Polyvagal Theory, Part 2: The State Tells The Story

The 1% Chance explores themes of hope, wellness and discovery in the context of MND / ALS. This article is for informational purposes only and is not medical advice. The author is not a healthcare professional. Please consult a healthcare professional about your own healthcare needs.

Transcript

Well, hello! Welcome to The 1% Chance, exploring themes of hope and wellness in MND slash ALS. My name's Graham Dargie, I was diagnosed with MND in 2023 and I’m on a mission to stay well - physically, but also mentally and emotionally. I’ve spoken about polyvagal theory before, but let’s take a closer look.

Developed by Dr. Stephen Porges, polyvagal theory shows us that our autonomic nervous system is constantly acting on our behalf to keep us safe. It does this through a process called Neuroception - subconsciously scanning and interpreting situations more quickly than our brain can consciously read them. This is an ancient, mammalian system that acts for our protection - think of a zebra on the plains of Africa, constantly using all of its senses to keep watch for predators. The main goal, above all else, is survival.

Living with MND makes it easy to constantly have that sense of an impending threat. Every time I feel a new sensation of weakness, strain or cramp in my body, my mind can spiral off into storylines of a bleak future, taking me out mentally for hours or even days. In reality, I probably just slept in a funny position and the feeling will go away on its own, but the autonomic nervous system is built to detect danger and - this is key - our nervous system state determines the storylines we tell ourselves.

The system has three main states: safe (ventral), fight or flight (sympathetic), and shut down (dorsal). When we find a place of safety, you could say we’re in a regulated state. Our internal narratives speak of positivity, creativity, optimism and possibility. When we feel unsafe or threatened (sympathetic), the script changes to the language of mobilisation, defensiveness, aggression and fear. In a shut-down (dorsal) state, the story moves to one of resignation. Here, the body can go into a kind of 'freeze' mode, designed to protect us when escape doesn't feel possible.

Let’s bring this to life a bit with some examples from my own experience with MND. I think for me, I’ve been in fight-or-flight for most of the time since my diagnosis. At that moment, life as it was, simply ceased. My relationships were instantly redefined and my plans, dreams and hopes for the future were scuppered - replaced with what seemed like a living nightmare. The sense of being in danger, the urgency to ‘fight’ by delving into understanding the disease and finding ways to stay well has been driven by that mobilising energy that comes from being insight-or-flight. The narrative that comes with this state can be combative and defiant.

At a certain point, my research culminated and my state shifted toward safety. I felt I had an understanding of what I had to do to give myself that 1% chance of turning things around. I became more calm, optimistic and my sense of creativity - which had been on the shelf since I was diagnosed - returned. I started writing my book and was able to enjoy life a little more than when the diagnosis was fresh.

That’s not to say I haven’t had down times on this journey. At my lowest, I’ve experienced the most painful moments of my life where I’ve felt useless, abandoned and alone, making me want to skip to the end and give up. The storyline here, speaks of surrender and defeat.

When we zoom out like this, the system makes sense. As human beings, spending time in each of these different states is normal. Yet, when it’s happening in real time, it’s harder to be objective and we can suddenly find ourselves riding an emotional rollercoaster, seemingly out of control. Again, this is a natural, self-protective mechanism but staying in dysregulation long term can have consequences for our health or, at the very least, can ruin our day. The more familiar we become with how the system works, the more equipped we’ll be to start to operate it - rather than having it operate us.

Here’s are some tips that help me…

1 - Actively notice the change

It might sound obvious but the first step is to notice the nervous system state you’re in. The more tuned-in you are to your thoughts and emotions, the easier it will be but remember - the story your thoughts are telling will let you which state you’re in.

2 - Questioning why you found yourself in this state

When we shift away from a state of safety, there’s usually a ‘trigger’ - a situation or event that caused your nervous system to feel threatened. Our autonomic nervous system catalogues all of the experiences we’ve had and when a current situation flags-up an echo of something dangerous from the past, it can kick us into fight or flight as an act of self-protection. By practicing the first step - actively noticing our nervous system state - we'll begin to identify our triggers.

3 - Question the validity of the trigger

The next step is to question whether the trigger is valid. To go back to our zebra analogy - that rustling we heard in the grass is more likely to be a meerkat than a lion. If it is a lion, our fight or flight instinct will take over and we’ll deal with the situation as best as we can. If it’s just a meerkat, we can begin to actively bring ourselves back to a feeling of safety.

4 - Choose a different response

Whether the trigger was a lion or a meerkat, by noticing and questioning, we’ve already interrupted the autonomic system and given ourselves the opportunity to choose a response. Even if we’ve been set-off by a genuine threat, we have a much better chance of coming back to safety quickly rather than losing the day to racing thoughts or rumination.

Bonus Tips

For me, my meditation practice has played a complementary role in building this skill. Meditation, in whatever form we choose to do it, trains us to actively notice our thoughts and to bring our attention away from the kind of distractions that can lead us down rabbit holes.

Glimmers also have a role here. Glimmers are prompts we can use to help move ourselves back to a safe state, where we not only feel better emotionally, but where our body can return to functioning at its best. Examples of glimmers include, a comforting hug from a loved one, social engagement, (laughter, eye contact etc), mindfulness practices and breathing exercises, dance or physical movement, listening to music and acts of creativity and spending time in nature - although, - dad joke incoming - I guess zebras spend a lot of time in nature anyway.

Now, I want you to know, I’m no great expert on this stuff - I’m sharing as I’m learning - but I can tell you, these skills are changing the game in terms of how I navigate my health journey. By becoming more able to notice when I’ve moved away from that feeling of safety, I’m able to have far more good days than bad days. For me, when I’m in dysregulation, I remind myself, ‘I can’t find healing here’.

This may not be a cure for MND, but whatever happens in the future, I want to find internal peace and emotional healing. When I’m in a regulated, safe state, I’m living with hope, resilience and positivity - and I much prefer that to living in fear, bitterness and despair.

Remember, your internal dialogue is a giveaway to the polyvagal state you’re in - the state tells the story.

Thanks for listening. I stand with you.

As always, this podcast is just me sharing what I’ve learned and what helps me. It’s not medical advice—please talk to your healthcare team for anything related to your care.