**🔼 Up:** [[❍ Nervous System Work]] **\#️⃣ Tags:** #NervousSystem --- ![[TDGAHPVN.png]] - [[The Definitive Guide to Accessing the Healing Power of the Vagus Nerve#Introduction|Introduction]] - [[The Definitive Guide to Accessing the Healing Power of the Vagus Nerve#Why the Vagus Nerve Matters|Why the Vagus Nerve Matters]] - [[The Definitive Guide to Accessing the Healing Power of the Vagus Nerve#Understanding the Autonomic Nervous System with Polyvagal Theory|Understanding the Autonomic Nervous System with Polyvagal Theory]] - [[The Definitive Guide to Accessing the Healing Power of the Vagus Nerve#The Social Engagement System|The Social Engagement System]] - [[The Definitive Guide to Accessing the Healing Power of the Vagus Nerve#Exercises to Restore Ventral Vagal Social Engagement|Exercises to Restore Ventral Vagal Social Engagement]] - [[The Definitive Guide to Accessing the Healing Power of the Vagus Nerve#Applying This Work to Chronic Conditions|Applying This Work to Chronic Conditions]] - [[The Definitive Guide to Accessing the Healing Power of the Vagus Nerve#Living with Vagal Awareness|Living with Vagal Awareness]] --- # Introduction Stanley Rosenberg presents a powerful approach to health, wellbeing, safety and regulation in his book [[Accessing the Healing Power of the Vagus Nerve by Stanley Rosenberg|Accessing the Healing Power of the Vagus Nerve]] by focusing on something most of us (including the traditional medical field) don't really consider in our day-to-day lives—the proper functioning of our vagus nerve. Drawing from Stephen Porges' Polyvagal Theory and over 35 years of experience as a rolfer and craniosacral therapist, Rosenberg bridges modern neuroscience with ancient wisdom to deliver the message that many of our physical ailments and emotional struggles may stem from dysfunction in our vagus nerve. More importantly, he suggests we can directly influence through specific exercises and techniques which overtime helps us to build vagal tone and bring us into a state of social engagement. What makes this approach special is the understanding that social engagement relies on a network of five cranial nerves working in concert, not just the vagus nerve alone. While many approaches focus solely on "toning" or "stimulating" the vagus nerve, this approach recognises that true healing comes from addressing the entire neural orchestra responsible for social engagement. The vagus nerve (CN 10) is a key player, but the other four nerves (CN 5, 7, 9, and 11)—which we'll explore in detail later—must work harmoniously with it to create a state of wellbeing. This guide will walk you through the core concepts and understanding from Rosenberg's work whilst also presenting the self-led exercises (including how to do them) so you can easily build the focus of working with your vagus nerve into your daily routine and be on your way to more relaxation, relief from anxiety and improved social connection. The best part is, the exercises are made for average people like you and me who perhaps haven't found solutions to our health needs within existing treatment modalities. Many of us have a hard time affording getting help and treatment. The techniques and exercises in this guide are completely free, require no equipment, are incredibly easy to do whilst being safe, and can be done in just a few minutes per day. Let's go! # Why the Vagus Nerve Matters The Vagus Nerve can be thought of as the conductor of the body because it acts as a communication network that integrates all our organ systems. It is the 10th out of 12 cranial nerves, and it is very special because it is the only cranial nerve which leaves the head and neck and connects into or innervates all other organ systems in the body. It winds all the way from the brainstem down through the face, throat, heart, lungs and into the digestive organs. It touches and connects into nearly every system involved in how we feel, connect and heal. It acts as the sensing system—the ears, eyes, nose and mouth—of our inner organs. While our usual five senses give us information about the outside world, the vagus nerve tells the brain about our inside world through bi-directional communication which carries messages between the organs and the brain. ![[AHPVN — 2.png|400]] ***Figure 1*** When the vagus nerve is functioning well through its ventral branch it supports our rest, breathing, digestion, emotional regulation, facial expressions, muscle tensions and our ability to connect with others. The ventral vagal state lays our foundation for friendship, authentic connection, joy and good health. When this system is compromised though, the effects cascade throughout the body and all areas of our lives. Rosenberg links a compromised ventral vagal system to everything from migraines, neck and shoulder tension, and digestive issues, to anxiety, depression, [[✦ Trauma]], PTSD and even ADHD or autism. [[❍ Nervous System Work]] and subsequent knowledge around the vagus nerve has been becoming popular lately within healing circles (and for good reason), but it's still sorely overlooked in the traditional medical system. Because it innervates so many organs in the body, if this conductor and communication network is working sub-optimally, it sends compromised and potentially inaccurate messages up to the brain. The brain then sends out instructions based on this information which can lead to us feeling unwell—even if the organs themselves are fine and all the standard medical tests are saying there's nothing wrong. # Understanding the Autonomic Nervous System with Polyvagal Theory The prevailing view of the autonomic nervous system splits our experience into two basic lenses—sympathetic (fight or flight) and parasympathetic (rest and digest). But this traditional model has some big limitations. One of the major issues with the old way of looking at our nervous system is that it just lumps the entire parasympathetic system into one category or one mode—rest and digest. But that view fails to recognise that the vagus nerve itself has two distinct and unique branches. So then how then could we explain states that come with overwhelm, shock, helplessness or chronic depression? It didn't, and this was the other major issue. It also doesn't explain the physiological conditions we need for connection, safety and intimacy. That's where Stephen Porges' Polyvagal Theory—introduced in 1994—came in. Although no theory can ever represent what's happening in true reality, it provides a much more accurate map of our autonomic nervous system than our prevailing understanding. It helps us to understand why traditional stress management techniques often fall short and offers a more nuanced understanding of how our nervous systems [[✦ Attunement|✦ Attune]] to and respond to the world around us. ## The Three Circuits Polyvagal Theory proposes that our autonomic nervous system functions through three distinct circuits that are organised in a hierarchy with each having developed at different points in our evolutionary history: ![[AHPVN — 1.png]] 1. **Dorsal Vagal (Freeze, Collapse, Shutdown)** — The oldest circuit that's present in all vertebrates from primitive fish upward. This pathway activates when we face overwhelming danger (either real or perceived) and we find ourselves feeling helpless or hopeless, i.e. mobilising into Sympathetic doesn't seem possible. 2. **Sympathetic (Mobilisation, Fight, Flight)** — This circuit evolved later and enables our fight or flight response. When we perceive threat, the sympathetic nervous system activates the body and prepares it to fight or flee through muscle tension, redirected blood flow, a change in stress hormones and increased heart rate. 3. **Ventral Vagal (Rest, Connection, Safety)** — The most recent and uniquely mammalian (although some non-mammalian animals have a ventral circuit, though it's not like ours) circuit that supports social engagement, rest, calmness, a sense of safety, relationships and connection. When this nervous system is active, the body feels safe, the voice softens, our faces become expressive and we're more open to engaging with others, co-regulating and healing. ## Neuroception At any given moment, our nervous systems are adjusting its state based on how it senses and perceives is happening in our environment. This is what Porges calls "Neuroception" and it's something that happens below awareness in the primitive parts of the brain, constantly monitoring sensory information from both our internal bodily states and the environment. When neuroception is functioning well, our responses are appropriate based on what's going on in the present moment. When we detect safety, the ventral branch of the vagus nerve activates. On the other hand, our nervous systems can perceive risk and become dysregulated as a result even when there is no immediate risk and we are safe—the cliché of how modern humans are no longer being chased by tigers, yet are still dysregulated as if we were. Rosenberg calls this "faulty" neuroception but that's perhaps a bit too pathologising. Highly attuned neuroception to both real and perceived threat isn't faulty, rather it's an learnt and integrated experience of how we experienced our environments whilst growing up as children, as well as due to traumatic experiences. When this happens, our nervous system shifts down into either sympathetic activation or the dorsal branch of the vagus nerve. Feeling safe isn't just a psychological comfort but a biological necessity because only in safety can our body direct its resources toward healing and growth rather than defence and survival (see: [[Survival Attunement distorts our entire way of being|Survival Attunement]]). This is why Rosenberg emphasises creating the conditions where the body can recognise safety and heal by activating the ventral branch of the vagus nerve, which is necessary for social engagement. # The Social Engagement System Everyone in this space bangs on about the vagus nerve as if it were the only character in this story. In many ways it is, but there's actually five cranial nerves in total that need optimal functioning for social engagement. A lot of focus seems to be placed solely on 'stimulating' and 'toning' the vagus nerve, and this is precisely why Rosenberg's approach to working with the vagus nerve is so insightful and powerful because full and functional social engagement is a little more nuanced than this. While the vagus nerve itself is of course pivotal, the other four cranial nerves are also crucial for healthy social engagement—it is a team effort. ## The Five Cranial Nerves These five cranial nerves all originate in the brainstem and work synergistically to coordinate things like facial expression, vocal tone, eye contact, neck and head movement, swallowing and even how we listen: 1. **CN 5 (Trigeminal) —** Responsible for jaw movement and facial sensation. It plays a key role in how well we're able to listen to and understand conversation. 2. **CN 7 (Facial) —** Responsible for controlling the tensing and relaxing of individual muscles in the face. It also innervates a tiny muscle in the middle ear which helps to reduce the volume of sounds above and below the frequency of the human female voice (which allows infants to effectively hear their mother's voice). 3. **CN 9 (Glossopharyngeal) —** Plays a role in swallowing and carries sensory information from the throat, tongue and middle ear. It helps regulate breathing by keeping track of carbon dioxide levels in the blood. 4. **CN 10 (Vagus - Ventral Branch) —** We know this one well. The ventral vagus innervates the muscles of the throat, vocal cords and upper oesophagus. It helps slow the heart, calm the body, sooth vocal tone, steady the breath and facilitates the shift into rest, digest and connect. 5. **CN 11 (Spinal Accessory) —** Controls the sternocleidomastoid (SCM) and trapezius—the muscles responsible for moving the head and shoulders. These muscles allow us to move our head smoothly and expand our visual field. When they're chronically tight (as they are with many of us), our ability to physically orient toward others and the environment is restricted, and this affects how others interpret us too. When all five of these nerves are working harmoniously together, we orient toward the world with [[✦ Presence]]—we are within our [[Working With Our Window of Tolerance|Window of Tolerance]]. We hear, speak, respond and connect well with others and our environment in real-time. But when one or more of these nerves aren't working the best—whether that be through unresolved [[✦ Trauma]] or a pure physiological issue—the social engagement systems starts to break down. Suddenly, our voice flattens. We might be harder to read. Our face might lose it's light and expression. It's harder to connect with ourselves, and others might misinterpret us as distant or disinterested (which can reinforce the [[Understanding Traumatic Invalidation|invalidation]] cycle and have us believe we're broken or deficient), when really, our nervous system is just protecting us. # How to Tell If Your Social Engagement System Is Struggling With the understanding of neuroception, our bodies speak a subtle language about the state of our nervous system and subsequently, our way of being. Rather than thinking in pathologising terms like "dysfunction" or something being "wrong", it's more helpful to recognise when our social engagement system might be struggling and trying to protect us. When our social engagement system isn't functioning the best, we might notice emotional shifts like: - Struggling with persistent low mood or flat emotional states. - Finding it hard to feel joy or enthusiasm when we're socialising. - Experiencing anxiety in situations that probably should feel safe. - Feeling disconnected from others, even when we want to connect. - Noticing that social interactions leave us more drained rather than energised. In terms of physical signs, our bodies might signal that we're in protection mode through: - A forward head posture. - Cold hands and feet from poor circulation. - Digestive issues that flare up around stress. - Jaw tightness or teeth grinding (especially at night). - Tension in the neck and shoulders (those trapezius muscles). - Shallow breathing—into the chest rather than the diaphragm. - Lack of range of motion in head and neck movement (the sternocleidomastoid muscle). ## Simple Experiments to Test the Vagus Nerve There's a couple of really easy and straightforward tests you can do to gauge how your social engagement system is functioning: 1. **The Soft Palate Test —** Examines how well the pharyngeal branch of your ventral vagus nerve activates the muscles in your soft palate (the back of the roof of your mouth). 2. **The Trap Squeeze Test —** Looks at the function of cranial nerve 11 (the spinal accessory nerve) which controls the trapezius muscles on the tops of your shoulders. Both tests are simple to perform and can be used before and after exercises to gauge improvement in your nervous system regulation. Head over to [[Vagal Assessment — Discovering Your Nervous System State]] for details on how to do these tests. # Exercises to Restore Ventral Vagal Social Engagement Below are the core fundamental exercises for restoring the social engagement system and therefore the ventral branch of the vagus nerve: 1. [[Basic Exercise for the Vagus Nerve|Basic Exercise]] — Draws on principles from osteopathy and craniosacral therapy and works by using simple eye movements while supporting the back of the cranium to activate the neural pathways that help to shift our nervous system into a socially engaged state. 2. [[Osteopathic Technique for Treating Hiatal Hernia|Stomach Pull-Down]] — An effective visceral massage technique to encourage the stomach to release from the diaphragm to address function of the ventral branch of the vagus nerve that is responsible for social engagement. 3. [[Salamander Exercise for the Vagus Nerve|Salamander Exercise]] — Works to progressively increase flexibility in the thoracic spine and free up movement in the joints between the individual ribs and the sternum. It improves breathing patterns, enhances vagal feedback loops, and helps relieve tension in the neck and shoulders. 4. [[SCM Exercise for the Vagus Nerve|SCM Exercise]] — Focuses on the sternocleidomastoid (SCM) muscles which are innervated by the 11th cranial nerve to relieve tension in the neck and increase mobility. It brings about noticeable improvements relatively quickly, supporting activation in the ventral branch of the vagus nerve. I'd recommend performing these in the order as above—there's a nice rhythm and flow to this. ## The Rotation Test For Muscle Stiffness Before and after doing any of these exercises, but particularly the [[Basic Exercise for the Vagus Nerve|Basic Exercise]], you can do the rotation test to check muscle stiffness and range of motion: - Turn your head slowly to the right and left. Note where any pain or stiffness occurs. - If pain appears on the side opposite of the direction you've turned toward, it likely involves the trapezius or SCM. The [[Salamander Exercise for the Vagus Nerve|Salamander Exercise]] and [[SCM Exercise for the Vagus Nerve|SCM Exercise]] will work on this. - If pain occurs on the same side of the direction you've turned toward, it likely involves the levator scapulae, which is secondarily engaged in the [[SCM Exercise for the Vagus Nerve|SCM Exercise]]. ## When to Do Them and How Often You can do these exercises pretty much anytime you're feeling stressed, anxious, overwhelmed or dysregulated. Of course, you don't need to be feeling any of those things to do them since they has benefits regardless. If you are experiencing sympathetic or dorsal nervous system activation, the [[Basic Exercise for the Vagus Nerve|Basic Exercise]] alone is quick, easy and great to do situationally. In any case, some ideas of when you could do them: - First thing in the morning before you start your day. - During stressful situations to prevent getting stuck in fight-or-flight. - When feeling emotionally overwhelmed or shut down. - Before social interactions. - After prolonged digital screen use. - When experiencing symptoms like tension headaches, anxiety, digestive issues, or breathing difficulties. In terms of frequency, it's a good idea to do this at least 1-2 times per day. Personally I do it once after I wake up, and once before I go to bed. I find that it helps me relax, get to sleep faster and experience deeper sleep during the night. ## What to Expect During and After While doing any of these exercise there's a few signs to look out for that your nervous system is shifting. **During:** - A natural yawn, sign, swallow or deeper breath. - General feelings of relaxation and calmness. **After:** - Increased range of motion when turning your head and a decrease in muscle stiffness and tension (confirmed by doing the rotation test). - Deeper and easier breathing. - Mental clarity and calmness. Most people notice immediate benefits, though the full effects can develop over the next few hours as the body integrates the changes. At first, the changes and improvements might be subtle but tend to become more noticeable with consistent practice. # Applying This Work to Chronic Conditions Rosenberg connects vagal nerve function to a surprising range of chronic conditions throughout the book of which he's had extensive experience with in his clinical practice. While this approach offers insights for many conditions, we need to remember that restoring proper vagal function creates the foundation for healing rather than being a cure all. It is not a panacea, and therefore shouldn't be treated as such. Addressing vagal function doesn't replace appropriate medical care, but it can complement it by creating the physiological conditions which are more conducive to healing and wellbeing. ## Migraines and Headaches Sub-optimal functioning of the eleventh cranial nerve (CN 11) plays a significant role in migraines because it controls tension in the sternocleidomastoid (SCM) and trapezius muscles. When these muscles develop problematic tension patterns, they can trigger pain that manifests as migraine headaches. When the eleventh cranial nerve isn't functioning well, the ventral brach of the vagus nerve (CN 10) and the ninth cranial nerve (CN 9) are usually also compromised. The [[Basic Exercise for the Vagus Nerve|Basic Exercise]] works to restore function to all three of these nerves (including the other two—CN 5 and CN 7). ## Neck and Shoulder Pain Sore and/or stiff neck and shoulder muscles commonly relate to muscle tension in the sternocleidomastoid (SCM) and trapezius muscles, which are innervated by CN 11. When this nerve is functioning sub-optimally, these muscles are unable to maintain an ideal resting tension where they might be too tight or unable to engage properly, therefore leading to pain. Research shows that a well functioning ventral vagus nerve is essential for achieving lasting results with techniques aimed at releasing muscle tension in the shoulders. This explains why some massage or physical therapy interventions might provide temporary relief—dysfunction of the vagus nerve (CN 10) is directly mirrored in the dysfunction of CN 11. Both need to be address for lasting improvement. Both the [[Salamander Exercise for the Vagus Nerve|Salamander Exercise]] and the [[SCM Exercise for the Vagus Nerve|SCM Exercise]] address the sternocleidomastoid (SCM) and trapezius muscles. ## Digestive Issues The vagus nerve (CN 10) is central to regulating digestion, with both its dorsal branch and ventral branch influencing our digestive function. A sub-optimally functioning ventral vagus can lead to many digestive issues. The vagus nerve innervates basically the entire digesting tract from the oesophagus to the large intestine, so it plays a crucial role in digestion, nutrient absorption and proper elimination. Digestive function suffers in a number of ways when the ventral vagal state is compromised. Acid reflux, irritable bowel syndrome (IBS), constipation, bloating, nutrient malabsorption, and inflammatory responses can all stem from poor vagal tone. Hiatal hernia is just one example that can be relieved by addressing vagal nerve dysfunction through the [[Basic Exercise for the Vagus Nerve|Basic Exercise]] followed by the [[Osteopathic Technique for Treating Hiatal Hernia|Stomach Pull-Down]] to relax the upper oesophagus and help the stomach return to its proper position. ## Anxiety and Panic Attacks When we're anxious or having a panic attack, our body is literally stuck in an emergency state. Our nervous system is either revving too high (fight-or-flight) or shutting down (freeze). Instead of traditional approaches to managing anxiety like talking about it or taking medication, we can instead work to restore the social engagement system. The exercises help to activate the ventral vagal pathway that tells our body and nervous system that we're safe. When we practice this in moments of rising anxiety, we're essentially showing our nervous system that the situation we are in now is okay and safe. With practice over time, we can help teach the nervous system that it's okay to return to safety, even when we're triggered. ## Trauma and PTSD Trauma, or even the memory of a traumatic experience, can lead to structural changes like rotation of the first two cervical vertebrae (C1 and C2) which then potentially affect blood flow to the brainstem and the cranial nerves involved in social engagement. The goal of the [[Basic Exercise for the Vagus Nerve|Basic Exercise]] is to directly improve the alignment of C1 and C2 vertebrae. Rosenberg also makes an important distinction being post-traumatic stress, which is associated with sympathetic activation—fight or flight, and post-traumatic shutdown, which is associated with dorsal vagal activity—immobilisation with fear. He says that after trauma, many people are actually left in a state of dorsal vagal activity with depressive behaviour rather than a state of chronic stress, but are still describing their condition as post-traumatic stress. This is problematic for a few reasons, but primarily because it may lead us to the wrong or just ineffective treatments. The overall goal of healing trauma is to lift us out of these defensive states and into social engagement by improving ventral vagal function. This provides a physiological explanation for why trauma is described as "stuck" in the body and offers a direct path to release through nervous system regulation. ## Depression Depression is often accompanied by a state of dorsal vagal dominance, which explains the withdrawal, lack of energy, and disconnection experienced. Before Polyvagal Theory, there was no clear physiological model for these dorsal vagal issues, making effective, non-pharmaceutical treatments for depression difficult to develop. By using techniques to establish social engagement and improve ventral vagal function, Rosenberg says it's possible to address depression at its physiological root. Low heart rate variability (an indicator of low ventral vagal activity) has been consistently linked to various psychological problems, including depression. ## ADHD and Autism Low heart rate variability is linked to difficulties with concentration and motor inhibition, which are symptoms commonly found in children with ADHD. This suggests a potential connection between lower ventral vagal activity and certain ADHD symptoms. For autism, the focus is on the specialised functions of cranial nerves going to muscles in the middle ear (CN 5 and CN 7) and how proper listening enables social engagement. Rosenberg suggests that issues with listening and processing human voices in autism might relate to poor function of these nerves. The [[Basic Exercise for the Vagus Nerve|Basic Exercise]] can improve hearing by increasing blood flow to the brainstem where CN 5 and CN 7 originate. In his work, Rosenberg found that evaluating and addressing the function of CN 5, 7, 9, 10, and 11 in those with autism can help improve communication skills and social behaviour while also stabilising the shifts between states of stress and withdrawal often seen in autism. # Living with Vagal Awareness Understanding and working with our vagus nerve opens a new dimension in how we approach our healing, health and wellbeing. For deep and lasting healing to occur, we need to not only be safe, but also feel safe. Throughout this guide, we've explored how the social engagement system forms the foundation for our feelings of safety, connection, and physiological regulation. The techniques and exercises presented here offer daily practices we can use to support our nervous system, without the need for any special equipment or extensive training. Remember that this work is both immediate and progressive. You might see quick shifts in how you feel after doing the exercises, but the deeper benefits come from building a safe and long-lasting relationship with your nervous system over time. [[Go slow and be kind to yourself|Go slow, be kind to yourself]] and [[Meet yourself exactly where you're at]]. It's not a race, and we're not trying to brute force our way in here to try and fix things up because [[We're not broken, we're not deficient, and there's nothing missing|we're not broken]]. Every time we help our body return to a state of social engagement, we're widening our [[Working With Our Window of Tolerance|Window of Tolerance]] and strengthening its ability to find and maintain that state more effortlessly in the future. Good luck, and all the best!