Polyvagal Theory & Listening Hands

Touch Receptor Artwork by Kaitlin Walsh at Lyon Road Art

 We are not a machine – we are a dynamically interacting living biological system. When we touch something, we touch everything within us and we also touch the people we interact with. Physicians in the medical community need to be more connected to the people they are treating.” (Porges, p. 182)

Stephen Porges’ Polyvagal Theory has altered our professional landscape in ways yet to be fully actualized. The Polyvagal concept has become popularized for good reason – it illuminates so much about both the importance of and how we can understand safety. The Polyvagal Theory could be thought to be the ground for an evolving New Science of Safety. 

There is so much we could unpack in the quote selected above. Here, I want to focus on touch (of course). In another post I will explore the last sentence and advocate for a more fully realized vision of another increasingly popular concept – Narrative Medicine (understanding the Polyvagal Theory and Interpersonal Neurobiology – IPNB – can help us take this narrative idea deep). 

We use the phrase Listening-hands in all of our classes. Lots of bodyworkers use this phrase, we aren’t necessarily unique in that regard. However, if we link the idea of listening to another being with our hands to what the Polyvagal Theory shows about safety the concept becomes deeply meaningful in using touch to work with the nervous system.

One of the most instructive concepts in the Polyvagal Theory is Neuroception. Porges defines it this way: Neuroception is the process through which the nervous system evaluates risk without requiring awareness (Porges, 19). We are feeling-perceiving beings, we are always perceiving and Porges says a part of us is attuned to our perceptions to make sure we are safe and that this is happening below the levels of conscious awareness – all the time. We are particularly attuned to facial expression and tones of voice in social settings. And, though Porges doesn’t focus on this, our bodies are highly attuned to how they are touched and I believe our neurocpetive system is working to make sure we are safe in all touch settings – including our treatment rooms.

In his definition of neurocpetion, Porges continues; Although we are usually not aware of cues that trigger neuroception, we tend to be aware of the physiological shift (i.e. interoception). Sometimes we experience this as feelings in our gut or heart or an intuition that the context is dangerous (Porges, 19). Our feelings are just that – feelings that occur in our bodies that signal to us there to pay attention. Our neurocpetive system exists, according to the theory, so that we can assess safety and then downregulate our nervous system so that we can foster degrees of connection and intimacy. It also exists to keep us safe.

When we touch people in our work (or any setting) this dynamic is at play. So when we use the concept of llistening hands we are using touch in a way that can communicate to this below-the-level-of-conscious-awareness system and give it an opportunity to feelthe nature of our touch, our presence and respond to that presence. This requires a touch that can create time and space. It is a touch rooted in listening before doing. We can use what the Polyvagal Theory teaches about dialogue – that we want to feel safe and that our neuroceptive system is always responding to non-verbal cues – to use our touch based work skillfully to help dysregulated aspects of a person’s nervous system become more integrated into their bodies and their consciousness. 

In dialogue, we all appreciate attentive listening. We know somebody is listening because we feel them through their eye contact and body language – their presence. This can also live in our hands, when our hands move slow, listen to the subtle signals in the tissue – a softening or a tensing, the breath, if it becomes more rapid or there is a sigh, the skin, if there is sweat and we respond accordingly – by giving space and checking in with the person and remaining in contact with them so that they can safely explore what is arising.

Our work is always occurring within an emergent field, it is an emergent field both between us and the person we are treating but it is also an emergent field within that being that is occurring in our presence. Our touch can become a fundamental component of our relationship and participation in this process – but only when we are following the signals from the body and not directing or overriding them. If our touch moves at a pace that is coherent with a persons interoceptive and neuroceptive systems they will feel deeply understood – and safe. This requires consistently monitoring our pace and our depth, being ever attendant to what is arising in the emergent field. Our touch has the potential to be a profound dialogical component of another being exploring the story of their life contained within their body. This occurs by listening with openhearted curiosity. 

Bibliography: The Pocket Guide to the Polyvagal Theory, the transformative power of feeling safe. Stephen Porges, WW Norton 2017.