Neuroscience
Dynamic Healing—The New Paradigm Medicine Needs
Polyvagal theory provides a new way to address the root cause of disease
Posted June 14, 2021 Reviewed by Hara Estroff Marano
Key points
- Your body exists in one of three physiological states–threat (flight or fight), neutral (homeostasis), or safety (rest and digest).
- It is desirable to be in neutral or safety most of the time. Intermittent threat states are necessary for survival.
- Being in a sustained threat state creates physical/mental illnesses and disease.
- Understanding the role of the autonomic nervous system through polyvagal theory reveals solutions.
What the world of medicine needs is a new, data-based dynamic approach to successfully deal with our epidemic of chronic disease. It must acknowledge the all-important interaction between circumstances (stressors) and your body’s capacity to process them, which determines the makeup of your body’s chemistry.
The hormones and signaling cells released in response to experience create mental and physical reactions to optimize your chances of surviving and then thriving. When your stresses overwhelm your coping capacity, your body will go into “fight or flight” mode; neural regulation of the autonomic nervous system is disrupted and you experience an array of mental and physical symptoms
Addressing only symptoms cannot, has not, and will not solve the burden of chronic disease.1 What is needed instead is “dynamic healing,” a term that emphasizes the feedback circuits regulating the bodily processes that would optimize health, growth, and restoration.
Dr. Stephen Porges delineates the role of the nervous system in regulating the body's organs in his model, Polyvagal Theory. It emphasizes the bidirectional communication between visceral organs associated with the autonomic nervous system and brainstem structures.
The theory focuses on the surveillance and regulatory role of the vagus nerve, a prominent cranial nerve that connects visceral organs with brainstem structures. Disease is often related to a coordinated threat reaction that disrupts homeostatic processes; a vagal pathway has the capacity to downregulate threat and optimize homeostatic processes.6
The root cause of disease
Two aspects of this sequence determine the expression of symptoms. One is the magnitude and duration of your stresses (input), the other is the reactivity of your nervous system. There are three possible outcomes (output) – safe, neutral, or threat. Living creatures are in the neutral zone most of the time and gravitate to safety whenever possible to rest and regenerate.
The perception of danger (threat) causes the nervous system to send signals to prepare for battle and wage it if necessary—“fight or flight.” Your body’s response (activated) is intended to feel unpleasant enough (anxiety) to compel you to take action to resolve the situation. The goal is to remain in this agitated state for as short a time as possible.
But what if you cannot solve the problem and you’re chronically fired up? Your body stimulates even more of a response to regain control, and you are hyperactivated (angry). Unpleasant sensory input progressively impacts your body at three levels.
· Response
· Symptoms
· Illness/ Diseases
When the threat is short-lived your physiological response is appropriate to the situation and quickly resolves. When threats are prolonged, you experience symptoms such as back pain, tension headaches, anxiety, poor appetite, nausea, urge to urinate, sexual dysfunction, burning sensations, skin rashes, dizziness, ringing in your ears, and insomnia. There are over 30 different physical and mental symptoms that can occur.2
When threats are sustained, you have a significant chance of becoming seriously ill or developing a disease. It is well-documented that chronic stress kills people and unfortunately the symptoms of an illness or disease also add to the threat load. This is particularly true in chronic pain.3
The nature of your body’s physiology under threat
Environmental cues of threat set off a defensive response. Immediately, before you are even aware, your immune system girds for the possibility of injury by initiating inflammation (to protect cells against invading bacteria, viruses, cancer cells), elevates metabolism to provide fuel for defense, increases the speed of nerve conduction–which increases your alertness but also your pain sensitivity, and elevates the levels stress hormones (cortisol, adrenaline, noradrenaline, histamines). Much of this defensive state is modulated by small signaling proteins called inflammatory cytokines.
In this physiological state, your heart is racing, you are sweaty, tired, anxious, overwhelmed, nervous, stomach feels tight, blood pressure is elevated, pain is heightened, and your breathing is rapid. You don’t feel great in this heightened neurochemical state. Are these symptoms imaginary? Not a chance. None of them.
Defining threat
Examples of physical threats include viruses, bacteria, being attacked by a predator—human or animal, hunger, lack of shelter, poverty, lack of opportunity, being bullied at work or school, racism, authoritarianism, trapped in a difficult living or family situation, and physical maladies.
Mental threats are processed in a similar manner as physical ones with the same physiological response.4 They are more problematic: Unlike visible threats like tigers or a severe storm, we cannot escape our thoughts. Repressed thoughts and emotions have even more impact on your body’s neurochemical state. Many of our unpleasant thoughts are based on cognitive distortions or “stories” about our lives. Unfortunately, whether the threat is real or perceived it has the same deleterious effect.5
Systematically addressing the root cause—circumstances versus coping capacity
First, it is always important to undergo a medical workup to make sure there is not a structural issue such as vascular disease, pinched nerve, tumor, or an infection.
Second, regardless of the findings of the workup, maintaining your body’s metabolic, immune, and nervous system balance is important. If you require a procedure, your odds of a good outcome will be maximized.
Third, all three aspects of chronic illness must be addressed. Here are some examples of interventions for each one.
Input (what are you uploading into it and what are you holding onto?)
· Cognitive Behavioral Therapy
· Expressive writing
· Never discussing your pain or medical care
State of the nervous system (calm or hypervigilant)
· Exercise
· Sleep
· ACT (Acceptance Commitment Therapy)
· Processing prior trauma
Output (physiological profile – safe, neutral, threat)
· Breath work
· Humming
· Vagal stimulation
· Certain pitches of music
Finally, you must take charge of your own body and health. Chronic diseases are complex, and you are unique. You are the only one who can figure out a solution. The first step is understanding the nature of chronic disease. The solutions lie In implementing strategies that address the root cause of disease and lower inflammation,6 which destroys tissues throughout your body. It is more doable than you think. Not taking charge may have severe consequences.
Modern medicine is continuing down the wrong road
Modern medicine is mainly addressing symptoms (output). This approach works well when there is an identifiable structural problem that can be fixed. But the vast majority chronic illnesses/ diseases result from being in a prolonged fight of flight state and structural approaches cannot and do not work. The burden of chronic disease continues to rise without an end in sight.1
Dynamic healing medicine
Dynamic healing medicine requires listening to and knowing you. Feeling safe positively affects your neurochemical profile.6 It is important to understand both your circumstances (input) and your coping skills (nervous system resilience) to develop a healing relationship with your provider. We are launching a movement, “Dynamic Healing.”
Many books now provide a foundation and framework to understand and implement your own solution to chronic illness.7 Taking responsibility for your care is the greatest factor in predicting healing.
Updated neuroscience research and understanding the implications of polyvagal theory enable clearer understanding of chronic mental and physical pain and allow patients to more quickly find their way out of the abyss.
Help bring dynamic healing into mainstream awareness.
References
1. O’Neill Hayes, Tara, and Serena Gillian. Chronic disease in the United State: A worsening health and economic crisis. Americaactionforium.org; September 10th, 2020.
2. Schubiner H and M Betzold. Unlearn Your Pain, 3rd Mind Body Publishing, Pleasant Ridge, MI, 2016.
3. Smyth J, et al. Stress and disease: A structural and functional analysis. Social and Personality Psychology Compass (2013);7/4:217-227. 10.1111/spc3.12020
4. Eisenberger NI, et al. An experimental study of shared sensitivity to physical pain and social rejection. Pain (2006);126:132-138.
5. Burns, David. Feeling Good. Harper Collins, New York, NY, 1980.
6. Porges, Stephen. The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe. Norton and Co, New York, NY, 2017.
7. Hanscom, David. Back in Control: A Surgeon’s Roadmap Out of Chronic Pain. Vertus Press, Seattle, WA. 2016.