trauma & attachment
Polyvagal Theory & “Interoception”: A Neuroscience Understanding of Attachment Trauma
by Lissa Rankin MD
Neuroception & Interoception
One way to begin healing developmental trauma is to learn about what the founder of Polyvagal Theory Stephen Porges termed “neuroception.” He uses the term neuroception to describe how neural circuits distinguish whether situations or people are safe, dangerous, or life threatening. He writes, “Because of our heritage as a species, neuroception takes place in primitive parts of the brain, without our conscious awareness. The detection of a person as safe or dangerous triggers neurobiologically determined prosocial or defensive behaviors. Even though we may not be aware of danger on a cognitive level, on a neurophysiological level, our body has already started a sequence of neural processes that would facilitate adaptive defense behaviors such as fight, flight, or freeze.”
In other words, neuroception is our autonomic nervous system’s response to real or perceived threat or safety- and it happens unconsciously. Our minds might know we’re safe, but if the body’s neuroception is firing “danger,” maybe because intimacy with other humans scares us because of developmental trauma, then our nervous system might be in conflict with what our conscious mind thinks.
For example, you might have a new partner- and your mind is saying, “This is great. We want closeness and intimacy!” But your nervous system might be firing, “Threat! Threat! Scary danger!” This may cause you to pull away, need an inordinate amount of personal space, and limit intimacy, even if some part of you craves it. Heartbreakingly, your avoidance of intimacy may then cause others to lean away from you- because you lean away first.
Your Autonomic Nervous System Anatomy
How does this happen inside the body? Let’s nerd out on the nervous system for a minute. The nervous system, which includes the brain, as well as the peripheral nervous system, has two main branches- the parasympathetic nervous system and the sympatheticnervous system. We typically think of the sympathetic nervous system’s “fight or flight” response as how we respond to danger, but fighting and fleeing are only two of four options when you feel threatened. You can also “freeze,” feigning death like a gazelle that might drop when a leopard chases it. If fighting back or fleeing fails, the dorsal branch of the vagus nerve fires and shuts down the gazelle, dropping the gazelle as if it has died. In this feigned death state, the leopard may pass it by. If it stops for a snack, the gazelle is neurologically “checked out,” dissociated out of its body and prepared to be eaten with minimal suffering.
Pete Walker, author of Complex PTSD, adds one more “F” to fight, flight, and freeze- “fawn [flocking].” While fawning may not help with a leopard, it may help with humans. “Fawn types seek safety by merging with the wishes, needs, and demands of others,” writes Pete Walker, the therapist who coined the concept of fawning as the fourth F. “They act as if they unconsciously believe that the price of admission to any relationship is the forfeiture of all their needs, rights, preferences, and boundaries.” Walker explains that fawning is another way a child responds to threatening situations. The child “learns that a modicum of safety and attachment can be gained by becoming the helpful and compliant servants of their parents. They are usually the children of at least one narcissistic parent who uses contempt to press them into service, scaring and shaming them out of developing a healthy sense of self.” These folks wind up apologizing for everything, even when it’s not their fault. They find it hard to speak up for their feelings and needs. They prioritize everyone else’s needs above their own and often become caregivers of their parents- and everyone else. They tend to flatter others and suck up to parents, teachers, and later on, colleagues, lovers and friends as a way to feel safe.
What if the threat is severe and chronic- and nothing else works? What if fighting or fleeing is too dangerous and fawning fails? If a child feels threatened enough during early childhood development, the child’s nervous system learns to default to the “freeze” response under threat. The unmyelinated dorsal branch of the vagus nerve fires, leading to nervous system collapse, which can be highly protective at the time, but in adulthood, it’s still the default when someone feels unsafe- but is actually safe.
There is such wisdom in our survival strategies! In the frozen state, the child may be able to avoid too much pain by dissociating, leaving the body, staying immobilized and invisible, and probably gaining access to esoteric spiritual states that may have been comforting at the time. None of this is her fault. She has done NOTHING wrong, although because she’s so little, she likely blames herself as a way to protect her dependency needs and attachment to the unsafe parents. Understandably, if the home is unsafe, it’s not safe to stay in your body. Checking out and hanging out with angels and spirit guides becomes a wise move.
Over time, the dorsal vagal branch of the vagus nerve will fire automatically in the face of even the slightest threat, like a low pitched noise that could signal a predator or even the slightest hint of the wrong tone of voice signaling anger or disappointment or shaming in someone else. The window of tolerance of the nervous system becomes hair trigger sensitive. Any little thing can cause the nervous system to fire “DANGER.” Others may wind up walking on eggshells around these folks.
In a healthy, less traumatized nervous system, when we feel safe, the myelinated ventral branch of the vagus nerve is active. This is the “rest and restore” aspect of the parasympatheticnervous system that we typically think of as the self-healing state of the nervous system, when the body fights off cancer cells, mounts immune responses against potential infections, repairs broken proteins, and otherwise cleans house. It’s also the social connection state, when we nurse our babies, cuddle our partners, and have safe, open-hearted, intimate conversations with our loved ones. In a healthy, less traumatized nervous system, when we feel threatened, we reach out for support from others. When a child develops a healthy nervous system, she grows up to reach out for safe others when she feels threatened, and those who love her co-regulate her until she calms down, cuddling her, talking and processing triggers, and repairing a sense of disconnection and lack of safety quickly.
But what if there were no safe others? What if Mom and Dad were checked out, gone, drunk or high, or traumatized themselves? She may grow up defaulting to the dorsal vagus nerve whenever she feels threatened. Then “others” become the enemy, leading to attachment wounding and intimacy avoidance, as well as many psychiatric and medical disorders caused by a misfiring autonomic nervous system that spends way too much time in a dorsal vagal freeze state, even when there’s no real threat. Instead of seeking out co-regulation to help calm her nervous system, she learns to isolate- because humans become scary. Intimacy becomes a threat, something to avoid, especially in the face of something unsettling, like a loved one who is experiencing a strong emotion or making her body feel uncomfortable.
What Happens When The Dorsal Vagus Becomes The Default Under Stress?
How can you recognize a dorsal vagal freeze state? We’ve all been there, so just think about a time when you felt publicly humiliated, deeply shamed, abandoned, and you felt like you wanted the ground to just swallow you up whole. You feel paralyzed, full of dread, unsafe. All the energy drains out of you and you can barely move. Your mind goes blank as you dissociate, getting out of your body lickety splitbecause it feels REALLY unsafe. You feel horrible- and you just want to disappear. When you feel like this, it’s really hard to reach out for support, which requires the ventral vagus, the nerve of social connection. The dorsal vagus leads to the opposite- social isolation.
If this is ongoing because of early childhood trauma and an adult winds up spending a lot of time in this dorsal vagal freeze state, it can predispose people to a whole host of medical syndromes that doctors rarely associate with a dorsal vagal state. We might call it “adrenal fatigue” because the sympathetic nervous system has run out of steam, but it goes beyond that. In addition to causing personality disorders and attachment wounding, a chronic dorsal vagal freeze state can also lead to psychotic states and other kinds of mental illness, because the mind makes up delusional stories to try to match the nervous system’s perceived sense of threat. (This might partly explain why so many people made up conspiracy theories this past year. Could joining the cult of Q be a trauma symptom of a traumatized nervous system- a confused mind trying to make sense of a nervous system firing THREAT? One can speculate…)
When this happens, the nervous systems of trauma survivors adapt to this frozen state. Folks learn coping strategies to pull them out of dorsal vagal freeze states- like addictive stimulants, extreme sports, or hypersexuality that move someone from the dorsal vagal freeze into a more mobilized sympathetic state, which can make you feel temporarily better. But caffeine, cocaine, porn, and working out only leads to a false sense of improvement. These folks still spend very little time in the optimal ventral vagal state of healthy, intimate, safe homeostasis. Over time, this takes a huge toll on physical and mental health.
These folks have a hard time maintaining intimate relationships because intimacy- even when they’re relating to someone who is actually safe- causes this dorsal vagal freeze state in the nervous system. Those who didn’t develop a healthy autonomic nervous system that reaches out to others in the face of threat and activates the ventral vagus nerve to engage social connection wind up terrified of intimacy, even when they also crave it. If someone gets too close, the traumatized nervous system collapses, especially if there’s any kind of rupture in the fragile feeling of safety these folks require. Any little slight can feel like a huge rift when the window of tolerance of what feels safe in an intimate relationship is very narrow.
Instead of connecting and repairing relationship ruptures, the way people who attach in healthy ways are inclined to do, someone in a dorsal vagal freeze state is likely to dissociate- or even fall asleep or otherwise lose consciousness- rather than heal the rift. This may play out as someone who needs a LOT of space to process any trigger- days, maybe weeks- before they feel grounded and present enough to even talk about what happened. As a result, people with access to healthy, secure attachment, who like and need more immediate repair, tend to give up on them.
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Treating Trauma Master Series
