Deb Dana and Dr. Stephen Porges – The Polyvagal Theory, Welcome VS Warning, and Regulating the Self

Thomas Hübl: Welcome back to the Collective Trauma Summit, my name is Thomas Hübl, and I’m the organizer and convener of the summit. And I have the great pleasure to be here today with Deb Dana and Stephen Porges, who joined us also last year. First of all a very warm welcome to both of you. I’m happy you joined us and I’m curious and want to learn a lot through our conversation, so a warm welcome.

Stephen Porges: Well, thank you for having us. It’s a pleasure to be here.

Deb Dana: Lovely to be here with you.

Thomas: Many years ago, when I read the first time about the Polyvagal Theory, it made so much sense, and it’s a visceral experience, and I think sense-making, and sensing, and sensing each other is deeply connected. So I’m a deep fan of the Polyvagal Theory and its applications. And I know you both work a lot on refining and creating more and more applications. So I would love to first understand, how any one of us that works professionally through process facilitation therapy, any kind of mediation I think, or even teachers in schools, or couples, or parents, the fields are thousands, where we find an application for the knowledge, but also the practice of what the Polyvagal Theory offers. And maybe you can just share with us a little bit about applications that are helpful for everybody, and then more in specific for therapists. How we can use the understandings of the Polyvagal Theory in our lives, and professional lives. So maybe we start…Deb do you want to start today?

Deb: I can. I’m happy to. When you were talking about all of the different professions or people, I thought, “Well, we can just keep going,” because Polyvagal Theory is really about human-to-human contact. The nervous system is the common denominator in our human experience and it’s where all of our daily experiences emerge from; from this wonderful nervous system. And Steve’s work with Polyvagal Theory has given us a roadmap, to begin to understand that. My particular work is mostly with clinicians, or people in the helping profession, because I get clinicians, and coaches, and speech therapists, and occupational therapists; people who are working with people. But through Polyvagal Institute, Steve’s work is now getting out to schools, and medical settings, and business people, and it’s just really exciting to see how that’s beginning to unfold.

Stephen: Now, let me add a little bit to it. Not much, but a little. If we think about what the theory brings to us, in a sense it teaches us about what is to be a human, and that is this necessity to connect with another. And this is functionally the biological imperative of a social mammal, and we have some similarities with other social mammals. And the part that I like to emphasize is that sociality, this notion of connecting and interacting, is just not merely a psychological or social behavior. It’s a neurophysiological one. It’s part of our health process. We interact with others to become healthy. And we have to remember that part of the problem with the history of, let’s say Western society, is the peeling off of an understanding of our biological substrate from our cognitive or intentional behaviors. And we were suffering. We paid a big price for that, and we call those stress-related disorders.

And in doing that, we also are dishonoring what’s really happening. Stress-related disorders, or psychiatric disorders like anxiety, are mislabeled, or misdirections. It’s really that our bodies are now in states of threat because we haven’t developed the skill set of co-regulating with each other. And it’s not even that we develop a skillset, we functionally develop skillsets not to co-regulate. That’s our normal mode, is to connect. And yet societal demands basically force us into feeling threatened, or in states of threat that interfere with this ability to co-regulate with one another.

Thomas: Let’s talk a little bit about when one state in society is anxiety and fear, and what’s our remedy? Because it seems the remedy is built into our bodies and we need to read the menu, which you gave us and apply it. So, how do we create safe spaces? Because everybody who facilitates processes knows that creating a safe space is the foundation of any kind of healing work. So how do we do that?

Stephen: Let me start with this, then head it off to Deb because Deb is our therapist. She’s our clinician and I want to make sure that people don’t think that I do clinical work. I come up with ideas and other people like Deb, actually put it into practice. But let’s even reframe your question. And that is, you’re already saying that we need help to, in a sense, reach our core; who we are. And we have to, in a sense, honor what our body evolved to do, and it evolved to regulate itself in the presence of others. So it meant that it was co-regulating with others and this concept of mind versus body was another form of internal co-regulation. Where bottom-up and top-down meet together in the brainstem and they share a vision of what it is to be a healthy organism. It’s in us. It’s part of our plan of health.

And what we have done is we literally have not honored what the body is always trying to teach us. So, people who suffer from, we used the term earlier, anxiety or chronic stress, they will tell you that they know they’re doing something wrong. That it’s not what they want to do, they can’t tell you what they want to do. But the body has its program. And it doesn’t mean that we can’t inhibit that program for periods of time to do our cognitive learning, to do our work, to create the resources, but we just have to still lyrically understand that our system needs time in which it’s not under those types of demands. And Deb, in the world of therapy, has learned, not learned it’s again, her intuitive, instinctual unfolding of these intuitive ideas, she’s able to translate them into actually direct practices. And it’s really been quite impressive to see the effectiveness when you can move it into a language that both therapists and clients can understand.

Deb: Yeah. When I think about our clients, and sitting with clients, and coming into connection, I like to talk about the fact that our nervous systems are having a conversation, and it’s our job to tune into that conversation. And then I think part of our work is to help our clients speak that language as well, and so we keep following this back and forth conversation that’s happening below the level of awareness. We bring it into explicit awareness so that we can actually have that. And I like to say, “I’m helping my client become a more active operator of their nervous system.” They understand it, they befriend it, and then they can begin to shape it. To have more of what we call ventral on board. And I say that I truly do believe that we all have a home in ventral, that our nervous system knows how to get there, that the pathways have often been covered up because of our experience. But my work as a therapist is to help uncover those pathways and walk those pathways with my client so that they become more used to being on that path.

And so that’s our home. We have a home in ventral, that we long to be in, and our nervous system knows how to get to, so let’s help uncover those pathways. And in order to do that, we have to reduce the warnings that our nervous system is getting from inside our bodies, we get warnings, or welcome. And then from the environment, we get warnings and welcomes. And then, as Steve was talking about, this beautiful connection between nervous systems, we get a warning or a welcome. And then that’s that co-regulation piece, which as a clinician, it’s our responsibility to be regulated so that we can offer that regulating experience and energy to our clients. And that, I think, is one of the real gifts of Steve’s work, is understanding that this is not something for clients.

This is something clinicians need to understand and embody, and then we bring to our clients, and we travel with our clients, but it’s first, what we have to understand about our own nervous systems. I think there’s such a power in that. In understanding and knowing how to get to my own regulated place. And then, understanding when I’ve left regulation and how to get back there. Because that’s what happens to us all. Think about the clients you’ve seen over the past week and think about the moment when, “Oh, that was a bit messy,” because I lost my anchor in ventral. And I had a moment when I felt a little bit of that overwhelming sympathetic, “What do I do?” Or that dorsal, “Oh, I give up. Nothing’s ever going to change.”

And then we come back to ventral and go, “Oh, wait a minute. I can notice the small things that are changing and I can hold the hope with my client.” This happens all the time. So understanding that helps me do what Steve said, to not create a story of blame and shame, and judging, but create and understand the story of my biology. And then I can do something with that understanding so that I’m more able, with that particular client, to stay anchored and offer them that missing experience, that is often the missing experience with trauma survivors, of safe co-regulation.

Stephen: Let’s add a little bit onto that. And Deb’s saying something else, in addition to what she said, so there’s a backstory here. She’s saying, that the state that the therapist is in affects the client. And we live in a world where people have learned to deliver therapy as if it were a pill. So it became manualized. And what Deb is saying, our bodies are so clever we react to other people’s presence, and if they’re not authentic, if they’re not truly supportive, they won’t be good clinicians. So I have this code word that I use. I say, “In this world, there are some super co-regulators.” And when we meet them, we know it. And there are others, and I put myself in that other category, that are “good enough”. And that is, that we can interact with the other people, they feel good with us, but a super co-regulator, can walk into the presence, the space, of someone who’s dysregulated, and suddenly the portal opens and the co-regulation can begin.

Deb: Yeah. And then that comes through that beautiful neuroceptive pathway. That below the level of awareness you feel held in an energy, an environment, an experience, and your nervous system knows it. So your brain may say, “Well, I don’t know,” or, “Not sure,” or a different story, but your nervous system knows it and begins to come into that space, and begins to allow “Oh, maybe.”

Thomas: Yeah. That’s beautiful, and maybe circling back to one thing that you said that maybe completes that also, is when you said before, maybe for our listeners to define a bit more, what’s a warning from inside my body and what’s a warning from my environment? Maybe we can make this more explicit. I think it’s a…be very good to hear.

Deb: Yeah. So if you listen inside your body in this moment, and if everybody listens, listens inside their body, they may find a place, we’ll look for a warning and a welcome. Look for a warning, you may find a place that feels a bit numb or a bit too excited. I’ve got sort of a throat that keeps going and coming, so that’s a warning to me. It’s like, “Oh, this is…” So I can feel that. What do you find? Do you find a warning inside when you check inside, what do you notice?

Stephen: Basically, what I noticed is that I’m inherently relatively calm. It doesn’t mean that I lived a calm life, but I start realizing it much more in others. Where they can’t sit still, they walk around, they create a narrative, they create an action, which they have to fulfill. So they get mobilized and now they have to complete something. But what I like to talk about, in terms of what you were saying, is that we live in a world that really has treated us as from a young age, to tell us not to listen to those cues coming from our body. So it just says, “Turn off the feedback.” “Sit still.” “Do more of this. “You only have another hour of this work to do.” Basically, teaching us at an early age, to develop a skill set of dissociation. And what are we dissociating from? What our body has been telling us.

Now, you can develop, I would use the term a happy harmony, where you are aware of what your body’s telling you, but you just basically shift priorities. You say, “I have to get this done.” So you acknowledge what you need to do. “I can’t eat right now.” Or, “I have to do this.” Or for younger children, it’s like, “I can’t go to the bathroom at this moment.” You start developing a certain understanding of your biological processes and you become the master. You control it, but you listen to it. And what I’m really saying is, the world, all of us, whether we are we’re in Europe, or Israel, or the U.S., our reaction was, “Sit on it. Inhibit those feelings. They’re just going to get in the way of what you need to do.”

Now, that’s a very interesting set of priorities. But what it does is it creates the collective diseases, or stress-related…whatever we want to call them. They get lists of where our body is now, in a sense, refusing to be compliant. But the whole issue is not being aware of our body. And if we go through this reframing, in terms of tells or telltales within our body, we react to cues in the body and outside the body through, basically this process that I labeled as neuroception. The interesting part about neuroception is we lack the awareness of the source of the cues, but we are aware of the bodily reactions. And in a sense, that’s how your therapy works. You work from there, and you get people to sit still for a moment and not create a story of why their body feels that way, but to feel that body.

So they understand that the body is now in a state that has great accessibility, or vulnerability, it can all be the same, and then the narrative falls in. And this becomes, again, one of the important points, why there’s so much anxiety, or mobilization, or stress-related disorders, or why people are in therapy. And that is, sitting still or being accessible is vulnerability to them. And the healthy person says, “Stillness, sitting still, is really where I want to be.” But the person who has that complex trauma history, when they experience that same… In a sense, their body is now no longer mobilized, they’re really experiencing great threat. So accessibility means something different based upon your own personal clinical history.

Deb: And trauma survivors are taught, fairly explicitly, to not see what is happening, to not feel what is happening, and what they’re feeling is not correct. So there’s an explicit teaching of that to trauma survivors when you grow up in a dangerous world  and in a dangerous family. And so to come back into connection with that is a slow and patient process. To say, “Your body is sending you a warning,” and usually it’s the big warning we can feel first, we don’t feel the subtle ones, and then, “Is there a welcome in there?” And often, in the beginning, it’s a place perhaps of no feeling. Or a place that doesn’t have that intense pain on the inside, because we leave our bodies for good reason. So learning how to safely come back in is a very slow process. And sometimes the body feelings that we start with are the ones here [gestures towards head]. Because that’s where we live. So, “I have a headache.” Okay, people can feel headaches because it’s here. Or I can feel, “Oh there’s a bit of warmth.” It’s interesting to explore coming back into connection with the body. 

That’s the internal, and then Thomas you asked about the environmental. As we started today, I had this lovely sense of being welcomed into your space because, for my nervous system, your space is very lovely and welcoming. That environment was like, “Oh.” I could feel myself there in it. For me, it wasn’t even my environment, which I do love, it was your environment that was sending me a welcome. And then my warning in my environment, I had to close my window because they’re doing some roofing project and so it was this hammering out there. I was like, “Oh, no. No.” And then if we go to the between, which is where we started with co-regulation, that sense of a welcome or a warning between, I actually am trying to find a warning right now because…I just feel very connected to the two of you and my nervous system feels very welcomed.

There’s a sense of the smile on Steve’s face, your beautiful welcome face, that I hadn’t seen until a little while ago, but there’s this welcome that comes. The warnings we often feel in the between space is somebody may look away when we’re talking, or look down, and be focused on something else, and that’s an autonomic, automatic warning that comes in. It’s like, “Oh, what just happened? There’s a disconnect that happened.” So, for people listening, maybe they’ll look at our faces and say, “Is there a welcome?” Is there a welcome that they feel here, and then think of people who they are in relationship with and think of what’s the warning? Not what they say, not the words, but what’s the autonomic warning?

It may be the tone of voice. It may be the way they come too close or distance. Those are the sorts of welcomes or warnings that we’re always looking for. And what I’ve come to recognize is that they’re always both present. And so it’s not that I don’t ever have warnings, it’s that my cues of safety, is what I call them, but my welcomes outweigh the cues of danger. And when that happens, when that equation is in that direction, then I can feel regulated; safe enough to come into connection. So that’s really what I’m working with.

Thomas: That’s beautiful, it was a lovely description. I think many people can find themselves in what you both shared now. Circling back for a moment, and then I want to deepen a bit the conversation around trauma, circling back to regulation, Deb you said before, I think you both mentioned it before, when I feel that I’m stepping out, or I’m getting out of my regulated state, first of all, how does one notice that? Maybe that’s not fully clear to many people that that’s happening. And the second thing is, what are actual practices of how to return to that regulated state? I think that’s a very important question to many people listening to us here.

Deb: Yeah. Steve, do you want to talk about the science of how you know you’re dysregulating?

Stephen: I will venture into that space. What I’ve noticed, and I’m not going to really talk too much about the science more than observations, my comments are going to be more based on observations, that if you look at people’s muscle tone through their arms and legs, because you’ll see people when they’re talking they’ll clench their fist. If you listen to their voice, if their voices lose the melodic, prosodic features, since the larynx and pharynx are regulated by vagal pathways, they’re basically telling you whether or not they’re in a ventral vagal state or not. And so you’re hearing in their voice, their physiology. You’re seeing in their body if the muscle tone is tight, it’s a high sympathetic excitation. Their voices are high pitched, and squeaky, or they lack a melody, they’re in a sympathetic state. If it’s a male voice that goes to a low, booming, yelling voice, so there’s no frequency modulation, but volume modulation, it’s a sympathetic aggressive state.

Our bodies know this. This is not a new knowledge to our body. The issue is, we’ve been taught to neglect it. We’ve been taught to say, “When I experience that, I should neglect that and I should focus on what the person is saying.” And that’s where you get this violation of authenticity. And that’s the gut feeling, that you’ve been violated and you should have known. Because your body is saying, “This is a risky interaction.” And then when you get injured, you say, “Oh, crap. I should have picked this up.” And it happens for many people frequently, because they go into the situation with a degree of benevolence and positive expectation, and they also go into it without an honor of their own detective system, their own neuroception.

They’re not respecting themselves, they’re deferring to the other. They make statements like, “If the person holds this position, the person must be smart.” “If the person is a therapist, they must be a good therapist.” They start, in a sense, creating or, “The person is an expert, I’m not an expert. So I need to listen to what they are saying.” But their body’s telling you that what they’re saying doesn’t carry any truthfulness to them.

Deb: And what I like to help clients do is have a moment of feeling regulated. Even if it’s a micro-moment of, “What is that experience?” Because then we can contrast it with, “How do you know you’re dysregulating?” Because you can’t know that until you know both, right?

Thomas: Right.

Deb: So we have a micro-moment of regulation, which often is between me and my client. That this the moment that we come into connection together and I can feel, “Oh, so we’re both feeling safe and okay right now. Let’s really describe that. What’s happening in your body? What are you thinking? What are you feeling? What are some of the things you want to do in this place?” And then we can begin to contrast that to, “Okay. So when you begin to go to that place that Steve just described so beautifully, that sympathetic, overwhelming, chaotic, disorganized energy of fight and flight, how do we know that? How do you feel that in your body? What do you think? What do you feel? What do you do here?” And then the other one, where so many of us trauma therapists understand because our trauma survivors go to that place of disconnect.

That’s the place we want to also map. Like, “Okay. So when you go to that place where you’ve lost fight and flight. All of the energy is gone for you. You’re in that hopeless despair, going through the motions, but not really here place. How do you feel that? How does your body tell you that? What do you think? What do you feel? What do you do?” So, those are the basic landmarks that we’re always mapping in the beginning and actually creating a map. Because we have to have that map of our system in order to know…The question is, “Well, where am I? I have a map now.” Yeah, Steve.

Stephen: Sorry about jumping in, but you’re also asking that when you move into those states, or you’re suggesting, the concept of optimism and purpose in life goes right with it. So when the person is in, in a sense, that state of despair, purpose in life is gone, ability to be supportive of other, or co-regulatory is gone. So you start seeing what gets pulled away from the beauty of what is to be a human being. And what I have come up with, in the sense, what I’ve learned from the trauma community, is I’ve learned what it is to be a human being. What are the gifts?

It’s a paradoxical thing to say, that you learn more about the benevolence of being a human being from those who have been so hurt by society and others. That you see what has been pulled away, but what you also see within them is a vision of being able to be co-regulated with someone, even though their bodies will not allow anyone to come close to them. So you start seeing what’s built into the nervous system, this positive, optimistic narrative, and then you see what the body is doing with that information.

Deb: Yeah. And I like to invite my clients to really bring that curiosity to this exploration and the recognition that in the moment, when your nervous system takes you to sympathetic, survival energy, or dorsal, disconnecting energy, it’s doing that because your neuroception is sending a message that the world is dangerous right now, you’re in danger. And your nervous system is simply going to take you to one of those places without thought. It’s just going to do it. And can we first just bring curiosity to it, and then later on, can we even bring some gratitude for the way the nervous system has creatively rescued us? In the beginning, that’s a stretch. In the beginning, we simply want to be a bit curious and understand that your biology is working in service of your survival always. And that I do put in in the beginning, in service of survival. And then we begin to appreciate that service of survival when we’ve moved a little further along in our work.

Thomas: There’s one question that comes up, listening to you. Going through such therapy, is regulation a muscle we train and we are getting better at it? Or meaning the other way around, is safety something we grow? Or is safety something we rediscover moment to moment? So, let’s speak a little bit to where we start and what’s actually an internalized safety if there is something like that? And how do we develop it? So maybe we can…

Stephen: Let me start with this and it’s, again, how do we conceptualize our presence on the planet? Do we see ourselves as machines that learn and have to be trained to do everything? Or do we see ourselves as a system, an organism that has a lot of what would be calling merchant properties, if we are allowed to nurture that organism? So it’s like a flower blooming. It needs light, it needs nourishment, and what do we need to be who we really are? And that becomes an extremely important dialogue. So you start off with the notion, is it a muscle? It is like toning and exercise. And I’d like to talk about neural exercises because that’s all we’re really doing.

In social behavior, social interactive play, those are neural exercises to help us regulate our state. But remember, if we use the word “play” it’s subjugated to a low priority in our society. It’s something that is not necessary. But play is critical because it creates this neural organization, this neural exercise of reciprocal interactions, calming, and movement, which is what our nervous system needs to be exploratory on the planet and to be calm by itself when it’s exploring in its mental space or spiritual space. So without this capacity to regulate our physiological state, we’re not a very complex organism. We just don’t do what we could do.

Deb: And I guess I do talk about shaping our system, that we have patterns of protection and patterns of connection that are shaped throughout our life. And most of our clients come to us, really, in those patterns of protection, more often than an ability to come into patterns of connection. So that’s what therapy…when I’m working with clients, that’s what I say we’re doing. “We’re helping you walk those patterns of connection more often.” And the more often we do that, then they become easier to walk and we don’t fall as much into the patterns of protection, but they’re always going to be there ready to rescue when needed. So I think what I like to see, and I like to track with my clients, is the subtle ways their responses are changing.

And as we notice those nuances of change, when I often ask clients when they come back, “Tell me something that happened differently this week. Not something that was better, but something different,” because that’s what we’re looking for. “What happened differently in your nervous system? How did your nervous system respond in a different way?” Because if I’m habitually stuck in that state of collapse, the difference might be the, “Wow. I had a sympathetic moment of fight,” And we go, “That’s right.” Isn’t that wonderful? Your system’s started to come back to life in that way. So tracking those ways. And then, the story changes with clients because they begin to see that their system is changing, and they feel the outcome of those little changes that then are going to add up to something larger. I do talk about shaping, and I think it’s a very helpful thing for clients to notice these small ways that something new happened.

Stephen: So Deb, I would just reframe it in a different way, but it’s exactly what you’re saying. And that is, inviting the client on a shared journey of exploration. And I think this is missing in education and in medicine. Where everything is evaluation-oriented when it could be a shared journey to learn about your body or learn about your intellectual competence in education; a journey. And we go to physicians, what do we do? We get tests. When we get those tests, are we anxious, or fearful that the tests will show something? So we create the same window of, basically, threat in all these institutions. When medicine could be framed, “We’re doing these tests, and when we get them, we’re going to sit down, talk to you about what these things really mean. And we’re going to learn about the wonder of your body and how it’s trying to essentially create these homeostatic systems, these regulatory systems, and sometimes they get out of whack. And we need to develop joint strategies of helping them work.”

We don’t frighten people and say, that if they’re not scared, they won’t be compliant. And this has fallen into both physical health treatment in medicine, and also in the psychiatric world. You have to scare the clients sufficiently, that they’ll be compliant. What does that mean? Take their drugs, do their homework.

Deb: Yeah. And you’re talking about medicine and psychiatry, but we want to bring that into the clinical psychotherapy world too because even the first meeting with a client can often feel very dangerous to a client. And the fact we’re doing this initial assessment, it’s called an assessment, right?

Stephen: Yep.

Deb: Rather than a, “Let’s get to know, what has brought you here? Let’s get to know that.” And then, people have to tell you about their childhood history. It’s like, “No, no. Let’s not do that. Now, let’s get to know. Let’s spend time connecting.” And it’s important to recognize that, even in the world of therapy, we have not been trained to take the time to do that, to really establish the safety of this relationship. And for many clients coming into connection with a therapist and really feeling safe enough to share, to talk, to go on a shared journey, which is, I tell my clients, “We’re going on an autonomic adventure,” and for clients to actually be willing to do that, their nervous system has to trust my nervous system. I have to be dependable. I have to be trustworthy. In order to do that, I have to be regulated, and I have to be transparent about the moments when I dysregulate.

And that I think is one of the beauties of working in this polyvagal guided way, is that when I have a moment when I get pulled out, because all of a sudden I remember, “Oh, I get it. I’ve got four things I have to do after I finish with this client,” And then I come right back, and I think, “Oh, they’re not going to notice.” Well, their nervous system noticed. You can’t get away with it. So what I’ve discovered, is it’s so much better to say, “Did you notice, I just got pulled away for a moment? My sympathetic system just dragged me away and now I’m back.” Because that’s what happened. And I’ve had so many clients tell me, “Thank you for saying that because I felt something, but I didn’t know what it was.”

So we’re giving them the context so that they can create the story that makes sense. Instead of renewing the trauma story that, “Oh, Deb was bored with me.” Or, “She doesn’t want to work with me.” Or, “I’m too broken.” Or any of those things. So again, I think it’s just a lovely way to work and to really attend to the relationship in that way.

Thomas: Yeah, that sounds very beautiful and profound. Also the authenticity of being congruent with the process, it’s beautiful what you said now. Given everything we said right now, if we applied it, one question I have for both of you, and also Steve for you as a researcher when we say intergenerational, because some it’s about collective trauma, like massive wounds that we share culturally, and over generations, and the transgenerational transmission of trauma, so if somebody has a strong transgenerational transmission of trauma, so we come into life with higher stress, and fear receptors, or with some epigenetic changes, how would we see this in the bigger context? Would that apply similarly? Is there anything that, for example, co-regulation would help us to maybe affect that condition we came into life with? What was your finding as a researcher on the nervous system? Are there any signs of transgenerational trauma?

Stephen: Well, I haven’t done transgenerational or intergenerational research, but I look at trauma history and how it relates to autonomic reactivity in other clinical symptomatology. And the interesting part of that story is that the variants of trauma history, in terms of outcome, is virtually 100% accounted for by autonomic retuning. It’s not 100%, but it’s extraordinarily high. And we did a study during the pandemic, and this is of people who were not infected, but we measured anxiety, and depression, and worry, different features of worry. And basically, we created our own adversity history scale and we measured a subjective tool that I developed, called the body perception questionnaire, that really gives you an index of what autonomic reactivity is. And interestingly, or, it would be obvious that the greater your trauma history, the more adverse events you have experienced, the poorer your outcomes would be in terms of symptomatology, and also the more adverse history you had, the more autonomically reactive you are.

But if you create a model that says, “I have trauma history here, and then I have whether or not my autonomic nervous system is retuned to be a threat system.” Then the path from trauma history goes right through the autonomic state to the outcomes. And virtually nothing goes from trauma history to the outcomes by themselves, without a retuned autonomic nervous system. But therapists see that, they see that the autonomic nervous system of trauma survivors is different, they have a variety of comorbidities, but they don’t conceptualize it as a re-tuned autonomic nervous system that is re-tuned to be in a state of chronic threat.

Now, to circle back to your question, Thomas, the issue is if your autonomic nervous system is in a state of threat, how do you find the portal to normalize it, to shift it back? And this is where Deb’s work, and even the work with the Safe and Sound Protocol, is all about. It’s giving cues of safety to the nervous system, to allow it to be accessible for periods of time. And what Deb was talking about was during those periods of time, where she is having moments of co-regulation with her client, those become a window that can start expanding, because there’s a shared journey of learning about one’s own visceral state and the ability to tolerate those minor shifts in visceral state, that we then would say, “You’re a resilient person.” Versus a person, “Oh, he lost it again.”

And we know this in the world that we live in. Many of us, I used to say, “We all have,” but I realized, especially in the clinical world, very few clinicians work for other people. And then I say, “Oh, they’re really smart people.” Because when you work in another environment, you’re dealing with people who are unpredictable in their ability to be co-regulatory, and they can often be reactive to you, independent of what you do. And academics is just one of those places because people are under, let’s say, internalized demands, and everything becomes about intellectual productivity and not about collegial, mutual support.

Deb: I have two things. One, I wanted to just say something about that. I have so many colleagues here in the States who work for agencies, and they have a lot of those same threat cues that come up, of productivity. Somebody else making your schedule, all of these things, and it truly is disruptive to the nervous system. It’s very hard to have all of those unpredictable things, and those overwhelming demands, and then come and sit, and be regulated and bring that to a client, so there is that. The intergenerational piece, or the transgenerational transmission of trauma, I take it just very simply with clients and ask about their mom and dad, and their mom and dad’s families.

Because for me, it’s simple to say, “Okay. So tell me about your mom’s family. How did she grow up?” Because that’s where her nervous system was shaped in that environment. And then your dad’s. And then you can go back, and you can keep going back, if you have that information and say, “Those nervous systems all were held in dangerous, dysregulated environments, and learned how to survive in those. And then it keeps getting passed down. So your mom and dad, were the two nervous systems. If it was a mom and dad, or whoever was in the family, those are the nervous systems. That was the air you breathed. That was the sea you swam in. That’s where your nervous system learned how to survive. So for me, that way of thinking about how it’s passed down, makes it easy for clients to understand. And also, to look back and see the biological dysregulation and sometimes have some compassion in a different way.

Stephen: Deb, let me add to that by saying that we are a traumatized species. So it’s not merely that our grandparents immigrated under great duress, or that they were Holocaust survivors or other things. If we go in and look at most of the population in the U.S., it’s an immigrant population. And it’s immigration not under the best of circumstances. And the native population, in a sense, the immigrants weren’t welcoming to the native ones. So you start seeing, this is total trauma. If you go to Australia, you see it actually almost…well it’s in our lifespan, the way that the first peoples of Australia were treated. And even though the intention may have been, in a sense, from the perspective of the 1950s, and 1960s, the perspective was, “We’re doing the right thing to educate, and take them out of this uncultured environment.” It just replicated the trauma history that was embedded within the UK to begin with. And then if we say, “Well, Europe, not the British Isles, but Europe, they’ve always been at war.”

And you start seeing that there is not a place where, in modern times that we can think of, that has had a long history of, in a sense, peaceful coexistence, that was inviting to diversity in co-regulatory. So even though we can say, “Oh, the Holocaust was horrible,” we have to look at that intergenerational, or what’s going on in Ireland, where we’ve had discussions with those people, it’s the same story. I was just talking to a person whose parents left Lebanon in the ’50s, actually during one of the Lebanese civil wars, it’s the same story. And they immigrate, their kids do well, but it’s also the lack of sense of safety within the family or within the community. Meaning that you’re living in the wrong areas. You’re being beaten up by people from other ethnicities. You’re excluded. You start seeing this whole scenario unfolding all over the place. And we have to, in a sense, sit back and say, “The core of humanity is wonderful and we have to allow it to express itself.” That’s part of our mission.

Deb: When you were talking, I was thinking, often clients come to us, trauma survivors come to us, and they say, “I want something different for my kids.” Right?

Stephen: Yeah.

Deb: That’s the longing. And through an autonomical lens, I can say, “We can do that. Because as you become regulated, you are then providing an environment where there is safety, autonomic safety, at least. If nothing else, there’s autonomic safety. There is safety and connection, and your children’s nervous system is going to be shaped in that way through that, and it will begin to change.” And there’re some times that I thought about, “Does time really only flow in one direction?” I often will tell clients as we do this work, “We can also offer a gift backward. We can work backward and offer that healing back to generations.” So for me, that feels important.

Stephen: The backwards healing, I’m actually going to build on that, because what it enables us to do is literally honor the traumas of our relatives, and to see them in their heroic light, as opposed to seeing them as challenged in raising us. And for me, that’s been, in a sense, transformative for me, to reverse it and see my parents as children. Seeing my parents as what they experienced and what my grandparents experienced. And saying, “Oh, they really did well with what they had.” Which is a very different perspective than a teenager has. And I think this is very important in terms of developing our own personal narratives.

Deb: It’s a very different experience than an adult who is still feeling dysregulated and living the story of survival that they had to live in their family. So when I can come to a place of regulation, and then begin to look out into the world through the eyes of regulation, that allows me to be curious and compassionate.

Stephen: You’re giving, again, it’s a shared journey, and you’re the explorer leading the team, and saying, “This is possible.” You can, in a sense regained your heritage. That’s really what we’re saying. And this ability to be co-regulatory, which we also say, is merely the basis of good sociality and good health, is our heritage. And you’re, in a sense, leading people back to their heritage.

Deb: Right. And then from that place, they create a new family story.

Stephen: That’s right.

Deb: It’s so lovely. Yeah.

Thomas: It’s so lovely to listen to both of you, how you’re riffing off each other and now you’re in a dance together. It’s very beautiful.

Stephen: Co-regulatory. Co-regulatory.

Thomas: Right. It’s very beautiful to watch. And I love what you’re saying about two-way healing; the passing on and also going back into our own ancestors. So that’s very beautiful how generosity starts to flow in both directions. It’s beautiful. And the Safe and Sound Protocol, you mentioned this before Steve, can you both share a little bit what that is?

Stephen: Yeah. Okay. If we think back, a lot of things that we were saying, and that is, a prosodic voice, a mother’s voice, a lullaby will calm a crying baby. And then if we think about it, if you have a dog or a kitten, how do you talk to that? Or a horse? You use a melodic voice and suddenly these uncomfortable animals start coming closer to you. And then finally a dog goes on its back and you rub its belly because you are sending, with that prosodic vocalization, the term I use, is distilled essence of safety. You’re sending a cue that their nervous system can’t reject. And the composers, the great classical composers of symphonies, Mozart, Beethoven, and Haydn, all of these people understood the principles. They used it in their opening movement with the melody, which was the Mother’s Lullaby, and then you got familiar with that, and you felt safe, and you got open. And what do they do with the melody? They give it to a broader range of instruments with lower and lower frequencies.

And suddenly your body is retuned to be accepting of this broad range. The Safe and Sound Protocol works on the same principle. It says there are certain frequencies that disarm our nervous system, enable us to be calm. They also, those same frequencies, end up functioning as if it were an acoustic vagal nerve stimulator that basically increases ventral vagal tone. And with the Safe and Sound Protocol, it’s a five, one-hour program, that initially was being delivered over five sequential days, in which the frequency bands were being modulated, and it was a true neural exercise. It was a treadmill literally of this neural circuit. But when this worked, really, I would say, exceptionally well with kids and people who were functionally in safe environments or felt safe in their environment, and with many autistic kids, they would become spontaneously verbal and social – engaging.

But when the trauma therapist who had heard me speak said, “Oh, we’ve got to try this.” They ran out and they tried it and they started seeing some interesting things that really, I would say, disturbed me. Because it started to be a trigger. And some of the trauma therapists were so insightful, they said, “A trigger. This means this is very powerful.” To me, a trigger was, “Oh, this has made people feel uncomfortable, and I don’t really want to be the one that is harming anyone.” But what they ended up understanding was that you could basically slow up the procedure, and often really slow it up to only a few minutes a day. And what you’re doing is re-educating that nervous system, just like the classical composers were. You’re using a little bit of the frequencies, and then over time, you’re expanding the experience, and through neuroception where the body is now reacting to the cues. And their neuroception, they’re becoming aware of their physiology, but they have no narrative to put on it.

So now it becomes something they can control. “I’m listening to music and suddenly my body has this feeling, and this feeling is that of a violation of trust.” Well, isn’t that interesting? So then the therapy works with the person’s own detection, or perception, of their bodily reaction. And they start realizing that their nervous system is retuning. So it’s really quite a remarkable…let’s say, it’s an adjunctive therapy to other therapies. It’s not a therapy unto itself. It makes many individuals who have complex trauma histories, more accessible to other therapies. And in a way, it jump-starts therapy. It makes them a bit more accessible.

Deb: And one of the things I love about the Safe and Sound, is that when our clients first come to us, they want change, they want to be fixed, “Help me do something.” Safe and Sound Protocol, is something that is an actual piece of technology. We can do something, even if it’s five minutes a day, we can do something, and it gives clients something that they feel successful with. It’s a way to dive in and say, “Yes, we’re going to do this,” and this, at the end of five hours, or now we have three tracks of five hours each, so at the end of all this, your nervous system is going to have been shaped in a new way. So I find for clients in the beginning, as a way to say, “Here’s something we are going to do, in the midst of all of this other stuff that feels very not sure,” it’s a lovely cue of safety.

Stephen: Yeah. See, I think there’s a part of the Safe and Sound Protocol that really hasn’t been emphasized. And that is, literally the debriefing – the interaction with the therapist to discuss those visceral feelings. And that, I think, becomes that pathway of reconnection of, let’s say two parts of our nervous system, the head and the body. We’re now seeing or feeling. And we’re understanding that, “When I listen to things, my body is reacting to them. And I’m feeling things.” And remember, with many people with complex trauma feeling is a distal phenomenon. Except for pain. They’ll feel pain, but now they’re feeling something that has a gradation to it.

Deb: Right. And the question, “So what happened?” And if we’ve done the map and they have enough sense of something shifting and say, “Where did that take you? Where did those five minutes of music take you?” And that’s the exploration and it’s so lovely, you’re right, to do that together because we’re both learning.

Stephen: Well, let’s also put into context, that if you’re giving distilled cues of safety, what’s the history of someone with complex trauma? That their trust with a person, or a violation of trust with a person, is deep in their history. And now by presenting cues of safety, their body is going back initially to that physiological state and then they read that within their body and say, “I’ve been there before. Getting out of there.” And it’s really a remarkable thing to actually observe a person moving so rapidly into that and showing the power. And that’s a top-down interpretation of a bottom-up, and that’s where an understanding in that dialogue was. That people realize, and this is the optimistic part, that they can, in a sense, become accustomed to that and start enjoying it.

I had a psychiatrist who tried this herself, wrote me a letter, this is a 21 or a 27-page, single-spaced letter, and I will just read the bottom… I’ll not read, I’ll tell you the end story. She used to take drugs before her first client in the morning, and now she doesn’t have to do that. And she now saw that her seven-year-old was funny, not annoying. And she then said to me, in this letter, “I now know why people like music.” So you can just imagine what her world was like. But in her doing it, and she did the thing that you should never do, she self-administered and she had a course of trauma history. She ended up going through it three times and the first two times were like going through a tube. She basically forced herself through it. It didn’t resolve, but she was persistent. And by the third time, she was retuned and she became, “Now a different person.” Related to her family differently, related to her clients differently. A very brave person, in a sense, to take that visceral feedback. But also told me a lot about her and that was, she didn’t go and get help.

Deb: Right. There’s that independence, is what we call it.

Stephen: Or shame. She was a professional psychiatrist, it was… she didn’t go and get help or delivery with someone who was working with this and other clients. No. She just did on her own.

Deb: Right. Because it comes out of a sympathetic place.

Stephen: We don’t even have to say that, we can say it comes out of a state of threat.

Deb: Yep. It’s a survival energy that says, “No, I’m going to do this on my own.”

Stephen: “I’ll do it on my own, because it’s going to be humiliating if I tell people I have a vulnerability.”

Deb: Yeah. Or, “I don’t know how to connect with someone and ask for help and be under their care, under their guidance. I have no idea how do to that.”

Stephen: Why? Because they don’t trust anyone.

Deb: Right. Yeah. The nervous system has learned not to.

Stephen: That’s right.

Deb: Yeah. Absolutely. Yeah. And also a lovely thing about SSP (Safe and Sound Protocol,) just like Polyvagal Theory, to understand it and embody it, SSP is to understand how it works and go through it yourself before you try it with a client. Get to know your own nervous system and let’s do it with somebody else. “I’ll even do it.”

Stephen: Well, to me it’s amazing. It’s the range of reactions to it. So when I developed this, this is innocuous, it doesn’t do very much much, but it seemed to work with autistic kids. They start to spontaneously engage and their auditory processing became normal, so this is good, but I didn’t really have much of a response, except I decided I would overdose with it. So I listened for many hours and became hypersensitive to human voice. And I should really say, I couldn’t even sit at the computer monitor, because the computer fan was too noisy. So, I became so attuned to certain frequencies. I could hear voices through the walls. It took about two weeks for it to dissipate and I’m basically very careful with that.

But the issue is, I’m shocked that certain people…there’s a pilot project, a feasibility study, going on now with Parkinson’s disease, and when the first hour of delivering, the first hour of SSP took about, I think, a few weeks with this first client, because he was so sensitive. Now he’s gone through at least four hours and now he’s out dating because his face is working, his voice is working, he moves well, and he likes the women, and the women like him now. So it’s really this wonderful bit about a nervous system that was in a state of threat. Now Parkinson’s is a real disease. The question is, are all the symptoms permanent that are locked with that disease, or are some of them the body’s reaction to the disease? So when we get Parkinson’s, does our body go into a state of threat?

And then the threat reaction becomes embedded in what we think the disease is. Alternatively, maybe there are aspects that are rehabilitative. And the bottom line is, it works well. And when there’s also convergent data on vagal nerve stimulation, as reducing symptomatology in Parkinson’s. So I think what we’re learning is, that if the reactions that we’re seeing in different disorders look like a threat reaction, a defensive stress threat reaction, they are probably retunable.

Deb: Right. When clients come to us, they bring what we usually call a presenting problem. And my work is to say, “Tell me about that, because it’s your nervous system showing us some way it’s dysregulated.” And then, “Okay, let’s now put this over here, and work here, to bring some regulation. And then we’ll take this presenting problem back and put it here, and look at it from this more regulated place and see what has changed.” Because it will change. It’s fascinating what changes, and the options that clients have all of a sudden to, “Oh. I could do this.” They come up with these amazing options I could never come up with, because it’s their nervous system that’s saying, “Oh, this is something we can do.” So again, I think you’re right, that the dysregulation that brings this symptom is where we want to be. We go underneath the symptom to regulate and then things begin to change.

Thomas: And again, it’s so lovely to follow you dancing.

Stephen: No. We want to bring you into it, Thomas.

Thomas: No, I’m enjoying it entirely. It’s lovely to see you dance together. It’s very beautiful. It’s very attuned between the two of you, it’s lovely. So maybe since I see our time, I have one more question. Let’s see, a little bit to summarize, because Stephen you said before that we are living in a traumatized…or we are a traumatized species, it’s a traumatized world for a long time. So if we see us as a collective healing movement and we apply, now, things that we heard here, what can we do in order to do our contribution? All what you mainly shared, now with us. What’s the movement? What’s the contribution?

Stephen: I think, even though I said we’re a traumatized species, and there’s a lot of those disruptions going on worldwide, I’m extraordinarily optimistic. I think the fact that we can talk about trauma and trauma is being discussed everywhere, and it’s even getting a foothold into basic medical practice, we are acknowledging what has happened to our species. We’re not denying it. So, I think the dialogue is there and we’re learning that whether it’s through, let’s say, breathing practices, or yoga, or through SSP, or through spiritual practices, we’re learning that the body can find other states that are comfortable and nurturing, and above all, that our interactions with others are really the underlying core of what it is to be a human.

Deb: And then for me, I can feel very overwhelmed with the world because we are living in really challenging times, and I love Steve’s optimistic viewpoint. I sometimes feel this, “Oh my goodness, where do I even begin?” And then I come back, really, to Steve’s beautiful theory and the fact that if I can come to my own place of regulation, then what I am putting out into the world through my nervous system, are cues of safety and a welcome to come into connection. And as I move through the world, my nervous system is then communicating with other nervous systems. My nervous system is communicating with yours today and is communicating with anybody who’s listening. And if I am anchored in ventral and send that out into the world, then I think we’re changing the world one nervous system at a time, which for me feels both doable and powerful.

Stephen: So with that statement, let me share with you what someone said at one of my workshops. There were two women in the front row at one of my workshops, it was a five-day workshop at Cape Cod, and their husbands were engineers. And they said to me, “We are changing the world, one engineer at a time.”

Deb: I love that. You know Steve, you once told me this definition of benevolence—and then I think you forgot where you ever told it to me, so I just say, “Steve told me, Steve said this,”—but I truly love this and I end all my workshops with this invitation, that ventral is not only a place that we can get to and that changes our own experience of physical and psychological wellbeing, but it’s something we can actively use in the world. So what Steve said was, “Benevolence is the active, ongoing, intentional use of ventral vagal energy in service of healing.” And that I think takes it to another whole level, not only to be in ventral, but I can actively use that energy and serve as a healer.

Stephen: Yeah, thank you Deb.

Thomas: That’s so beautiful. It was a lovely, beautiful ending. And if there’s anything you want to share with us to complete, if you feel that we left anything out that is important to you, there is a space for it, of course, now.

Stephen: The only comment I’m going to make is, that what we’re doing, or what you’re doing Thomas, in creating this Collective Trauma Summit, is extraordinarily important. And I appreciate it, and I’m sure Deb does too. I don’t like to speak for others, but we appreciate being part of it, in a sense, to enable our message to move out there and to be incorporated, not to displace, but to be incorporated in other messages. And this has been, what I would say, the beautiful journey of Polyvagal Theory is that… It was not a theory that was a therapy, it was a theory that informed people who were doing therapy. So in a sense, we created this term that we called polyvagal-informed. So whatever you do can be polyvagal-informed. It doesn’t mean that you can’t do what you’re doing, it just means that you have a greater respect for the state of the nervous system of your client, and your state while you are delivering therapy.

Deb: Yeah. I love that thought about polyvagal-informed because it really means that as I move from daily life, I am looking through the eyes of my nervous system and I’m looking at other people’s biology. And then being curious about how that’s happening and staying tuned into the autonomic communication that’s always happening. And I do think that it’s a different way of moving through the world and a really healing way of moving through the world.

Thomas: Very beautiful. And as I said, I want to highlight your dance together. I really enjoyed this time and I enjoy you being part of the Collective Trauma Summit. I think your message is very important. I highly appreciate it and I think it enriches our world a lot. I think it’s a very powerful contribution and I would love to have you back again next year, or whenever we continue. It’s very deep to see also your attunement with each other, speaks the unspoken words.

Stephen: Thank you very much, Thomas. Thank you, Deb.

Thomas: Thank you.

Deb: Thank you, it’s been lovely.