Why social engagement matters when recovering from trauma

By now, most of us know the fight/flight mechanism to be an evolutionarily adaptive response to threat and danger. We feel threatened, so we prepare to either run away, or stay and fight. This well known mechanism is part of our autonomic nervous system (ANS), which is responsible for regulating our arousal levels. The ANS is further divided into two subsections, the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The SNS is responsible for nervous system activation, which occurs on a continuum from mild stress to extreme overwhelm. The PNS, on the other hand, is responsible for nervous system deactivation, from mild relaxation to complete coma. These two branches work as a team; one accelerates, one brakes. 

Much of peoples struggles in daily living result from an imbalance within this system. This is particularly true in trauma, where there can be a chronic overactivation of the SNS, leading to feelings of threat and hypervigilance, but also in chronic over-activation of the PNS, leading to states of extreme depression and dissociation. Much of the work of therapy is about retraining the nervous to find balance once again. 

All of this was widely accepted with little deviation for many years. In recent decades however, Steven Proges has made “the single most progressive contribution to the understanding of the autonomic nervous system in recent times” (Rothschild, 2021). It is known as polyvagal theory, and it has been enthusiastically taken up by researchers and therapists across the world. 

Porges theory identifies a distinct nerve called the “vagus nerve”, with two branches, dorsal and ventral. These branches serve specific functions and help us as therapists to understand when someone is calm (ventral vagal activation) and what happens when someone collapses under extreme stress (dorsal vagal activation). What is critical and most interesting to Porges theory is the role of social engagement which is facilitated by the vagus nerve. 

For Porges, what is central is social engagement. This is mediated by the ventral vagus nerve. It connects from the base of the brainstem to the major regulatory organs of the human body. The Ventral Vagal Complex (VVC) is highly attuned to the social signals of others. Body posture, voice and subtle facial movements give us a bodily sense of safety or threat, depending on how they are perceived. We constantly and implicitly scan for and assess our social environment in order to detect either threat or safety. When we detect threat, we shut down social engagement, and are unable to enter into meaningful relationships, which for human beings is highly distressing. 

People with trauma have difficulty accurately assessing these social signals. Re-engaging the social engagement system can actually be the first step in creating the conditions of safety, and can be much more important than talking about the trauma. Thus the first phase of trauma treatment is always safety and stabilisation. It means helping clients experience and identify when they feel physically safe, and understanding the social cues which tell us when we’re safe. Therapy is not the only way to do this, and Bessel Van Der Kolk talks about the importance of social group activities and programs for people with trauma - yoga, choir, dancing, theater ect.

Sources

Rothschild, B. (2021). Revolutionizing Trauma Treatment: Stabilization, Safety, & Nervous System Balance. WW Norton & Company.

Van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York.