Polyvagal Theory, Debate, and Clinical Practice: What I Want My Clients to Know
If you’ve worked with me in therapy, you’ve likely heard me reference the nervous system, and occasionally, Polyvagal Theory.
Recently, there has been more public conversation and debate within the scientific and clinical communities about Polyvagal Theory (PVT). Some of my clients have come across articles or discussions questioning aspects of the theory and have asked thoughtful questions: Does this mean the theory is wrong? Should we stop using it altogether? What does this mean for therapy?
I want to take a moment to speak to that directly and transparently.
First: What Polyvagal Theory Is, and Why It Resonated
Polyvagal Theory, developed by Dr. Stephen Porges, offers a framework for understanding how the autonomic nervous system responds to safety and threat. It describes how our nervous system continuously scans for cues of safety or danger, often outside of conscious awareness, and shifts our physiological state accordingly.
For many of my clients (and for myself), this framework has provided language for experiences they struggled to explain, like why their body shuts down in conflict, why anxiety can feel automatic, and why connection can feel both deeply desired and frightening. Polyvagal Theory offered a way to understand these experiences. And for many people, that understanding alone can be regulating.
What the Current Polyvagal Theory Debate Is Actually About
It’s important to be clear: the current debate is not arguing that the nervous system responds to threat, or that trauma impacts physiology. These are well-established and widely accepted. The debate is more specific.
Researchers and scientists are discussing whether certain aspects of Polyvagal Theory, particularly its evolutionary explanations and some of its proposed neural pathways, are fully supported by current anatomical and physiological evidence.
This is how science works. Theories are proposed. They are studied. They are challenged. They are refined. Challenge is not failure. It’s part of the process of deepening understanding.
What Is Not Being Disputed
There are several things that remain broadly accepted across neuroscience, trauma research, and clinical practice:
The autonomic nervous system plays a central role in emotional regulation.
Trauma and chronic stress impact physiological regulation.
Humans have innate physiological responses to perceived safety and threat.
The therapeutic relationship itself can influence nervous system regulation.
Helping clients build awareness of their physiological states improves emotional regulation.
These principles exist beyond any single theory. Polyvagal Theory is one framework among many attempting to describe and organize these realities.
The Value and Limitations of Theories like Polyvagal Theory
Theories are maps. They are not the territory. A map can help you navigate. It can orient you. It can give language and structure. But the map is not the experience itself. In therapy, we don’t treat theories. We work with people. The value of a theory lies in whether it helps us understand and support the person sitting in front of us, not whether it is a perfect or complete description of reality.
All theories evolve. Many of the most influential theories in psychology and neuroscience have been revised, expanded, or challenged over time. This is a sign of growth, not failure.
What I’ve Seen in My Therapy Office
Regardless of how specific theoretical mechanisms continue to be studied and debated, I’ve consistently seen the value of helping clients understand their nervous systems. When my clients begin to recognize that their reactions are not character flaws, but adaptive physiological responses, something shifts. I’ve seen shame soften, curiosity increase, and regulation become more accessible.
Clients often move from asking, “What’s wrong with me?” to asking, “What happened in my nervous system?” And to me, that shift matters, not because of a specific theory, but because of the expansion it makes possible.
A Comparison That May Be Helpful
Think of Polyvagal Theory like early models of weather prediction.
Decades ago, meteorologists didn’t have the tools we have today. Their models weren’t perfect. Some assumptions were incomplete. But their frameworks still helped people understand patterns, prepare, and respond more effectively. Over time, those models were refined. We didn’t throw out the entire field of meteorology because early models weren’t perfect. We improved them.
Similarly, Polyvagal Theory has contributed meaningfully to how clinicians and clients understand nervous system regulation, even as scientific inquiry continues to refine the details.
Why I Don’t Believe in Throwing Out Something Entirely
In clinical work, rigid thinking, either blind allegiance or complete rejection, rarely serves people well.
My approach is integrative and grounded in multiple frameworks, including Interpersonal Neurobiology, attachment theory, trauma research, and somatic approaches. Polyvagal Theory has been one lens among many. I don’t rely on it as a singular explanation. I use it as a tool, alongside others, to help my clients understand their experiences and build capacity for regulation, connection, and healing. As research evolves, so does my understanding and clinical practice. That’s part of practicing ethically.
What Matters Most
What matters most is not whether a theory is perfect. What matters is whether therapy helps you:
Feel safer in your body
Understand your reactions with more compassion
Improve emotional regulation
Strengthen your relationships
Experience greater stability and connection
These outcomes are not dependent on any single theoretical model. They emerge from relational, thoughtful, and evidence-informed care.
What This Means for the Safe and Sound Protocol (SSP)
Because the Safe and Sound Protocol (SSP) was developed by Dr. Stephen Porges, it’s understandable that clients might wonder whether the current debate around Polyvagal Theory changes anything about the Safe and Sound Protocol itself.
It’s important to distinguish between a theoretical framework and a clinical intervention.
The Safe and Sound Protocol is a structured, therapeutic listening intervention designed to support nervous system regulation through patterned auditory input. Its use in clinical settings has been studied across populations, including individuals with trauma histories, anxiety, autism spectrum differences, and sensory sensitivities. While researchers continue to refine the theoretical explanations for why the Safe and Sound Protocol works, many clinicians, myself included, have observed meaningful changes in clients’ capacity for regulation, emotional tolerance, and social engagement.
More importantly, the Safe and Sound Protocol is never used in isolation.
It is always integrated within a relational therapeutic context, where we pay close attention to pacing, safety, and each client’s unique nervous system. The listening itself is only one part of the process. The therapeutic relationship, the preparation, and the integration afterward are equally important in helping the nervous system recognize and sustain regulation.
As with any intervention I offer, I remain attentive to evolving research and committed to using the Safe and Sound Protocol thoughtfully, collaboratively, and in service of each client’s individual needs, not as a standalone solution, but as one supportive tool within a broader, relational approach to healing.
Why the Therapeutic Relationship Matters More Than Any Single Theory
One of the most consistent findings across decades of psychotherapy research is this: the quality of the therapeutic relationship is one of the strongest predictors of positive outcomes, often more than the specific modality or intervention used.
This has been demonstrated across approaches, including cognitive behavioral therapy, psychodynamic therapy, somatic therapies, and trauma-informed care. Regardless of theoretical orientation, what matters most is whether the client feels safe, understood, and supported within the therapeutic relationship. This is especially true in trauma treatment.
Trauma often disrupts a person’s sense of safety in relationship, both with others and within themselves. Healing, therefore, doesn’t happen solely through techniques or interventions. It happens through consistent, attuned, relational experiences that allow the nervous system to gradually learn that safety, trust, and connection are possible again.
Theories like Polyvagal Theory can help us describe and understand these processes. Modalities like Brainspotting, Sensorimotor Psychotherapy, or the Safe and Sound Protocol can support regulation. But none of these replace the core element that makes therapy effective: the relationship itself.
In my work, I view theories and interventions as supportive frameworks, not the foundation. The foundation is the relational space we build together. A space where your nervous system doesn’t have to perform, defend, or protect in the same ways it may have needed to before. This is where lasting change happens. Not because of a single theory, but because of a consistent experience of safety, attunement, and understanding over time.
My Commitment to You as a Therapist in Dallas
My commitment is not to any one theory. My commitment is to you.
To staying informed.
To practicing therapy thoughtfully.
To integrating evolving research responsibly.
To supporting your nervous system, your relationships, and your healing with care and integrity.
Theories will continue to evolve. What will remain constant is the importance of relationship, safety, and understanding in the therapeutic process.
If you’ve found yourself thinking more about your nervous system, your responses, or how past experiences may still be living in your body, therapy can offer a place to explore that safely and thoughtfully.
At Crescent Counseling in Dallas, my work is grounded in relational, trauma-informed care that honors both your lived experience and the evolving nature of scientific understanding. I integrate approaches such as Brainspotting, Sensorimotor Psychotherapy, and the Safe and Sound Protocol when appropriate, always within the context of a collaborative therapeutic relationship.
No single theory defines the work we do together. Instead, we focus on helping you build greater awareness, regulation, and connection, both within yourself and in your relationships.
Whether you’re navigating trauma, anxiety, relationship challenges, or simply wanting to better understand your nervous system, therapy can be a space to move toward greater steadiness and self-trust.
If you’re curious about beginning therapy or learning more, I invite you to reach out. I would be honored to support you.
