of of structure, and is what I'm really getting locked into now, is looking at this phylogenetic or evolutionary transition in gene expression and how the organism, at the level of a mammal uses structures differently than it would at the level of an amphibia or fish. So it's not like we don't share the common structures, but we've repurposed them, and it's that repurposing which makes things really interesting.  The interesting part is the hierarchy, and this is polyvagal theory. The polyvagal theory is really saying that our autonomic nervous system, the nervous system of our viscera, our organs, is actually a three-tiered system. It's a hierarchical system, and it follows its evolutionary history, and that is when we were very primitive vertebrates. We're a viscera with a autonomic nervous system. Of what we in mammals would see is below the diaphragm, primarily a gut and metabolism organism. And then through evolution, we become an organism of movement, skeletal motor. And so we reframe autonomic function from supporting smooth muscle to supporting skeleton muscle. And then when mammals came off of this common ancestor that basically is the parent of both reptiles and mammals, it had certain attributes, and that is where the muscles of the face and which were controlled by cranial nerves. Now what I'm learning, and this is what I'm going to be talking about at the fascia meeting, is that each of those stages has different types of fascia. And the fascia with more evolved vertebrates, or more evolved being mammals, have much more sensory components in them, and that sensory connection is much it has faster velocities. So our fascia becomes part of our autonomic nervous system. And that's really what the talk will be, is that even though, when people are often taught anatomy, the fascia is ripped off, they don't even see the fascia. Yeah, basic part is that the fascia is unique for cranial muscles, muscles regulated by the cranial nerves, muscles regulated by the thorax and then muscles regulated by the visceral organs below the diaphragm. Now the reason the diaphragm is critical in this story, and of course, in your world, you'll see it in terms of breathing and the movement of the chest wall, especially the ribcage, which is really big in body work, you can see it. And when people are stressed, what happens to the ribcage is that the diaphragm is unique to mammals. It's a It's just like having breasts or or or suckling and nursing, or it's what it's unique to mammals reptiles don't have a diaphragm, and this, this is actually, well, it creates this demarcation where we can see things and understand it in this hierarchy, because polyvagal theory talks about, literally, a facial system, or facial which is listening, vocalization, smiling, we. Broadcasting my physiology. And through evolution, that got linked with cardio inhibitory fibers, meaning vagal fibers to the heart. So our face was basically broadcasting our physiological state. And what does that mean? Are we safe enough to come close to so it's not only face, it's the voice.  More intonation in the voice, more vagal tone to the heart, more facial expressivity, the same story.

 

Til Luchau  

And when I'm thinking of breath rhythm too, as a way that we sync up our connector.

 

Stephen Porges  

or attempt to, because we're trying to go in with the signal, when the system may be so dysregulated, says I don't want to hear it, and so it's that's why breath work is wonderful, but not causal. That's why even you know a somatic worker, touch is wonderful, but if the body is defensive, it's not going to incorporate those signals of safety and mobility or rhythmicity that you're describing.

 

Whitney Lowe  

So we can kind of, if I'm sort of getting this, Jim, this is fascinating, opening up a lot of things to think about with, you know, reptiles and and, you know, other birds, in particular, other animals that don't have highly expressive, expressive facial features. So we can kind of, then assume that that's something along. What you're saying here is this is something that has developed along the evolutionary scale to this level of complexity in these other animal species. 

 

Stephen Porges  

But Whitney, we have to understand that when we bring up reptiles and birds, they have their own history. They've already split from mammals. Yeah, reptiles split from mammals, so we can't learn too much from reptiles and birds. They're interesting in themselves, and your extractive point is correct. They do not have the same facial expressivity. In fact, most reptiles are not vocal at all, but birds can be very you know, evolved lots of vocalization, a lot of communication through vocalizations. But that's not, they're not our relatives. They're our cousins. It's like they're not a direct lineage. The direct lineage goes to what's called a common ancestor, and that common ancestor really is the parent for both reptiles and mammals and birds are part of that reptilian branch. 

 

Whitney Lowe  

I want to also just real quickly jump back to something that you said, too, when you too, when you were talking about the fascia being different in these different areas and having, you know, much more significant innovation, for example, along in the facial realm, is that the main difference that you've noticed was, was level of innovation, or the degree of innovation in there, or were there other things that you were able...

 

Stephen Porges  

Let's refine what we mean by innovation. We're really saying a stronger linkage between sensory pathways leading to the autonomic nervous system, and we would say feelings, so in the sense that feelings, visceral feelings, so we have greater specificity with these newer circuits like facial fascia has more basically specificity than thoracic or skeletal motor or visceral. Visceral is the oldest, and it's the most diffuse. So we, in fact, when we have pain below the diaphragm, we sometimes don't know, really where it's coming from,

 

Til Luchau  

Harder to locate. You know, we tend to be super practical as body workers. I know our audience questions are usually about like, okay, so what does this mean in practice? We want to know where to touch and how. What I really appreciate about the influence you've had on me, is it it makes me see the interaction as the whole rather than just the touch part of it. But anyway, what insights can your theory, polyvagal theory offers on where to touch and how well?

 

Stephen Porges  

Let's say what the theory tells us is more like when to touch. So in a sense, when you become a polyvagal-informed therapist or clinician. What are you doing? You're evaluating the autonomic state of your client. How are you doing that? You're observing, you're listening to their voice. You're listening intonation of their voice, their facial expressivity and their muscle tone, and what you tend to see, and I'll use it says body worker terminology, tightly wrapped people and people that are more accessible, and you already know intuitively that that tightly wrapped person is going to take some time to work with. And so what you're we've done in that you've made a polyvagal informed decision. You said that body that's like this is in a state of threat and defense. Why would that body in that state allow me to dig in and manipulate?

 

Til Luchau  

You're saying we need to take into account the autonomic state. And the question is timing and when and how we do. Not so much wear, because that'd be the simplistic takeaway what we've talked about so far is the oh yeah, we should always work the diaphragm and the face. But just like, it's much more nuanced than that.

 

Stephen Porges  

It's extremely nuanced. The point is that you learn, I've learned from the gifted therapists, whether they were bodyworkers or psychotherapists, what did they do? They make their clients feel safe or at ease, whatever term you want to use. But if you're a bodyworker, what does that mean to the tissue? It means it's pliable, it's accessible. And you and I used to love the term "tightly wrapped".  It told me so much about the state of the client. It should never be interpreted as intention on the part of the client, but reflecting that the client's in the state of defensiveness and is locked into states of chronic threat, the body is doing what's supposed to do in that state, and that is not give you access.

 

Whitney Lowe  

So along those lines, Do you have suggestions or ways? Because, again, this is kind of getting back to Til's  point about the practicality of people wanting to know, like, what do I actually do? Or, how do I do this clinically? Any hints or suggestions about for the people who may not be terribly familiar with some of these concepts, how do they make those evaluations? Like, how do they recognize the tightly wrapped person, or how do they? How do they know you know what to do or what to do, when kind of thing? 

 

Stephen Porges  

Well, I would say that. I mean this is not to be dismissive or evaluative, but everybody, everyone who is engaging with humans, whether you're a teacher or you're a psychotherapist or a bodyworker should be aware of the state of the other. So in a sense, understanding that it's not do what I tell you, but I have, as a therapist or a teacher, I have an understanding that the state you're in determines, literally, the range that you can even follow the instructions, yeah, or make sense of it. The problem again, this is the big problem, is that we're not schooled into thinking about our physiological state. We're very schooled into thinking that our behavior and even our feelings are dependent upon intentions, and we think we control intentions. So when a person gets on the table in your world, they have an intention for someone to work on them. They may have the intellectual intention, but their body may not be accessible. So the first step in any form of therapy is a type of what I call body awareness. And this goes back to another journey. So in the 80s, I actually was involved with the Rolfing society, or whatever it is, together and Richard Emerley, who was Ida's son, who was in NIH he ran a lab in Biomedical Engineering, and he was in charge of research, and actually we became friends, and his daughter actually worked in my wife's laboratory. So it was kind of a small world phenomenon. But the real part of the story is that I started to develop a subjective test, and it later evolved into what's called the body perception questionnaire. It's available for free on a website called the Traumatic Stress Research Consortium and what the the test was for, so they asked me the question,  How would you do research in Rolfing? And everyone was about, we need to put electrodes on. We need to measure this. I said, Do you even know if people how they feel? What are their feelings? Yeah, basically, there was no knowledge base. So No, no one is and set up these items. So I worked on setting this up. And it took, actually, I did a rough one in the early 90s, but by actually, I revisited in the, I think it was 2013 or 14, I revisited the data set and the items, and we actually did all the complex psychometrics and revised the test, and there are over 500 peer-reviewed papers using this test now, and it basically seems to be a pretty good proxy for putting electrodes on so in a sense, rather than spending your money measuring physiology, asking these questions and then you basically gives you a sense of their autonomic reactivity. 

 

Til Luchau  

Some lovely irony there about the bodyworkers hearing from the scientists to pay more attention to feelings and less to the electrodes. 

 

Stephen Porges  

Yeah, it's like there's a different level of data that you can get you, and that data is is can be a good proxy for the physiology. And the way I like to view the term I use a lot, called homeostasis, and that's when our body literally is doing what's supposed to do, supporting health growth and restoration. When a body is doing what it's supposed to do, it forms a platform upon which we can can feel safe. It doesn't mean we do feel safe. And what we're seeing, of course, in a traumatized world which we live in is that many people don't feel safe, and this is manifested in the disruption of their bodily processes, gut problems, heart problems, tissue problems, and you see it in structural problems or somatic issues. The point is, people, when you start explaining and understanding that when their body moves more into a homeostatic state of supporting health, growth and restoration and even sociality as a homeostatic process, then they have the possibility of feeling safe in their body. And that means then their tissue becomes accessible to others. 

 

Til Luchau  

And we do that as just as organisms, but we also do specific as body workers, we track each other's nervous systems and states, both consciously and intuitively. How could we get even better as body workers, at sensing and responding to those things we track?

 

Stephen Porges  

Well, it's interesting.  You might even just use the scale and do a self study on it, so it helps you map where you are. And a lot of therapists where polyvagal theory has really gotten traction within the trauma world of trauma therapists is not just tracking the client, but tracking the therapist as well.

 

Til Luchau  

So you're tracking on a scale of how would that go?

 

Stephen Porges  

Well, you go through the items and you basically say, this is where, and then the items provide you with a metric. And fortunately, the the metric is, it is norm. We now have it on several thousand, so we know normative data. What was interesting is that there was a study recently published on within the past few years on body psychotherapists in their body perception question of the autonomic state versus normative people so and the relationship between trauma their autonomic reactivity with the body perception question there, and how being a body psychotherapist mediate that relationship between trauma history and autonomic reactivity. So trauma history normally maps into being less well regulated. What was interesting is that the body psychotherapists, even though they had more trauma historically than the normative people, the autonomic nervous system was more regulated using this questionnaire. So you start understanding that working with people and interacting on this very personal level that body psychotherapists or somatic workers are has not only helpful to others, it has a reciprocal regulatory component of therapists.

 

Til Luchau  

It calms us down as well. What kind of items are on the questionnaire? What are the specifics of being contracted? 

 

Stephen Porges  

Well, it's basically asking you things like, Do you have trouble swallowing? It talks about your gut issue. It talks about sweating. And it's structured to deal with above the diaphragm and below the diaphragm reactions. But in general, if we basically use both of those together, we get a very robust measure. What was also interesting about that measure of body, what's called autonomic reactivity, from the body perception questionnaire, is that during COVID, we did a study looking at trauma history, symptoms during COVID, and the body perception questionnaire and trauma history mapped into more emotional problems during COVID without getting COVID. This is the early spring 2020 however, if you take the path from trauma through autonomic reactivity to symptoms, it was like three times more of the variance of the symptomatology was predicted if you do their autonomic state. If you have trauma history and your autonomic state is retuned to be defensive, you have a lot of bad symptoms, if you have a trauma history, and just that is a direct effect. It's there, but the real one is what happened to your autonomic nervous system. So rather than thinking about trauma as an event, we think about it as a reaction to an event, meaning that some people can be devastated. Some people not. And the other part that's important is once we realize that a traumatic event may not be traumatic for one person, we then ask this other question, what if an event changes autonomic reactivity like a traumatic event would, but doesn't appear to be trauma? Matter to someone else, and you're getting clients like that, where their bodies got recounted by, let's say, being humiliated in public, or being embarrassed or doing something, where their nervous system incorporated as as a life threat.

 

Til Luchau  

That's such an important point, and I think probably I'm listening to you talk and realizing this is something else I learned from you, trauma, thinking about trauma as an event rather than as a thing. When people talk about trauma being in the body, that's a useful metaphor, but it's also really helpful for me to think about it as a process or a recovery, or responding, a response to something that happened, rather than a physical thing that's in there, yeah, and that map you've just given us about, we're helping people find safety. Again, I find that that process in themselves, rather than squeezing the trauma out of their muscle,

 

Stephen Porges  

It's interesting. Okay, so let's go back to my own relationship with Rolfing, which is really my first one, yeah. I basically said, Oh, this is pretty nifty. However, does it stick? Which is the real question. And this is where the neural part of the story comes in. The structural part works. The body feels better. But you know what bodies do when they're kind of used to being in states of defense, they go back to that, And the other part that I've learned, and this is through my acoustic interventions that I developed, by just merely trying to create stealth methods of signaling safety. So, you know, Rolfing is a lot of intentionality on the therapist, and it's also, ah, there's a personal element of it, that you're the people are now exposed, and they many people under threat don't want to be close to others. So I had the idea, can I signal the nervous system to feel safe, and then would it just be open in the spontaneously engaging to other? And this is more about me than about you or many of my colleagues. I don't like to engage on certain levels, but if someone engages me, I'm fine. So it's like I have this kind of respect for this boundary, and so if I can signal that I'm safe and the person engages me, I'm all off with the play. I'm in there. Now, what happened is that this worked great with kids, neurodivergents and that was they started to engage. They say, how are you? I love you, Mommy. All these things. Then we moved it into the trauma world, because it seemed like the obvious place, and for many people, was extraordinarily helpful. But those with their we can use the term Complex, deep trauma, like early childhood, really profound traumas these individuals that they listen to, they became accessible, and then their body had that feeling of what we would call openness, and then the interception, that feeling triggered in their brain and association that that is the most dangerous feeling they could ever have, and they were out of the room. And actually, this is very much linked to how Somatic Experiencing works, that what Peter discovered is that you can do titration, move them in and out, and that's what the people did with the acoustic stimulus. They call Safe and sound protocol, and so that you signal the body, and then the person learns what that feeling is, and then the reactivity to that feeling through interoception becomes ameliorated.

 

Til Luchau  

So your safe and sound protocol is an acoustic domain, I remember, right? And it's will anything you want us to know about that before we move on.

 

Stephen Porges  

Basically, it's based on the principle that there's certain intonations, prosodic features of human speech that our nervous system unambiguously identifies as safety. Like, how do you calm a baby? How do you how do you encourage, encourage your cat or dog to come close to you? It's all going to be this melodic voice. So the nervous system has no choice. But now it happens. It basically works in the area of the brain still regulates the vagus or the ventral vagal area, so facial expressivity, listening to melodic voices and the prosodic intonation on one's own voice is a vagal. So pharyngeal, laryngial nerves are vagal. So the issue but they're not cardio inhibitory. They're vagal, though. So the issue is that this whole system of calming our heart is really linked to facial expressivity, the muscles of our middle ear to enable us to hear human voice and to dampen background sounds. Now, as we start talking about muscles, we already know there's going to be cranial fat. Fascia, you see, and we know that now it's going to be part of a feedback loop, because that cranial fascia is loaded with sensory afferents, and that those afferents are now going to go to areas that are calming areas, and basically regulate cardio inhibitory slowing circuits.

 

Til Luchau  

We hear a lot these things about vagal stimulation, and you have a suggestion about how, hands on, therapists would think about the vagal nerve. Is that something we are stimulating? Is that a helpful way for us to think about it? 

 

Stephen Porges  

Well, you see, the conceptualization of that is, I was going to use the word, pretty raw, because they're not really vein. What you're really doing, they're making a fostering a belief system that if you get your hands on the vagus, you have control of your body, right? The irony of all this is that the part of the vagus that you're stimulating is the sensory part. It's going into the brain stem. And what are those signals being interpreted as the signals of safety. Now what that means is that if you have an understanding of what those signals are, you don't have to necessarily port them in through electrical or stimulation in the vagus. You could rock people, you could have posture shifts. You could use sounds. And that's really what I've been doing, is a sense rhythmic sounds and even breathing manipulations will impact on the vagus. So the idea is, don't think of hacking the vagus. Think about getting signals of rhythmicity and safety into the brain stem so the brain stem can now move out of defense. The important part of this, and this is very subjective, because most people understand it, when the brain stem calms down and is in its homeostatic level, it literally frees the cortex to do interesting things, which could be creativity, dreaming, visions, whatever you want to do. In general, we're using our cortex as an inhibitory organ, inhibiting our brain stem. And in fact, the philosophy of western society tells us that; notion of don't do this, don't do that, inhibit drives, inhibited feelings. That's cortical inhibition of foundational biological systems, and that's what we're using our cortex for. Now what if we gave it permission to do what it really evolved to do solve problems?

 

Til Luchau  

The cortex is a problem solver.

 

Stephen Porges  

The brain stem is not. The brain stem is as enables us to survive, but it's not a problem solver.

 

Whitney Lowe  

Yeah, I think you've really hit on a key thing that's really valuable for a lot of bodyworkers and manual therapists to tune into, is this idea. because, as Til mentioned, we do hear this a lot with, I guess, it's just more of a sort of a structural mindset of people talking about things like emotions being stored in a particular tissue or someplace in the body. And realistically, maybe it's, it's a pathway process of understanding that it's not, it's not like something gets stuck or stored somewhere but there is a there's a way to tap into the effects of what happened, either through trauma, emotion or whatever? 

 

Stephen Porges  

This is actually, it's a very important question leading to a as a more refined thinking about what we're talking about. It's even like my good friend Bessel van der Kolk, what's the title of his book, The Body Keeps the Score? Well, it's not really even the body that keeps the score. It's really the brain stem. So in the sense that the circuits that are monitoring the organs and the tissue have basically got locked into certain positions. If we can think of that type of feedback loop, we need to think more in terms of feedback loops, and we even understand that now I know that in the somatic world, there's always been this conflict or contradiction when we start moving into medicine or basic medicine, because basic medicine does not incorporate in treatment of people feedback loops. So it's very a physiological and in many ways, not very scientific. So he thinks that if you have something that acutely works, it would be useful for the chronic case. And it's certainly not. The mechanisms underneath chronic illness or chronic pain are very different than acute illness and acute pain. Yeah. And in fact, that that part of the entree, why people come for manipulations or massage is that traditional treatments or pharmaceuticals don't solve their problems. So the issue is the feedback loop that becomes the critical issue of understanding. So we need the storage your point. Whitney. About not or locking our emotions being locked in tissue. The tissue is involved, but it's not the seed of it the way, because we're not this is even the issue, like with fascia. Fascia, let's assume that fascia loses pliability, or gets ripped and it's loaded with sensory efforts. What are those sensory afferents going to be sending? And where are they sending it? Well, if you injure the tissue, and the tissue is sending signals of being injured, it's in a way, locked into that tissue. But that's not if. But the issue is, when it's acute, the body learns about recovery. When it's chronic, the tissue is no longer the source even of the stimulation. It's, quote, a higher brain learned relationship that becomes the confusing thing, and this is why manipulation works even with chronic illness, is is that the sense a creates a re patterning of that sensory information that disrupts, in a sense, when people get chronic pain, they are going to, in a sense, change the neuromuscular tone of their body to support that pain. And this is where the manipulation you reach in you, in a sense, change that flow, and then when you stop it, the body will often go right back. But if you do this slowly enough times, there's what I call neural exercises there going on. And I think if we start thinking of the sensory relationship between the tissue and the feeling, as opposed to saying the feeling is locked in the tissue. 

 

Whitney Lowe  

It's almost like a metaphor of, maybe, like a stereo system or something like that, where we we keep trying to change the music by doing some senses the speakers, instead of changing the source at the amplifier or something.

 

Stephen Porges  

Yeah, it's a good analogy, but it the part is, if that's a we are, we're a dynamic system in which the status of the organs, the status of the tissue, affect everything upstream, and the upstream stuff can affect everything downstream. There's a wonderful quote from a Nobel Laureate in 1949 by name of Walter Hess, and I often quote read the first paragraph of his Nobel speech, because he really says everyone has always known that everything is connected to everything in our nervous system, basically that newer circuits are dependent upon older ones. It's really a beautiful couple of phrases. I often would read this in a talk, and I put in some papers, and I would say that if I made that statement in a grant proposal, they would not even consider the grant proposal. And it says the guy this, he took the liberty at his Nobel Prize speech to say this, but it really forces the individual out of this deterministic, simple, causal model into a more complex model in which simple, old feedback loops influence new ones, and new ones can influence old ones. So it's this intertwining of complexity, and in a sense, forcing us to try to break down that hierarchy,

 

Til Luchau  

and let's say, with all the complexity that's grown up around polyvagal theory, what? What's, can you say something to us about intuition, or the role of intuition, to therapist, moment to moment, decision making, in a way,

 

Stephen Porges  

Okay, so here's what I would say, is that the insightful therapist is polyvagal-informed whether they know it or not. So what the theory gives the insightful therapists is a language to understand what their insight is teaching them, because their body is responding to their clients. And there's kind of this subset or sub current within the body work of, quote, healers, or this or that, the answer is this reality to really what that is. And it's not mystical, although some people want to use that channel. It's a degree of sensitivity to the other, an awareness of the other's body, whether one feels it with their hands or feels it literally with their gut.

 

Til Luchau  

You also talk about how our own nervous system shapes the interaction and plays into the interaction. Can you tell us something about that as body weight?

 

Stephen Porges  

Yeah, so I look at you, and I know how you shape the interactions with people. Just I mean, I'm going to direct the audience to your face. And in fact, your face is the upper part of your face, your eyes, the ability, your eyes open while you are providing accessibility in your presence. Now, not everyone has, I would say, that range and that capacity. But for you, it just, it just blooms right out there. So the part is that we need to understand that we are broadcasters of our own physiological state and that impacts on others. In a way, it's a strange type of responsibility. I remember as a as a faculty member with a relatively large lab, telling my lab group to basically discount my expression for for the days, because I just got a bad review on a grant. You know, it's like, yeah, it's like, I could, I could feel it in my body and but, you know, you tell people, it's not you, it's how I'm feeling. It may be helpful, but it's not enough. They're still going to respond to you as if you're evaluating them, and your expressions are reflecting something they did. And a lot of our life we need we're not well schooled at understanding and respecting and honoring our own physiological state and as come directly at your question, our state really is being broadcast to everyone in our proximity and in terms of our tone of voice, our facial expressivity, our gentleness, our openness, I'd like to it says, summarize this in a very simple way. We have only one gift to give, and that's our own accessibility. And what does that really mean? It means when we broadcast that we are, have we're accessible to other, we're we're there in their space. It's the gift that keeps giving back endlessly

 

Til Luchau  

Lovely. Couple more questions I hope to get to, but I wanted to give you a chance to tell us something about interception, neuroception, the importance of those perhaps.

 

Stephen Porges  

Yeah, okay, so there's no problem in building a model that basically tracked the phylogeny, the evolutionary history of the autonomic nervous system. There was no problem saying there's a hierarchy, because the systems are developed later. But there was a problem, how do we come up with a construct that enables us to say, when this happens, the system shifts state? I had no mechanism, and so neuroception became the nervous system mechanism, literally to move us to different states. It was not and this became an internal dialog with myself. I want to use perceived danger, perceive this, perceive safely. But I had to. Couldn't use it because perception has is, is ambiguous. People say, Well, what if I missed it? Then I didn't perceive it? Then they start feeling bad. They start thinking that perception includes a dimension of intentionality, which it does in our language. So I really want a system of detection that was not perception that attributed to a level of our nervous system that was outside of our word, our awareness, therefore the neuroception is Yeah, so therefore it's not my my responsibility. My responsibility is my responsibility to learn about what I react to, but the reaction is not under my control. Now we're fine with that, with startle reflexes or pain reactions, but I want to, in a sense, give the mammal, give us a different dimensionality of neuroception, and that was where safety so like the intonation of a mother calming her baby with the voice that's no reception of safety. Now the danger side is across with virtually all living organisms, even down to single cell or plants or leaves. When the animal, when a leaf is is chewed upon, there's actually a reaction within the neuro system. Is not a very complex neuro system within plants that starts creating a healing barrier for the damage. So that's a neuroception as well. So the ability to protect after being injured or to detect danger or threat is a no reception. But safety is unique. Then I had another problem, and that is everyone thought there was only one defense system, and that was fight, flight, sympathetic. But talk to people within the world of trauma, and they start describing disappearing, passing out, defecating, you know, hitting the floor and missing out, yeah, and so. And then you start studying,  as is, comparative physiology, and you start realizing that animals of prey is, you know, like mice and guinea pigs and rabbits, they would literally immobilize, and sometimes that immobilization leads to death and and that was kind of like pushed out of the literature because people didn't quite understand it. And like, there were studies back in the 50s of hopelessness. Actually, this is it became learned helplessness. But the real work was by Carl Richter at Hopkins, and he put rats in beakers of water and basically wait til they died. And laboratory rats would stay floating or thrashing around until they died of exhaustion, but the wild rats, when put in the water, within two minutes, dove to the bottom and just died. And when they did the autopsies, rather the hearts being contracted, which is sympathetic, they were engorged, they had a vagal death. So there was a totally different model. And in fact, he put electrodes on some of these rats, and the heart rates went slower, slower and then stopped. So it was really these amazing stories of what I would call the precursors for many the features of polyvagal theory, long before polyvagal theory occurred.

 

Whitney Lowe  

And so, for example, when we look at the reactions that clients or people have with experiences. It's never one of these things exclusively. It seems like there can be varying different degrees of of each of those things that are left within them as the remnants of that experience.

 

Stephen Porges  

The one remnant I think stays is the gut. I think people who have gut problems are it's part of this dorsal vagus life threat reaction. And even though you may not get the slowing of the heart rate, you will almost universally see digestive

 

Whitney Lowe  

issues. Interesting.

 

Til Luchau  

Okay, so big question a lot of us are wondering about this, what about the larger systems around us where we might feel uncertain or threatened? How do we find safety in an unsafe world? Should we just swim to the bottom and freeze we struggle on the top as long as well?

 

Stephen Porges  

It depends on if you live within social media or cable news, and the answer is, it's totally overwhelming, but the pragmatic aspect is that we've been a traumatized species. We always have been under threat, and survival was always finding enough or sufficient number of individuals with whom you felt safe enough to give up that hyper vigilance and defensiveness. We are a very flexible species. It's not that threat life threat and chronic and stress from work or environments or cable news. We can't deal with it. We can't deal with it. 24/7, we need some safe time. And that becomes a way in which we teach our children or teach our colleagues how to function. I'll give you an example of when I saw total chaos. I was doing a a webinar for Israeli therapists after Hamas intrusion, and they want some advice about how to treat, you know, to do things. However, within a few minutes, I realized these people were broadcasting their state, and their state was not welcoming or comfortable. They were in the state of anger and fear. It was really an amazing reaction. It was quite justified. You know, they were now fearful because their concept of safety had been totally violated, and they were angry. And so the first part of our with them was you need to honor those reactions. They're real. They're your own body, and you need to understand that you can't do what you think you need to do when you're broadcasting that, and this is really, I think, the basic question here, when you're broadcasting fear and anger, you can't be a therapist. So what are your choices? Your choices you can't say, I'm not going to be a therapist and I'm not going to broadcast fear and anger. I don't. But that's not a top down decision. So it means that they have to enable certain relationships, like with colleagues. They'll enable them to co regulate, calm down, maybe fewer hours of therapy, some walk and talks with their colleagues. But they have to understand that they have to co regulate each other so they can provide the resource for those outside their clinic. It's a heavy,

 

Til Luchau  

So important set of solitary line of work we're in as individual practitioners. 

 

Stephen Porges  

Well, you're you're internalized this, first of all, this gift. You have gifts in this domain of helping and making. Making people feel better. However, your ability to express those gifts are totally dependent upon your physiological state and what you broadcast to the other. And again, we keep thinking that everything we do is manualized. And even though it may be harder today for me to do it, I will still do it, but that being harder to do, you're now broadcasting the stress and duress that you're under, and the client's body doesn't want to hear that.

 

Til Luchau  

So we need colleagues to co regulate with,

 

Stephen Porges  

you know, it's kind of like saying, it's kind of a simple term. We need safe friends. You know, it's like, it's, it's kind of like, it's outrageously simple, that as a species, we can be as competitive as we want or need to be, but we need safe places and safe friendships. That's

 

Til Luchau  

amazing. That's great. 

 

Whitney Lowe  

Curious on your thoughts, sorry Til,  just one quick second, go ahead, curious on your thoughts about this, this idea of looking for safety and talking about needing and having the great benefit of other colleagues around us to help us get to that place, because we do operate in such a solitary type of work situation. Do you think it's feasible for people to achieve that through their social media channels, for example, of their their networks and their Facebook groups, or the things that where they have similar colleagues who are going through other types of things. You think we can do that in that non being, not in the same space with each other, kind of place where we don't see facial expressions and things like that.

 

Stephen Porges  

So this may be generational. In my generation would say, not really, if I take it from an informed view, because I do have, my children are quite grown up, and they're professionals, and they they are basically telling me that the social world is different now than it was. And the answer is, really, we need to take an appraisal of what type of social nourishment we'll use that word social nourishment your nervous system needs. And I think for many of us, and I put mine myself in that category, the pandemic was a severe challenge to my nervous system, and it was a retuning that really made me feel more comfortable in obtaining some social reinforcement or nourishment from zoom or from what you're talking about Facebook issues in general, I think the efficient one is being safe in the presence of another. And this is better, okay, I will say that like being on online with the two of you is better than not meeting you. But I think if we were around a table with a cup of coffee, it would be even better. 

 

Til Luchau  

I really hope that this conversation put out as a podcast, is helping some people find safety, find some calming in themselves. I know it has for me. This time with you, I want, before we wrap up, I wonder if you want to tell us about your new book and anything else you want to recommend for listeners who want to know more about your work?

 

Stephen Porges  

 Okay, so the thing I do want to send you towards, and there's a paper called Polyvagal theory, a Science of Safety. It's a Frontiers Open Access paper, and I think it will be very, very helpful to this community. There's, there's a couple of books that have come out. Actually, three books have come out in the last or, actually, I'm embarrassed, four books in the past few years. The one I was just mentioning to you earlier was the book on somatic therapies. I think that one is very, very linked to your community, and there are something like 30 chapters. There's short chapters or 5000 words. The book is, it's a hefty book, but it crosses many of the disciplines that deal with basically body psychotherapy. So there's some Rolfing in there. There's basically a somatic experience. There are a lot of things in there that this community would find of interest. And the part that I like is I actually like the preface I wrote, which describe my relationship with the somatic world and about how I was brought into it from Peter Levine and how I viewed myself as being in the shadows. And then I was given an award by the US ABP, the United States Association for Body Psychotherapy as a Pioneer Award. And I was kind of like, what's this about? And so I had to do a reappraisal about what was my, let's say, impact within the somatic field. And likewise, I was asked to be a co editor on this book, and initially I said, I'll be helpful. I'll get you a contract, but this is your book, but I ended up basically recruiting, I would say, a significant portion of the authors, and to. My surprise virt, I would say 80% of the chapters discuss polyvagal theory in it. So I started to have a different sense of what these ideas that I've been talking about in this in the somatic world have actually gained some traction. And I just felt as a privileged visitor in the somatic for they enjoyed it.

 

Til Luchau  

You have been hugely influential. And I can't think of anybody else that would, you know, deserve the prize more than you. What's the name of the book?

 

Stephen Porges  

Not a good thing to ask me. Well,

 

Til Luchau  

look it up.

 

Stephen Porges  

Yeah, it's a northern book. It's on Amazon. The first author is, is uh, is Grassman, and I'm the third editor. It's easy to find there's another book that came out within a couple months ago called The Safe and Sound protocol. This is a book that I wrote with my collaborator, Karen Onderko. This book is quite interesting because it's about the acoustic intervention, but when, if you were to read it, you'd see a lot of steps and clinical cases that sound very much like what you do as somatic people. Also, there are a few chapters of somatic people in that about case studies. So there's not we wrote the book, but there are case studies, and the therapists basically helped provide the information for the case studies. And then, let's say there's a readable book that came out about a year and a half ago, which I wrote with my son, Seth. It's called Our Polyvagal World. Very readable because he's, he's a journalist, he was able to translate his father's work, and that it's all out there. Now there. It's there.

 

Til Luchau  

Wonderful. There's some great resources. We'll make sure we look them all up and get them into the show notes.

 

Stephen Porges  

 The one I would basically say that you're the community. Would the two things, one is the somatic edit book fits very nicely. The other one is the Polyvagal Theory, a Science of Safety, I think, crosses a lot of domains and basically provides a very, I wouldn't say succinct, I would say readable, of what the major points of what our discussion has been about today.

 

Til Luchau  

We'll get those, get those looked up. 

 

Whitney Lowe  

Yeah. Well, thank you so much for your time today. This has been absolutely wonderful, chatting with you and talking about that all kinds of great things to open up and look into in greater detail.

 

Stephen Porges  

Thank you very much. 

 

Whitney Lowe  

And on that note, Books of Discovery has been a part of the massage and body therapy community for over 25 years, nearly 3000 schools around the globe teach with their textbooks, e textbooks and digital resources, books of discovery likes to say that learning adventures start here, and they find that same spirit here on the Thinking Practitioner podcast, and are proud to support our work, knowing that we share the mission To bring the massage and bodywork community thought provoking and enlivening content that advances our profession,

 

Til Luchau  

Instructors of manual therapy education programs can request complimentary copies of Books of Discoveries' textbooks for review use in their programs. Listeners can explore their collection of learning resources for anatomy, pathology, kinesiology, physiology, ethics and business mastery at booksofdiscovery.com where you as a listener can save 15% by entering "thinking" at checkout. And I also want to thank the Fascial Research Congress, happening August 10 to 14th of 2025 in New Orleans, where Dr Porges is a keynote speaker. They are offering you, Thinking Practitioner listeners, $100 off on your enrollment by entering the word "thinking at checkout. Just go to frscongress.org,

 

Whitney Lowe  

And we would like to say thanks to all of our listeners and to our sponsors. You can stop by our sites for the video, show notes, transcripts and any extras you can find that over on my site, at academyofclinical massage.com. Til where can they find that for you?

 

Til Luchau  

advanced-trainings.com. Whitney and I want to hear your ideas or input or feedback about the show, just email us at info@thethinkingpractitioner.com. Include some really expressive emojis of your face to give us nice safety cues that we can incorporate your feedback or look for us on social media and YouTube. Don't spend too much time there, but go there to send us a little note. I am at Til Luchau, my name, Whitney. Where can people find you?

 

Whitney Lowe  

also under my name, Whitney Lowe over there. And we'd really appreciate it if you would rate us on Spotify or Apple podcast, as it does help other people find the show or wherever you happen to listen. So please take a few seconds to do that. And as always, thanks so much for listening. Thanks so much for sharing some time with us. Do be sure to share the word and tell a friend, and thank you again. Dr Porges for this wonderful, inspiring conversation. It was great visiting with you today. Okay. Thank you very much.