Our Polyvagal World by Stephen W. Porges

Author:Stephen W. Porges
Language: eng
Format: epub
Publisher: W. W. Norton & Company
Published: 2023-08-20T00:00:00+00:00

Shared Symptoms

Many of the symptoms that we’re talking about as being related to trauma can also be found in a wide range of medical diagnoses and psychiatric conditions.

These include autism, schizophrenia, depression, borderline personality disorder, and many, many others. All of these disparate conditions feature a shared core of symptoms that include auditory hypersensitivity, difficulty extracting a human voice from background activity, flat facial affect, difficulty regulating behavioral state, a lack of prosody in the voice, and a baseline autonomic state that tends to have higher heart rates and less vagal regulation of the heart.

Many of these shared symptoms involve the physical features of the Social Engagement System and our ability to detect and express emotions.

When we talk about these conditions and “treating” them, it’s important to specify that our goal is often not to “cure” somebody. There’s an increasing awareness through the neurodiversity movement that many people are simply wired differently, and there’s nothing wrong with that.

Sensory and autonomic hypervigilance can make sense as being sometimes beneficial from an evolutionary standpoint when one considers that such individuals may have been better tuned to pick out predators or other dangers. We’ve spent a lot of time talking about how resource intensive alertness and vigilance are, but social behavior also takes a lot out of us and can make it more difficult to spot potentially lethal dangers in the wild.

Rather, our goal is to make life better for people. If hypervigilance and auditory hypersensitivities make it physically painful to go through the day and cut people off from the beneficial effects of feeling safe, then that’s something we need to pay attention to. Likewise, we may not be able to “cure” trauma, but we can certainly reduce its harmful impacts on people and perhaps keep it from massively disrupting their lives.

Many of these symptoms are so tightly tied to certain diagnoses that people have long viewed them as innate—and even defining—features. You see this specifically with auditory issues and autism. The two were long viewed as so tightly intertwined that the auditory issues were considered essentially untreatable as long as somebody had autism.

What we’re now finding is that this is not always the case. Instead of viewing auditory issues as a key component of what makes somebody autistic, I (Stephen) think it’s more accurate to view such symptoms as a side effect of a nervous system that is stuck in a state of hypervigilance and never feels properly safe. And with the Polyvagal Theory as our guide, that is something we very much can treat.

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