Talks about Polyvagal theory, autism, and viewing life though the lense of the ANS

1. Social Behavior:
An Emergent property of the
phylogeny of the autonomic nervous
system
Stephen W. Porges, Ph.D.
Brain-Body Center
University of Illinois at Chicago
sporges@uic.edu
Acknowledgments
! Special thanks to:
Olga Bazhenova, Ph.D.
»
» John Denver
» Keri Heilman
» Jane Sorokin
» Elgiz Bal
! Funding provided by:
» NIMH Grant MH-60625
» NLMF Family Foundation
» Unicorn Children’s Foundation
» Cure Autism Now
Overview: The Polyvagal Theory
• Evolution provides an organizing principle to understand
neural regulation of the human autonomic nervous
system.
• Three neural circuits form a phylogenetically-ordered
response hierarchy that regulate behavioral and
physiological adaptation to safe, dangerous, and life
threatening environments.
• “Neuroception” of danger or safety or life threat trigger
these adaptive neural circuits.
• New models relating neural regulation to health, learning,
and social behavior may be reversed- engineered into
treatments.

2. The metaphor of safety: A basic principle
of our nervous system
Environment
outside the body
inside the body
Nervous System
Neuroception
Safety Danger Life threat
Spontaneously engages others
Defensive strategies
eye contact, facial expression, prosody
death feigning/shutdown (immobilization)
supports visceral homeostasis
Defensive strategies
fight/flight behaviors (mobilization)
Evolution
Neural Regulation of the Heart in Vertebrates
CHM DMX SNS AD/m NA
X+
Cyclostomes
Elasmobranchs X+ X-
X+ X- X+
Teleosts
X+ X- X+
Amphibians
X+ X- X+ X+
Reptiles
X+ X- X+ X+ X-
Mammals
Polyvagal Theory:
Emergent “Emotion” Subsystems
VVC SNS DVC
heart rate +/- + -
bronchi +/- + -
gastrointestinal - +
vasoconstriction +
sweat +
adrenal medulla +
tears +/-
vocalization +/-
facial muscles +/-
eyelids +/-
middle ear muscles +/-

3. Polyvagal Theory: Phylogenetic
Stages of Neural Control
Stage ANS Component Behavioral Function Lower motor
neurons
Myelinated vagus Social communication, Nucleus ambiguus
III
self-soothing and
(VVC – ventral vagal
complex) calming, inhibit
sympathetic-adrenal
influences
Sympathetic- Mobilization (active Spinal cord
II
adrenal system avoidance)
(SNS – sympathetic
nervous system)
Unmeyelinated Immobilization (death Dorsal motor
I
vagus feigning, passive nucleus of the
avoidance) vagus
(DVC – dorsal vagal
complex)
Polyvagal Theory: A Phylogenetic
Hierarchy of Response Strategies
Structure Function VVC SNS DMX
Head Communication +
Limbs +
Mobilization
+
Viscera Immobilization
Phylogenetic Organization of
the ANS: The Polyvagal Theory
head
viscera
limbs
trunk

4. Phylogenetic Organization of
the ANS: The Polyvagal Theory
head
“old” vagus
viscera
limbs
trunk
Vasovagal Syncope
Apnea/Bradycardia

5. Phylogenetic Organization of
the ANS: The Polyvagal Theory
head
viscera
limbs
trunk
Phylogenetic Organization of
the ANS: The Polyvagal Theory
Corticospinal Pathways
head
Sympathetic Nervous
System
viscera
limbs
trunk
Mobilization: Flight Behaviors

6. Mobilization: Fight Behaviors
Mobilization:
Fight/Flight Behaviors
Phylogenetic Organization of
the ANS: The Polyvagal Theory
head
viscera
limbs
trunk

7. Phylogenetic Organization of
the ANS: The Polyvagal Theory
head
Corticobulbar pathways
“new” vagus
viscera
limbs
trunk
Social Engagement
© Jeff Hunter/ The Image Bank
The “Smart” Vagus and
Social Engagement System
cortex
brainstem
Muscles of Head Turning
Cranial Nerves
Mastication
V,VII,IX,X,XI
Middle Ear Bronchi
Muscles
Facial Larynx Pharynx Heart
Muscles
environment

8. Social Engagement System:
Emergent Behaviors at Birth
Social Engagement System:
Self Regulation
Heart Rate Rhythms:
A measure of the “new” vagus
RESP
800
RSA
HP (ms)
0.10
900
60 BPM
1000
HPV
1100
1200
0 30 60 90 120
SECONDS

9. Looking and Listening: Common
Neurophysiological Mechanisms
Middle Ear Muscles:
Role in Extracting Human Voice
Borg & Counter, 1989
t
Scientific American
Social Engagement

10. Social Engagement and Otis Media?
The Face: A Critical Component
of a Social Engagement System
• At birth the mammalian nervous system needs a
“caregiver” to survive and signals the caregiver via
the muscles of the face and head.
• At term the corticobulbar pathways that regulate the
striated muscles of the face are myelinated.
• The face is “hardwired” to the neural regulation of
visceral state via a mammalian “neural circuit.”
• Metabolic demands, stress, trauma and illness
retract the “mammalian” neural circuit with the
resultant symptoms of a face that does not work and
social engagement behaviors are absent.
The Social Human Infant
Fantz, 1963

11. The Social Human Infant
Neonates can discriminate between direct
and averted eye gaze and look longer and
more frequently at faces with direct eye
gaze
Farroni, Csibra, Simion, & Johnson (2002). Eye
contact detection n humans from birth. Proceedings
of the National Academy of Sciences, 99, 9602-
9605.
My Child’s Face Does Not Work!
Gabriel Metzu, The Sick Child
When Other Faces Do Not Work!

12. When the nervous system fails use Botox!
Beauty is a journey that starts with a
choice… Learn about your
Choices
Autism
People Need People:
A Biological Basis for Social Behavior
Regulators of physiology are
“embedded” in relationships
M. Hofer
New York State Psychiatric Institute

13. How are the adaptive defensive
systems (flight, fight, and freeze),
which are mediated by the amygdala
and other limbic structures, inhibited
to promote the positive spontaneous
social behavior associated with the
Social Engagement System?
Neuroception
Life Threat
Amygdala
(central nucleus)
ventrolateral
Periaqueductal Gray
Freeze Autonomic State
(pyramidal tracks) (dorsal vagal regulation)
Inhibitory pathways
Excitatory pathways
Neuroception
Danger
Amygdala
(central nucleus)
dorsolateral and lateral
Periaqueductal Gray
Rostral Caudal
Fight Flight
(pyramidal tracks) (pyramidal tracks)
Autonomic State
(sympathetic)
Inhibitory pathways
Excitatory pathways

14. The Trustworthiness of Faces
R. Adolphs, 2002
Neuroception
Safe
FFA/STS Motor Cortex
Amygdala Medulla
(central nucleus) (source nuclei V,VII,IX,X,XI)
Social Engagement System
Somatomotor Visceromotor
(muscles of face & head) (heart, bronchi)
Inhibitory pathways
Excitatory pathways
Social Engagement System:
Observable Deficits in Several Psychiatric and
Behavioral Disorders
• Prosody
• Gaze
• Facial expressivity
• Mood and affect
• Posture during social engagement

15. The Polyvagal Theory:
Insights into the selection of outcome measures
Stephen W. Porges, Ph.D.
Brain-Body Center
University of Illinois at Chicago
sporges@uic.edu
Acknowledgments
Special thanks to:
• Olga Bazhenova, Ph.D.
• John Denver, Ph.D.
• Keri Heilman, M.A.
• Jane Sorokin, M.A.
• Elgiz Bal
Funding provided by:
• NIMH Grant MH-60625
• NLMF Family Foundation
• Unicorn Children’s Foundation
• Cure Autism Now
Overview: The Polyvagal Theory
• Evolution provides an organizing principle to understand
neural regulation of the human autonomic nervous
system.
• Three neural circuits form a phylogenetically-ordered
response hierarchy that regulate behavioral and
physiological adaptation to safe, dangerous, and life
threatening environments.
• “Neuroception” of danger or safety or life threat trigger
these adaptive neural circuits.
• New models relating neural regulation to health, learning,
and social behavior may be reversed- engineered into
treatments.

16. Polyvagal Theory:
Risk Assessment
Environment
outside the body
inside the body
Nervous System
Neuroception
Safety Danger Life threat
Spontaneously engages others
Defensive strategies
eye contact, facial expression, prosody
death feigning/shutdown (immobilization)
supports visceral homeostasis
Defensive strategies
fight/flight behaviors (mobilization)
Social Engagement System
Observable Deficits in Several Psychiatric and
Behavioral Disorders
• Prosody
• Gaze
• Facial expressivity
• Mood and affect
• Posture during social engagement
FXS
A compromised social engagement system?
http://www.fragilex.org

17. Behavioral Features of FXS
• Hyperarousal, distractible, impulsive
• Hypoarousal
• Difficulties in listening
• Sensory defensiveness
• sound sensitivities
• oral motor defensiveness
• Tactile defensiveness/hypersensitivity
• Poor eye contact and difficulties in social communication
• Speech-language delays (males)
• Anxiety
• Hypervigilance
• Affect regulation (e.g., tantrums)
• Shyness
• Low cardiac vagal tone
http://www.fragilex.org
Phylogenetic Organization of
the ANS: The Polyvagal Theory
head
“old” vagus
viscera
limbs
trunk
Vasovagal Syncope

18. Phylogenetic Organization of
the ANS: The Polyvagal Theory
Corticospinal Pathways
head
Sympathetic Nervous
System
viscera
limbs
trunk
Mobilization: Flight Behaviors
Mobilization: Fight Behaviors

19. Phylogenetic Organization of
the ANS: The Polyvagal Theory
head
Corticobulbar pathways
“new” vagus
viscera
limbs
trunk
Social Engagement
© Jeff Hunter/ The Image Bank
Polyvagal Theory: A Phylogenetic
Hierarchy of Response Strategies
Structure Function VVC SNS DMX
Head Communication +
Limbs +
Mobilization
+
Viscera Immobilization

20. Social Engagement System
Observable Deficits in Several Psychiatric and
Behavioral Disorders
• Prosody
• Gaze
• Facial expressivity
• Mood and affect
• Posture during social engagement
Social Engagement System
Anatomical basis
cortex
brainstem
Muscles of Head Turning
Cranial Nerves
Mastication
V,VII,IX,X,XI
Middle Ear Bronchi
Muscles
Facial Larynx Pharynx Heart
Muscles
environment
Heart Rate Rhythms:
An autonomic component of social engagement
RESP
800
RSA
HP (ms)
0.10
900
60 BPM
1000
HPV
1100
1200
0 30 60 90 120
SECONDS

21. My Child’s Face Does Not Work!
Gabriel Metzu, The Sick Child
Looking and Listening
Common Neurophysiological Mechanisms
Middle Ear Muscles:
Role in Extracting Human Voice
Borg & Counter, 1989
t
Scientific American

22. How are the adaptive defensive
systems (flight, fight, and freeze),
which are mediated by the amygdala
and other limbic structures, inhibited
to promote the positive spontaneous
social behavior associated with the
Social Engagement System?
Neuroception
Life Threat
Amygdala
(central nucleus)
ventrolateral
Periaqueductal Gray
Freeze Autonomic State
(pyramidal tracks) (dorsal vagal regulation)
Inhibitory pathways
Excitatory pathways
Neuroception
Danger
Amygdala
(central nucleus)
dorsolateral and lateral
Periaqueductal Gray
Rostral Caudal
Fight Flight
(pyramidal tracks) (pyramidal tracks)
Autonomic State
(sympathetic)
Inhibitory pathways
Excitatory pathways

23. The Trustworthiness of Faces
R. Adolphs, 2002
Neuroception
Safe
FFA/STS Motor Cortex
Amygdala Medulla
(central nucleus) (source nuclei V,VII,IX,X,XI)
Social Engagement System
Somatomotor Visceromotor
(muscles of face & head) (heart, bronchi)
Inhibitory pathways
Excitatory pathways
Social Engagement System:
Observable Deficits in Several Psychiatric and
Behavioral Disorders
• Prosody
• Gaze
• Facial expressivity
• Mood and affect
• Posture during social engagement

24. Social Engagement System
Where to look? What to measure?
Cortex ERP, EEG, EOP, fMRI
Autonomic heart rate, vagal tone
(RSA), respiration
Middle ear muscles impedance
words from noise
Facial muscles facial EMG, thermography,
video coding of faces
Laryngeal/pharyngeal acoustic properties of
muscles vocalizations, language
Gaze eye tracking
Control: 12 year old male
Eye 57%
106C
OFF % EYE % MOUTH %
32.6 57.18 10.22

25. Before Intervention: Autism 10 year old male
Eye 1%
111A
OFF % EYE % MOUTH %
39.31 1.15 59.54
After Intervention: Autism 10 year old male
Eye 71%
119B
OFF % EYE % MOUTH %
26.15 71.38 2.47
Fixation Duration Percent
90
80
70
60
50 Pre
40 Post
30
20
10
0
t(19) = -7.343, p <.0001

26. Fixation Duration Percent
70
60
50
Control
40
Pre
30
Post
20
10
0
OFF EYE MOUTH
Control/Pre F(1,38) = 39.005***, 69.207***, .219 ns
Control/Post F(1,38) = 21.371***, 14.551***, .030 ns
SCAN Test
12
10
8
Control
6 Pre
Post
4
2
0
SCAN FW SCAN CW
Control/Pre F(1,39) = 187.272***, 27.400***
Control/Post F(1,39) = 6.290**, 0.108 ns
Respiratory Sinus Arrhythmia
(ln msec2)
8
* Control * Pre * Post
7
6
5
4
3
Control/Pre F(1,38) = 16.067***
Control/Post F(1,38) = 3.805 ns
Pre/Post F(1,38) = 16.427***

27. What Needs to be Done?
•New Populations: Apply the Listing Project interventions to
individuals with language delays and older and more severe
autistic individuals
•Repeated interventions: Change protocol to evaluate the
effect of repeated interventions on the trajectory of individuals
in existing treatment programs.
•Describe the autistic nervous system: Validate neural
mechanisms mediating vulnerabilities in social engagement
and the behavioral changes following intervention (fMRI, NIRS,
ANS, facial EMG & IR thermography)
•Expand intervention strategies: Incorporate visual stimuli to
trigger multisensory neurons that facilitate language and social
communication.
Potential Applications of the Polyvagal Theory
in Psychiatry, Psychology, and Education
! Aspects of several physical and psychiatric diseases can be
explained as emergent properties of the neural regulation of the
autonomic nervous system (feedback, evolution, development)
! New diagnostic methods and new treatments can emphasize
measurement and manipulation of the neural regulation of the
autonomic nervous system.
! Environments can be designed to support the functions of the
nervous system with positive impact on social behavior and
emotion regulation
– Computers that modulate neural regulation of the ANS
– Quiet environments
– Nervous system “friendly” classrooms
– Improved social behavior: People need people – a biological basis
Summary
• “Neuroception” of safety or danger mediates the
beneficial consequences of social behavior.
• Autonomic reactions to challenges are organized in a
phylogenetically-determined hierarchy.
• Various atypical behaviors are adaptive for short
periods.
• Several psychopathologies are expressed as deficits
in the Social Engagement System.
• Biologically-based behavioral interventions can
trigger neural circuits that mediate positive social
behavior.