Polyvagal Theory Explained: What It Says, and What It Gets Criticised For

Two women, same week, same clinic.

The first is fifty-two and describes herself as permanently on. Wakes at four with her heart going. Snaps at her family and feels guilty for hours. Can’t sit through a film without checking her phone. She uses the word wired about six times in twenty minutes.

The second is forty-seven and describes almost the opposite. She’s not anxious, she says. She’s just not really there. Watches herself go through the day. Doesn’t cry, doesn’t laugh much, gets everything done and feels nothing about any of it. She says she’s fine roughly four times, and then says she doesn’t know why she’s come.

Both are stressed. On a simple two-branch model of the nervous system — mobilised or calm — the second woman is unexplainable, because she’s plainly not calm and equally plainly not mobilised.

Polyvagal theory is a framework that accounts for her. That’s the reason it’s spread so widely among clinicians, and it’s worth understanding both why it’s useful and where it’s genuinely contested.

What the theory proposes

Stephen Porges introduced it in the mid-1990s. The core claim is that the parasympathetic nervous system isn’t one thing — that the vagus nerve has two functionally distinct pathways which produce quite different states.

The theory describes three, arranged as a hierarchy that we move down through as demands exceed our capacity.

Ventral vagal — social engagement. The newest system evolutionarily, associated with a pathway of the vagus that connects to the heart and to the muscles of the face, throat and middle ear. When this is dominant, you’re calm but alert. You can make eye contact, hear tone in someone’s voice, feel connected. Your heart rate is regulated, your digestion works, you can think clearly. This is the state where connection and repair happen.

Sympathetic — mobilisation. When the situation exceeds what social engagement can handle, the system moves to mobilising. Heart rate up, energy to the muscles, threat scanning. Fight or flight. The first woman lives here.

Dorsal vagal — shutdown. If mobilising isn’t working or isn’t available — if there’s nothing to fight and nowhere to run and the demand won’t stop — the system drops to the oldest response: immobilisation. Conserve energy. Numb out. Disconnect. This is the second woman.

The theory adds a second idea that’s arguably more useful than the hierarchy itself: neuroception. The proposal that your nervous system continuously assesses safety and threat below conscious awareness, using cues from your environment, other people’s faces and voices, and your own internal state. You don’t decide you’re safe. Your system decides, and you find out afterwards by how you feel.

Why clinicians find it useful

Three things, and they’re not trivial.

It explains shutdown. Numbness, flatness, dissociation and that watching-yourself quality are extremely common and poorly served by a model with only two settings. Having a name and a place for that state changes how people relate to it — usually from what’s wrong with me to my system has gone somewhere.

It reframes the response as protective rather than defective. Freeze and shutdown are protective strategies, not failures of coping. For women who’ve spent years being told they’re too much or not enough, that reframe does real work.

It changes the intervention. This is the practical payoff. If you’re mobilised, you need to come down — long exhales, slow breathing, discharge. If you’re shut down, coming further down is exactly wrong. You need gentle activation, sensory re-engagement, movement, connection. Handing a shutdown pattern a calming exercise and telling someone to try harder is a very common and completely counterproductive mistake.

That distinction alone justifies knowing the framework, whatever its scientific status.

What the theory gets criticised for

Here’s the part most articles leave out, and I’d rather you heard it from someone sympathetic to the model than discovered it later and felt sold to.

Polyvagal theory has attracted substantial criticism from comparative physiologists and neuroscientists. The main objections:

The evolutionary claim is disputed. The theory rests on an account of when the two vagal pathways evolved and in which animals. Researchers working on the comparative anatomy have argued this account doesn’t match the evidence — that the relevant vagal architecture appears earlier and more widely than the theory requires.

The mapping of states to anatomy is questioned. Whether specific psychological states map cleanly onto specific vagal pathways in the way described is not established. It may be a useful description of experience without being an accurate description of mechanism.

Some testable predictions haven’t held up well. Elements of the theory that can be tested empirically have produced mixed results.

And the popular version has drifted a long way from the original. A great deal of what circulates online as polyvagal theory — particularly claims about specific exercises directly toning specific vagal branches — is well beyond anything Porges proposed or anyone has demonstrated.

So is it useless?

No. But it’s worth being clear about what kind of thing it is.

It’s best treated as a clinical map rather than an established mechanism. Maps are judged by whether they help you navigate, not by whether they’re the territory.

And on that measure it does well. The three-state description matches what people actually report. The distinction between mobilised and shut-down states genuinely changes what helps. Neuroception describes something real — your physiological state does shift in response to cues you never consciously registered.

What’s separately well-established, independent of the theory: the vagus nerve does apply a brake to your heart; that brake does vary with your breathing; slow breathing with a long exhale does increase heart rate variability and vagal activity; and higher vagal tone is associated with better emotional regulation and faster recovery from stress.

Those findings stand on their own. You can use the map without needing every claim about its geology to be correct.

A reasonable way to hold it: use the three-state description to work out what state you’re in and what might help, and be sceptical of anything that claims a specific exercise directly targets a specific vagal branch. The first is a useful clinical observation. The second is a mechanistic claim that hasn’t been demonstrated, and it’s where most of the overselling happens — the ear devices, the resets, the exercises promising to move you from one branch to another in ninety seconds.

Where women in midlife fit in this

Two things worth naming.

The first is that perimenopause makes downward moves through the hierarchy more likely, for physiological reasons. Oestrogen supports vagal tone, so as it declines the ventral vagal state becomes harder to hold. Sleep fragments, which reduces capacity. Palpitations and hot flushes generate internal threat cues that your neuroception reads as danger — your system doesn’t know the racing heart is hormonal rather than dangerous.

The second is that shutdown in midlife is chronically under-recognised, because it looks like coping. A woman who has gone flat is usually still functioning — still working, still managing the household, still turning up. Nobody worries about her. She may not worry about herself. She just notices, at some point, that she doesn’t feel much about anything, and files it under being tired.

If that’s familiar, it’s worth taking seriously rather than waiting for it to become a crisis. [LINK: Nervous System Dysregulation] describes the patterns in more detail.

What actually helps, by state

If you’re mobilised — wired, racing, scanning — you need downward regulation. Long exhales, slow breathing, physical discharge like a brisk walk. Standard calming advice applies and works.

If you’re shut down — flat, numb, distant, heavy — go the other way. Gentle activation. Movement before stillness. Sensory engagement: cold water on the hands, texture, sound, being outdoors. Use your voice — humming, singing, talking — because the muscles of the face and throat are part of the system that goes offline in shutdown, and using them is one of the more reliable routes back.

In both cases, the underlying work is capacity. A system with more reserve drops less far and recovers faster. That’s built through everyday breathing, sleep, and enough recovery to matter — not through techniques deployed at the worst moments.

Knowing which state you’re in is the first skill, and it’s harder than it sounds because shutdown is quiet. The Breathing Quiz gives you an objective read — it shows what your breathing pattern is doing, which is one of the most reliable early signals of how your nervous system is coping underneath, and the two patterns don’t look the same.

Where to take this next

If you recognise yourself in the flat, distant version, The Reset Audios are a sensible starting point. They work through sensation rather than instruction, and re-establishing contact with what you can actually feel is the route back — done at a pace your system can stay with rather than one that floods it.

If you want to understand the physiology and rebuild the underlying capacity, The 30 Day Breath Reset takes you through the mechanism and the daily practice together.

Used together, you get both sides of the change — the understanding and the experience. That’s what holds.

And if there’s a long history behind the shutdown — grief, trauma, or years of running on empty — that deserves more than a general programme. Working with me one to one means the pace is set by your system, which matters a great deal when what’s underneath is significant.

Related reading: Nervous System Dysregulation |  Calming the Nervous System