Offices in Castro Valley & Pleasanton, CA
April 16th, 2021 | Neuroscience, Relationships, Stress, Trauma

A Ladder and a Map: Tools for Emotion Regulation

I recently had the opportunity, due to the pandemic, to attend a virtual version of an annual conference for psychotherapists that is usually held in Washington D.C. One of the webinars I attended, by Deb Dana, LCSW, offered some simple and practical tools to use with clients, based on a not-so-simple to explain theory, the Polyvagal Theory. The first tool is a ladder; the second, a map, or a series of maps.

 

Polyvagal Theory was developed by Dr Stephen Porges, and even though I’ve read his book and listened to several talks he’s given, I still have trouble clearly explaining it. In a nutshell, it merges evolutionary neurobiology with attachment theory to describe the mechanisms behind a hierarchy of human responses to perceived threats. These responses include one most of us are familiar with, the “Fight or Flight mechanism,” as well as a “Freeze” response. Porges’ theory helps us understand how emotional regulation is a function of interpersonal connection, how trauma disrupts those connections, and most importantly, how people can regain emotional equilibrium after being dysregulated by a threat or trauma.

 

Before I get to the ladder and the map, a little background. If you studied human anatomy in school, you learned that our autonomic nervous system (ANS) has two branches, the sympathetic (SNS) and the parasympathetic (PNS). The SNS governs movement, doing, while the PNS governs resting, being. The “fight or flight” response is generated by the SNS, while the PNS leads us to “rest and digest.” In a healthy functioning ANS, the two branches work in harmony. The sympathetic branch acts like the accelerator on a car, while the  parasympathetic branch acts like the brake. Simple, right?

 

Here’s where it gets more complicated. The term polyvagal comes from the vagus nerve, which is a large nerve that connects the brain with the major organs of the body – lungs, heart, stomach – as well as the face, eyes and ears. The vagus nerve is like “command central” for the PNS. A key discovery of Porges was that there are two pathways of parasympathetic response, one of which causes the “freeze” response, when a person becomes immobilized in the face of a threat or trauma. The other pathway has an opposite response, leading to social engagement and connection. The immobilization response is a more primitive protective mechanism that all mammals have. The social engagement response is a more evolutionarily advanced mechanism, which only some mammals (dogs, cats, horses, elephants) and all humans have.

 

These two pathways are called Dorsal Vagal and Ventral Vagal. In the Dorsal Vagal response, the organism moves to shut down, in an attempt to save itself (think of how a mouse might feign death to escape from a cat, who loses interest when it stops moving). A person in this state may feel numb, disconnected, lost, abandoned, invisible, hopeless, and despairing. The Ventral Vagal response, in contrast, moves the organism to connect to self and others. A person in this state may feel alive, energized, tuned in, resourceful, flexible, and hopeful. Can you recall experiencing either, or both of these states?

 

The ladder is a visual representation of the range of responses to a perceived threat, from immobilization (Dorsal Vagal) at the bottom, to social engagement (Ventral Vagal) at the top, with the sympathetic responses that mobilize us (Fight or Flight) in the middle. The ladder is a tool that allows you to locate where your own response lies, to identify how dysregulated you  are, and to see that it’s possible to climb out of immobilization into mobilization, and from there into engagement and connection. Most likely, you will need help to do this.

 

Polyvagal Theory recognizes that all of these responses are adaptive survival mechanisms that often operate below the level of conscious awareness. We don’t choose to fight, flee, or freeze, so there’s no reason to get down on ourselves when we do. The good news is that once we can come to understand what’s happening, we can learn how to move out of that automatic reaction into a more regulated state.

 

Connectedness is actually a biological imperative. People are inherently social beings, and our nature is to interact and form relationships with others. And it is within those interpersonal relationships that we learn to regulate our emotions. Think about how a baby cries when it is hungry, tired, or has a soiled diaper, and how its mother-caregiver offers comfort through a soothing voice, facial expression, and physical touch. These are instinctive responses that bring mother and child into “co-regulation” of their physical and emotional states, an equilibrium. As adults, we still want and need to experience co-regulation with others. When we do, we feel safe, at ease, relaxed, content. We can face challenges and function effectively in the world.

 

Trauma and other threats to our safety and well-being disrupt this natural drive to connect, and interfere with an individual’s ability to seek and experience co-regulation. The fight or flight responses, and especially the Dorsal Vagal collapse, are coping mechanisms designed to keep us alive, but they aren’t intended to be long-term modes of functioning. And they block us from establishing the connections we need to co-regulate and regain emotional equilibrium. The dilemma is, how can we engage and connect with others when we don’t feel safe?

 

This is where the map comes in. In Deb Dana’s process, therapist and client co-create a map or series of maps to first name and describe where the person may be on the ladder, and then identify the steps that will move them toward connection and social engagement. For example, if they are immobilized in a Dorsal Vagal collapse, the first steps may include establishing a sense of safety by doing grounding exercises, and to offer themselves some kind words of comfort and soothing gestures. The maps include both things the person can do on their own, and things they can do that involve others, for example, text a friend, accept a hug, or go for a walk in a park where there are other people around.

 

If you would like to learn more about the Polyvagal Theory, there are many YouTube videos with Stephen Porges, and a TED talk by his son Seth Porges. To learn more about Deb Dana’s approach to restoring emotional equilibrium, I recommend her new book, and podcast, “Befriending Your Nervous System.”  And if you would like to work directly with a therapist to learn how you can use the ladder and maps for yourself, please contact me!

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