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What is a Polyvagal Therapist and How Can They Help You?

Updated: Dec 8, 2023

You've embarked on a path toward healing and self-discovery. You have crossed paths with numerous potential avenues of doing so, like therapy, coaching, courses, and more. And within these paths lie more, like Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Somatic Experiencing, Internal Family Systems, psychoanalysis, etc. There is a new pathway to recovering from trauma everywhere you turn.

If you've gone deep enough, you probably encountered the Polyvagal Theory and wondered how a "Polyvagal Therapist" can benefit you. But to understand that, you will first need to understand what the Polyvagal Theory is and get clarity on what a Polyvagal Therapist is, if anything.

Understanding the Polyvagal Theory.

The Polyvagal Theory is a relatively new concept in the field of psychology and the practice of therapy, although it has been around since 1994. The Theory has become very popular in trauma recovery, providing an understanding of trauma that does not rely on abstract psychological concepts like "parts," "archetypes," or a "shadow self."

Instead, the Theory provides a scientific foundation for understanding trauma and mental health. However, it's not solely a psychological theory; it applies to numerous fields. Psychology is simply one field that has embraced the Polyvagal Theory, especially in trauma recovery.

The Theory proposes that there are three branches of the autonomic nervous system. These three branches can be on or off (though it is more complex!). When these branches are activated, they result in different experiences. The three branches of the autonomic nervous system are:

  • Ventral vagal parasympathetic - responsible for social behaviors and emotions when safe.

  • Sympathetic - which is responsible for flight/fight behaviors when in danger.

  • Dorsal vagal parasympathetic - responsible for shutdown immobility experiences when in life threat.

The Polyvagal Theory is much more complex, but this is a good enough overview for now. At a minimum, a Polyvagal Therapist understands the state of their client's body and its preparation for safety or defense. But it gets much more complex...

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"Polyvagal-Informed" is probably a better title than "Polyvagal Therapist."

While "Polyvagal Therapist" seems appropriate, it might be misleading. No therapist is directly measuring the state of their client's autonomic nervous system. We don't have monitors or gadgets to gauge our client's autonomic state throughout a session.

Instead, we use the client's presentation and reporting as our assessment tool. We can use these measures, compare them to our knowledge of the Polyvagal Theory, and make inferences about the client's Polyvagal state.

So the term "Polyvagal-informed" may be more appropriate.

The Polyvagal Theory is not a prescription or a therapeutic modality.

Also, there is no one right way to be a Polyvagal-informed therapist. The PVT is the science that helps us understand our clients' state and capacity for change. PVT is not a therapeutic modality with a set of techniques to apply like Cognitive Behavioral Therapy is.

A therapist may be Polyvagal-informed and use their knowledge within their therapeutic modality. So a somatic therapist can use their PVT knowledge just like a psychoanalytic therapist. The PVT knowledge fits in better with some modalities vs. others, especially the ones that utilize more mind-body and somatic interventions.

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Benefits of Polyvagal-Informed Therapy.

Not all Polyvagal-informed therapists will utilize their knowledge the same, but some expected benefits would include the following:

  • A focus on the client's capacity to feel safe and present

  • The therapist provides co-regulation to the client to assist them with feeling safe and present

  • Meeting the client where they're at in their capacity to continue with difficult material

A Polyvagal-informed Therapist will be able to deeply understand their clients' present-day experiences in light of their current and past circumstances. They will do so through the lens of the autonomic nervous system and their clients' shifting into and out of states of safety and defense.

The Polyvagal-informed therapist will provide compassion to their clients without judgment. They will see their clients as having experienced autonomic shifts that were out of their conscious control and bring a non-judgmental, non-blaming attitude to the therapeutic process.

The PVT-informed therapist is less likely to utilize a neutral or unemotional presence. Neutrality is what people may typically expect from a therapist. Instead, the PVT-informed therapist will utilize their face and voice to convey warmth and safety to the client. They don't shy from expressing emotion compassionately with their client.

However, to be compassionate with their client, this therapist will prioritize their self-regulation to ensure they are first grounded in their safety state. Being grounded in safety allows the therapist to provide the client with co-regulation and project safety cues.

A PVT-informed therapist will go beyond clients' thoughts and emotions and utilize their internal sensations and impulses better. Many therapists focus on changing their clients' thinking. This cognitive focus can be frustrating for both the therapist and client. The Polyvagal-informed therapist understands there is more to their client and incorporates everything that stems from their Polyvagal state, not just the client's cognitions.

I created a free resource for you that connects all of these domains together. It's called "State Sensation Impulse Emotion Cognition" and can be downloaded here.


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Finding a Polyvagal Therapist.

If you are interested in working with a polyvagal-informed therapist, you will need to research and find a licensed therapist who has received specialized training in this area. However, this may be easier said than done.

The Polyvagal Theory is not widely adopted in common graduate-level curricula, though it is growing. Typically, this is information that a therapist acquires through their own continued research and learning. So to find a Polyvagal-informed therapist, you will need to search for therapists in your area and then vet them through their website and social media content.

Vetting is more difficult than simply using Psychology Today to find someone. It requires you to set aside time to comb through who is in your area. But it allows you to spend more time with your potential therapist match and get to know their values, skills, and knowledge level.

If you are in the United States, you will need to find a licensed therapist within your state. Due to state regulations, they are not necessarily allowed to practice outside their state. You can attend therapy sessions virtually if the in-state provider is too far from you. Virtual sessions are a great option and provide you with more possible candidates to work with.

Other options if you cannot find a Polyvagal Therapist.

I have also heard from podcast listeners who have introduced my Polyvagal work to their current therapist and have found this beneficial. My podcast episodes 101-109 are a great free resource to bring to your current provider.

You could also find a Polyvagal-informed Coach. But I would encourage you to scrutinize these possibilities even more, as anyone can call themselves a coach with little or no training. Coaching is not therapy, but it can be helpful, depending on your level of need.

Another option is to work with a Somatic Experiencing Practitioner. SE Practitioners should be Polyvagal-informed and can be therapists or coaches. Somatic Experiencing is a trauma treatment modality anyone can train in and utilize.

Take Polyvagal-informed courses.

This next option isn't therapy, but it might be good for you, depending on your needs. If you do well with learning new concepts and being guided in a course structure, then consider purchasing and joining a Polyvagal-informed course. The main source for the Polyvagal Theory and education is the Polyvagal Institute. They offer numerous courses, many for providers, but may have something for those just looking to deepen their learning. This page has options ranging from $50-300 for beginners.

I also have free Polyvagal learning on my site. My Polyvagal Intro is a great place to start, and it's free. I have two more Polyvagal-informed courses, plus a private community, to take things further into trauma recovery and living with more emotional freedom. All my Polyvagal-informed trauma recovery courses and my private community can be accessed through one subscription in the Total Access Membership.


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Is there a risk to working with a Polyvagal Therapist?

I believe there is no greater risk to working with a Polyvagal-informed therapist than any other therapist. The Polyvagal Theory is a scientific foundation, not a modality. The PVT does not prescribe what to do in therapy. So the therapist is still very much guided by their therapeutic modality.

Conversely, if a Polyvagal-informed therapist misapplies their knowledge of the PVT, this could lead to problems. For example, suppose the therapist misunderstands the difference between shutdown and freeze. In that case, they may recommend unhelpful interventions or even worsen things. But this applies to any therapist using any piece of knowledge or modalities.

I recommend that you work with a Polyvagal-informed therapist that can focus on your direct experience in the present moment. The PVT is great as foundational knowledge and can act as a springboard or a common language between therapist and practitioner. But ultimately, the therapist can only work with what the client is bringing to them. A good therapist can work compassionately with their client in the here and now, no matter their training or knowledge base. They can clearly share their thinking process and work together on the necessary steps with their client.


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I'm a Therapist & I was Wrong About Trauma Recovery.

When I first learned the Polyvagal Theory and the autonomic aspects of trauma recovery, I got something wrong...

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Q&A

Q: What is Polyvagal Theory, and how does it relate to trauma recovery?

A: Polyvagal Theory is a scientific framework that helps us understand the autonomic nervous system's response to stress and trauma. It provides insights into how our bodies react and offers strategies for recovery and regulation.

Q: How can a Polyvagal-informed therapist benefit me?

A: A Polyvagal-informed therapist understands the autonomic nervous system's role in your experiences and helps create a safe and present environment for healing. They offer co-regulation, meet you where you're at, and deeply comprehend your experiences through a Polyvagal lens.

Q: What if I can't find a Polyvagal Therapist in my area?

A: If you can't find a specialized Polyvagal Therapist, you can introduce Polyvagal work to your current therapist and explore its benefits together. Additionally, considering a Somatic Experiencing Practitioner or a Polyvagal-informed Coach can be helpful alternatives.


 

Quotes from this blog:

The [Polyvagal]Theory has become very popular in trauma recovery, providing an understanding of trauma that does not rely on abstract psychological concepts like "parts," "archetypes," or a "shadow self."
A Polyvagal-informed Therapist will be able to deeply understand their clients' present-day experiences in light of their current and past circumstances. They will do so through the lens of the autonomic nervous system and their clients' shifting into and out of states of safety and defense.
The Polyvagal Theory is a scientific foundation, not a modality. The PVT does not prescribe what to do in therapy.
 

Author Bio:

Justin Sunseri is a licensed Marriage and Family Therapist and Coach specializing in trauma relief. He is the host of the Stuck Not Broken podcast and author of the book Trauma & the Polyvagal Paradigm. He specializes in treating trauma and helps individuals get "unstuck" from their defensive states.

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