Polyvagal Theory and Trauma Recovery: What Your Nervous System Is Actually Trying to Tell You

NERVOUS SYSTEM & TRAUMA RECOVERY • July 28, 2026

The Woman Who Knows She’s Safe But Can’t Feel It

It’s 6:40 on a Tuesday morning, and Nechama is standing at her kitchen counter with a mug of coffee she hasn’t touched. She’s 44, a partner at a mid-sized law firm, the kind of person junior associates describe as unflappable. Her husband is asleep upstairs. Her kids don’t need to be up for another hour. Nothing is wrong. She has said this sentence to herself four times already this morning. Nothing is wrong. And still, her chest is tight, her hands are faintly cold, and she’s been standing at this counter for eleven minutes without moving.

“I know I’m safe,” she tells me later that week, in my office, turning her wedding ring around her finger the way she does when she’s trying to explain something that doesn’t make logical sense to her. “That’s the part that makes me feel crazy. I know it. I can list the reasons. Good marriage, good job, no actual threat in the room. And my body just doesn’t believe me. It’s like I’m giving a closing argument to a jury that already made up its mind twenty years ago.”

Sitting with Nechama that morning, I felt the particular kind of recognition that comes from hearing the same sentence in a slightly different accent for the thousandth time. Not pity. Something closer to relief on her behalf, because she’d finally said the thing so many driven, capable women say in my office in one form or another: I know the facts. My body isn’t reading them.

What I’ve come to think of as the safety-knowledge gap is exactly what a framework called polyvagal theory tries to explain. It doesn’t answer every question. Some of its more specific neuroanatomical claims are still actively debated among researchers, a point worth holding onto rather than smoothing over. But it gives language to something I watch driven women live inside of every week: the gap between what your mind knows and what your body has decided, a gap that no amount of reasoning seems able to close on its own.

What Is Polyvagal Theory?

Before we go further, it’s worth being precise about what we’re actually talking about, because this is one of the most cited and most casually misquoted frameworks in the trauma field.

I recently read Porges’s 2025 paper on the framework’s current status and clinical applications, and one line stayed with me longer than the rest: he writes about the theory as a bridge between subjective experience and physiology, a way of taking what a client reports feeling and connecting it to something happening in the body, rather than treating the two as separate conversations.¹ That’s the piece I think gets lost when the theory gets flattened into an Instagram infographic. Porges wasn’t trying to hand clinicians a diagnostic tool for reading bodies from across the room. He was trying to explain why talk alone sometimes isn’t enough, and why some people’s bodies keep responding to old danger long after the danger has passed.

The theory has done something useful in the field that’s easy to undersell: it gave trauma therapists a shared vocabulary for a phenomenon we all saw constantly in our offices and had no good, common way to describe before Porges published his work. It also picked up a lot of loose, informal use along the way, some of which drifts past what Porges’s model actually claims. Holding both of those facts at once is the responsible way to use this framework, and it’s the way I try to use it with clients like Nechama.

I say this as someone who uses the framework most weeks and who also reads the critiques of it, because both postures matter here. A number of researchers have pushed back specifically on some of Porges’s more granular anatomical claims, including questions about how cleanly the ventral and dorsal branches of the vagus nerve can be separated in the way the model sometimes implies in its popular form. Porges has published responses defending the theory’s core structure while acknowledging where the underlying science still needs more work. None of that debate changes what happens in my office on a Tuesday afternoon. It does mean I try to talk about this model the way I’d want a good lawyer to talk about a contract: accurately, with the fine print included, rather than only the part that sounds reassuring on a podcast.

The Three States of the Autonomic Nervous System

Here’s the part of the model most people have half-absorbed from a podcast or a therapist’s Instagram post: the idea that the autonomic nervous system isn’t a simple on/off switch between calm and stressed, but something closer to a ladder with three rungs.

I think of neuroception as the part of this model that explains the timing problem so many driven women describe to me. They’ll say something like, “I was fine, and then I wasn’t, and I can’t tell you what happened in between.” Neuroception is Porges’s proposed answer to that gap: a lot of the environmental read happens before the thinking, narrating part of the mind gets a vote. That doesn’t mean the body is smarter than the mind, or that the mind should simply defer to it. It means the two systems are often working on different timelines, and a large part of trauma-informed work is helping those timelines sync back up.

The three states Porges describes, moving from newest evolutionary circuit to oldest, are these. First is the ventral vagal state, associated with feeling socially engaged, curious, and grounded, where a person can connect, problem-solve, and access flexible thinking. Second is the sympathetic state, the fight-or-flight response most people already have language for, associated with mobilization, urgency, and a body ready to act. Third is the dorsal vagal state, the oldest and most primitive circuit, associated with shutdown, numbness, dissociation, and a kind of biological last resort when neither fighting nor fleeing seems possible.

Here’s what I find clinically useful about laying the states out this way, whatever the state of the underlying neuroanatomy debate. Clients who’ve spent years being told they’re “just anxious” or “too sensitive” finally get language for a pattern they’ve lived their whole life: a state that can look like restless overdrive on the outside while feeling like quiet dread on the inside, or a state that can look like calm compliance while feeling, from the inside, like the lights going out one by one. Bessel van der Kolk, MD, psychiatrist and trauma researcher and author of The Body Keeps the Score, has written for decades about the ways trauma is stored at the level of the body’s stress response, not only in the explicit, narratable memory most talk therapy targets.² Polyvagal theory doesn’t prove that mechanism. It gives clinicians one map for talking about what they’re already seeing in session, which is a different, more modest claim than the one you’ll sometimes see made online.

What can look, from the outside, like a woman shutting down in a meeting after being interrupted for the third time might be described, in this framework, as a shift toward that older, more protective circuit, a shutdown state that has nothing to do with how much she cares about the meeting and everything to do with a pattern her body learned to reach for a long time ago. I want to be careful about how I say that. I’m not diagnosing anyone’s nervous system state from across a room, and neither should anyone else. What I can say is that this framework gives us a more compassionate hypothesis than “she’s being difficult” or “she’s not trying hard enough,” which is most of what makes it worth using with care.

I think about that image often with clients whose bodies seem to be running a program written before they were old enough to consent to it. Not because the metaphor is scientifically precise. Because it names something true about inheritance that no diagram of vagal pathways can capture on its own: a great deal of what an adult nervous system carries into a room was choreographed somewhere much earlier, by people who may not have known any other steps themselves, and who were doing the best they could with the steps they’d been taught.

How Relational Trauma Disrupts the Ladder

Tereza is 40, an operations director at a logistics company, and the first thing she told me about herself in our first session was that she doesn’t cry. “I haven’t cried since I was maybe twelve,” she said, sitting very upright on the edge of my couch, hands folded in her lap like she was at a job interview. “It’s not that I’m suppressing it. I actually don’t have access to it anymore. Things happen, bad things, and I just go quiet. Efficient. People used to say I was so calm in a crisis. It’s not calm. I don’t know what it is.”

She grew up the oldest of four in a small apartment outside Bratislava before her family moved to the United States when she was nine, the child who managed her younger siblings while her mother worked two jobs and her father’s temper filled whatever room he was in without warning. “You learned to read the air before you walked into a room,” she told me. “You’d know from the sound of the door which version of him was home. And you learned that the safest thing to do, no matter what, was to go still. Not run. Not fight. Just go still and wait it out.”

Sitting with Tereza, I felt the particular quiet that settles into a room when someone has just described, without any clinical language at all, exactly what a nervous system trained toward the dorsal vagal end of the ladder can look like from the inside. Not calm. Absence. A door that used to open and now mostly stays shut, because staying shut was once the thing that kept her safe.

What she described next stayed with me for a long time afterward. “My mother used to say I was her easy one,” Tereza told me, looking at her hands rather than at me. “Out of four kids, I was the one she never had to worry about. I used to be proud of that. Now I think about what it actually took to be that kid, and I don’t feel proud. I feel like I was doing a job nobody should have handed a nine-year-old.” She said it flatly, without much visible emotion, which was itself, I noted privately without saying so, consistent with the pattern she’d described walking in the door.

What I’ve come to call the stillness-as-survival pattern is one I see constantly in adults who grew up in unpredictable or frightening households. The child who goes quiet, compliant, and easy to manage during chaos isn’t choosing a personality trait. She’s using the tools she has. In a framework like this one, repeated early experiences of unpredictable threat, especially from the people a child depends on for survival, are proposed to shape which state the system reaches for first and how easily it can move back toward feeling settled. This is a hypothesis with real clinical resonance, not a fully settled account of how early adversity gets encoded, and researchers are still working out the details of that encoding. What isn’t up for debate, in my experience across thousands of clinical hours, is that a woman like Tereza can arrive in her forties running an operations department with total competence while her body still, in certain rooms, behaves like it’s twelve.

Peter Levine, PhD, trauma researcher and author of Waking the Tiger, describes trauma less as the event itself and more as what happens when the body’s protective response gets interrupted or stuck without a chance to complete.³ Tereza’s stillness wasn’t the trauma. It was the closest thing to safety a child with no other options could build. Understanding that difference doesn’t erase what it cost her. It does change what we’re actually working on together, which is not “teaching her to feel” as if feeling were a skill she skipped, but helping a nervous system that adapted brilliantly to one environment learn, slowly, that this one is different.

The Polyvagal Ladder in Daily Life

Most of the driven women I work with don’t recognize these states by their clinical names. They recognize them by their Tuesday-afternoon costumes.

The ventral vagal state, in daily life, can look like the version of Nechama who walks into a deposition, makes eye contact, thinks clearly under pressure, and leaves the room still able to laugh at something absurd her co-counsel said on the way out. It’s not the absence of stress. It’s a nervous system that has enough felt safety to stay flexible while it works.

The sympathetic state, in daily life, can look like the version of Nechama who answers a Slack message at 9:40pm with her heart already racing before she’s finished reading it, who reorganizes her closet at midnight because she can’t sit still, who feels productive and slightly manic in a way that’s hard to distinguish from ambition until it’s 2am and she still hasn’t slept. Sympathetic activation isn’t always visible as panic. Sometimes it’s dressed up as a very efficient Tuesday.

The dorsal vagal state, in daily life, can look like the version of Tereza who goes quiet in a leadership meeting after her idea gets talked over, who describes feeling “far away” during an argument with her husband, who can’t remember what she said in a conversation twenty minutes after it ended, not because she wasn’t listening but because some part of her had already left the room. This is the state most often misread by other people as apathy, coldness, or not caring enough, when what’s actually happening is closer to a system that has run out of other options and settled into the oldest one it has.

I want to be careful here, because this is exactly the point where the framework gets used irresponsibly online. None of this is a diagnostic tool for reading someone else’s nervous system state from their behavior. A woman going quiet in a meeting might be in a dorsal vagal state, by this model’s account, or she might simply be thinking, or bored, or annoyed, or holding her tongue on purpose. The value of the framework isn’t in diagnosing other people. It’s in giving a woman like Nechama or Tereza a more compassionate hypothesis for her own internal experience, one she can test out in session and in her own life rather than one anyone hands her as a verdict.

Here is where I want to name something specific about the women I see most often in this pattern: they are rarely, by outward measures, struggling. Nechama makes partner. Tereza gets promoted, eventually, after the meeting where she went quiet stops being the norm. From the outside, both look like women whose nervous systems have nothing to complain about. What this framework helped both of them do was stop waiting for their external success to convince their bodies of something their bodies had already decided, long before either woman had a law degree or a title, was not true.

An internal link worth following here, if this pattern sounds familiar, is our guide to the window of tolerance, a related concept that maps closely onto this same territory from a slightly different angle.

Both/And: Your Nervous System Isn’t Broken. It’s Doing Its Job

Here is where I want to slow down, because this is the both/and that gets lost every time this framework gets turned into a self-help slogan.

Both things are true. Nechama’s chest tightening at the kitchen counter over nothing observably wrong is not a malfunction. It’s a nervous system doing exactly what it was built to do, responding to a pattern it learned to treat as dangerous, based on a history that included real danger. And also: that response is no longer serving her the way it once might have. Both can be true without contradiction. The response made sense once. The response is now, in her current life, more costly than protective.

Tereza’s stillness in the leadership meeting is not weakness, and it is not a character flaw to be argued out of her. It is also, right now, standing between her and a promotion she is qualified for and wants. Both/and. The nervous system’s old strategy earned real respect for what it once did for her. It also, gently and over time, needs room to change.

“I keep waiting to feel like a different person,” Tereza told me a few months into our work. “And what’s actually happening is I still go still sometimes. I just come back faster now. That’s it. That’s the whole change so far.” I told her that was not a small change. Coming back faster is, in this framework’s language, evidence of a nervous system with more flexibility between states, more capacity to move rather than stay locked in one place. It is not a cure. It is not the end of the pattern. It is, by every measure that has mattered to Tereza, real.

This is the both/and I want every driven woman reading this to sit with: your body’s old strategy was not a defect. And you are allowed to want something different from it now.

The Systemic Lens: Why This Framework Resonates With Driven Women

It’s worth asking why this particular framework has caught on so widely, and specifically why it resonates so deeply with driven, capable, accomplished women in particular. Part of the answer lives outside the nervous system entirely, in the terrain these women are standing on.

Women, and especially women raised to be competent, agreeable, and useful, are taught early that their job is to manage the emotional climate of every room they enter. Read the mood. Smooth the conflict. Anticipate what’s needed before anyone has to ask. That’s not a nervous-system fact. That’s a cultural one, reinforced across families, schools, and workplaces that reward a girl for scanning a room accurately and reward her more, not less, the longer she can do it without seeming to try. By the time a woman like Nechama is a law firm partner, the scanning isn’t a skill she chose to develop. It’s terrain she’s been standing on since she was small enough to learn it was necessary.

Polyvagal theory offers language that lands specifically for women who have spent a lifetime being told their bodily responses are “too much,” an overreaction to be managed rather than information to be understood. A framework that says your nervous system had reasons, even reasons rooted in a history that predates you personally, undoes a particular kind of gaslighting that women receive constantly about their own physical experience: that they are being dramatic, sensitive, difficult. Which is why it lands the way it does in Tuesday-afternoon terms: fewer women arriving in my office believing they are broken, more women arriving curious about a pattern with an actual shape and a history, one they didn’t invent and aren’t stuck inside forever.

How to Heal: Working With the Ladder, Not Against It

I want to say clearly what this section is not. It is not a set of exercises that treat trauma. Nothing here is a substitute for working with a licensed clinician, and nothing here should be read as a promise about outcomes. What follows is what tends to be useful, in my clinical experience, as one piece of a larger process, not the whole process.

The first shift, for almost every driven woman I work with, is simply learning to notice which rung of the ladder she’s standing on without immediately judging it. Not “I’m anxious again, what’s wrong with me,” but “I notice my chest is tight and my thoughts are racing, that sounds like a state my body reaches for under stress.” Noticing without judgment doesn’t resolve the state. It does interrupt the shame spiral that usually follows it, which is often the more exhausting part.

The second shift is building what clinicians sometimes call co-regulation, the experience of borrowing calm from another person’s steadier nervous system, whether that’s a therapist, a trusted friend, or a partner who can stay present without escalating alongside you. Deb Dana, LCSW, clinician and author of The Polyvagal Theory in Therapy, writes about relationship as one of the primary routes back toward a felt sense of safety, not because another person fixes anything, but because a nervous system regulates, in part, in relationship with other nervous systems.⁴ This is a description of a proposed mechanism, worth naming honestly, not a guarantee about how quickly or completely it works for any individual.

The third shift, and the one that takes longest, is building a wider range of tolerance for the states themselves, so that sympathetic activation doesn’t have to escalate all the way to panic before it’s noticed, and dorsal shutdown doesn’t have to go all the way to full dissociation before someone reaches for support. Some clients find practices like slow-paced breathing, gentle movement, or singing along to music in the car anecdotally helpful for shifting how a moment feels in their body. I want to be precise about what that is and isn’t: these are self-reported, in-the-moment comfort practices, not treatments for trauma, and nothing about doing them constitutes therapy or guarantees a change in someone’s nervous system patterns over time.

None of this work happens on a predictable schedule, and I want to resist the pull, so common in this space online, to turn a clinical framework into a five-step program with a guaranteed finish line. Some weeks Nechama’s chest tightens at the counter and nothing about the morning changes. Some weeks Tereza goes quiet in a meeting and doesn’t catch it until she’s back in her car. Progress in this kind of work tends to look like slightly more good weeks over a long stretch of time, not a clean line upward, and I think driven women in particular are owed that plain version of the story rather than a tidier one.

Gabor Maté, MD, physician and author of The Myth of Normal, writes about healing as a return to wholeness rather than a return to some imagined, undamaged former self.⁵ That distinction matters here. Nechama is not trying to become a woman who never feels her chest tighten again. Tereza is not trying to become a woman who never goes quiet. Both are working toward something more modest and, I think, more honest: a nervous system with more room to move, and two women who no longer mistake an old survival strategy for the whole truth about who they are.

If this pattern is showing up in your own life, our guide on the co-regulation can be a useful next read, alongside our guide to relational trauma more broadly.

Nechama, the last time I saw her, still stood at that kitchen counter some mornings with a mug of coffee she hadn’t touched yet. What’s changed isn’t the standing still. It’s what happens in the minute after. She’s learned to name the state instead of arguing with it, and some mornings, not all of them, that’s enough to let her hands warm up again before she has to leave for court.

Related Reading

• Porges, Stephen W. The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. W. W. Norton & Company, 2011.
• Porges, Stephen W. The Pocket Guide to the Polyvagal Theory: A Guide to Feeling Safe. W. W. Norton & Company, 2017.
• Dana, Deb. The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation. W. W. Norton & Company, 2018.
• van der Kolk, Bessel. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking, 2014.
• Levine, Peter A. Waking the Tiger: Healing Trauma. North Atlantic Books, 1997.

References

Peer-Reviewed Research (Vancouver)

1. Porges SW. Polyvagal Theory: Current Status, Clinical Applications, and Future Directions. Clin Neuropsychiatry. 2025;22(3):169-184. doi:10.36131/cnfioritieditore20250301. PMID: 40735382.

Books & Cultural Sources (Chicago Author-Date)

• van der Kolk, Bessel. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking, 2014.
• Levine, Peter A. Waking the Tiger: Healing Trauma. North Atlantic Books, 1997.
• Dana, Deb. The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation. W. W. Norton & Company, 2018.
• Maté, Gabor. The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture. Avery, 2022.

Warmly, Annie

About the Author

Annie Wright, LMFT

LMFT · Relational Trauma Specialist · W.W. Norton Author

Helping driven women finally feel as good as their résumé looks.

Annie Wright is a licensed psychotherapist (LMFT #95719) and trauma-informed executive coach with over 15,000 clinical hours. She works with driven women, including Silicon Valley leaders, physicians, and entrepreneurs, in repairing the psychological foundations beneath their impressive lives. Annie is the founder and former CEO of Evergreen Counseling, a multimillion-dollar trauma-informed therapy center she built, scaled, and successfully exited. A regular contributor to Psychology Today, her expert commentary has appeared in Forbes, Business Insider, Inc., NBC, and The Information. She is currently writing her first book with W.W. Norton.

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