Polyvagal-informed therapy is about working with your nervous system rather than against it. Many reactions people describe as anxiety, shutdown or burnout are the body’s protective responses doing their best to keep you safe. When you understand these patterns, you can build practical ways to shift state, widen the window of tolerance, and move back toward connection, clarity and choice. I explain these ideas in my long-form blog on polyvagal theory, which offers an accessible primer on why some people tip into hyperarousal while others drop into numbness and collapse, and how everyday regulation tools help.

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Polyvagal theory, developed by Stephen Porges, describes how the autonomic nervous system organises responses to cues of safety and danger through three common states: ventral vagal engagement, sympathetic mobilisation, and dorsal vagal shutdown. It highlights neuroception, the body’s continuous, outside-awareness scanning for safety. Mapping these states gives a practical route for recovery, relationship repair and everyday steadiness.

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How this approach helps

People usually arrive with one of two experiences. Some feel stuck “on”, keyed up and vigilant, with racing thoughts, poor sleep and a body that will not settle. Others feel stuck “off”, foggy or disconnected, unable to get going even when they want to. Both are normal survival patterns. Therapy helps you notice where you are on that map, reduce unhelpful triggers, and add cues of safety so your system can shift state more flexibly. Naming these shifts reduces shame and increases options. It is not about being calm all the time. It is about being able to move.

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A polyvagal lens is not a separate brand of therapy. It is a way of understanding and organising care that sits alongside established, evidence-based methods. In practice, I weave state awareness and regulation skills into Acceptance and Commitment Therapy (ACT), Compassion Focused Therapy (CFT), EMDR, CBT and ERP. The aim is to make each method easier to engage with and more sustainable by improving stabilisation, pacing and connection.

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What sessions are like

We start with a gentle formulation. Together we map the situations that nudge you into fight or flight, the moments you dip into shutdown, and what already helps. We look at sleep, movement, relationships and work rhythms because these are the places where cues of safety and threat often hide. Then we co-create a small, realistic plan for the week ahead. The plan usually includes one or two state-shifting practices and one values-guided action that matters to you. We review, refine and build from there.

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The relationship itself is part of the method. Tone of voice, pace, posture, predictability and consent are used deliberately as cues of safety. You remain in charge of the speed. If arousal drifts out of range, we pause and return to steadier ground before moving on. This keeps the work effective without overwhelming you.

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Core ideas in everyday language

When your body reads the world as safe enough, the ventral vagal system supports presence, clear thinking and social connection. When it detects possible threat, sympathetic mobilisation prepares you to move, which can feel like anxiety, restlessness or irritability. If the threat feels inescapable, dorsal vagal shutdown conserves energy, which can feel like numbness, fatigue or collapse. Therapy helps you recognise these shifts quickly and cultivate routes back to steadiness.

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This is a developing scientific framework with growing clinical use. It gives a helpful language for linking biology, emotion and behaviour, and it integrates well with existing trauma and anxiety treatments.

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Skills we may practise

Most work is experiential and brief. Practices are adapted for neurodiversity, health conditions and trauma history, and are always optional.

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• Breath and rhythm: paced exhale or voiced breathing to support down-shifting from overdrive.

• Orienting and sensory anchors: five-sense noticing, eye-gaze shifts, temperature or touch to reconnect with the present.

• Micro-mobilisation: foot press, reach-and-return, short rhythmic movements to move out of freeze.

• Co-regulation in relationships: predictable routines, clear signals of availability, warm prosody and steady pacing.

• Values-guided action: using ACT principles so state skills translate into real-world choices that matter to you.

 

How this integrates with my other therapies

• Acceptance and Commitment Therapy: combining defusion and acceptance with state skills so you can act in line with your values even when feelings are strong.

• Compassion Focused Therapy: strengthening the soothing and affiliative system and softening shame, which often keeps people in threat mode.

• EMDR and trauma processing: using polyvagal-informed stabilisation and pacing before, during and after processing so the work stays tolerable and effective.

• CBT and ERP: state awareness reduces reliance on safety behaviours and makes exposure kinder and more effective.

 

Results that tend to matter to clients

People often report feeling less pushed around by their nervous system and more able to do ordinary things that had started to feel difficult, like sleeping through the night, having a hard conversation without shutting down, or getting back to exercise and social contact. They notice earlier when they are drifting into overdrive or shutdown and they know what to do next. Progress looks like flexibility, confidence and choice.

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A short FAQ

Is this just breathing exercises
No. Breath is one route into the system. We also use voice, gaze, posture, sensory input, movement, relationship cues and values-guided behaviour.

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Is it evidence-based
Polyvagal theory is an evolving framework that describes how the autonomic nervous system coordinates responses to safety and threat. Clinically it complements established therapies by improving stabilisation and engagement. It does not replace them. It supports them.

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Will this replace my current therapy
It does not need to. We can layer polyvagal-informed skills into work you are already doing so it becomes more doable and less exhausting.

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How soon will I notice change
Many people notice small shifts within a few weeks with regular practise. Effects accumulate with repetition and when linked to actions that matter to you.

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Next steps

If this approach resonates, we can begin with a short assessment to map your state patterns and build a simple state-shifting plan for the week ahead. Then we integrate these skills with your therapy goals. Don't forget, if you prefer a deeper dive into the science in plain English first, you can read my blog on polyvagal theory and we will build from there.