Scientists Vs. Polyvagal Industrial Complex

39 leading vagus experts give their verdict as to the polyvagal theory scientific claims, calling it 'an erroneous belief system' and untenable. Will therapists still go 'Nah, I think it's science"?

Dear Gentle Reader,

Never snarky for the sake of it, this author wants to stand for better standards of neuroscience in psychotherapy. Will you join me in that?

This week saw the publication of a bombshell paper authored by an impressive lineup of 39 scientists, most of them the biggest names today in the autonomic nervous system control, physiology, anatomy and evolution of the vagus nerve. It’s titled WHY THE POLYVAGAL THEORY IS UNTENABLE. An international expert evaluation of the polyvagal theory. The paper offers an unambiguous and comprehensive takedown of every aspect of polyvagal theory (PVT), describing it as an “erroneous belief system”.

Some snippets:

PVT assertions around the central vagal control of the heart are fictitious

The whole polyvagal ladder idea is a bunk. The whole dorsal vagal shutdown is a bunk, too.

Talking about why applying PVT in mental health may be harmful, they state:

“We maintain that an erroneous belief system regarding relationships between psychological states and neurophysiology may be harmful when presented as facts to healthcare providers, patients and their families”

When it comes to how PVT relates to science overall:

PVT proposes a line of argumentation that ignores the overwhelming scientific consensus

And finally, they also make a recommending to our professions to try to do the following:

reorient and consider other already existing, as well as novel, psychophysiological explanations that are in line with modern conceptions and evidence regarding autonomic regulation of bodily functions

This is interesting and I will zoom into this last point in the end of this piece.

Polyvagal theory has been debunked before, so how is this a bombshell? OK, so until now, only one scientist working in the field had issued a formal and sustained rebuttal of PVT - I am talking about Paul Grossman’s epic debunk (the original thread and the subsequent paper). Many other scientists were simply unaware of it - so obscure this ‘theory’ is in the science world. Others yet shrugged it off as quirky pseudoscientific theory and did not give it time of the day. This restraint and apparent neutrality ultimately backfired, as polyvagal theory continued to spread and thrive. Having passed itself off as bona fide neuroscience for many years, it has reached today a position of the most influential and established neurobollocks. And by a long shot.

On one side, we have the 39 most knowledgeable people in the world on all things vagus - ranging from neurophysiology, evolution to neuroanatomy of the vagus nerve, spanning several generations. On the other side, we have a single individual, deeply invested on multiple levels in maintaining the status quo of relative ignorance within psychotherapy and mental health professions when it comes to the mechanics of autonomic regulation and the functioning of the vagus nerve.

In fact, the PVT’s attempts to maintain the ignorance amongst therapy readership and professionals is even more concerning. When doing research for this article I have realised that the Polyvagal Institute pays Google to be the first search result when someone does a “polyvagal theory critique” search - effectively attempting to prevent people from critically engaging with PVT ideas, leveraging the power of their $$ (I can’t even imagine how much that costs, but it’s not gonna be cheap to run the global Google ads, I can tell you that much). This is shocking conduct for a scientific theory - but normal behaviour for an industrial complex and commercial enterprise, which is, I argue, what in reality it is.

Before we start in the earnest, some housekeeping:

• If you don’t know what polyvagal theory is, you can read my original piece Polyvagal Neurobollocks - a name well deserved - and also the follow up Polyvagal Neurobollocks Q&A

• If you think that me calling the polyvagal theory pseudoscience is a little over-the-top, please check the definition of pseudoscience below

• If you think that calling the polyvagal situation the polyvagal industrial complex is unfair, please refer to the definition of an industrial complex further below

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Definition pseudoscience (Wikipedia)

Pseudoscience consists of statements, beliefs, or practices that claim to be scientific or factual but are inherently incompatible with the scientific method. Pseudoscience is often characterized by contradictory, exaggerated or unfalsifiable claims; reliance on confirmation bias rather than rigorous attempts at refutation; lack of openness to evaluation by other experts; absence of systematic practices when developing hypotheses; and continued adherence long after the pseudoscientific hypotheses have been experimentally discredited.

Others might find the label of junk science to better fit polyvagal theory. I can live with that.

Definition of An Industrial Complex

This term is used today to describe an ecosystem of organisations, prominent figures, professionals, training bodies, publishers and commercial actors around one system of ideas, doctrine or theory that are all intertwined through shared investment in those ideas and benefit, including financially but also status-wise, from maintaining the status quo and extension of the idea into other fields reward practices or products that align with the ideas, doctrine or theory and through a closed system create an echo-chamber feedback loop that reinforces the appearance of consensus. No one of the actors in the system has the incentive to question or reevaluate the initial idea or theory because, at this point, they invested resources in it and their livelihood might, at least partially, depend on it.

You might have heard of the wellness industrial complex, the neuro-industrial complex or even the mental health industrial complex.

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In this piece, I will:

• Give you an idea of who the scientists behind this new paper are together with their areas of expertise

• Share the main conclusions and recommendations that they make

• Talk a little about reptiles and their sociality (because who doesn’t want to know about reptiles, after all they have given us the reptilian brain)

• Mention the dodgy citation and scholarship practices courtesy polyvagal theory

• I will end with an appeal to scientific community

If you end up reading the paper, you might find the name of this author buried somewhere in the manuscript - extra points if you do.

The Vagus Scientists vs. PVT

Now these scientists and experts, who are they?

I take it that many of you familiar with the PVT saga probably know who Paul Grossman is. Until he came along, the whole technical language and concepts of the PVT were kind of impenetrable to us and all we could do was either trust our gut and that nagging feeling that something was off or hope that all that neurobabble was reflecting some scientific truth. Then came Paul and changed that. All of the sudden, we had this other person, on a par with the knowledge, saying “hang on, this is utter bollocks”. For his epic expert takedowns of PVT see here and here.

While other scientists watched the inexorable spreading of PVT and shook their heads in disbelief from the shadows (with some notable exceptions), the narrative of an isolated critique of PVT somehow took hold.

So who else is in this impressive lineup?

We have Michael Spyer, James S. Schwaber, Robin M. McAllen, Winfried Neuhuber, Michael J. Joyner and Edward G. Lakatta who are all distinguished autonomic physiologists or neuroanatomists from the older generation.

Almost all of them were cited by S. Porges over time to support the polyvagal theory, while in fact it misinterpreting their work - the fact underlined in the paper. (Wait, what?)

Going to the next generation of autonomic physiologists we have Alexander V. Gourine UCL, Julia Shanks University of Auckland, Clément Menuet INSERM France, Vaughan G. Macefield Monash University, Julian F. Paton and Rohit Ramchandra University of Auckland, Kalyanam Shivkumar UCLA, Sahib S. Khalsa studying interoception in human health at Laureate Institute for Brain Research. The list goes on.

From the vagus evolutionary biology side we have Edwin W. Taylor University of Birmingham and Tobias Wang Aarhus University, both leading scientists in their field- they already wrote a debunk of PVT of their own.

Again here, S. Porges stated their work as support for polyvagal theory - we are noticing a pattern here - by misinterpreting to the point they feel compelled to speak out about it.

Finally, leading evolutionary biologists of vertebrate social behaviour J. Sean Doody, Vladimir Dinets (they also debunked the PVT sociality claims in a separate paper ).

And the list goes on. (I can’t mention everybody individually, but feel free to search up some of the names yourself.)

I am not here, of course, to feed you the Who’s Who list of the autonomic regulation world - ultimately, it is about us understanding the sheer scale of the problem and cognitive dissonance between what we have been told (“PVT is your cutting edge science”) and the reality of scientific consensus across boards today.

The fact that all of these people went out of their way and joined their names on this total and unambiguous takedown, should tell us not only how peed off they are but speaks also of their concern - seeing junk science and pseudoscience sold to people like us, who work and influence the mental health of hundreds of thousands of people in need, day in day out. Have we, as a profession, been hoodwinked en masse?

The thing is: we can’t possibly critically assess the complex science behind the vagus physiology and evolution, and we’d believe almost anything, as long an authority figure tells us “This is real science“ and throws a bunch of references at us.

I’ll let you decide.

“WHY THE POLYVAGAL THEORY IS UNTENABLE.” - the Lowdown

Here are the main conclusions from the paper:

• The dorsal and the ventral vagal pathway don’t confere distinct ‘emotional’ or ‘psychological’ functions:

  • Furthermore, the dorsal vagus has never been shown to have anything do with heart-rate control in humans. The dorsal vagus is primarily responsible for influencing gut function.

  • The ventral vagus is important for controlling heart rate, whether during the experience of positive or negative emotions.

• Neither emotional freezing nor psychological dissociation

  among humans typically induce “massive“ or “lethal“ slowing of heart rate, making the notion of “dorsal vagal shutdown” a total bunk

• Non-mammalian vertebrates, such as reptiles, amphibians and birds exhibit complex social behaviors

• All vertebrates and not only mammals have the famous myelinated vagal fibers that allow for the fast autonomic reactions

• PVT assertions around the central vagal control of the heart are fictitious

• In sum, PVT proposes a line of argumentation that ignores the overwhelming scientific consensus

• As bonus, we find out that the latest PVT paper is supported by dodgy citations and poor scholarship practices. This is of course a MAJOR RED FLAG (you can see more in the original paper)

As a little story, do you remember the ‘super technical’ narrative we bought into about the myelination of the vagus fibers? Hearing and knowing about the myelination and how that determines our movement into socially engaged states really gave off that vibe of insider knowledge, didn’t it? Like reducing the complex and often impenetrable web of social life of humans to a simple alphabet. No wonder it stuck. The story goes like this - and I quote: “As a result of its myelinated pathways, the ventral vagus provides rapid and organized responses (Porges, 1997). In a ventral vagal state, we have access to a range of responses including calm, happy , meditative, engaged, attentive, active, interested, excited, passionate, alert, ready , relaxed, savoring, and joyful.”

Essentially, the PVT hinges on the ‘fact’ that myelinated cardioinhibitory vagal fibers are found only in mammals. Turns out that that this is a total bunk too. Unbelievable.

See the graph below, from the paper, synthesising the findings on the evolution of different aspects of the vagus nerve and its physiology, including myelination. The cardiac vagus is myelinated in all vertebrates.

Saving the Best for Last: the Social Engagement Polyvagal Neurobollocks

I have criticized this specific tenet of PVT before simply on the grounds that it is absolutely preposterous to claim that human sociality - including attachment(!) - all hinge on the anatomy and the physiology of one cranial nerve. I mean if that were the case, what is the whole social neuroscience as a discipline doing? Just fold it and close the shop. I still stand by that critique as sufficient to counter the quasi-totality of the PVT argument. But, for those who want to suffer more, the PVT is Untenable paper gives an in-depth rundown.

In a nutshell the PVT asserts that the specific branching and anatomy of the vagus nerve is causal of human and mammalian sociality - the social engagement system [In words of Stephen Porges, and I quote: “While reptiles and birds retain a brainstem region identified as the NA, they lack the myelinated cardioinhibitory vagal efferents that define mammalian autonomic flexibility and social engagement.”].

As we have seen before, the whole myelination limited to mammals is a bunk, but even if it wasn’t, the fundamental premise that only mammals are social is nonsense.

I quote here from the PVT is Untenable paper: “many nonmammalian vertebrates show significant levels of social behavior that overlap with many mammals, including (depending upon species) long-term pair-bonding, monogamy, mate guarding, extended and/or communal parental care sometimes, including nursing the offspring, sexual selection, complex courtship, social proximity seeking, shoaling and schooling and other social affiliative behaviors, communal nesting, prosocial choices, food sharing, social learning, developing theory of mind, reciprocal helping, eavesdropping, cooperative hunting, territoriality, dominance hierarchies, group vigilance, social-stress buffering, signaling and posturing.”

For reference see here and here.

The cover of the book: The Secret Social Lives of Reptiles.

It Is Anything But…

Some people with a good heart feel that it might all just be a big misunderstanding. It is the oversimplificators’ fault, it is the social media fault, those who commercialise it are to blame, those too eager to use it but don’t understand it. It is all just one big misunderstanding but the founding principles and the polyvagal theory, as proposed by Stephen Porges, are bona fide groundbreaking science and the path to follow to recover the social harmony and sense of safety. The original theory in its pure form is legit, only it has gotten out of hand - victim of its own success - and others have spoiled it.

We don’t want conflict, it’s a nice story, everyone gets to be a good guy and creates a form of plausible deniability.

I will argue that it is anything but by asking you to consider the following points:

1. So, the general public and the therapists are not getting it right (oversimplificators)

2. The experts are also too thick to get the polyvagal theory correctly. Okey. (misinterpretators)

3. Let me ask you now: who is actually getting it right? Seems to be only one person in the world.

I rest my case.

I want to say one more thing: the polyvagal theory, in its popularised form, has notoriously and explicitly been endorsed by its creator Stephen Porges - as his omnipresence in popular training events, conferences and book endorsements amply show.

So, I am sorry, I’m just not buying it. I will leave it at this gentle reader.

Appeal: Come And Help Us.

You heard the experts : the polyvagal theory is really untenable. And is potentially harmful. Now, if you still want to go away saying ‘Neh, I still think it’s science’, there is nothing more I, or anybody else for that matter, can say or do. But I am hopeful, dear gentle reader, you’ve got this!

Now, before this author leaves you to ponder that vital question, she would like to return to that recommendation that the scientists give to us, as a profession. You remember? Their recommendation is to:

“reorient and consider other already existing, as well as novel, psychophysiological explanations that are in line with modern conceptions and evidence regarding autonomic regulation of bodily functions”

Upon hearing that I kind of want to kick to ball back into their court and say: that is lovely, but how exactly do we do that? Please help.

I hope you can join me in that plea, dear gentle reader.

As always, thank you for reading and until the next time.

Further References

• Your common and critical sense.

• The present paper WHY THE POLYVAGAL THEORY IS UNTENABLE. An international expert evaluation of the polyvagal theory

• Fundamental challenges and likely refutations of the five basic premises of the polyvagal theory : point-by-point PVT takedown by Paul

• The evolution of sociality and the polyvagal theory

• Functional anatomy of the vagus system: How does the polyvagal theory comply? (Spoiler: it doesn’t)

• An overview of the phylogeny of cardiorespiratory control in vertebrates with some reflections on the ‘Polyvagal Theory’