Thursday, 14 August 2014

Polyvagal Theory and the origins of Chronic Fatigue

My recent reading has led me to discover a theory first identified by Stephen Porges on Polyvagal theory of development. This states that there are three levels of the autonomic nervous system which relate to which era of our evolutionary development they originated in.
  1. The unmyelinated vagus nerve which developed 500 million years ago in the fish. Myelin is the covering or sheath around nerve fibres which makes them insulated and able to transfer nerve impulses very fast so without it the messages are necessarily slower. 
  2. The sympathetic nervous system (or fight' and flight' system as many know it) which is based on basal ganglia from the spinal cord - this comes from our mammalian past.
  3. The myelenated vagus belonging to the parasympathetic system which is the opposite to fight and flight in that it is responsible for calming us down and giving us time to relax and enjoy interaction with others (the social bonding system).
If this is down-regulated as it often is with chronic stress we will be forced into the level below (i.e. sympathetic dominance) where we are ready to 'fight the tiger', our heart rate will be high, and our gut unable to function as blood is diverted away from it - hence churning and IBS symptoms. If our systems are even more exhausted (as they are with years of chronic pain in for instance chronic fatigue syndrome) then the other two levels are hijacked and we operate in the 'freeze' mode of the unmyelinated vagal system (freeze state) whereby nothing works. Our energy levels are so low we cannot function, even the most moderate tasks exhaust us. Our mitochondria are getting the signal to 'go slow'.. It down-regulates all metabolic activity. We are operating at the level of a reptile.

The next question is why and this is where my researches and experience working with people suffering from chronic fatigue shows me that subconscious trauma (perhaps more accurately termed unresolved emotion) seems to be the key here. If, in early life, the person suffers a traumatic experience and interprets that they are worthless or dangerous, then any subsequent event which plays into this subconscious belief system will trigger the body to go into a meltdown freeze state. The earlier the traumatic event in the person's life the more likely this is. Women also seem to be more biologically prone to this as men are more likely to go into fight and flight.

There may be periods of remission where the person has a reasonable ability to function but the next event which triggers these subconscious beliefs they will go downhill again. Thus it explains both the metabolic fatigue and the relapse and remission cycle common to all fatigue syndromes (ME, CFS, Fibromyalgia). Remember these events are recorded in the emotional brain or limbic system with the sensations and emotions that they first caused. They are processed differently from normal memories and may get 'stuck' in the emotional brain/limbic system where they continue to dictate behaviour and  symptoms.

I want to present this theory to the chronic fatigue community - including other clinical professionals at a webinar specifically set up so that we can understand why tinkering at the top level i.e. with diet and pacing can seldom work, if it doesn't approach the real underlying causes of the subconscious neural processing. Thus in summary, we are emotional beings with three increasingly sophisticated nervous systems overlaid on top of eachother (note also this occurs in the brain as well - see the Triune brain theory) - the final one belonging to a reptilian past. If, due to life circumstances this one becomes dominant as the others are suppressed, then our life becomes severely and devastatingly limited. In the next blog I'll be talking about how we can reverse this suppression with various tools from energy psychology.

With thanks to the writing of Peter Levine for these insights and my clients for their practical application.


  1. p,s A new client of mine has pointed me in the direction of an American programme called Dynamic Neural Retraining System which appears to support my theory. I note that on the DNRS website they state that "Chronic Fatigue Syndrome is a Limbic System condition brought on by neurological trauma which may involve viral, environmental and/or psychological factors. The way in which the brain/mind/body expresses this trauma is unique to each person...

    The condition of Chronic Fatigue indicates that the brain is stuck in a distorted self-protective mechanism centered on energy conservation.

    This cross-wired neuronal circuitry directly affects the physiology of the body and manifests in a range of neurological, immunological and endocrine system abnormalities.

    In response to a chronic trauma cycle the body's abilities to rest, digest or regenerate are affected interrupting the normal growth cycle and detoxification process catapulting the brain and body into a cycle of chronic illness. "
    I wish the team responsible for the POTS theory (see next blog) and other symptomatic diagnoses were aware of this...