Polyvagal Theory: Why You Feel So Anxious All The Time - Dr Stephen Porges - #1128

You've authored more than 400 peer-reviewed scientific papers and literally created polyvagal theory. It's sort of rare that you get to ask Mike Tyson about how to throw a jab or the founder of a really impactful theory about what it means. So I guess, how do you describe polyvagal theory to someone who isn't familiar with it? It's really quite simple. It's that our underlying physiological state affects how we perceive the world, how we interact with others, and how receptacle we are to others engaging us. So in a sense, we kind of got dropped into a world where we think that all our behaviors are intentional, but we don't acknowledge that some days we feel basically quite constrained, and some days we feel very energetic and engaging. The bottom line is that we have to start paying attention to our own underlying physiological state because it will help us navigate through a very complex world. So we're responsive in that way to the local ecology, kind of like a plant? We are a plant in a way, exactly. We're detecting signals just like plants. We're responding. The difference is that with our great intelligence, we think it's all our, we caused it all. We create narratives of control when in reality, we're being swept away by the challenges of the environment in which we are in. And when we feel swept away and overwhelmed, we're being swept away by the challenges of the environment in which we are in. And when we feel swept away and overwhelmed, at that point, we start acknowledging things. But we don't acknowledge it until it really gets over a certain threshold. Why is that adaptive? Why have we evolved to have that dynamic? Because the world was a dynamically changing place. That's as simple as that. But we've lost some of the, I would say, innate and intuitive skill sets. And that's being aware of when our body loses that resilience. And instead, we're. Instead, we're trained by our culture to say, you can do it. It's like, I mean, that's a quote from the Waterboy, if you don't remember that movie. But the issue is we live in a world in which everyone thinks we can suppress our feelings or we can get over something when in reality, our body is just percolating and broadcasting signals to our awareness. And now we're being told, don't pay attention. I understand why. And this is a pivot in the world of nonfiction, communication, personal development, self-growth that I've been really fascinated by. The forget your feelings, just work harder approach. I understand why. Because maybe for a lot of people, they're too at the mercy of their feelings. They actually could do with a little bit more agency. They could do with, I can do it. We're in a meritocracy and we want to uphold people. But as you say, it's denying the real dynamic that we are a system that is interacting with our environment. There are certain things that you're like skimming across the top of because implicit in what you're saying is you have some idea of what being a successful human being is. And what I'm saying is our markers of success may be somewhat confounded because part of being a successful person is feeling good about being a person. And I think that's a really good point. And part of the motivation for working is to, in a sense, get over those feelings of inadequacy. So we get kind of twisted and tricked by all this. And the other part is that we don't truly acknowledge it as we numb our body out or don't listen to it. We're literally turning off neurophysiological feedback loops. A feedback loop is the part of us that monitors our functioning and a part of us that now creates the motor actions. And so in a way, we are destroying our own bodies. And those who work hard acknowledge that. They said, I'm stressed out, I burn out. But there's a physiology to that. And that is in part, we're not listening to our body. That's so wonderful. You're so right. How many people are chasing success to give themselves the sensation of feeling good, but in the pursuit of achieving the success, they have denied themselves of the feeling of being good? Yeah. Now, as you say that, listen to what you said. And there's a secularity there. And then you're, you know, then you accumulate. And listen, you're in Austin. So you're in the midst of a lot of what is now the success track. I'm patient zero. Yeah, yeah, yeah. This is ground zero right here. Yeah. And the issue is, yeah, acquisition, wealth, influence, these are wonderful things, but wonderful things for what? So how do you leverage that success as an acquisition of respect and accumulation to become more, to do more, to be, you know, in a sense, what are our goals in life? And this is kind of a complicated and very personal question. So our goals, acquisition or goals, curiosity, learning, or our goals, benevolent and compassionate. No, we can set our goals, but they're not merely here and now. We as a species, to do things that are different. We'd like exploration. We'd like curiosity. We'd like humor. And, you know, we like to meet people as well, which is part of that whole bit. So you could accumulate resources without having, in a sense, a type of curiosity that enables our nervous systems to thrive. So in a way, the manual for living a good life has been mistranslated. Can we use that term? So brilliant. So great. Okay. What was the actual problem that you were trying to solve in 1994? Like what didn't fight or flight, rest and digest? What didn't that explain? Well, it gets, okay, there are different levels. So you're sitting across from me, at least metaphorically, and you're asking me those questions, but there is really decades before that as well. Like who was I? What were the types of questions that I personally was asking? I was asking what was going on? Basically, I was asking, what was going on? And I was asking, basically, behind the smiles of people, what was going on in their mind? What was going on? What were they feeling? I was asking different level questions, not levels of what were your scores on your test or how fast was your reaction time? I was kind of more interested in what was going on inside of them. And it didn't have really an area of science. Science was really very mechanistic. So behaviorism was big. And then you don't, so behaviorism was to explain certain types of physiological conditioning, was to explain everything. And then the other part, what was going on in the mind, like psychoanalysis, mental health, that was something else totally independent of the body. So the issue then was if something's bothering you, just sit on it. Don't let it percolate. There was no understanding that the way we feel, which was kind of like, was anything other than optional. Until something catastrophic, happens in people's lives, like loss of a loved one or a severe injury, or let's say a traumatic event where someone is raped or mugged on the street. And suddenly everything is different in their world. And what used to be comforting and engaging is no longer there. Or what happened to me was I got pneumonia. And I had been extremely a social individual. And this was when I was a tenured, actually, I was probably a full professor at that time. And the issue was, I basically no longer could be around crowds of people that start to bother me. My threshold, and you see this after COVID for many people, they had chronic illness, and they have words for like chronic fatigue syndrome. And people are literally marginalized when they say they have that. Come on, get back into the flow. Everybody gets tired as they get older. Everyone's a little bit undislept. Yeah, or fatigued. But those who suffer really get very upset because they're being dismissed. And they're trying to explain to you that they had a body that listened to them, and now their body doesn't. And that's the interesting part that I started to ask, why doesn't your body respond? What was going on? But let's get back to your question, going back to 1995. I was starting to do work in intensive care units with preterm babies, and I was building this, in a sense, a vagal or related theory about parasympathetic nervous system was very important. I was basically trying to describe the other side of the world, the other side of stress. What are the systems that calm you down? Where does, you know, let's say, in a sense, even meditative aspects, where do these insights, what state supports that? And so you had fight and flight and stress, and then you had this wonderful system that was a rest and restore system. And that was kind of an interesting model until I worked in a neonatal intensive care unit, where you have these preterm babies. And of course, they have a fight-flight response frequently to high heart rates and tachycardia. But you know what their defensive systems were? Shutting down a lot of this vagal slowing heart could actually compromise their ability to get oxygen to the brain. And I couldn't quite understand why. what I later called the vagal paradox. How could this same nerve, which was really associated with basically good states, health, growth, and restoration, how could it kill you? In a sense, how could a good. In fact, a neonatologist wrote to me after I wrote a paper in a journal and said, maybe too much of a good thing is bad. And that was the way most people think. Too much of a good, it shuts down. And I said, that doesn't make any sense. That's not how systems are. It's all evolved or wired. And I started to get deep into the anatomy and then into the evolution. Basically, it was called phylogeny, where you look at species changes in autonomic regulation. And then there was something that became very mammalian, something of which we are mammals. And we start to have a very different type of autonomic nervous system. Yeah. A nervous system that enabled us to be safe in proximity of another. So it was breeding cues. So, you know, when mothers talk to their babies or if you have pets, do you have a pet, a dog, or a cat? No, I am on the cusp of getting a dog, but not yet. Okay. Well, you have friends at least. Yeah. And I treat them like dogs sometimes actually. So that probably works. But when you don't, you probably don't. This is the secret of it. The way people treat their dogs, they use very. Very melodic, prosodic voices. It's the way that mothers talk to their babies. And that's when I started to realize that we as mammals have a whole collection of, it's called a behavioral repertoire, of broadcasting signals of safety to others. And those seem to affect their physiology. And so that's where this whole story started, was trying to identify what was uniquely mammalian and using the preterm baby as this window to the future. As this window of an opportunity to see a system that was not fully developed. And I could see it coming on board. Can you just give me the adaptive explanation for those three states as you conceived them? Sure. Everything is adaptive in the model. Nothing is wrong. Nothing is bad. Nothing is pathological. They're adaptive in certain contexts. So in a sense, we have. Because the system basically for. And those are all the species of backbones. As they evolved into amphibia and then basically mammals and reptiles broke off at the same time and had basically parallel evolutionary pathways. The mammal had a very unique pathway because it needed to nurse. It needed the parent to take care of it. And it also, when it matured, when it was born, it needed to be taken care of. Now, the other species laid their eggs and walked away. So what happened was that you had a very special need to survive for this type of vertebrate, which we became, which we are part of, mammals. And they needed to broadcast their underlying physiological state in their vocalizations, in their facial expressivity. They needed to broadcast, to signal. Everything's about now signaling. And other species didn't. They didn't need that because they could just survive. They could scamper off and survive. So you needed this new signaling system. And ironically, what that signaling system did was enabled social behavior to act positively on our physiology. So that's why I asked if you had a dog. And when you have a dog, you realize that the dog's engagement to you and the way you vocalize with the dog is going to be a great regulator, of both your physiological states. And that made us uniquely mammalian. And that's why dogs and humans, or if you look, can you see my cat? Yes. Yeah, we will be able to. Yeah. So the cat back there loves for me to talk to her. And if I don't talk to her, she will talk to me. And that's her broadcasting that she is there and she wants this comforting back. So let's go through the three. The old vertebrates had a very primitive, old vertebrates had a very primitive, autonomic nervous system, the system that regulated your organs. And that's fine. It had basically a primitive vagal system and it had a bunch of chemicals like adrenaline or chemicals like that in the body. So it could mobilize and had a neural system of calming. That neural system was not merely acting on the organs. It was also reflecting what the organs were doing. And this becomes really critical here. It's that we tend to focus on the organs on the brain neural regulation of the organs when most of the neural traffic is the body sending signals to the brain. And that's what our culture has said, forget it. Yeah, just don't attend to it. So the vagus initially was fine when we were in, we could rest and restore with it in peaceful comfort. But when we had a fight flight mobilization, we interfered with that rest and restore. Right. But what happened now with mammals, they had a very, let's say, nuanced vagal system that became a vagal system that enabled social engagement, enabled even mobilization without fear. And we call that play and dance. And we didn't merely have to be immobilized and intimate to, in a sense, have this physiological calming. We could be interactive. So the mammal basically had not only a fight flight system, and not only a older dorsal, the back of the brain, vagal system that regulate your organs, but also had this newer ventral vagal that was locked to our voice and the muscles of our face and head. Basically, we were broadcasting that visceral state and we were, in a sense, encouraging others to co-regulate with us to come closer. So the whole, in a sense, in Austin, where you're seeing, you know, startup businesses and all those things, the question always will become the degree of cooperation within a workplace. And as we become more and more remote, that type of the social cues become more and more separate from the actual interaction. So the mammal had this remarkable system that enabled it or us to control our fight flight and actually co-op it as play and to control our immobilization or our health growth and restoration by being safe in the arms of another. And to also signal that we needed help, that we needed care, that we needed support. Yeah, signal is the magic word here. We are a nervous system that is looking for signals, signals literally of safety and connection. And what you really were saying is, so if you go and meet someone and you engage them and have a drink with them, you make face-to-face contact, you smile with them, and you start now creating almost a template of what that person is like. You start, it says, inferring, is that a person you would like to spend more time with? Or do you look at your watch or your phone and say, I gotta go? And you're picking up all those signals and those signals are really signals of whether that person is accessible to you and are you accessible to that person? Or are you defensive? Does that person, in a sense, make you feel uneasy? You want to get out of there. And you may have those same feelings doing podcasts. You may have to say, wow, is the hour almost up? Or what am I going to talk about? Or can I move on? Yeah, you say that we come into this world with a quest to be safe. Yeah. Why? Because we can't survive by ourselves. So, I mean, there's a function to all this. So it's not like it makes it unimportant because it's pragmatic. It's just how we evolve. We didn't evolve as an independent, self-controlled or self-contained system. We needed others in our world. And for many, especially those who survived trauma, people have great difficulty moving into their worlds or they have difficulty moving to others. So they often gravitate to horses or dogs or cats. They want some type of co-regulation from a social mammal. People don't get enough fiber, which is why Momentous built Fiber Plus, because hitting your daily fiber target through food alone is actually kind of hard, even harder than your last toilet trip. Fiber isn't just a digestion thing. It's the foundation of your gut health, which drives how well you absorb nutrients, how stable your energy is, and how quickly you recover. If your gut isn't dialed, everything else you're doing is working at a fraction of its potential. Fiber Plus is a three-in-one formula built to address digestion, gut barrier strength, and blood sugar stability, all at once that's why i plan to make my next big dump momentous best of all they offer a 30-day money-back guarantee so you can buy it and try it for 29 days and if you don't love it they'll give you your money back plus they ship internationally right now you can get up to 35 off your first subscription and that 30-day money-back guarantee by going to the link in the description below or heading to live momentous.com slash modern wisdom and using the code modern wisdom at checkout that's l-i-v-e-m-o-m-e-n-t-o-u-s.com slash modern wisdom and modern wisdom at checkout What does feeling safe actually mean? Okay, it means basically we can, okay, so let me flip it on you. What does feeling stress mean to you? High heart rate, sweating, tightness in the body, ruminating thoughts, intrusive thoughts, concern, lack of creativity. Lack of ability to access your capacities. Yes, yes, constrained capacity. Right. So now let's flip it and say, when do I feel I have options to access my capacities? When do I feel exploratory? When do I feel expansive? There are basically two different physiological states. One supports our physiology of health growth and restoration, and one is very constrained and is costly to us. And we know that. We call it burnout or exhaustion. And we also know that there are benefits. Safety really is the child of a physiology that is homeostatic. It's just taking care of itself. That's why when we start to block the feedback loops, because when we talk about homeostatic or the body regulating itself, it has to assess itself and act on itself. So it's a feedback loop. But if we numb our own feelings, those feedback loops become less effective. Mm-hmm. Mm-hmm. What's the most powerful force of safety in the human world? Let's reframe it. What are the most powerful signals of safety? Mm-hmm. And they would, you know, you could identify them. That would be maybe a smiling face, a voice that's prosodic. Prosodic voices, melodic voices are powerful. And just ask that crying baby who feels isolated, out of control, and how rapidly. That baby will calm down when the mother's, if the mother has a good engagement, good voice. In fact, we actually did research on this where you kind of like disrupt the baby. And then you talk to the baby and see what happens. And if the mother's voices were more melodic, the baby's heart rate dropped almost immediately. The mother engaged without a melodic voice. No way. Yeah. So when you get your dog, you can try this all out. Yeah, I will do. I would say if you had a child or if you have a spouse or a partner, you can try it out as well. Yeah. Child soon cometh. Just give me, I need a little bit more time on that one. Okay. So to sort of recap, to recap where we're at, is it right to say that your position is our ability to connect with others is fundamentally a biological state and not just a psychological choice? Feeling safe enables curiosity and empathy. Empathy and social engagement. Yeah, I think that's quite accurate. I would kind of reframe one word. I would say our capacity to, which is not necessarily our ability. So our capacity. To connect with others. Yeah. And so part of, I view my goal in life is to navigate in the, let's say, complex world that has lots of signals so that my capacities can be expressed. So if I'm in a world that is too aggressive, too noisy, too overwhelming, I can't access my capacities. Why do some people never truly feel safe even when objectively everything's fine? I think that's the greatest, that was the question that got me going because I said, you know, we use this word safety and it's not like there's a metal detector. That's not going to make me feel safe. It's something different. And it's because our culture sees threat and the removal of threat as obviously being safety. It's not. Safety requires signals. Safety requires signals just like threat. So it's not like take away the signals of threat and everything's fine. No, you can take them away, but we really, really want signals of safety and they will be, you know, watch children playing. And actually you think that like when we mobilize this fight flight, when you watch children running in play, they're still smiling. And when you look at them, you feel good. But if you see children running from a. School or something else, your body gets a totally different response to that signal because the faces are telling you everything. So that was the part that really got me going. This is now we're in the 1990s because the nerves that control the face, the smile, nerves that control the intonation of her voice were linked to how that mammalian Vegas was working. So as a mammalian, Vegas was really sending signals of calming. It was triggering social engagement. So it was like, this is the broadcasting part of what we can see physiologically. And the mammal social mammal, when it evolved, it literally gave a window to that underlying physiology. So we know by people's voices and faces, whether they're safe to come to. To some people just naturally in terms of disposition before conditioning, do some people require a different dose of signaling in order to feel safe? I've, I've read a little about, uh, HSPs, highly sensitive people. I'm trying to think about how much of, how much of personality and how much of safety is really nervous system state. How much do people differ in terms of what it is that they need? We could actually kind of build a model and say, before we think that it is a lot. Maybe it's a locked-in temperament or a personality, maybe it's a physiological state that got retuned and got locked into this more defensive mode. And so let's kind of look at things optimistically. The interesting thing, or one of the interesting things you're bringing up is that if a person has a history of not having safe individuals in that person's history, when someone tries to engage them, even with prosodic voices and those signals, they may actually react adversely to it. Especially if there's a, a real abusive trauma history and you can actually read what's going on in their nervous system. The nervous system is getting triggered and they hears that voice and that face. And it goes, wow. Then the body starts feeling those feelings inside the body and those feelings for healthy or say healthy is not the right word for a typical nervous system are feelings. You feel good. But if those feelings are feeling good or associated with being abused, what happens? So you get the feeling and then the brain remembers, it says, been there. This is what happened to me. I'm out of the room. So if you're interjecting, that feels a little bit, uh, Skinnerian. That feels a little behaviorist-y that we have this stimulus response. What is it that we have associated? Is that fair? Is that fair for me to sort of add that little bit of a twist into how the condition is? It's so, so we have in the sense of reflex, which is no cognitions necessary. And you talk with, to me, or I talk to you or you, you talk to your dog and the dog just kind of relaxes, uh, that's a reflex. It's not an awareness. Now the body responds. And so you have that feeling that's an awareness. Now that awareness becomes conscious and then you can associate that with good and bad things. Yes. Yes. So there are two different. Two different parts of this sequence. One, my nervous system has a propensity to react. I can't change it. That's who we are. You know, we, we can get triggered. It's like this, this reason I have a smile is that my wife used to say to me, you should be above it and I've said, I'm human. I can get triggered. We all get triggered. And so the real issue is being triggered is not the real issue. The issue is what happens when you get triggered and when you get triggered, your body shifts state and what is your awareness of that state? So when you get aware that your body shifted state, what do you do? Do you scream at the other person across the table from you? Or do you say, wow, I got, yeah, people are going to say, you think you're weird, but you say, oh, well, it must've been triggered. Where did that come from? Very few people have the patience to stop getting in the way of that physiological shift and wanting to create the narrative to get out of it. What's interesting. You used the example of when you got pneumonia and, um, preferred to be around smaller groups of people didn't want as much social stimulus that that's shows just how adaptive, not only across time, right? Human evolution, adapting to the environment, creating these different capacities and signaling that means that it's more likely that you'll survive. But even within a single organisms, life span, your, your survival. System had adapted to see an old stimulus. Yeah. In a new light. Yeah. Yeah. That's, that's who we are. You know, we're flexible species. And the problem is that when we have things like pneumonia or chronic fatigue or long COVID, that flexibility gets reduced and that tends to be a shock to many of us when it happens and that we, the, the up part of it is that there's. Pathways of Rehabilitation. there are ways in which you can seal the system to slowly gain confidence in itself again. It feels, I need to break the fourth wall a little bit for a second, so bear with me. It feels very timely to be speaking to you, so you probably won't be aware of this, but a lot of the audience will. I released a health vlog about nine months ago or so, tracking a journey that I'd been on from long COVID, chronic fatigue, Lyme, CMV, EBV. I lived in a house that had mold with every different polymorphism that you don't want in order to have mold toxicity, heavy metal, just this laundry list of challenges. It had meant that I was tired at seven o'clock at night every night. It meant that no matter how much I slept, I never felt recovered. I hated the smell of standing water. I couldn't stand silence, but I also couldn't stand music. It's this real sort of big mess. We get to the back end of last year and I'd made some good progress. I'd improved all while doing this, right? Bits of the brain that are associated with word recall, working memory, being in a good mood, all of those were the ones that were being slammed while I was trying to put on a good show and be a professional for a few million people a week. And to try and do this well. So that felt like a big tension. I go and do a tilt table test in February. I failed my tilt table test. Oh, succeeded, depending on how you looked at it. 11 minutes, full vasovagal syncope, fainted, heart stopped for five seconds. So for the people that don't know, this is a test for autonomic flexibility, autonomic response. They strap you onto a table. You've got blood pressure cuffs everywhere, heart rate sensors on your feet, on your hands. There's an IV in case you. Faint and need to come back around. And after you've laid down and done some breathing exercises, they raise you up to sort of 70 degrees and they see how your body responds. There's something about that 70 degree angle that your body doesn't like it. And after five minutes, I felt a little sweaty. I felt a little uncomfortable. I started to feel a little bit sick, but I've done a lot of meditation, a lot of breath work. And I was like, right, okay, well, this is the time to apply some of your meditation and breath work. You're not allowed to move at all. You can't wiggle your toes even a bit. You can't move your calves. You're on this special bed. You're all strapped in, not moving because they don't want you to help your circulation to get a fully valid test. So I start breathing through it and it gets a little better. And then it gets quite a bit worse. And then my vision starts to go blurry. It's nine minutes in. And then I start to sweat and it's 10 minutes in. And then the next thing that I knew, I was flat on the bed and the nurse had come over me, this small Filipino nurse, there was a really lovely guy. He came over me in the first sentence that came out of his mouth after I sort of came back around was, okay, so your heart stop, your heart's no worries, buddy, your heart stop. I was like, hey, dude, if I've just passed out, okay, I don't want the first words out of your mouth when I come back around to be your heart stop. Anyway, all of this together, I've got about as strong of a personal investment in your work, and in the world of nervous system regulation, as I think I could, this has been unbelievably personal to me over the last two years, and specifically the last nine months. And you're catching me today. This week coming up, I'm going away on my first ever meditation retreat for seven days. And a big part of the motivation for that has been to try and get my autonomic system back in check to be gentle with myself. So anyway, I just appreciated you opening up about your about your case with the pneumonia thing, because it felt like it gave me a lot of strength. You have license to talk to me about anything. So the interesting part is, first of all, it's a slow journey back. I thought we could just throw a switch. I had optimism about these things as well. Basically, listen to your body. It is telling you things. I will tell you a similar story when I was getting a heart checkup. They were basically put AIV in me, and the IV started to get worse. I was getting a heart checkup. And so I started to tell them, I'd say, twiddle it. And I wanted to do vasovagal syncope as well. And they then looked at me, and they said, what are you scared of? I said, I'm not scared. You're basically tweaking with my bowel receptors. Basically, you're playing with the blood pressure receptors. But they don't think of it in that way. So they see this autonomia, which is what they're looking for. And actually, for many of the people who fail those tests, they start, they have a broad, let's say, array of symptoms. And they tend to be treated by the medical community as if there's nothing wrong with them. And yet these symptoms keep coming out. What I'm saying to you is be patient. Your nervous system is on a recovery track. And long COVID is the story that I want to tell you is a metaphor for you to think about. You survived a pathogen. You had COVID. And COVID is, for some people, lethal, as you know. The other part is that when our body wins the war, kills the pathogen, it doesn't always inform the entire nervous system. You know what my Filipino friend said to me? He said, this is what I do. I'm a technician for the tilt table test. And prior to COVID, I would maybe do between three and five of these a month. And now I do between three and five of these a day. Wow. I think long COVID or the consequence of the pandemic have been so underestimated. I've just completed a study on long COVID. I was part of an interesting government-funded project, basically doing it remotely. And basically the intervention was vagal nerve stimulator, which was developed by a colleague of mine. And another intervention, a sound intervention that I had developed, basically. It's called sonic augmentation technology. It's a new stuff that I've developed with a colleague called Anthony Gorey. And what it does, first of all, the vagal nerve stimulator, you know what it does. It's sending a signal to the vagus. And it's basically trying to tell the vagus that everything is okay in your body. And if it tells you that, then it may start connecting to the organs of your body and you feel better. So it's a signaling system. It's not regulating the motor part of the body. It's not regulating the motor part of the vagus. It's sending a signal in. The sound does the same type thing. It basically sends signals of literally that you're floating in a rhythmic sea. So it's just like, think of the tilt table, but not like that. Think of it as rocking slow. More like a cradle than a tilt table. Yes. Yes. And we all have that visual image like babies, kind of like coming away and floating in space, but no fear of falling off. And basically, the sounds had the same effectiveness as the vagal nerve stimulator. It was very profound in terms of what it did over a four-week period. And so basically, we had massive effects on all, basically all the parameters we had were measuring on, they were all questionnaires and symptom arrays. There were no blood samples, but symptom arrays of how people felt and whether they had fatigue. And whether they were anxious or depressed. And basically, all the indicators improved in a very, let's say, powerful way, which provided the whole model, whether it's a vagal nerve stimulator or the sound, is that if you know what the signal profile is that your nervous system is looking for, you can get at that. 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Right now, you can get a free AG1 welcome kit that includes a bottle of D3K2, an AG1 flavor sampler, and that 90-day money-back guarantee by going to the link in the description below or heading to drinkag1.com slash modernwisdom. Why would it be the case that a dysregulated nervous system would cause people to feel more anxious, people to feel more depressed, them to have lower energy, them to be. Why would this huge suite of things occur? First of all, let's tap you on the back and give you a congratulation for observing and calling out that it is a suite of systems that are. In fact, it's not one. It's not really. Just tired. Not just sad. You're not just distracted. And it's not just you have poor sleep. It's not that your gut isn't working. It's not that you're half-tired. it's everything about your autonomic system, nervous system's regulation. So it's a regulatory disorder. And we have difficulty in, I would say we, I'm talking about modern medicine, in seeing a system and seeing the system and its function. The system is dysregulated. It's not coordinated in the way that it should. And we're picking up on it. And so the issue is, yes, and I'll give you a word that fits in with all this. Your body's in a chronic state of defense. It's as simple as that. It's like you kill the pathogen, but that information, the success of that war didn't retune how your nervous system worked. So it's still prepared for war. Oh, you're locked into this price. Oh, that's interesting. So in the same way as a traumatic emotional event or physical event, a traumatic pathogenic event. Yeah. It's all the same. But the difference is when something has occurred consciously, people can talk back to, well, I got into that car crash. So getting into cars, it makes sense that that would make me feel nervous now. The same thing we don't draw because it's below the conscious threshold. We don't draw the same analogy to pathogens. Because we're numb to our body. We don't have the language. So our narratives and say, look, it doesn't matter what was a car wreck or a car accident. Someone humiliated me in public. It doesn't matter. My body reacted to it as if I was going to die. And this is what bodies do when they think they're going, they don't think when all the signals are that death is imminent. So I actually gave a couple of recent talks that I call sentinel trauma. And that is how does the body react to the single events of mortal threat? And I'm actually saying that COVID, can be a mortal threat to the nervous system. And that's the consequence. It gets hardened as a response pattern. And you're living through it. I would say optimistically, you're doing well. And even your curiosity, so where you're going with it is, and you're going to end up on that journey about understanding about the body's own feedback loops and how they got challenged. And that's exactly what they're assessing in the tilt table test. They're assessing whether the feedback loop is working on your blood pressure, meaning your vascular bed, the vagus, the sympathetics, and your own blood flow. Now I will tell you what are my exercises every morning. I have a backswing, basically a tilt table in the basement. You ever see when the back swings? So it tilts down like that, and you can go upwards like that. Like an inversion table? Yeah. Yeah. It doesn't go under. I can't rotate, but I can go like 70 degrees down, 70 degrees up. Yep. Yep. Yep. I have seen that. Why? I'm challenging my down receptors. I'm doing a neural exercise on them every morning. How long are you doing that for? I'm doing, first of all, I tilt downward and do basically sit-ups and basically about 10, five minutes or so of exercises in the inverted table. Physician. Then I do tilts on each breath, 30 of them. They're quite rapid. You would pass out. Yeah, I bet I would. Yeah. But I'm not passing out. Look, I'm 81. So it's not like I, what I'm saying is I'm trying to stay here for a while. And if I were totally sedentary, my body may think it's, you're too old to do those things. Hmm. How fascinating. Okay. I, I, I think this is important to get into across all of your research. What interventions have you found to be most impactful for improving autonomic function? Okay. So first of all, if we go back, we're going to go back into the nineties. I actually was playing around with the tilt table. I had a motor on it where I rocked people up 21 degrees and then back down to horizontal. It took seven seconds up. So one, two, three, four, five, six. So you can start feeling that it's kind of, very nice rocking even slower than what you're doing much slower. And so no one wanted to get off the table. That was the first. So the research showed that I could entrain rhythms associated with literally vascular bed activity. I could actually get into that system and exercise those, but the subjective response, how people felt was to me, the most interesting part of it. No one wanted to get off the table. And I never forgot that. And that's when I started to develop the acoustic one. I was mimicking what the tilting was doing. And so the, the issue is that the acoustic interventions that I've developed two of them, one has been used by a few hundred thousand people. Now it's called the safe and sound protocol. And what it does is basically mimic the acoustic features of a mother's voice. So it's broadcasting, calmness and engagement. And they're finding that it works quite well with, you know, pediatric populations, but the trauma population, people have used it with other therapies and it's been intertwined with EMDR and with various cognitive behavioral therapy and all forms of it in sense to make the client more accessible to the therapy. So what it's doing is priming a system to be more connected to the patient. And so that's what I've been doing. Connected with the therapist. So what I'm doing, so both of the, and then on the new one I developed, which is called a sonic augmentation technology and the intervention was called rest and restore protocol. And that was dealing really with visualized, basically floating in a wonderful sea without having any need to connect. You feel so safe. You don't have to look for someone. You feel safe. You feel so safe. You feel so safe. You feel so safe. And when you deal with, when you deal with it, meditation is too hard. Okay. And, and the issue is if you deal with meditation for traumatized individuals, they run out of the room because that immobilization now is a signal to the nervous system of vulnerability. Fascinating. So, okay. You've managed to isolate frequencies of a mother's voice. I think it's like 1500 to 3,500 Hertz. Is that right? You read real well. Yes. Can I say, I do my research. Also, obviously like unbelievably personally invested in getting this right. Um, and that's why, uh, layering into music, making the connection that that's enough to signal safety cues to the nervous system. Yeah, but it's actually even broader. So anything it's like 500 to 3,000 will be fine. Or, uh, basically it enables the frequent, actually all mammals, even little mice like animals, they vocalize in a certain area of the auditory spectrum. That is very similar. If you looked at their full spectrum. So dogs, cats, and horses overlap with our, uh, band of social communication. So you can calm a dog or a horse or a cat by talking to them. Is that part of the reason that we have collaborated and partnered with those animals? So, oh, that's so fucking cool. Okay. So part of the reason that humans, cats, and cats, dogs, and horses have bonded so well is that our frequency of calm when vocalized is in a similar range to the one that they use. Absolutely. That is so cool. It's totally amazing. It's so interesting to watch how people talk to their pets. It's like they have a manual. Have you ever seen, uh, there's a, a video, a short video of a golden retriever and there's two hands down in front of it. It's on a couch somewhere. And the golden retriever is going from dad to mom. And with dad, the golden retriever is used to play fighting. So he bears, bears his teeth and sort of pretend bites at the hand as he's putting the hand down. And then when he goes to mom, he just rests his chin on the top of a hand, but the dog does it two seconds, two seconds, two seconds, two seconds, bite, rest, bite, rest, bite, rest. And, um, I just thought that was, it's so funny. It's so funny how, um, uh, quickly adaptive that that is. Yeah. That is to be able to have. Listen, there's my cat does something similar. My cat likes, likes to mouth me, my hands, not my wife's. It's the same. Okay. So if that, if this is the case, right. And safety cues can be cued through, uh, auditory, um, input. Why not just play this music all the time? If it's that simple, why not just play the music permanently? Okay. Interesting. And so I had that idea and I decided to play it in a preschool to see what would happen. And I was playing it in the preschool and guess what? The kids were talking to each other. They were gravitating near the speakers and they were very socialized. I played the same music without the algorithm, uh, modulating it the way I wanted. And they were, they were solitary, this very solitary. And I played other music and nothing happened. So the part was that our nervous system recognizes it, but here is the problem. And this is a massive problem. And I thought that we're just there sitting. They're waiting for love sounds and sounds of connection to occur. And wouldn't the world be so much nicer? I forgot that if you come out of a traumatized environment, someone who is broadcasting those same frequencies is a predator to their nervous system. So the history, their own history, retunes them and keeps them out of social settings. And again, in the world that we both live in, we know people who have had very bad relationships. And we also know that they talk about finding the right person, but you know after meeting them, there will never be a right person. Because their nervous system is not broadcasting signals of accessibility. That's interesting. Okay, so what about vagus nerve stimulators? That's something else that you mentioned earlier on. How much? Which is real and how much is bunk with regards to that? Oh, I mean, number one, it's real. The question is for what and what reason do you want to use it? A lot of people want to use these things because they think it's a simple way out. That they can change the context of their life by stimulating a nerve. And the answer is the nervous system is smart. If you stimulate the system to be calm and accessible and you abuse it, the nervous system will cut off that. Yeah. you have enough resources to uh sit down and have this food that suggests that there's not a threat also it's a reinforcement that there's calories so you're not in starvation mode no too smart you have to go back there that's a problem i have all the time it really is well yeah no you're trying to you're building your narrative when all you need to be was a simple observer and that is you watch a baby suckling okay and what you realize is that the nerves and the neuromuscular control of sucks while in breathing that coordination are the same of social expressivity it's the same thing so we're in a sense using the same neural system when we ingest than when we are interacting with others and this becomes really i in some of my talks i said we we try to share ingestion but not digestion and digestion is a private matter it's a dorsal vagus ingestion is the ventral vagus which is our social engagement system so we say let's get together and have something to eat that's a social act and in fact if we start tracking the history of society ingestive practices or rituals literally are part of the history of community you know what's uh interesting i had a communication expert a guy called uh chase hughes on the show a couple of weeks ago and he deals in micro expressions and body language and and some interesting things and he had one insight around uh people who are feeling anxious and unsafe he says that they tend to keep the inside of their arms in close they don't want that brachial vein to be exposed but one of the other things as i was um got him to break down a killer who was being sentenced yeah this guy this guy that had done some pretty heinous crimes and he highlighted that as the uh sentence was being given to him and the judge was reading out what he'd done and sort of giving him his his dressing down he was there and he his tongue came out just a tiny little bit licked his lips and then pushed back in and i said what what's what's going on there and he said well it's a vanity thing uh moistening the lips makes you look better but also as a baby who is pre-verbal the first no that you have is because it's pushing whatever is in your mouth maybe a nipple out of your mouth and he he had that as the the uh a human's first no and i have no idea if it's true but i thought it was really cool all these things can be true but there are other parsimonious strategies uh if you're getting a sentence are do you think your mouth will be drier than if you're getting an award so it can be really the body's uh dehydration at that the the adaptive reaction is to kind of re-lubricate your your orifice yeah um i think re-lubricate your orifice indeed yes yeah okay that's another point because they they anyway another another time let's let's go to this this bit this is for me i basically talk about this is accessibility when the arms pull out okay that's showing the ventral side and like when my cat my cat loves to do that that's that's not a normal posture for a cat but she loves because she likes her belly to be rubbed she wouldn't be doing that if she was underneath a foreign parked car out on the street or a stranger but this is really we hold in we protect we protect the ventral side so the issue of the evolutionary history is the ventral side is a side of vulnerability to injury and and it becomes how we protect ourselves versus not so part of the bracing symbolic if i were to sit like this you'd have a different interpretation than if i were like this what's the biggest myth about anxiety from your perspective anxiety is the body being a defensive state simple as that we don't need the word anxiety we don't even need many of the words that we associate as emotion the characteristics of anxiety are we're mobilized why are we mobilized now what people like to say i'm mobilized because i have to get something done but what we notice is that quote anxious people it doesn't matter if they get it done if they get it done they're still anxious so that's just the narrative of how they are explaining their feelings so the myth about anxiety is that it's outside of us when it really is we're really broadcasting our physiological state i guess a lot of people may feel and obviously very self-serving um they go through periods of life where new lower tolerance periods lower tolerance uh abilities with regards to how much stress they can put up with how much energy they can put up with how much energy they can put up they've got their startle response their level of ambient anxiety uh their capacity to deal with stress and change and uncertainty and ambiguity and stuff where that gets constrained yeah what's the difference between somebody who gets locked in from that situation and somebody who ends up bouncing back and how much how much resilience can be re-inherited after it's potentially being damaged okay so you're living through a recovery phase of post uh long covet so you know exactly that your range of resilience is different than what it was pre-covet correct but you also know that it's getting greater than it was immediately after covet or during coping so you have a trajectory that you can assess so the part of it is that uh we tend to think that if we're not flexible we're not trying hard enough and the issue is we have to understand what it is that is uh implementing the constraint on us our nervous system wants to blame something outside of us it tries to blame uh let's say colleagues or bosses or spouses or let's say fiscal demands or political issues it tries to create a whole set of other issues to externalize feelings that are really being generated inside our body i'm not saying that the external ones aren't real they are real but the issue is uh it's not that they're not real or not that they are real it's how we deal with them so we can't solve the problems we can't navigate in the complex world if our body's in a state of defense so what i've been working on is this whole idea of what optimizes our ability to utilize or gives us the access to our capacities and that should be really the real question we should be asking not what is your capacity but what gives us access to our capacities so what you experienced and are experiencing is that the capacities that you know that you have were being compromised and that creates a conundrum you don't understand why or how you want it to be fixed and the answer is the nervous system is really broadcasting a message that those capacities are not accessible and that's why we're in this situation and that's why we're in this situation it's not that they haven't been taken away they're just not accessible so the real question is what enables them to be accessible and that's where we move into the concept that our physiological state how we start the conversation our physiological state is really giving the boundary conditions of permission for these capacities to be expressed but the problem is when it's giving us constraints how do we reverse that and that is that's the problem that's part of our whole dialogue and that is it's all going to end up with signaling the nervous system and it's basically okay to come out and play again it you know it's almost like that you know it's almost like is it safe enough to come outside you know it's like a horror movie our nervous system wants to be reassured and this is difficult because we do not know the signals our culture is horrible with signaling our nervous system just think about the traumatic disease and the trauma and the trauma of the disease and the trauma of the disease and the trauma events of schools with mass shootings and the solution is give guns to teachers and principals and put metal detectors what is that doing to the nervous system of these children yeah yeah i mean it's not like metal detectors aren't useful and having someone with a gun may be very adaptive in in complex situations but those are profound signals to a developing nervous system it's it's not like metal detectors aren't useful and having someone with a gun may be very adaptive in anything else if you if you had dirty dirty drinking water and that impacted uh the way that a child's digestion worked or if you had uh loud music and it was obvious how distracted they were if you can see stimulus and response quite easily the the fact that the pushback against that intervention would be quite obvious what we don't see for instance like are humans built to see uh assassinations live streamed on x you know within minutes of it happening posted around the world, are we supposed to watch movies and car crashes? and, and, you know, well, we know the answers, you know, the answers, of course, at the end, but the question is, you, you start with a very interesting and very important question. And that is if our nervous systems were visible and I'm saying they are to much more of an extent than you think. Yep. They, because people's faces broadcast their voices broadcast their muscle tension. Can you explain what a low tolerance nervous system expressing person and a high tolerance nervous system, how would they show up differently? Okay. First of all, the face would be flat and you've seen flat faces, especially the upper part of the face, the lower part, you have much more control. And so you can make false smiles, but the upper part tells you really truthful emotions or feelings. The other one is, intonation. And again, this is from your seat as a podcaster. When it, when your interviewee is, has a, a monotone voice or hype, that's a high pitch voice. It doesn't show any flexibility. It's just broadcasting to your ear and to your body anxiety. So they're broadcasting their physiological state. And I think when you brought up your question about anxiety, is, you know, spend, well, it's not, it's a rhetorical question. If you spend time with someone who's highly anxious, there's no doubt that your body is feeling their anxiety. And what are you detecting? What are the things that you feel? You basically say, I don't want to be around this person. That is, you make a global statement and you try to distance yourself. You haven't really, uh, it says, uh, gave the simple answer. The physiological state that that person is in is broadcasting. That state to me and it's bleeding all over me. Yep. Yep. Yep. And, and so what it does is it changes our responsibility in the world that we are in. We feel as a species that we can say whatever we want. It's all, I shouldn't say, it doesn't matter how we say things. It's what we say is important. And I'm saying it's how we say it becomes as important or more important. Hmm. Yeah. We utilize this wonderful, uh, apparatus vocalization. Hmm. Okay. How do you advise people to increase their window of tolerance and build safety practically? Then we've talked about a variety of interventions. What's something that's, uh, high compliance, high impact? Well, you actually brought up things that people are doing. They're working on breath. I would say when they do breath, they start really working on their own internal feelings of the breath. So they're helping the feedback loops become, uh, more enhanced. I think, you know, like residence breathing is, is powerful. Yoga breathing is powerful. I think part of what's missing again, even in the world of, let's say elite athletes and exercises, people are not saying as you exercise, go into the exercise and feel your body responding to it. You know, so we put on the television while we on treadmills, we don't take the exercise as a moment of Zen. Why is that important? Why is it important to feel the thing that's happening? Why is it not enough to just do the thing? Ah, this is where the nervous system comes in. If we're not feeling it, we're isn't a down regulating the feedback loop of the feelings of the sensory information coming in. We're dampening the sensory information. And I don't think we appreciate the, I would say the power of what sensory information is. And I don't think we appreciate the, I would say the power of what sensory information does to our brain. And so even like with the concept of the Vegas, which has a lot of press, 80% of the fibers of the Vegas are sending sensory information to the brain. 80%. It's a, it's an internal surveillance system of our body. Our body craves that information. So are you suggesting that the, because 80% is going Vegas up and only 20% 20% is going brain through Vegas down that by paying more attention to the breath as you're doing resonance breathing to the sounds as you're doing safe and sound protocol to your body as you're exercising, playing a dancing that you're, uh, opening up the aperture, uh, inside of your mind to pay attention to that 80% that's coming back. I'm saying it's not even paying attention. It's allowing the feedback loops to complete themselves. This is all metaphoric by the way. Yeah. There is absolutely, as far as I know, no research on this, but is in a sense the whole, uh, uh, I would say underlying or implicit theory behind meditative work, meditative breath, uh, that is that we can literally travel or body scans where people literally try to travel within their body that it may be sound like it's kind of weird or woo, but think about what you're doing. You're allowing the neural circuits to send information. Yeah. Into areas of your brain to have a degree of awareness and then to act on that, to, or allow, I would say act on it may be merely be to be more patient and more reduce your own muscle tone. So we think of activity as skeletal motor, but some of our activity is visceral motor, our organs and cranial motor, like the muscles of our face is we have to start to appreciate these different sources of motor systems. Our systems in our body. Most people have no idea where their testosterone levels sit, but what if I told you there was a solution, something that identifies low T faster than a high school bully, and it won't cost you all your lunch money. That's where function comes in, gives you access to over 160 lab tests, including a deep dive into your full hormone paddle. Every result is reviewed by clinicians. Anything out of range is flagged and you get clear explanations with a personalized protocol with actionable next steps. So if something's off, you know what to do. Exactly what to do about it, whether you just need to go to the gym more or you need to play Creed louder in your car function will tell you exactly where your testosterone and everything else stands. Normally this level of testing would usually cost thousands, but with function it's $365 a year. That's $1 a day to stop guessing with your health and start knowing. And right now you can get $25 off, bringing it down to 340 bucks. So get the exact same blood panels that I do and save $25 by going to the link in the description below or heading to the link in the description to functionhealth.com slash modern wisdom using the code modern wisdom, a checkout. How, uh, how important do you think metabolic support is to provide a window of tolerance to somatic interventions in terms of myocardial that, or is that, yeah, yeah, yeah. And, and, and, uh, Oh, I think it, okay. Now we start talking in personal information. Okay. So I had, um, um, let's say I had radiation and I had prostate cancer and I had treatment, and the treatments really wiped me out and they wiped me out so much that I couldn't walk up a flight of steps. And I, you know, I just was gone. And, um, in fact, we went to Greece and I couldn't even go to the banquet. We were at a, my wife was talking at the conference and the conference was on physiology of stress. She's an endocrinologist. She, by the way, she's the person who discovered the link between oxytocin and social behavior. Sue Carter. That's my wife. So she, uh, basically talked to the organizer who was a very famous stress physiologist and said, what's the matter with Steve? Steve wasn't going to come. And so he said, it sounds like mitochondria. Okay. And, and then we talked to someone else and we got the answer. The answer was there are supplements that kind of signal the mitochondria to come out and play again. And the one I took was called L-carnitine. It's, it's, it's off over the counter. And I was now, I couldn't go even walk up a flight of steps or walk to my office. I took that the next day I did two miles on an elliptical. So it was a switch change. And actually it may be helpful to you as you recover from long COVID. So what it is doing is signaling the mitochondria to, and the, and the ATP production is basically saying, come out and talk to him again. Right. So there is a, could it be the case that you could be doing the work, doing the work, um, from a, yeah, you would be metabolically incapable of the work having any impact. Bingo. Yeah. And the issue is you need certain resources. So you need the nerves have to communicate. And there's another thing about like neurotransmitters are part of that. And we I'll say decades, I've been taking lecithin, which is a, has a phosphatidylcholine, a precursor for acetylcholine because acetylcholine is the, uh, used in the vagal nerve transmission and a lot of other neurotransmission. And I've been taking, and fish oil. So I've been taking a lot of precursors that are useful in neurotransmission. So, which is, yeah. I'm interested in the, the what happens if someone goes from having this narrow window of tolerance to regaining safety again? Why is it that the nervous? system seems to oscillate between hypo arousal and to hyper arousal okay what you have and actually i i got an email from someone from a physician from the uk who says the letters start i have a client who's suffering from the polyvagal syndrome which i had no idea what he meant but i read through it and what it really was exactly what you're saying moving from hyper to hypo and being poorly regulated in between that's because access to that ventral vagus is not there so the system goes in one direction then goes in the other when you have the ventral vagus it's kind of like a choreographer it creates it enables us to repurpose fight flight into play repurpose immobilization into intimacy and restoration so it's like it's like this social net that's over us and when it's there these other components really uh basically serve our needs but when that that's gone we are basically functioning like in a way almost decorticated animals you know it's like we're down and we don't have this master regulator so we're a regulated system oh yeah you're just much more at the at the mercy of everything flip-flopping from one side to the other some like an element that i wasn't aware of but there's a paradoxical relaxation and startle response where the nervous system interprets parasympathetic states as threats so as people start to relax as they start to get below the window of tolerance on the bottom end yeah that their system sees that as a threat and bounces them out the top like why would why would that be the case why in a system that needs more relaxation why would it bounce you out the top this is what we talked about the interception of that calm state is now associated with vulnerability and injury right so it's a sense our higher brain structures sabotage us so the lower brain says relax you need it the higher brain says can't relax in this environment it's to is prioritize this threat and i guess this is where the safe and sound protocol yeah would come in slowly slowly with those who have that type of history the i would say the greatest surprise to me on this interesting journey uh was that the safe and sound could be a trigger for people i mean it could create defensiveness and i had no concept that in my theoretical model so i had how does something that only is broadcasting signals of safety or calmness how can it be responded to then you start asking the question who are the people responding what are their clinical symptoms what's their history and then it becomes a script the script is that they were injured by let's say a biological parent and and so the vulnerability of to signals that are is in our dna becomes signals now of threat why does tinnitus often show up in highly activated people what is it about the ear that's i know some of your research has gone into the ear territory yeah the issue with tinnitus tinnitus is just let's use it's not a very descriptive diagnosis so the history of tinnitus is that people thought it was in a sense uh in the ear and they actually did such things as aggressive surgeries and removed the entire ear internal ear structures the tinnitus was still there even god you would be really annoyed if you had your ear structure removed and you were still hearing ringing in your in your head that's right because it was now uh the solution to that is basically it's on the auditory cortex that type of tinnitus and the solution now is actually they put a stimulator on the auditory cortex to scramble those sounds so it so that's one type of tinnitus i have uh tinnitus or had it and it was i have something called an acoustic or vestibular neuroma it's a non-malignant tumor on the vestibular branch of the auditory nerve and it was discovered because i started to get severe tinnitus it was like hearing sounds of being in the kitchen and people throwing dishes it was not a calming humming it was a lot and then i actually uh okay so two issues on that they uh the medical community this is 2002 said there's only one solution as you need to have surgery i said well that do they said we we're going to do we'll have to cut this out the tumor and you'll be able to have hearing however you're going to lose hearing which is really the consequence of the surgery and i said well you're going to have to have a surgery and i said well and you know i i'm not your average or your normal patient so i went and did my literature search and i started to read the publications were not giving me any information but the conference papers which are done before publications start to tell me about what would be called watch and wait and they basically said look a lot of people don't get surgery nothing happens you know it just they they live they so it's not going to kill you and if it big venue, which is extraordinarily rare. Now, what I found out was that when I was, quote, stressed, the Tintas would bother me. Okay, this is where your question is for the focus on. And in fact, this is now 25 years ago or 20 years ago. I'm now in Miami visiting my father and I'm driving across a railroad track and on the tracks, as I go to the tracks, the Tintas is going on and off, on and off. Okay, so there was a physical component. And what I was dealing with was in the literature, when I read the material, there was an inflammatory component to the expression of the tumor. So I started to take high doses of fish oil and the Tintas disappeared. The fish oil has an anti-inflammatory. So what I'm saying is that that's what I was getting. Now, my Tintas was due to the actual nerve being inflamed. And I could control that with fish oil. So I was very fortunate. And now I don't even know that I have Tintas. Why would it be the case that a dysregulated or a lower tolerance system would worsen Tintas? Why is that an interaction? Well, because inflammation is part of that defensive system. Oh, okay. Yeah. Okay, so let's go back, rewind the tape. And we're talking about clusters of symptoms that are together. Inflammation is one of them. So the whole family of things happen. It's not merely your heart rate gets up, your regulation of heart rate and sweating. The inflammatory component is there as well. Yeah, that makes complete sense. I'm interested in the link between the vagal nerve and the gut microbiome and biome. What do you make of that connection? Well, just remember that 80% of the vagal fibers are afferent. And where's the vagus going is in your gut. It's really monitoring your gut. And I would think most of our many of the vagal afferents are really gut receptors. So why would that be the case? Just because digestion is really important? Yeah, it's not digestion. It's toxins. And the other thing, you have to think about what your gut is. It's a farm. It's a farm for molecules that your body needs. Think of it that way. You're raising all kinds of things in your gut. The flora of your gut is complex. So basically, I've actually been doing the past decade quite a bit of work in gastroenterology and was showing that most, a lot of the, of these syndromes within GI, which is also another one of these disciplines where it's very hard to document pathophysiology with the symptoms, that the autonomic nervous system is highly dysregulated in many of the individuals who have gut problems, including chronic vomiting syndromes and symptoms like that. What direction is that going from? Is that low-tolerance nervous system giving you bad gut? Is that bad gut giving you low-tolerance nervous system? What do you make of the gut biome's effect on the nervous system? Okay, you need to do some resident breathing now and realize that when we talk about a system, it's bidirectional. It's really sending up signal, and we know we can influence by how we feel. So we know our gut reacts to things happening in our environment. And we know if we have a stomachache, really, our capacity has become very, very limited. So we know that the sensations from the gut can disrupt our daily life, and we also know that our daily life can disrupt how our gut works. Now we start talking about what it is to be having a system, another thing that tends to be missing from our own narratives of explaining how our body works. Is there a sex difference in how nervous? Well, for decades, I've tried to neglect that question. My wife has always informed me that there are sex differences. the answer is probably i mean i think we can say that there are some basic mechanics that are in a way asexual and since systems work the same way but there are different demands on let's say different sex as a subspecies different demands on women than on men and at different times of their lives so there's a time course it's going to be different i think it's so understudy because most of the research on health has been done on males because females had more variability and especially when it comes to clinical trials variability kills you in clinical trials because people want it cause and effect relationships yeah yeah yeah i think what i'm interested in around the sort of sex difference for for nervous systems is male socialization antisocial behavior situations loneliness stuff like that um certainly seems to show up in men more than in women for a variety of reasons but i'm i'm wondering whether male socialization is partly a nervous system challenge uniquely i don't know i mean i haven't thought of it that way i keep thinking about it thinking of our socialization process of males and females and the history of humanity which was you know different social circuits uh for men and for women historically and and the issue and also the notion of birthing and how that was really a communal event uh i'm actually more interested now in the other part of the lifespan and that is how poorly we as a species are doing with end of life um which is not really discussed or worked on and so i'm getting very interested in palliative medicine and with with a desire that uh we have tools to enable us to literally smile and wave goodbye at the end of our duration here uh as opposed to trying to preserve life and make people fearful of the dying process it's interesting yeah i mean think about it because uh how many how many uh episodes have you had interviews on 1150 maybe okay how many have talked about palliative care or end of life less than 10 yeah and we're all gonna die right i think and it just gives you a glimpse into how we are so unprepared for the essence the whole life of uh the passage yeah yeah i think it makes at least a little sense about why especially around nervous system people understand that something which impacts you at the beginning uh lays the foundation and can be an echo which is heard throughout the remainder of the journey we don't talk about uh grandparent trauma we talk about childhood trauma because the trauma doesn't tend to move backward in time it tends to move forward in time so i i understand why it feels like um investing in the past and the future and the future and the future and the future and the in an early stage startup as opposed to a company that's very mature because well how much more is there to go but you're right i mean like everybody is going to pass away and the fact that we haven't looked at palliative care with the same level of uh of scrutiny even compassion let's use the word compassion well it's it's the one type of discrimination which is still almost universally accepted is ageism right like it's the one thing that you're never going to get pulled up for you can say i'm not going to get pulled up for it i'm not going to get pulled up for it i'm not going to say on a daytime tv show you can say on a comedy show you can shout it at somebody that cuts you off on the street like very has anybody ever stepped in and said hey hey don't talk about his age like that man like no one's stepped in to do that people have said it about race about sexuality about gender like all of these different things ageism is this one that the arthur brooks this is the one that is affecting me directly is understanding that the world that i had lived in for so many decades is not very uh accommodating for people who are getting uh frail yeah well you are spinning yourself upside down a couple of times every morning so i'm in i'm doing fine i was going to say the frail the frailness thing i wouldn't know but the the issue is uh when you're doing fine is when you should be exploring the future is really what i'm saying yeah just going back to the um sex differences thing you've said that co-regulation is is the biological basis of love that we literally regulate each other's nervous systems what do you think are the implications when a man has never experienced consistent co-regulation like potentially especially from a father um i think we can see that in in let's say our the politics of today uh so that our culture is not okay so there's a lot of okay the consequence what we're really saying is uh uh with that the experience of being vulnerable is part of the experience of having relationship and if we can't cope with our own vulnerabilities then we have difficulty navigating in the world we're in um and i think there's times when uh being bold or being impervious to or not acknowledging vulnerability serves us well but there's also other periods where it basically locks us out of community and uh i'm kind of watching this because to me it's the the script of life is becoming uh i think what you're saying about things that happen early in life we can see it moving on i think that script is uh now to my to my mind or my eyes and my ears become quite predictable you know it's like saying i can see the consequences and uh the issue is uh it doesn't fit with my view when i was young my view was a we can all be what who or whatever we want to be i was quite an idealist and i basically felt that options that i could do everyone else could do i didn't have an appreciation of let's say the uh permission the opportunities that i had um i didn't see them as as special and i didn't see the skill set or the insights as special and i think part of what because we're trained in sense to have a type of humility what i'm saying is that the concept of really being compassionate and benevolent is really an understanding that others don't have what we have it's such a good point i i had a conversation with a friend in bali earlier this year i mean i'm explaining to him about this journey that i've been on i've spent two years trying to piece myself back together after mold lime ebv cmv long covid stuff and then just as i've got myself to where i felt i'd made really great progress this dysautonomia kicks in and now i've got this new fight and i i'm you know i'm so i'm irritated i'm tired i'm agitated of having to do this i'm starting to get apathetic i'm like i'm just constantly having to be strong and having to show up and i'm even trying hard at not trying hard i'm trying hard at being empathetic i'm trying hard at doing this stuff but you gave me this big long voice note in response and i think it speaks to what you're saying and he said i don't know of a single person who has fully and truly understood humanity without going through a long period where they didn't know if they were ever going to get better he said this is a difference between just having a and having a life-changing difficulty that you face because in one of them everyone's been through a hard time everyone's lost a job everyone's lost a parent everyone's lost or whatever but the difference he said is not knowing whether or not you'll get better and that that is so true that now when i look around uh i've got more compassion for people who are ill i've got more compassion for people who are struggling with addictions i've got more compassion for people who are seemingly annoying like even stuff that's good that's that's you think is elective everybody's got compassion for somebody that was born disabled everybody's got compassion for someone that was abused as a child but what about that person who just never seems to stop is never able to stop talking about themselves or their accomplishments and i'm like i see so much more now hey something's happened at some point in this person's past either something's happened to them or they were born and this is something that they are the predisposition right they didn't get to choose either of these things like fuck like as a annoying as you are i should give you a lot of compassion and that has been that's been born out of this experience the last two years of of really trying to sort of grapple and battle with this thing that's that's been the the biggest takeaway humility and and more compassion yeah chris the as i you know listen and hear the array of of vulnerabilities that have hit you to me they're all the same even the hypersensitivity is sensitive to mold the system does not have resilience that's what you're saying now this is where the beautiful big cortex is useful so we evaluate okay my system does not have resilience I can move my system into places where it's going to be less vulnerable. Now, what does that mean? It means different things to different people. It's all based upon whether your daily demands, like doing podcasts, are nourishing to you at this stage of your recovery or they're not. And I think that becomes the first question to ask yourself. I mean, I'm just talking to you as a person, not as a therapist, but as the observer. And I think that's really the first question that you really have to come to grips with. Of course, that is, in a sense, containing you is the work, and this is what you do. This is how you define yourself. And the question is, if you didn't have that to define yourself, how is your body going to feel? So the issue is you can't deal with the vulnerability of the. disease entity that has invaded you unless you can deal with how you can feel without the container that may now be contributing to the expression of the symptoms. Dependent on whether it feels nourishing or sapping. That's right. Very interesting. One thing I haven't mentioned, what do you make of stellate ganglion blocks? What do you make of SGBs? Yeah, well, so Eugene Lipoff, who I know quite well, is really one of the originators. And I'm very, okay, from my view, it's turning, okay, it is actually something that we alluded to implicitly. If your sympathetics are now overextended, you're going to be locked in fight-flighty. You're going to continue to do that. And if you down-regulate them, the parasympathetic calming has an opportunity to express itself. That's what I think is happening. I mean, the stellite ganglion, is actually dampening that whole limb of the sympathetic sufficiently that the parasympathetic vagus can start to express itself. Okay, but the utility of it has been really, in terms of the world of trauma or PTSD, as far as I can tell. And PTSD is manifest in different ways. There are people who are locked into a state of fight-flight, and I think that's really the great toolkit to help treat it. But there are those who are kind of locked into a shutting down, withdrawal, and immobilization. And I'm not sure if that's going to be helpful for that group. Yeah, that's interesting. I've seen some research that says deeply traumatized baby mice require three generations to get back to a normal nervous system state. Do you feel like that's true for humans? You're asking what I call, okay, so they talk about, they talk about intergenerational trauma. I like to use the word transgenerational, because I think the country where we live, and I imagine the UK as well, historically is a transgenerationally traumatized environment. And what it doesn't, okay, you don't have to assume that it's epigenetics, or the genes have been modified and transmitted. All you need to think about is what is the culture? So think of the UK and the private, or the, the boarding schools, and the, you know, basically stripping kids from childhood. And, and then making this the elite. And totally. These are the trendsetters moving forward culturally. Yeah. Or they were the leaders. So I met a, actually became a friend. He's written a book called the, basically about the damaged elite of the UK, because they become the prime ministers and all these other people. And he's really saying their bodies are locked into states of defense. So their ability to be compassionate is quite compromised. Oh, that's so fascinating. And then you you're in an environment which probably makes that worse. It rewards a stoic, stiff upper lipness. I am not affected by this. I'm a safe pair of hands to drive this organization forward. Yeah. Or even, you know, the bit about the English view of sexuality, do it. It's not about sex with the queen or or I've never pulled that one out. But I will leave the line was, it will be over in a few minutes. Just don't worry. Yeah. Think of, think of queen and country and just keep going. Yeah. Yeah. Yeah. It's, it's not one of loving and engagement and connection. It's something else. Duty. It's closer to duty. Right. Okay. Um, obviously this you, you've, you've been working on this theory for a long time and it's, uh, unbelievably influential. What are the strongest criticisms of polyvagal theory in your opinion? Like which criticisms do you think are fairest there? Okay. So my view is this is quite a trigger to me because the criticisms are not of the theory. The criticisms have been misrepresentations of the theory. And, and so I don't mind criticism because they will improve articulation of what this is. Every criticism that I've seen as, been really a misrepresentation of what the theory said. And really what you have are people who think they know what the theory is and who are making statements. And I, I'm interested. What are the most common misconceptions when criticisms are being lodged? Then they, they don't understand the evolution of the vagal system. Uh, the fact that it, the nucleus that where the Vegas comes from in the ventral Vegas is an old, older nucleus long before mammals is fine, but that didn't have a cardio inhibitory fibers until mammals had it. So they don't understand the distinction between an anatomical structure and it's actually components, uh, neurophysiologically. They basically don't understand that polyvagal theory was never about the nerve. It was about the organization of this integrated brainstem system. They just don't understand what it's about. And what, what, what does that lead to? What does that lead them to wrongly concludes? What are the implications of not understanding that? What's the criticism that's levied because of that error? Oh, well, they say it's not based on physiology and what they've done is misrepresent every point of it. And then they would, if I, and what they may quote accurate physiology, but it's not relevant to do what the theory actually states. So it's been to the, in fact, I created a AI, a polyvagal scholar, and it has one basic rule beef. Uh, you have to have fidelity, fidelity to the theory. And I have not gotten a criticism that it doesn't basically kick out because the theory has not been accurately represented. The theory in a sense, the theory has evolved over decades with more clarification. And I'm just finishing two papers. One is on an architecture of the theory, but it's not of the Vegas is of this whole mammalian organizational system that enables us to, co-regulate enables our social behavior now to impact on our health and physiology. And they miss all that. They get stuck into something that doesn't exist. And, and this has been going on for almost 30 years. So it's like, you know, I basically have said this, uh, uh, read the papers. And if you can't read them, you know, don't tell people that, uh, they, you have, I mean, it's like, but I will also say that it's double edged and more people, uh, criticize it. The more lights that are shining on it. Yeah. It's like, it's not unknown. And it's really interesting because the clinical world, which really gave it, um, traction, uh, it, it works for them. The interesting part is the, uh, neuroscience world is too, uh, let's say, uh, siloed to understand the organizing principles of it. So it's kind of like, uh, ahead of its time. We're pulling things together because it requires an understanding of the interaction of too many components. So you can't criticize the theory based upon the Vegas. You can't criticize it based upon any single pathway because it's not about that. And by criticizing on it, you're not understanding what the theory is stating. So, uh, I'm actually extraordinarily confident that time, time is, I mean, not be here, but it will survive me by far. And the issue is because what I am now writing about is giving people a toolkit to understand what the theory is. So they don't get pulled into, let's say, uh, false arguments. Uh, what I would say if someone criticizes show by one basic statement, show, show me in the literature where I made that statement. And I mean, that's all I'm asking. And the bottom line is it doesn't really matter to me. If you want to argue with me, it matters to me. If you represent my work accurately, that's fine. I'm going to use your statement when somebody misquotes me on the internet as well. Yeah. Well, that's, see, that's the world you're in. And to me, the internet world and the social media world is so vulnerable because people can say anything, but they can also say that you've said anything, which is, uh, the default, the false, accusation equivalents. All right. We spent, we spent an entire episode talking about when, uh, people's nervous systems are, Too dysregulated, too sensitive, window of tolerance, which is too constrained. Can a person's nervous system be too safe, lead to risk aversion, lack of ambition, inability to tolerate challenge, like the pussification of people? Is there such a thing as too safe? Okay, so what I see, I wouldn't, my interpretation was, what if a nervous system feels too safe? Does that make them too vulnerable? See, I'm actually going to the other side. Yeah, yeah, yeah, yeah. And I actually was very concerned about that. I was actually thinking that that was a possibility. And the issue is, so it's like, if I feel safe, am I going to be, not detect signals of danger? That was my concern. And I basically, I feel much better after pondering this for quite a few years, that our nervous system, the healthy nervous system that. Has the capacity to connect and to basically love and share and trust, is usually the nervous system that can detect threat as well. So it's like, we're talking about a well-regulated system that enables this co-regulation to occur, tends to be the same system that can adjust and navigate to this complex world. Unreal. Stephen Porges, ladies and gentlemen. Stephen, you're so great. I've got. I have a million more things to say. I have a million more things that I want to talk about, about relating, about child rearing, about pediatrics and stuff. But we can save that for another time. I just really, I really appreciate you. I really appreciate you giving me and everybody a language with which to experience or to understand the way that we experience the world. I've been on the front lines of this, so to speak, with my own sort of priorities over the last two years or so. I've come to basically believe that our nervous system. We are our nervous systems when it comes to the way that we interact with the world around us. And it's the single most influential thing in terms of how we experience the world and how the world experiences us. So giving us language and insights about how to navigate that and understand it is awesome. So I just wanted to give you your flowers there. Well, thank you, Chris. And my summary of what you just said is that you're polyvagal informed. I mean, that's when you see the world through the way that you described it. That's what the theory was for. It's for us. It's to understand that when the nervous system or what I'm basically saying, our physiological state is really a major component of our behavior and who we are and our feelings. In my world, that's the world of academia would be polyvagal informed. In my world of the internet and degenerate culture, it would be polyvagal pilled. But we'll allow us to do one or the other. Stephen, you're great. I appreciate you. And I can't wait to speak to you again soon. Thank you very much. Thank you. Subtitles by the Amara.org community