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Polyvagal Theory: What Is It and Should CBT Therapists Pay Attention?
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Polyvagal Theory: What Is It and Should CBT Therapists Pay Attention?

As polyvagal theory dominates therapy social media and reddit threads, CBT therapists face a crucial question: does this trending framework offer valuable insights for evidence-based practice?

Jan 30, 2025
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Polyvagal Theory: What Is It and Should CBT Therapists Pay Attention?
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What is Polyvagal Theory?

Polyvagal theory, developed by Stephen Porges, focuses on how the vagus nerve - extending from brainstem to internal organs - influences our stress responses and emotional states1. The theory proposes different branches of this nerve mediate various stress responses, from feeling safe and socially engaged, to states of fight-flight-freeze.

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The Polyvagal Ladder describes three states: ventral vagal, sympathetic stress response and dorsal vagal.

Therapists incorporating polyvagal theory pay attention to which state the client feels they are in, and work with it as a physiological response as well as a psychological state. This may include work such as somatic experiencing2.

Polyvagal Theory - Image from Polyvagalinstitute.org

Rather than a protocol or therapeutic modality, polyvagal is a theoretical approach that can be applied to any therapeutic modality or diagnosis. In particular, it can help clients understand how trauma stays within the body, particularly those who feel they are stuck in a state of immobilisation and disconnection3.

Should We Incorporate Polyvagal Into CBT?

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