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Emotional neglect (EN), characterized by a lack of emotional attunement in childhood, leads to deficits in emotion regulation, increase in self-criticism, and poor mental health outcomes including depression, anxiety, and substance use disorders. Treatment for adults that experienced childhood emotional neglect is necessary, but not sufficiently studied. Self-criticism can be treated with Compassion Focused Therapy (CFT), but the impacts of EN require additional focus on regulating the autonomic nervous system. This practice advance utilizes trauma-informed care and polyvagal theory to augment CFT using a four-pronged approach. This includes the role of the therapist and the therapeutic relationship, assessment and identification of EN, client psychoeducation on the influence of EN on the mind and body, and integration of self-regulation and self-compassion activities. This multi-modal intervention can reduce the debilitating effects of EN for individuals, their loved ones, and the behavioral health systems that support them. [ABSTRACT FROM AUTHOR]

This paper introduces a metric capable of tracking a hypothetical brainstem “switching” mechanism involved in regulating the afferent influence of blood pressure on the vagal efferent control of heart rate. In theory, this metric could be applied to evaluate the “efficiency” of brainstem pathways involved in common mechanisms of autonomic function involving the vagal influences on the gut as well as the heart. Thus, by exploring the dynamic “efficiency” of the brainstem feedback circuit linking heart rate to posture, a clinically relevant index of vagal flexibility might be extracted that would provide a generalizable window into the vagal regulation of both the heart and gut. Recent research supports this contention and has documented that this metric, VE, appears to covary with disorders of the gut. Clinical application of this metric might identify individual vulnerabilities that frequently reflect symptoms assumed to have features of a dysregulated autonomic nervous system (i.e., dysautonomia). If this is confirmed by additional research, then this objective measure of neural regulation of autonomic function might provide insight into the pathogenesis of disorders of gut–brain interaction. [ABSTRACT FROM AUTHOR]

Aggressive student behavior is considered one of the main risk factors for teacher stress. The present study investigated teachers' physiological and behavioral reactions when facing aggressive student behavior and examined which resources favor adaptive teacher reactions. The sample included 42 teachers. We assessed (a) teacher self-reports (i.e., resources, risk factors, and vital exhaustion) (b) classroom observations, (c) ambulatory assessments of teachers' heart rate and heart rate variability, and (d) teachers' progesterone concentrations in the hair. The present study focused on a subsample of ten teachers (9 females, Mage = 34.70, SD = 11.32) managing classes which were potentially very stressful as they had a high density of aggressive behavior. High levels of work satisfaction, hair progesterone, and a low level of work overload fostered social integrative teacher responses. Moreover, in 75% of the cases, teachers succeeded in downregulating their physiological reaction. Our results support the notion that teachers evaluate stressors in light of their resources. When they perceive their resources as insufficient for coping with a challenging situation, stress arises, and subsequently, they react inefficiently to aggressive behavior. Thus, teacher education could benefit from strengthening teacher resources and strategies for coping with aggressive student behavior. [ABSTRACT FROM AUTHOR]

Aggressive student behavior is considered one of the main risk factors for teacher stress. The present study investigated teachers’ physiological and behavioral reactions when facing aggressive student behavior and examined which resources favor adaptive teacher reactions. The sample included 42 teachers. We assessed (a) teacher self-reports (i.e., resources, risk factors, and vital exhaustion) (b) classroom observations, (c) ambulatory assessments of teachers’ heart rate and heart rate variability, and (d) teachers’ progesterone concentrations in the hair. The present study focused on a subsample of ten teachers (9 females, Mage = 34.70, SD = 11.32) managing classes which were potentially very stressful as they had a high density of aggressive behavior. High levels of work satisfaction, hair progesterone, and a low level of work overload fostered social integrative teacher responses. Moreover, in 75% of the cases, teachers succeeded in downregulating their physiological reaction. Our results support the notion that teachers evaluate stressors in light of their resources. When they perceive their resources as insufficient for coping with a challenging situation, stress arises, and subsequently, they react inefficiently to aggressive behavior. Thus, teacher education could benefit from strengthening teacher resources and strategies for coping with aggressive student behavior.

Polyvagal theory advocates for working with the body, becoming aware of the body and connecting with the senses. Similarly, paying attention to and influencing one's physical and sensory experience is a core aspect of the creative arts and psychomotor therapies. Polyvagal theory offers opportunities for strengthening resilience by treating emotion-regulation problems, stress, and trauma, as well as restoring regulation of the autonomic nervous system. Paying attention to and influencing physical and sensory experiences are core aspects of creative arts and psychomotor therapies. This theoretical paper explores how polyvagal theory can serve as a foundational theory and support the creative arts and psychomotor therapies for emotion regulation in stress and trauma. A number of pillars in polyvagal theory have links with arts therapies, such as an emphasis on physical and sensory experience in situations of safety or threat. This theory may offer insight into the role of the body in stressful situations, the role of co-and self-regulation, and thus the functioning of and the rationale for use of creative arts and psychomotor therapies. Through interventions focused on promoting healthy autonomic responses and regulating physiological responses, clients can learn to better regulate and process their emotional experiences. Although this could be broadly useful, it would seem particularly promising in therapies focused on stress and trauma. This article provides an introduction to polyvagal theory and outlines how it can serve as an explanatory, hypothetical model for the working mechanisms that underlie creative arts and psychomotor therapies. The application of PVT in creative arts and psychomotor therapies will be explored by describing techniques for "noticing and naming" and "learning to change," as well as by highlighting the role of PVT in the therapeutic relationship. It provides case examples and discusses the role of creative arts and psychomotor therapies for stress regulation and resilience conceptualized in line with the polyvagal theory. [ABSTRACT FROM AUTHOR]

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Messages regarding climate change that are intended to stimulate responsible engagement can impact our mental health in both positive and negative ways, which in turn can increase or limit the potential engagement being sought through those very messages. Increasingly alarmist environmental metaphors are being brought into question due to their possibly detrimental impact on mental health and well-being, and in their place, relational environmental metaphors are proffered to instill hopeful and constructive individual and collective engagement for responsible climate action. This article discusses how both alarmist and relational environmental metaphors interact with eco-emotions. It proposes, in light of concepts arising from Porges' Polyvagal Theory -- on the psychophysiology of autonomic states created in contexts of threatening cues and feelings of safety and connection --, that relational environmental metaphors are preferable for stimulating responsible collective engagement and fostering global well-being in the midst of climate change. [ABSTRACT FROM AUTHOR]

Simple Summary: The review aims to explore the historical development of cardiac innervations and neuromodulation, tracing its origins back to the ancient Egyptian concept of "psychostasis"—the ritual weighing of the heart to determine one's fate in the afterlife. This ancient belief in the heart as the center of human wisdom, emotions, and memory laid the foundation for the later advancements in the scientific understanding of cardiac innervation. Importantly, this ancient cardiocentric worldview also established the ancestral ethical foundations for the study and application of cardiac neuromodulation. The Egyptians believed that the "lightness of the heart"—achieved through a balance of good and bad deeds—was crucial for one's wellbeing and fate in the afterlife. This ethical framework parallels the modern understanding of the importance of balanced cardiac autonomic control, mediated by the vagus nerve, for overall health and social engagement. The review chronicles key milestones, from Aristotle and Galen's early physiological studies, to the pioneering anatomical work of Leonardo da Vinci, Vesalius, and William Harvey's discovery of the circulatory system. It highlights the contributions of 17th century researchers like Richard Lower, who demonstrated the heart's neural control, and Albrecht von Haller, who discovered the heart's automaticity. The review emphasizes how the study of cardiac innervation and neuromodulation has regained prominence, particularly in understanding the cardiorespiratory symptoms and dysregulation observed in post-acute sequelae of SARS-CoV-2 infection (long COVID) and other acute respiratory infections. It draws parallels between the ancient concept of "weighing the heart" in psychostasis and the modern understanding of the "balance of different hormonal, chemical, electrical, and contrasting nervous stimuli" in cardiac neuromodulation. By tracing this historical evolution, the review aims to bridge the gap between ancient concepts like psychostasis and the modern applications of cardiac neuromodulation for cardiovascular health and disease management. Understanding the complex interplay between cardiac function, neural modulation, and overall wellbeing is crucial for addressing long-term cardiorespiratory issues, akin to the ancient notion of achieving "lightness of the heart". The review also highlights the relevance of the polyvagal theory, which emphasizes the role of the vagus nerve in regulating the heart's function and its connection to emotional and social engagement. This provides an ethical and physiological framework for understanding the importance of cardiac neuromodulation in promoting overall health and well-being. This review explores the historical development of cardiology knowledge, from ancient Egyptian psychostasis to the modern comprehension of cardiac neuromodulation. In ancient Egyptian religion, psychostasis was the ceremony in which the deceased was judged before gaining access to the afterlife. This ritual was also known as the "weighing of the heart" or "weighing of the soul". The Egyptians believed that the heart, not the brain, was the seat of human wisdom, emotions, and memory. They were the first to recognize the cardiocentric nature of the body, identifying the heart as the center of the circulatory system. Aristotle (fourth century BC) considered the importance of the heart in human physiology in his philosophical analyses. For Galen (third century AD), the heart muscle was the site of the vital spirit, which regulated body temperature. Cardiology knowledge advanced significantly in the 15th century, coinciding with Leonardo da Vinci and Vesalius's pioneering anatomical and physiological studies. It was William Harvey, in the 17th century, who introduced the concept of cardiac circulation. Servet's research and Marcello Malpighi's discovery of arterioles and capillaries provided a more detailed understanding of circulation. Richard Lower emerged as the foremost pioneer of experimental cardiology in the late 17th century. He demonstrated the heart's neural control by tying off the vagus nerve. In 1753, Albrecht von Haller, a professor at Göttingen, was the first to discover the heart's automaticity and the excitation of muscle fibers. Towards the end of the 18th century, Antonio Scarpa challenged the theories of Albrecht von Haller and Johann Bernhard Jacob Behrends, who maintained that the myocardium possessed its own "irritability", on which the heartbeat depended, and was independent of neuronal sensitivity. Instead, Scarpa argued that the heart required innervation to maintain life, refuting Galenic notions. In contemporary times, the study of cardiac innervation has regained prominence, particularly in understanding the post-acute sequelae of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection (PASC), which frequently involves cardiorespiratory symptoms and dysregulation of the intrinsic cardiac innervation. Recently, it has been recognized that post-acute sequelae of acute respiratory infections (ARIs) due to other pathogens can also be a cause of long-term vegetative and somatic symptoms. Understanding cardiac innervation and modulation can help to recognize and treat long COVID and long non-COVID-19 (coronavirus disease 2019) ARIs. This analysis explores the historical foundations of cardiac neuromodulation and its contemporary relevance. By focusing on this concept, we aim to bridge the gap between historical understanding and modern applications. This will illuminate the complex interplay between cardiac function, neural modulation, cardiovascular health, and disease management in the context of long-term cardiorespiratory symptoms and dysregulation of intrinsic cardiac innervations. [ABSTRACT FROM AUTHOR]

Aim: Psychological disorders have a significant impact on the global burden of disease, making it essential to identify and evaluate the effectiveness of non-invasive psychological interventions. This research aims to provide a comprehensive and systematic review of the efficacy of interventions based on polyvagal theory, a type of non-invasive neurobiological intervention for psychological disorders. Method: Relevant studies from 1994 to 2023 were searched using reputable scientific databases and relevant keywords. Nine high-quality studies were selected based on the PRISMA statement. Data analysis was performed using the third version of Comprehensive Meta-Analysis software, yielding 26 effect sizes. Results: The results showed a combined effect size of 0.26, which was statistically significant at the 0.001 level. According to Cohen's interpretation of effect size, this indicates a medium effect size. In other words, interventions based on polyvagal theory can play a significant role in reducing psychological disorders. The metaanalysis results demonstrated high statistical validity, and there was no evidence of publication bias, enhancing the reliability of the results. Conclusion: Interventions based on polyvagal theory can have a significant role in the treatment of psychological disorders. It is recommended that therapists and specialists utilize them in their treatment protocols. [ABSTRACT FROM AUTHOR]

A growing body of research has explored the contribution of prison art interventions indicating that these hold substantial rehabilitative value. Recent literature in this area has drawn attention to the need to expand social action and community-enhanced art interventions with the aim of aiding incarcerated individuals to reconnect to the community. The following research focused on a unique artist-led prison intervention model, wherein participants who are currently imprisoned create alongside participants who are art students from the local university. This joint space aimed to connect people by providing opportunities to engage with creativity in ways that are both individually and socially transformative. Through a phenomenological approach, this model was explored, aiming to yield relevant insights into the quality and processes of change it enhanced. Semistructured interviews were conducted with 18 participants involved in the workshop, and data were analyzed aiming to establish an insider's conceptualization of the meaning for them of the art group experience. The findings point to participants' experience of the workshop as a unique space in which barriers and stigmatic preconceptions were broken and where a sense of acceptance, belonging, and bonding developed in a nonjudgmental atmosphere of joint creativity. Understandings of the way these essential elements of the joint creative experience served to promote implicit processes toward growth and positive trajectories of change are discussed in light of the broaden-and-build and polyvagal theories. [ABSTRACT FROM AUTHOR]

A space, where the client feels safe, is necessary for therapeutic process. Its importance seems to be implicitly understood and agreed upon across different schools of psychotherapy. However, what it means and how it appears in therapy has not been clearly described before. This paper presents the findings from the first author's master thesis, which sought to answer the question 'Why is safe space important in dance therapy, and how do dance therapists define and create it in their practice?'. This phenomenological inquiry originated from a need to translate the experiential phenomenon of safe space into words. It is a first attempt to investigate safe space in depth and to provide a definition of its essence in dance movement therapy. Findings from this research describe working methods and interventions for safe space as well as qualities that therapists can embody to help their clients feel safe. [ABSTRACT FROM AUTHOR]

The polyvagal theory has led to the understanding of the functions of the autonomic nervous system in biological development in humans, since the vagal system, a key structure within the polyvagal theory, plays a significant role in addressing challenges of the mother–child dyad. This article aims to summarize the neurobiological aspects of the polyvagal theory, highlighting some of its strengths and limitations through the lens of new evidence emerging in several research fields—including comparative anatomy, embryology, epigenetics, psychology, and neuroscience—in the 25 years since the theory's inception. Rereading and incorporating the polyvagal idea in light of modern scientific findings helps to interpret the role of the vagus nerve through the temporal dimension (beginning with intrauterine life) and spatial dimension (due to the numerous connections of the vagus with various structures and systems) in the achievement and maintenance of biopsychosocial well‐being, from the uterus to adulthood. [ABSTRACT FROM AUTHOR]

Polyvagal theory advocates for working with the body, becoming aware of the body and connecting with the senses. Similarly, paying attention to and influencing one’s physical and sensory experience is a core aspect of the creative arts and psychomotor therapies. Polyvagal theory offers opportunities for strengthening resilience by treating emotion-regulation problems, stress, and trauma, as well as restoring regulation of the autonomic nervous system. Paying attention to and influencing physical and sensory experiences are core aspects of creative arts and psychomotor therapies. This theoretical paper explores how polyvagal theory can serve as a foundational theory and support the creative arts and psychomotor therapies for emotion regulation in stress and trauma. A number of pillars in polyvagal theory have links with arts therapies, such as an emphasis on physical and sensory experience in situations of safety or threat. This theory may offer insight into the role of the body in stressful situations, the role of co-and self-regulation, and thus the functioning of and the rationale for use of creative arts and psychomotor therapies. Through interventions focused on promoting healthy autonomic responses and regulating physiological responses, clients can learn to better regulate and process their emotional experiences. Although this could be broadly useful, it would seem particularly promising in therapies focused on stress and trauma. This article provides an introduction to polyvagal theory and outlines how it can serve as an explanatory, hypothetical model for the working mechanisms that underlie creative arts and psychomotor therapies. The application of PVT in creative arts and psychomotor therapies will be explored by describing techniques for “noticing and naming” and “learning to change,” as well as by highlighting the role of PVT in the therapeutic relationship. It provides case examples and discusses the role of creative arts and psychomotor therapies for stress regulation and resilience conceptualized in line with the polyvagal theory.

A study with 36 German participants (divided in 3 age groups: 1 gr. 7-11 years; 2 gr. 12-18 years and 3 gr. 19-50 years) was conducted to test the Polyvagal Theory. Our data analysis evaluated a therapeutic intervention using the so-called SSP (Safe and Sound Protocol) developed by Stephen Porges. Frequency modulated music stimulates the parasympathetic vagus nerve with an (musical) input process evaluated by the brain as socially-communicatively salient (musical signals with enhanced prosodic characteristics of human voices). Thus, acoustical processes of (musical) perception become available to the brain's assessment of social signals via the neurophysiology of the ANS. This, in turn, allows for internally processed signals of social safety, resulting in a reduced sense of stress from external sensory inputs. The SSP aims to generally reduce sensory hypersensitivity by stimulating the vagus nerve via the middle ear – and thus, to contribute to a better capacity of (down)-regulating sensory hypersensitivity. In the current study, we demonstrated that participants with ASD showed reduced hyper-sensitivity (visual, auditory, tactile and digestive) after using the SSP. In a second data analysis, we tested the overall impact of language ability and the influence on hyper sensory sensitivity in the autism spectrum. It seems that language ability in general already leads to better regulation and integration of sensory inputs via cognitive-linguistic processing in cortex areas: if a strong sensory stimulus can be assigned and evaluated linguistically, the strength of the stimulus is adjusted thereby. Conversely, different language abilities did not result in a more effective response to the SSP. Since the SSP amplifies prosodic elements of human speech in a characteristic way, the effect of reduced sensitivity to stimuli seems to be due to the autonomic response to paraverbal signals. The results are statistically analyzed using ANOVA. Disclosure Statement No potential conflict of interest was reported by the authors. * Corresponding author: Hristo Kyuchukov, 0000-0002-1965-8908 hristo.kyuchukov@us.edu.pl

This paper proposes the "calm contact" technique: an imaginative scenario where someone is in gentle contact with a loved one where the essence of the experience is to enjoy safety and calmness in peaceful social contact. The theoretical background is outlined by combining the brain mechanisms of stress reactions and hypnosis. In addition to the ancient stress responses (flight or fight or freeze), there are oxytocin-based options at the human level: tend and befriend behavior and the state of calm and connection, which is not a stress reaction but a resting reaction. These social-based reactions could prevent the organism from the primitive freezing response. Some studies proved that "hypnosis" as a setting reduces cortisol levels and could raise oxytocin levels. The beneficial mechanisms of the "calm contact" technique are analyzed in relation to "social support" and the psychoaffective effects of central oxytocin. The subjective effects of the proposed technique are outlined based on reports of healthy volunteers. The "calm contact" technique could be an alternative or adjunct to the "safe place" technique, applying the recent findings of endocrinological brain mechanisms of hypnosis. Clinical implications and limitations are briefly summarized. [ABSTRACT FROM AUTHOR]

Polyvagal theory is a neurobiological approach developed by Dr. Stephen W. Porges to explain the physiological basis of social behaviors and emotional responses from the perspective of the autonomic nervous system. The theory is based on an understanding of the vagus nerve and its role in the autonomic nervous system. The theory identifies three evolutionary layers of the autonomic nervous system that show different responses to threat and safety. The theory emphasizes that the ability to switch between the different vagus nerve modes is crucial for adaptation to social situations and for the perception of safety. A well-regulated ventral vagus contributes to a sense of safety and social connectedness. In a clinical setting, polyvagal theory can help to develop therapeutic approaches that promote the regulation of the autonomic nervous system. This article explores various aspects of this theory, including its application in a therapeutic context. [ABSTRACT FROM AUTHOR]

The Polyvagal Theory (PVT) of the US-American neuroscientist Stephen W. Porges can mean much more to therapists than just another narrative for addressing the mind-bodyproblem. Its impact on philosophy and science since the 17th century can hardly be underestimated, right up to the question of whether terms such as »psychic« or »mental« should still be used. This article attempts to contextualize Porges’ theory in a larger framework, in philosophical, neuroscientific and therapeutic implications of PVT. A categorization of three central concepts (neuroception, co-regulation and social engagement system) leads to the further discussed question of what (co-regulatory) »language« we can speak together in therapy to encounter and to heal each other. A short epilogue addresses the criticism of PVT before concluding by highlighting the chances. [ABSTRACT FROM AUTHOR]

The modern project management environment has become more complex due to various influences. For instance, stress and trauma are recognized as powerful influences on employee behaviors and decisionmaking. Although past studies have attempted to understand the psychology behind this phenomenon, scarce research has been performed on the influence of the autonomic nervous system on project management outcomes. Accordingly, this paper investigates the underlying nervous system responses that shape project management activities in different organizations. It relies on the Polyvagal Theory to elucidate the neurobiological responses that emerge when project managers are faced with stressful, dangerous or life-threatening situations. Thus, the paper can offer feasible recommendations for optimizing project management outcomes by strengthening the link between the heart, mind, and body. [ABSTRACT FROM AUTHOR]

This article shares extracts from an arts-based community model of mental healthcare that works with family and social systems to develop collective resilience and address intergenerational trauma in a culturally informed manner. The practice is situated in an African philosophy of collectivism, where the group is a resource and source of support. It invites arts therapists to engage with psychological practices outside of an individualistic focus with a practical approach to considering the ecosystem which influences health and well-being. Theories such as embodiment and polyvagal theory, community and collective resilience and intergenerational trauma are explored and translated to practise with an example of implementation in a remote farming community in the Western Cape of South Africa. The authors focus on practice elements derived from Dramatherapy and Applied Drama, which highlights embodied practices as they are applied to address intergenerational trauma and develop collective resilience. [ABSTRACT FROM AUTHOR]

This article highlights the origins of performance training and voice pedagogy in Canada developed, in part, through the work of Michel Saint-Denis and Iris Warren. It further connects the origins of performance voice to the social sciences, highlighting the historical influences that psychodynamic therapeutic approaches have had toward informing somatic voice methodologies and pedagogy. By revisiting one thread within the historic collaboration between these fields, the article encourages actively revisiting cross-disciplinary collaborations to support knowledge-creation; which has the potential to advance both fields and encourage the development of trauma-informed, embodied frameworks to support integrated pedagogies and accessible interventions across disciplines. [ABSTRACT FROM AUTHOR]

Research on the neuroscience of fear in both humans and non-humans has suggested that a lack of acquisition of safety cues might be a biological hallmark of posttraumatic stress disorder (PTSD). Danger perception, and in particular, feeling as one's own life is in danger, is thought to represent a major predictor of PTSD. Persistent danger perception is concurrently associated with a persistence of lack of safety. However, despite several research efforts, no validated psychometric tools exist regarding psychological safety as a unique core construct in the domain of a soothing-contentment system. By including social, compassionate, and bodily components, the Neuroception of Psychological Safety Scale (NPSS), neurophysiologically rooted in the polyvagal theory, aims to specifically assess psychological safety. Originally developed in English, we employed a rather large non clinical sample to validate our Italian translation of the NPSS (n = 338) and the scale was found to retain a three-factor structure. In light of its positive moderate correlations with the Unconditional Self-Kindness Scale (ρ = 0.376) and the Self-Compassion Scale-Short-Form (ρ = 0.481), good convergent validity and robust psychometric properties were shown by the NPSS. The Subjective Traumatic Outlook Questionnaire (ρ = −0.283) and the three subscales of the Body Perception Questionnaire-22—Body Awareness (ρ = −0.103), Supradiaphragmatic Reactivity (ρ = −0.234), and Body Awareness/Subdiaphragmatic Reactivity (ρ = −0.146)—were found to have weak negative correlations with the NPSS, which further demonstrated its good discriminant validity. Eventually, the NPSS was found to show good test-retest reliability (intraclass correlation coefficient = 0.922; three-week time interval), and its usage is fostered in clinical and research contexts where the evaluation of psychological safety is of relevance.

In this article, the author summarises Stephen Porges’ theory, which, as the American neuroscientist states, is intended to ‘provide neurophysiologically plausible explanations for many of the experiences described by people who have experienced trauma. For these people, the theory provided an understanding of how their bodies had tuned in response to a life-threatening event and lost the resilience to return to a safe state’.

Background: Stockholm syndrome or traumatic bonding (Painter & Dutton, Patterns of emotional bonding in battered women: Traumatic bonding. International Journal of Women’s Studies, 8(4), 363–375, 1985) has been used in mainstream culture, legal, and some clinical settings to describe a hypothetical phenomenon of trauma survivors developing powerful emotional attachments to their abuser. It has frequently been used to explain the reported ‘positive bond’ between some kidnap victims and their captor's, although scarce empirical research has supported this assertion. It has been used in various situations where interpersonal violence and mind control are reported and where clear power differentials exist, such as in child sexual abuse, intimate partner violence, human trafficking, and hostage situation scenarios. Objective: We propose replacing Stockholm syndrome with ‘appeasement,’ a term that can be explained through a biopsychological model (i.e. Polyvagal Theory) to describe how survivors may appear emotionally connected with their perpetrators to effectively adapt to life-threatening situations by calming the perpetrator. Conclusion: We believe the term appeasement will demystify the reported survivor experiences and will, in the eyes of the public, victims, and survivors, provide a science-based explanation for their narratives of survival that may initially appear to be contradictory. By understanding the potent reflexive neurobiological survival mechanisms embedded in appeasement, individuals and families can operationalise their survival from a perspective that supports resilience, a healthy long-term recovery, and normalises their coping responses as survival techniques.

Although there is a consistent literature documenting that vagal cardioinhibitory pathways support homeostatic functions, another less frequently cited literature implicates vagal cardioinhibitory pathways in compromises to survival in humans and other mammals. The latter is usually associated with threat reactions, chronic stress, and potentially lethal clinical conditions such as hypoxia. Solving this ‘vagal paradox’ in studies conducted in the neonatal intensive care unit served as the motivator for the Polyvagal Theory (PVT). The paradox is resolved when the different functions of vagal cardioinhibitory fibers originating in two anatomically distinguishable brainstem areas are recognized. One pathway originates in a dorsal area known as the dorsal motor nucleus of the vagus and the other in a ventral area of the brainstem known as nucleus ambiguus. Unlike mammals, in all ancestral vertebrates from which mammals evolved, cardioinhibitory vagal fibers primarily originate in the dorsal motor nucleus of the vagus. Thus, in mammals the vagus nerve is ‘poly’ vagal because it contains two distinct efferent pathways. Developmental and evolutionary biology identify a ventral migration of vagal cardioinhibitory fibers that culminate in an integrated circuit that has been labeled the ventral vagal complex. This complex consists of the interneuronal communication of the ventral vagus with the source nuclei involved in regulating the striated muscles of the head and face via special visceral efferent pathways. This integrated system enables the coordination of vagal regulation of the heart with sucking, swallowing, breathing, and vocalizing and forms the basis of a social engagement system that allows sociality to be a potent neuromodulator resulting in calm states that promote homeostatic function. These biobehavioral features, dependent on the maturation of the ventral vagal complex, can be compromised in preterm infants. Developmental biology informs us that in the immature mammal (e.g., fetus, preterm infant) the ventral vagus is not fully functional and myelinization is not complete; this neuroanatomical profile may potentiate the impact of vagal cardioinhibitory pathways originating in the dorsal motor nucleus of the vagus. This vulnerability is confirmed clinically in the life-threatening reactions of apnea and bradycardia in human preterm newborns, which are hypothetically mediated through chronotropic dorsal vagal pathways. Neuroanatomical research documents that the distribution of cardioinhibitory neurons representing these two distinct vagal source nuclei varies among mammals and changes during early development. By explaining the solution of the ‘vagal paradox’ in the preterm human, the paper highlights the functional cardioinhibitory functions of the two vagal source nuclei and provides the scientific foundation for the testing of hypotheses generated by PVT.

This paper takes the perspective through the lens of Stephen Porges's Polyvagal Theory in terms of three stages - social engagement, mobilization, and immobilization - to understand autistic meltdown. In 2004, Porges coined the term neuroception to denote an automatic neural process by evaluating safety and risk of the environment without conscious awareness. The behavioral response of the nervous system (either calm or rigid) of individuals with autism having meltdowns are also discussed based on the vagus nerve activity (involving ventral vagal and dorsal vagal systems). Previous studies linking autistic meltdowns to the Polyvagal Theory is also briefly discussed here. Finally, the theory has raised a better awareness among the educational therapists and other allied professionals managing autistic meltdown to understand that disassociation occurs due to disintegration of the neural connection between the brain and the nervous system, rendering behavioral challenges in both teaching and learning. [ABSTRACT FROM AUTHOR]

Dissociative disorders (DDs) are characterized by a discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, bodily representation, motor control, and action. The life-threatening coronavirus disease 2019 (COVID-19) pandemic has been identified as a potentially traumatic event and may produce a wide range of mental health problems, such as depression, anxiety disorders, sleep disorders, and DD, stemming frompandemic- related events, such as sickness, isolation, losing loved ones, and fear for one's life. In our conceptual analysis, we introduce the contribution of the structural dissociation of personality (SDP) theory and polyvagal theory to the conceptualization of the COVID-19 pandemic-triggered DD and the importance of assessing perceived safety in DD through neurophysiologically informed psychometric tools. In addition, we analyzed the contribution of eye movement desensitization and reprocessing (EMDR) to the treatment of the COVID- 19 pandemic-triggered DD and suggest possible neurobiological mechanisms of action of the EMDR. In particular, we propose that, through slow eye movements, the EMDR may promote an initial non-rapid-eye-movement sleep stage 1-like activity, a subsequent access to a slow-wave sleep activity, and an oxytocinergic neurotransmission that, in turn, may foster the functional coupling between paraventricular nucleus and both sympathetic and parasympathetic cardioinhibitory nuclei. Neurophysiologically informed psychometric tools for safety evaluation in DDs are discussed. Furthermore, clinical and public health implications are considered, combining the EMDR, SDP theory, and polyvagal conceptualizations in light of the potential dissociative symptomatology triggered by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate how the schema modes defined in Schema Theory group together and accordingly question the conceptualization of schema modes considering the theories combining evolutionary, neuroscientific, and psychological point of views in psychology literature. It was hypothesized that there would be differences in the categorization and conceptualization of schema modes conceptualized by Schema Theory based on Polyvagal Theory. The sample of the study consists of 2032 participants aged between 18 and 71 years old (M = 36.00, SD = 14.312) who applied to a psychotherapy center in Istanbul working with the approach of Schema Therapy. Short Schema Mode Inventory was applied to the participants. According to the results of the second-order factor analysis, compliant surrenderer, healthy adult, punitive parent, happy child, and detached protector modes were clustered in the first factor. Impulsive child, enraged child, condescending, and easily bored child modes were loaded under the second factor while demanding parent, detached self-soother, and status-seeking modes were loaded under the third factor. When the results were evaluated with respect to Polyvagal Theory, it was determined that the first factor represented the parasympathetic nervous system activation and consisted of schema modes that include surrender, freezing, and socialization responses while the second factor consisting of schema modes related to flight or fight responses represented the sympathetic nervous system activation. Moreover, the third factor consisted of the schema modes of the sympathetic nervous system, which included flight or fight responses with parasympathetic inhibition (vagal brake). The results were discussed in line with the literature. [ABSTRACT FROM AUTHOR]

Conceptual models of psychosocial influences on short-term changes (i.e., reactivity) in vagally-mediated heart rate variability (vmHRV) emphasize self-regulatory effort and social threat versus comfort. However, these two general perspectives have been tested separately in nearly all cases, limiting conclusions about the relative importance or possible interactive effects of effortful self-regulation and social stress. The present study compared effects of effort to regulate emotional expression and social stress versus safety on vmHRV reactivity during an interpersonal interaction, in a 2 (self-regulate emotion vs. express emotion freely) × 3 (positive vs. neutral vs. negative interaction valence) × 2 (male vs. female) between-subjects randomized factorial design. A sample of 180 undergraduates (90 women; 69 % White) discussed a current events topic (i.e., human-caused climate change) with a prerecorded partner, presented as a live interaction over a computer. Self-reports of affective responses, self-regulation effort, and appraisals of the partner's behavior, as well as observer ratings of participants' behavior during the interaction, supported the effectiveness of self-regulation and interaction valence manipulations, although the former manipulation may have been somewhat weaker than the latter. Primary analyses of high-frequency heart rate variability (HF-HRV) and root mean square of successive differences (RMSSD) in heart beat intervals recorded at baseline and during the interaction revealed larger decreases in vmHRV during negative than neutral or positive interactions, but no effects of self-regulation instructions. Overall, results indicated more robust effects of social stress on vmHRV reactivity, relative to effects of self-regulatory effort. • Social safety and emotion regulation can evoke changes in heart rate variability. • These two influences on HRV change are typically examined separately. • In a simultaneous test, only negative social interactions altered HRV. • Social stress may exert a greater influence on brief HRV change than self-regulation. • Interpersonal concepts and methods may be useful in research on HRV. [ABSTRACT FROM AUTHOR]

This review explores the historical development of cardiology knowledge, from ancient Egyptian psychostasis to the modern comprehension of cardiac neuromodulation. In ancient Egyptian religion, psychostasis was the ceremony in which the deceased was judged before gaining access to the afterlife. This ritual was also known as the “weighing of the heart” or “weighing of the soul”. The Egyptians believed that the heart, not the brain, was the seat of human wisdom, emotions, and memory. They were the first to recognize the cardiocentric nature of the body, identifying the heart as the center of the circulatory system. Aristotle (fourth century BC) considered the importance of the heart in human physiology in his philosophical analyses. For Galen (third century AD), the heart muscle was the site of the vital spirit, which regulated body temperature. Cardiology knowledge advanced significantly in the 15th century, coinciding with Leonardo da Vinci and Vesalius’s pioneering anatomical and physiological studies. It was William Harvey, in the 17th century, who introduced the concept of cardiac circulation. Servet’s research and Marcello Malpighi’s discovery of arterioles and capillaries provided a more detailed understanding of circulation. Richard Lower emerged as the foremost pioneer of experimental cardiology in the late 17th century. He demonstrated the heart’s neural control by tying off the vagus nerve. In 1753, Albrecht von Haller, a professor at Göttingen, was the first to discover the heart’s automaticity and the excitation of muscle fibers. Towards the end of the 18th century, Antonio Scarpa challenged the theories of Albrecht von Haller and Johann Bernhard Jacob Behrends, who maintained that the myocardium possessed its own “irritability”, on which the heartbeat depended, and was independent of neuronal sensitivity. Instead, Scarpa argued that the heart required innervation to maintain life, refuting Galenic notions. In contemporary times, the study of cardiac innervation has regained prominence, particularly in understanding the post-acute sequelae of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection (PASC), which frequently involves cardiorespiratory symptoms and dysregulation of the intrinsic cardiac innervation. Recently, it has been recognized that post-acute sequelae of acute respiratory infections (ARIs) due to other pathogens can also be a cause of long-term vegetative and somatic symptoms. Understanding cardiac innervation and modulation can help to recognize and treat long COVID and long non-COVID-19 (coronavirus disease 2019) ARIs. This analysis explores the historical foundations of cardiac neuromodulation and its contemporary relevance. By focusing on this concept, we aim to bridge the gap between historical understanding and modern applications. This will illuminate the complex interplay between cardiac function, neural modulation, cardiovascular health, and disease management in the context of long-term cardiorespiratory symptoms and dysregulation of intrinsic cardiac innervations.

Dissociative disorders (DDs) are characterized by a discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, bodily representation, motor control, and action. The life-threatening coronavirus disease 2019 (COVID-19) pandemic has been identified as a potentially traumatic event and may produce a wide range of mental health problems, such as depression, anxiety disorders, sleep disorders, and DD, stemming from pandemic-related events, such as sickness, isolation, losing loved ones, and fear for one's life. In our conceptual analysis, we introduce the contribution of the structural dissociation of personality (SDP) theory and polyvagal theory to the conceptualization of the COVID-19 pandemic-triggered DD and the importance of assessing perceived safety in DD through neurophysiologically informed psychometric tools. In addition, we analyzed the contribution of eye movement desensitization and reprocessing (EMDR) to the treatment of the COVID-19 pandemic-triggered DD and suggest possible neurobiological mechanisms of action of the EMDR. In particular, we propose that, through slow eye movements, the EMDR may promote an initial non-rapid-eye-movement sleep stage 1-like activity, a subsequent access to a slow-wave sleep activity, and an oxytocinergic neurotransmission that, in turn, may foster the functional coupling between paraventricular nucleus and both sympathetic and parasympathetic cardioinhibitory nuclei. Neurophysiologically informed psychometric tools for safety evaluation in DDs are discussed. Furthermore, clinical and public health implications are considered, combining the EMDR, SDP theory, and polyvagal conceptualizations in light of the potential dissociative symptomatology triggered by the COVID-19 pandemic.

A study with 36 German participants (divided in 3 age groups: 1 gr. 7-11 years; 2 gr. 12-18 years and 3 gr. 19-50 years) was conducted to test the polyvagal theory. Our data analysis evaluated a therapeutic intervention using the so-called SSP (Safe and Sound Protocol) developed by Stephen Porges. Frequency modulated music stimulates the parasympathetic vagus nerve with an (musical) input process evaluated by the brain as social-communicatively salient (musical signals with enhanced prosodic characteristics of human voices). Thus, acoustical processes of (musical) perception become available to the brain's assessment of social signals via the neurophysiology of the ANS. This, in turn, allows for internally processed signals of social safety, resulting in a reduced sense of stress from external sensory inputs. The SSP aims to generally reduce sensoric hypersensitivity by stimulating the vagus nerve via the middle ear - and thus, to contribute to a better capacity of (down)-regulating sensoric hypersensitivity. In the current study, we demonstrated that participants with ASD showed reduced hyper-sensitivity (visual, auditory, tactile and digestive) after using the SSP. In a second data analysis, we tested the overall impact of language ability, age, self-care ability and its influence on hypersensory sensitivity in the autism spectrum. It seems that language ability in general already leads to better regulation and integration of sensory inputs via cognitive-linguistical processing in cortex areas: If a strong sensory stimulus can be assigned and evaluated linguistically, the strength of the stimulus is adjusted thereby. Conversely, different language abilities did not result in a more effective response to the SSP. Since the SSP amplifies prosodic elements of human speech in a characteristic way, the effect of reduced sensitivity to stimuli seems to be due to the autonomic response to paraverbal signals. The results are statistically analyzed using ANOVA. [ABSTRACT FROM AUTHOR]

Mindful Coping Power (MCP) was developed to enhance the effects of the Coping Power (CP) preventive intervention on children's reactive aggression by integrating mindfulness training into CP. In prior pre–post analyses in a randomized trial of 102 children, MCP improved children's self-reported anger modulation, self-regulation, and embodied awareness relative to CP but had fewer comparative effects on parent- and teacher-reported observable behavioral outcomes, including reactive aggression. It was hypothesized that MCP-produced improvements in children's internal awareness and self-regulation, if maintained or strengthened over time with ongoing mindfulness practice, would yield improvements in children's observable prosocial and reactive aggressive behavior at later time points. To appraise this hypothesis, the current study examined teacher-reported child behavioral outcomes at a one-year follow-up. In the current subsample of 80 children with one-year follow-up data, MCP produced a significant improvement in children's social skills and a statistical trend for a reduction in reactive aggression compared with CP. Further, MCP produced improvements in children's autonomic nervous system functioning compared with CP from pre- to post-intervention, with a significant effect on children's skin conductance reactivity during an arousal task. Mediation analyses found that MCP-produced improvements in inhibitory control at post-intervention mediated program effects on reactive aggression at the one-year follow-up. Within-person analyses with the full sample (MCP and CP) found that improvements in respiratory sinus arrhythmia reactivity were associated with improvements in reactive aggression at the one-year follow-up. Together, these findings indicate that MCP is an important new preventive tool to improve embodied awareness, self-regulation, stress physiology, and observable long-term behavioral outcomes in at-risk youth. Further, children's inhibitory control and autonomic nervous system functioning emerged as key targets for preventive intervention. [ABSTRACT FROM AUTHOR]

[Display omitted] • Pathogenesis and salugenesis are the first and second stages of the two-stage problem of disease production and health recovery. • Salugenesis, the healing cycle, the integrated stress response (ISR), and the cell danger response (CDR) each describe different aspects of the same biology. • The healing cycle cannot progress without programmatic changes in mitochondrial function needed for local and organelle-to-organism signaling. • The rise and fall of extracellular ATP (eATP) after stress or injury is a key driver of salugenesis and the healing cycle. • The rising tide of chronic disease can be traced to impaired salugenesis, incomplete healing, pollution, and ecosystem changes caused in part by anthropogenic factors. Pathogenesis and salugenesis are the first and second stages of the two-stage problem of disease production and health recovery. Salugenesis is the automatic, evolutionarily conserved, ontogenetic sequence of molecular, cellular, organ system, and behavioral changes that is used by living systems to heal. It is a whole-body process that begins with mitochondria and the cell. The stages of salugenesis define a circle that is energy- and resource-consuming, genetically programmed, and environmentally responsive. Energy and metabolic resources are provided by mitochondrial and metabolic transformations that drive the cell danger response (CDR) and create the three phases of the healing cycle: Phase 1—Inflammation, Phase 2—Proliferation, and Phase 3—Differentiation. Each phase requires a different mitochondrial phenotype. Without different mitochondria there can be no healing. The rise and fall of extracellular ATP (eATP) signaling is a key driver of the mitochondrial and metabolic reprogramming required to progress through the healing cycle. Sphingolipid and cholesterol-enriched membrane lipid rafts act as rheostats for tuning cellular sensitivity to purinergic signaling. Abnormal persistence of any phase of the CDR inhibits the healing cycle, creates dysfunctional cellular mosaics, causes the symptoms of chronic disease, and accelerates the process of aging. New research reframes the rising tide of chronic disease around the world as a systems problem caused by the combined action of pathogenic triggers and anthropogenic factors that interfere with the mitochondrial functions needed for healing. Once chronic pain, disability, or disease is established, salugenesis-based therapies will start where pathogenesis-based therapies end. [ABSTRACT FROM AUTHOR]

This article discusses pathways for personal transformation in the context of physician burnout and the collective trauma related to the COVID-19 pandemic. The article explores polyagal theory, posttraumatic growth concepts, and leadership frameworks as pathways for change. It is both practical and theoretical in its approach and offers a paradigm for transformation in a parapandemic world. [ABSTRACT FROM AUTHOR]

In this article, author Waisman's work with mismatch combines with author Wagner's work with polyvagal theory to illuminate the dance of mismatch in healing multi-generational trauma. Author Waisman first became familiar with the concept of mismatch as it relates to gestures and words. During situations of conflict between Israeli-Arab and Israeli-Jewish students, Waisman noticed participants displaying gestures expressing meaning that differed from the accompanying words. Looking at mismatch through a polyvagal-informed lens, therapists can understand how mismatch relates to trauma. Polyvagal theory illuminates the anatomy that inhibits movement expressions as well as the intensity of the awakening of inhibited movement expressions. In this article, the authors suggest that mismatch of gestures and words relates to the inhibition of particular movement expressions—those which dance/movement therapists recognise as the 'fighting' rhythms identified by Kestenberg et al.. Shahar-Levy, a dance/movement therapist, speaks of coming out of 'emotive motor memory clusters'. Resmaa Menakem, author of My Grandmother's Hands: Racialised Trauma and the Pathway to Mending Our Hearts and Bodies, speaks of the need to move through the pain to grow out of traumatic retentions. Therapists benefit from a deeper awareness of the mismatch moment when the 'fighting' rhythms awaken. [ABSTRACT FROM AUTHOR]

Individual differences in children's prosocial behaviors, including their willingness to give up something of value for the benefit of others, are rooted in physiological and environmental processes. In a sample of 4-year-old children, we previously found evidence that flexible changes in respiratory sinus arrhythmia (RSA) were linked to donation behavior, and that these physiological patterns may support greater sensitivity to the positive effects of compassionate parenting on donation behavior. The current study focused on a follow-up assessment of these children at age 6. First, we examined the stability of individual differences in donation behavior and related parasympathetic nervous system (PNS) activity from age 4 to 6. Second, we examined associations between donation behavior and RSA at 6 years. Third, we examined whether the association between children's RSA and donation behavior at age 6 varied depending on mothers' compassionate love. We found low to modest stability in donation behavior and RSA reactivity from age 4 to 6. These findings provide preliminary evidence that stable individual differences in altruism, as reflected by generosity, and in some aspects of parasympathetic functioning during opportunities to be prosocial, emerge in childhood. In addition, we found that some of the same associations between donation behavior, RSA, and compassionate love that we previously observed in children at 4 years of age continued to be evident 2 years later at age 6. Greater decreases in RSA when given the opportunity to donate were associated with children donating more of their own resources which, in turn, were associated with greater RSA recovery after the task. Lastly, mothers' compassionate love was positively associated with donation behavior in children who demonstrated stronger decreases in RSA during the task; compassionate parenting and RSA reactivity may serve as external and internal supports for prosociality that build on each other. Taken together, these findings contribute to the perspectives that individual differences in altruistic behaviors are intrinsically linked to healthy vagal flexibility, and that biopsychosocial approaches provide a useful framework for examining and understanding the environmental and physiological processes underlying these individual differences.

This paper proposes the “calm contact” technique: an imaginative scenario where someone is in gentle contact with a loved one where the essence of the experience is to enjoy safety and calmness in peaceful social contact. The theoretical background is outlined by combining the brain mechanisms of stress reactions and hypnosis. In addition to the ancient stress responses (flight or fight or freeze), there are oxytocin-based options at the human level: tend and befriend behavior and the state of calm and connection, which is not a stress reaction but a resting reaction. These social-based reactions could prevent the organism from the primitive freezing response. Some studies proved that “hypnosis” as a setting reduces cortisol levels and could raise oxytocin levels. The beneficial mechanisms of the “calm contact” technique are analyzed in relation to “social support” and the psychoaffective effects of central oxytocin. The subjective effects of the proposed technique are outlined based on reports of healthy volunteers. The “calm contact” technique could be an alternative or adjunct to the “safe place” technique, applying the recent findings of endocrinological brain mechanisms of hypnosis. Clinical implications and limitations are briefly summarized.