Polyvagal Theory, Disordered Eating & Eating Disorders
What is Polyvagal Theory?
The Polyvagal Theory was developed by Dr Stephen Porges and revolutionised our understanding of how our body’s respond to stress and how we process stress in the body. Before this theory came about stress was quite binary (we were stressed or not stressed) - a little like a light switch, either on or off, no nuance. However, Dr Porges discovered that stress is a lot more nuanced than perhaps we previously thought. He discovered that we have multiple states of stress, in other words, multiple states of nervous system activation.
The Polyvagal Theory (poly meaning many and vagal coming from the vagus nerve) states that there are 3 different states of nervous system activation: (1) ventral vagal social engagement, (2) sympathetic activation and (3) dorsal vagal shutdown.
1) Ventral Vagal Social Engagement:
Is the state in the nervous system in which we are able to connect and relate to other people. In this state, we are able to empathise with others, connect and interpret their facial expressions and body language in an accurate way. In this state, we are able to feel playful, joy, love, and connection. In this state, we feel safe, secure and generally good. We can be present with ourselves and other people.
2) Sympathetic Activation:
This state is what we would associate with stress as it is our immediate reaction to stress that affects nearly every organ in the body. A state of mobilisation. The fight or flight response. This state is motivated to dispatch the threat (whatever that threat may be) usually by either fighting it or running away from it. Sympathetic activation, therefore, prepares us for this, usually through increasing our heart rate, breathing rate and helping to raise blood sugars to prepare us for action. It is correlated with feeling chaotic, frenzied, overwhelmed and anxious. The physical sympathetic nervous system resides along the front of the spine and when activated, can cause the back muscles to become very right and rigid.
3) Dorsal Vagal Shutdown:
In this state at some level, our nervous system believes we are in a very life-threatening situation and tries to keep us alive by keeping our body still. It is a place of immobilisation and can show up in one of two ways: a state of collapse or in a freeze response. In this state individuals are left feeling stuck and unable to take action and therefore is associated with feelings of lethargy, despondency, inability to self-motivate, hopelessness, and shame.
The Polyvagal Ladder
All three of these states can be somewhat active (to varying degrees) in our system at various times. Moving through the different states can be visualised as moving through different rungs in a ladder. Many stressors in life are ongoing in our personal and professional lives which can create layers and layers of stress. At times these stressors can cause us to move up the ‘Polyvagal Ladder’ into the Sympathetic Activation state, however, our body cannot sustain being in this state for a long period (due to the stress hormones adrenaline and cortisol). After a while, our body’s in an act of self-preservation may use the Dosal Vagal Shutdown to modulate the Sympathetic Activation. To note, stressors may be personal from person to person and are in may ways subjective and influenced based on context, personal experiences and trauma. For one person, public transport may be a stressor that activates these systems. For another, it could be trauma.
Being in the Sympathetic Activation or Dosal Vagal Shutdown states constitutes a survival state in the body and will sensitise us to pain, how we see the world (very threatening) and changes how we may perceive our reality. When dealing with these dis-regulated states, the body will not have as much energy as the body is not replenishing itself. For example, in the Sympathetic Activation state, the body is not focusing on digesting or assimilating food as it’s focusing on keeping you alive and away from danger. On an ongoing basis, this can impair digestive function, physical recovery, mental performance, cognitive performance and ability to connect to other people.
Polyvagal Theory, Eating Disorders and Disordered Eating
The Polyvagal Theory provides a new perspective on eating disorders and disordered eating as it stresses the importance of social connectedness and defines eating disorders as disorders of bio-behavioural state regulation. Dr Porges has said, “an eating disorder appears when ingestive behaviours replace social behaviour as a primary regulator of the autonomic state.” For example, behaviours around eating and drinking (as well as many other behaviours we see in eating disorders such as routines and rituals around food or exercise) are a means to regulate the autonomic state and a way to “feel safe”.
In order words, an eating disorder or disordered eating are to someone that is experiencing them a potentially effective strategy to regulate an underlying autonomic state and to feel safe. At the same time, we know that these can have severe physical, mental, emotional and social consequences.
An eating disorder or disordered eating behaviours can surface because of intense experiences that overload an already vulnerable nervous system. The act of eating uses the same neural platform as the social engagement system (Ventral Vagal).
In the Sympathetic Activation state, eating disorders can show up through obsessive thoughts about food and food rituals, loss of appetite, binge eating, IBS like symptoms or excessive exercise (examples of the flight response). The fight response can be observed in ED symptoms of purging, chewing and spitting, anger turned toward the body and other self-harm behaviours.
The Dorsal Vagal Shutdown or the freeze response presents itself in eating disorders / disordered eating through inhibition in digestion, irritable bowel syndrome, desire to disappear, and use of extreme measures to feel the body such as extreme sports.
Eating Disorder / Disordered Eating Recovery through a Polyvagal Lens
Binge eating, excess exercise and purging are often referred to as “compensatory” behaviours in the eating disorder field, however taking a more nuanced view, through a Polyvagal lens, allows us to consider the many ways in which the symptoms help the individual impacted to regulate the nervous system and provide a sense of safety, in the short term. The same can be true of returning to specific routines or rituals following during a period they have been more difficult to follow or indeed simply intensifying other ED or disordered eating driven behaviours.
Recovery from eating disorders and disordered eating under the polyvagal lens involves getting curious about when we may be transitioning through these different nervous system states therefore, reconnecting with the body and developing the ability through different tools and practices to move up and down the Polyvagal ladder, rather than being stuck in these states, or indeed stuck in patterns of behaviours which may give the illusion of safety but may actually be harming us or taking us away from the life we want to live.
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