Dr. Stephen Porges on Neuroception, Trauma, and the Polyvagal View of Depression and Anxiety

When someone lives through trauma, the wiring that scans for danger gets recalibrated. Events that are actually neutral start registering as threats. I like to compare neuroception to having your own personal TSA agent. Imagine an airport where the only guaranteed way to keep every terrorist off a plane would be to let no one board at all. That is roughly the stance a traumatized nervous system takes: nobody gets on. It reads as an adaptive move, a way to drive risk down to zero, because the system refuses to gamble. The person themselves may genuinely want closeness and connection, but the nervous system is calling the shots in a way that overrides those wishes, and that split is often what carries them into a therapist's office.

Eric: That maps onto what a lot of people describe as depression, doesn't it. The flatness, the fatigue, the sense of running on empty. Could you say something about how the nervous system expresses depression compared with anxiety?

Dr. Porges: Sure. The moment we reach for psychiatric diagnoses, we actually flatten out what Polyvagal Theory can tell us, because those diagnoses are closer to phrenology than physiology. They come out of clinicians sitting in a room, pooling their descriptions of a disorder. Polyvagal Theory works from a different starting point. It names the physiological state underneath the behavior. A state of shutting down, of lethargy, of drained energy is something the theory can account for directly. A state of mobilization, of fight or flight that then spills into anxiety, is also something it can account for. Diagnostic categories blur this, because depression sometimes carries anxiety with it and sometimes does not, and you end up in long, tangled debates over which label fits. Polyvagal Theory would rather leave those arguments to other people. Our job is to describe what your body is doing and what adaptive purpose it is serving.

So if you are keyed up with that coiled, tightly wound energy, you are clearly in a mobilized defense. If your muscle tone collapses and you cannot lift yourself out of the chair, the body is trying to vanish. It is immobilizing through fear, aiming to become an inanimate thing. Dissociative states, which follow from certain kinds of trauma, belong to that same family of disappearing and going still.

Eric: Helpful. Staying with the diagnostic side for a moment. You have talked before about borderline personality disorder, and about how, in that pattern, a person grows more and more frightened as a social encounter unfolds, which is the reverse of what happens when someone is well regulated and settles into greater safety as the interaction goes on.