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Deb Dana Interview: Story Follows State, Climbing the Ladder & Diagnosis

Updated: Jan 10, 2022

Some links below will take you to an Amazon page where I get a portion of the sale at no extra cost to you-

This was an absolutely incredible experience for me. I got to interview the one and only Deb Dana! I've broken down the entire chat below (which will match the audio better than the video), quoting some gold nuggets from her. I'd love to see how you benefited from her, so please leave a comment below.

She is the second member of my Polyvagal Trinity that I have interviewed. If you haven't watched or listened to it already, give it a shot after this one.

I highly recommend buying her book. It's a great breakdown of the PVT in easy to understand terms. If you're a therapist, it's a must own. Also this one. It's co-edited by her along with Dr Porges. In it, they've collected a wide range of essays where the PVT is applied: nursing, grief, therapy and more. It's a great one for those in the helping professions. And also her third book, which is good for clients or professionals.



:45 - “Your autonomic state comes to life and then the information is fed up to your brain and it’s your brain’s job to make sense of what’s happening in the body, so it makes up a story.”

1:46 - “You can see how the story changes dependent on the state, not depending on what I choose to think.“

2:08 - Listening Through Three States

Take a simple experience and then imagine that you’re looking at it through the 3 states and see what the story is that emerges

3:25 - Autonomic profile is created over our life span

“Our preferred home is hopefully [safe/social]... we [also] have a home away from home… That’s where I visit. That’s where my system was shaped.”

“I think we have a theme to our dysregulated stories.”

6:28 - “If you can look across the way and say, ‘oh, thats a dysregulated nervous system.. And if you can say, ‘it’s not that he doesn’t want to be in connection with me, it’s that his biology won’t let him right now,’ then that helps to give it a different story.”

6:54 - “We are story making beings, that’s what we do as humans. I’d like the story to be based in the biology. What’s your autonomic story, not what’s your cognitive story.”


8:19 - Stories in therapy

“I’d like for us to listen to your autonomic story, because I’ll bet you haven’t heard that one yet.”

“I like to start by witnessing the nervous system story first.”


8:45 - “Gotta befriend, and so many of us have a hard time doing that. Befriending involves some self-compassion which is also hard to get to.”

9:15 - “Every behavior is in service of survival. No matter how crazy. Your nervous system has enacted something because it’s trying to keep your alive.”

9:35 - gety to know nervous system before befriending

“When you’re in each state, to fill in the sentences - The world is and I am… Because those two sentences are the core beliefs that are at work when you are in that state.”

10:15 - “get to know, then get to befriend”

“Of course I think everybody’s against me when i’m in sympathetic. Because moving into sympathetic - that’s the feeling - you’ve not become my enemy, not my friend. I no longer care about social engagement because my biology simply wants to keep me alive.”

“If in sympathetic you’re my enemy, in dorsal you don’t exist. In dorsal, I’m just floating on my own out there somewhere.”

11:10 - “When we begin to take away some of that judgment, that self-criticism, then there’s room for curiosity. And curiosity is what you need in order to befriend.”


12:20 - “There have to be more cues of safety than danger in order for me to move into ventral.”

13:25 -”The adaptive response come out in response to cues of danger and often times what happens, there’s a cue of danger that has a bit of familiarity to something in the past and so my nervous system is going to go into that full blown response because it can’t discern.”

13:45 - “In this moment, in this place, with these people - is this intensity of response necessary? I get it was necessary then but i’m not sure it is now.”


14:30 - “In the beginning, for many people, climbing out of dorsal is really difficult... They need a co-regulator. They need somebody to accompany them.”

15:04 - a gentle return of energy to exit dorsal

“To begin to leave dorsal, you have to travel through sympathetic… we have to have our energy used in an organized way and often in connection with somebody else.”

15:34 - “None of us are going to spend all of our time in ventral. That’s even not the goal. The goal is to be flexible in how you navigate between states.”

15:55 - “Your nervous system knows just how to do this, we are just reminding your nervous system. It knows the way back to ventral. And we’re going to keep doing it so it remembers it more easily.”

16:15 - “Our trauma stories live in sympathetic and dorsal. So when we hit those states our truma stories grab use. They come alive and grab us.”

17:10 - celebrate mobilization!


17:40 - “Therapy is often this lovely, magical thing that happens, but it’s a mystery. I don’t want this to be a mystery to my clients. I want them to be active operators of their nervous systems.”

18:45 - “What I keep telling people is you think you can get away with not being regulated with your clients and you can’t because their nervous system knows it.”

19:00 - “We want our clients to be able to accurately identify when someone they’re with is dysregulated, but also accurately identify when they come back into connection. And those things are missing for many trauma survivors.”


20:00 - how it took off and her role in it

20:50 - Clinical Applications of the Polyvagal Theory - (link is to Amazon item, where I will get a portion of the sale)

22:00 - “It is our responsibility to be regulated and offer that regulation to our clients. Because otherwise they can’t engage in the process of change that they want. If we... broaden that into society, if we move through the world from a regulated place and offer that to others, the world will change.”


22:40 - glimmers and glows in the 2nd book!

23:00 - “A glimmer is that micromoment [of safety]… 10-20 seconds… if we can notice a glimmer and hang out with it and really just invite it in, let it fill us and spend some time and listen to the story, then it becomes a glow.”

23:45 “If you don’t have some ventral flavor in your system, you’re not going to see the glimmers because you’re not set up to find them.”

24:25 - “In a survival response, why would you want to see something beautiful and regulated? That’s not going to keep you alive.”

Make an intention to look for glimmers


25:10 - Nature vs nurture and a default state

25:40 - “It’s that moment you enter the world. How were you met? Were you met in loving arms? Were you met with someone who was afraid? We think about generational legacy… and I like to simply look at the nervous system and say, “If my mom grew up in a family system that was dysregulated, then she was probably dysregulated. And if her mom grew up in a system that was dysregulated…”

26:15 - “We’re shaped over our experience. The nervous system is a system of relationship. It’s shaped in relationship with others. The beauty of that is it can be reshaped as we go.”


28:00 - common themes to climbing the ladder and individual responses

29:35 - exiting sympathetic and channeling energy into relaxation, dorsal need to bring energy in

30:25 - “The nervous system language is about connection.”

31:00 - flat affect from the therapist

“Your flat affect is a cue of danger to your clients… Do not do therapy with a flat affect… You have become a threat to your clients.”

32:00 “If you don’t come somewhere close to the energy that their system is bringing… their nervous system is saying that nervous system has no clue what’s happening over here... Their nervous system is going to send a message of misattunement.”

32:30 anchoring in ventral as a therapist and simply being there

32:50 - turtle analogy

“To get a turtle to come out of the shell, you don’t knock on its shell and you don’t shake them... You just kinda sit there patiently... But you really have to be beaming that ventral vagal energy to that system.”

33:18 - “I like to say in dorsal I'm more of a guide, I can lead the way, show the way home. In sympathetic I’m following right along with ya… Let’s do it!”

33:55 - therapy and building the ventral capacity = resilience

34:25 - Dorsal takes longer to “make our way back.”

34:35 - sympathetic messages of impatience from therapist about making progress

35:20 - “notice and name”

42:00 - typical sensations and body posture of climbing the ladder in therapy


37:10 - How do you tell if someone is just smiling away the pain versus being actually happy?

38:15 - tracking across time exercise from 2nd book

In a five minute period, check three times:

My nervous system state is…

And now i am..

And now i’m thinking…

40:00 - “When you’re in sympathetic, you have two ways you can go - you can come back to ventral or go to dorsal - and one of the jobs of sympathetic is to keep us out of dorsal because dorsal is the most life-threatening for us as humans, the most difficult place to go. Sympathetic works really hard to keep you mobilize because if it calms down, the worry is you’re going to go to dorsal and not come to ventral.”

40:55 - “Stillness is the most complicated autonomic blend of states, because how do you come into quiet, into stillness, without stimulating shut down? It’s a tricky thing to do, especially for people with a trauma history. Because stillness is a very vulnerable place and I have to really feel safe to come into stillness.”


43:45 - “It is the bane of our clinical existence.”

44:05 - “Through the lens of the polyvagal theory, almost every diagnosis in the DSM is a dysregulated nervous system.”

44:35 - you give a client a diagnosis it follows them forever… I am very careful about that… I don’t think they’re useful in a lot of ways…

45:00 - Adjustment Disorder as an appropriate diagnosis, since it’s a response to a stressor and goes away

45:30 - anxiety as more sympathetic and depression as more dorsal

45:50 - “What you’re looking at is not so much what happened, but what was your client’s response to what happened? What was their autonomic response to what happened? You can begin to frame their dynamic formulation through their autonomic challenges and their autonomic things they do well.”


49:00 - “Wouldn’t it be cool if every kid could identify where they are? And the ones who are ventral could go help the ones who aren’t. Because then the next day the ones who aren’t are and the ones who are aren’t - they all help each other. That would be my wish. Because it’s about co-regulation.”

49:50 - “Polyvagal family” and shared language


50:50 - Wonder Woman!

“I’m definitely going to be Wonder Woman… I’m going to take some of her energies… She’s pretty amazing.”

51:20 - Autonomic experience of elevation

“When our nervous system has this mix of sympathetic and ventral and you see someone doing a good deed and you are then pulled to want to become a doer of good deeds yourself. That was the experience I had when I watched the Wonder Woman movie. I left there thinking - 'Change the world. What are we doing?'”


Intro/Outro music & Transition Sounds by Benjo Beats -

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