Polyvagal therapy PVT: the vagus nerve as key to recovery

Polyvagal therapy (PVT) is based on the work of neurophysiologist Dr Stephen Porges, and focuses on the influence of the autonomic nervous system on our behaviour and emotions. The vagus nerve, the longest nerve in the autonomic nervous system, plays an important role here. Through targeted techniques, PVT helps people regulate their stress response, feel safer and reconnect with themselves and others.

WHY is polyvagal therapy different?

Unlike traditional talk therapy, PVT does not focus primarily on talking, but on the body. The focus is on recognising and influencing physical signals associated with stress, anxiety or trauma. Through exercises such as breathing, movement and sensory tuning, you learn to better understand and control your nervous system. This makes polyvagal therapy particularly valuable for people who find it more difficult to express themselves through talking alone.

Who is PVT suitable for?

Polyvagal therapy is successfully used for a variety of complaints, including:

• Trauma and PTSD
• Anxiety and panic disorders
• Depressive symptoms
• Chronic stress
• Attachment issues
• Emotion regulation problems
• Sleep problems
• Physical complaints with no obvious medical cause.

According to research, improving vagus nerve function can help lower inflammation levels, reduce anxiety and enhance social connectedness (Laborde et al., Frontiers in Psychology, 2018).

How does it work?

Polyvagal therapy targets three nerve pathways within the autonomic nervous system, each driving a different response to stress and safety. The ventral vagus, also known as the ‘safe and social’ system, promotes calm, connectedness, empathy and a functioning digestive system. The sympathetic nervous system activates when threatened and triggers the body into action via the fight-or-flight response, with symptoms such as an accelerated heart rate and tense muscles. In contrast, the dorsal vagus triggers a freezing response or emotional closure when a person feels overwhelmed, which can lead to withdrawal and sensory absence.

Therapists help clients recognise when one of these systems is active, and teach them techniques to return to a state of safety and connection.

Exercises in PVT

• Grounding techniques: such as conscious breathing or feeling objects to stay in the here and now.
• Body awareness: feeling where tension is and releasing it in a focused way.
• Guided visualisations: evoking safe images to calm the nervous system.
• Sound therapy: soft music, humming or listening to soothing tones to encourage social engagement.
• Self-compassion exercises: developing a kind, non-judgemental attitude towards yourself.

Mindful move: such as yoga or tai-chi to release tension through movement.

Case study

Lotte (42) came to a polyvagal therapist after years of anxiety symptoms and social withdrawal. Traditional therapies helped only temporarily. In PVT, she learned to recognise the signals of her nervous system: a rapid heartbeat when crowded, or numbness when confronted. She learned breathing exercises and body-oriented techniques to better calm herself and cope with tense situations. After a few months, she felt more emotionally stable and more confident during social interactions.

Want to find out if polyvagal therapy suits you? Check out the list of qualified therapists on our website and filter by specialisation, location and experience. This way, you can easily find a professional who matches your care needs.