Exploring the Polyvagal Theory: Unveiling the Autonomic Nervous System’s Response to Stress

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Initially I introduced the background of Adult Medicine Specialists and the team of dedicated people that have helped to make it successful as we continue to provide a caring and listening environment for our patients.

I would like to now begin addressing a specific direction we have taken in this practice to take a more global view of patient problems and how we are addressing those problems.

As a healthcare provider, I have witnessed the significant impact of stress and trauma on patients’ physical and mental health. To deepen my understanding of stress and its effects on the autonomic nervous system, I discovered the intriguing Polyvagal theory. Developed by Dr. Stephen Porges in the 1990s, this theory sheds light on how our autonomic nervous system responds to stress and facilitates social engagement behaviors.  It has transformed my practice and has helped me to have a deeper understanding of how stress has an impact on virtually every problem faced by primary care physicians.

Understanding the Polyvagal Theory:

The Polyvagal theory offers a fresh perspective on the autonomic nervous system’s role in stress response. It emphasizes the importance of the social engagement system in promoting social interactions and co-regulation. On the other hand, exposure to multiple stressors can activate the sympathetic system, leading to a persistent state of hypervigilance and contributing to stress-related medical conditions.

Application in Primary Care:

In this series of blogs, I aim to explore the practical application of the Polyvagal theory in primary care medicine. This content is designed for healthcare providers, including physicians, nurses, and allied health professionals, who seek a comprehensive understanding of stress-related disorders and the Polyvagal theory’s implications. By examining the theory’s history, components, mechanisms, and relevance to healthcare delivery, we can improve patient care and outcomes.

Managing Stress-Related Disorders:

A significant focus of this blog series will be the practical implementation of the Polyvagal theory in managing stress-related disorders. By incorporating the theory’s insights, healthcare providers can develop strategies to help patients regulate their autonomic nervous system, reduce stress levels, and enhance overall well-being. We will explore evidence-based interventions, therapeutic techniques, and real-life case studies to illustrate the theory’s potential in optimizing patient care.


Dr. Stephen Porges’ pioneering work has revolutionized our understanding of the autonomic nervous system and its response to stress. By embracing the Polyvagal theory, healthcare providers can gain a comprehensive perspective on stress-related disorders and effectively integrate this knowledge into their clinical practice. My hope is that this blog series serves as a valuable resource, empowering healthcare professionals to navigate the complexities of the autonomic nervous system and transform patient care for the better. Together, we can apply the principles of the Polyvagal theory to improve patient outcomes and promote overall well-being.

Steven E. Freeman, MD, PhD.

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