#35: Polyvagal Theory Demystified: How Your Nervous System Drives Healing with Amy Sullivan
MAY 29, 2025
Powered by RedCircle
What if your emotions started in your body – not your brain? In this insightful conversation, Anna sits down with licensed clinical counselor, author, and international trainer Amy Sullivan to explore the life-changing lens of Polyvagal Theory. Known for her warm, accessible teaching style, Amy breaks down the nervous system's three core states and how they shape our sense of emotional safety, trauma response, and ability to connect.
You’ll learn:
What the vagus nerve is and why it matters for trauma healing
The difference between feeling safe vs. being safe—and why it matters
How shutdown, anxiety, and calm each have "safe" and "unsafe" versions
Somatic and expressive arts practices to help regulate your nervous system
Why co-regulation (even with pets!) is essential for healing
Whether you’re a therapist, trauma survivor, or just curious about your emotional wiring, this episode is full of empowering insights that can help you reconnect with safety and presence.
Episode Links:
Transcript
Anna: Hello, dear friends, and welcome to Courage to Heal. I am super excited about today's guest because we are going to talk about something that's both important and interesting to anyone who's trying to heal trauma. I am very pleased to introduce you to Amy Sullivan. Amy is a licensed clinical counselor, speaker and author, best known for her expertise in the clinical application of polyvagal theory with a background in body work and trauma healing.
She blends EMDR, somatic practices and Polyvagal Theory to support post-traumatic growth. She's a senior international trainer with Deb Dana's team and the founder of Rooted Compassion Counseling and Consulting in Cincinnati. She's currently co-authoring a book on polyvagal theory and children's therapy, and is celebrated for her engaging story reach, teaching style that makes complex concepts accessible and impactful.
Amy, welcome to Courage to Heal.
Amy: Thanks. I'm glad to be here.
Anna: All right. So Amy, I want to dive right in and ask, ask you let's dope. If you can give us an introduction to Polyvagal theory in that digestible, easy to understand way.
Amy: Yeah, so the Polyvagal theory was created by Steven Porges after many years of research.
He started his studies in the NICU, the neonatal intensive care unit. So, he was working with newborns and studying heart rate variability. And through that study he started to discover that there were key points for babies in terms of how they attach to their caregivers.
And out of that knowledge grew the polyvagal theory, which describes how our nervous system is involved with our sense of felt safety. And when I say felt safety, I mean emotional safety. So, in general, people understand safety as a concept that is physical in nature. We're either physically safe or unsafe.
Polyvagal really brings a new layer to understanding emotional safety. And basically, what the polyvagal theory tells us is that the emotions that we experience actually start in the body. So, I like to introduce this idea, asking people how do you know when you're afraid? So if you could answer that, what would you say?
Anna: Hmm. How do I know that? I'm afraid I would say I, I feel like an unpleasant feeling in my chest. Maybe my heart starts beating faster. Mm-hmm. And I kind of wanna curl up and maybe run away.
Amy: Yeah. Yeah. So, you indicated some body sensations as well as the feeling of wanting to be small or this urge to maybe flee.
To escape what's happening. And that follows right along with the polyvagal theory. So what we know now is that our emotions start as sensations in our body. And everybody's is different. Very typically with fear, we'll see an increased heart rate, maybe a sensation in the chest or the gut. Maybe 10 shoulders.
Some people get hot and sweaty or flush, and we have. Similar kind of categories of feelings. Or body sensations that are associated with different feelings. And it is the nervous system, specifically the vagus nerve that helps modulate all of those body sensations. They send those messages up to the brain.
The brain gets alerted, “Oh my gosh, I'm afraid.” And then the brain starts to take over. And so my, I'm very passionate about helping people understand that our emotions in our mental health actually start in our body and not in our brain. And that's what the polyvagal theory tells us there are. Do you want me to pause or should I just keep going?
Anna: I would love for you to keep going. Because I love what I'm hearing.
Amy: Yeah. And interrupt and ask questions at any point because, yeah. 'cause I could talk for five hours about this, honestly. So there are a few key components that Deb Dana teaches. So Stephen Porges developed this theory. Deb Dana sat with him, sought understanding, and then developed a beautiful way for us to use this theory in counseling.
And so that's really what my work is with her. I've learned from her and with her now I train for her. She's a good friend and a mentor, and what she helped us understand about the polyvagal theory is that there are basically. Three states to our nervous system, and she refers to those as ventral, sympathetic, and dorsal.
So the ventral state of our nervous system represents. The experience of feeling safe and settled, feeling calm and peaceful, and ability to access our brain think through things, use all those executive functioning skills, or be able to just kind of let the brain do whatever it wants to do because we're feeling so safe.
So a lot of times I'll ask people. When you're feeling really safe in a relationship, what are you thinking, feeling, doing? How's your sleep? What's your posture like? And it's sort of a trick question because the answer is my brain is actually doing very little. I'm just very present in the moment. So when we talk about that ventral experience, its social connectedness to others, connection, and to ourselves, and it brings this.
Peaceful, mindful experience to us. The second state that Deb refers to as sympathetic, and actually Dr. Porges refers to it as mobilization, is the experience of feeling a lot of energy in our body, driving us to want to do something when that energy is present and we feel unsafe. That looks like flee or fight.
It looks like a lot of people experience anger or anxiety in this state. So it's the experience of what people say, I'm triggered by that. I'm uncomfortable with that. I, I am not sure what to do. It might anger me. It might cause a lot of anxiety. What Dr. Porges clearly says though is that we can have that sense of emotional felt safety and have all that energy in our body and when we're we have that energy, it's where we can be very playful.
It's where we are passionate and productive and creative and able to really be in our lives and be active in the ways that we want to be active. The third state, Deb calls Dorsal, and Dr. Porges refers to it as immobilization. So when we're feeling unsafe in our bodies, in our emotions. We shut down, that would be the experience of a dorsal state.
So it was interesting when you answered that question earlier, you could respond to it both from a dorsal and a sympathetic. Mm. I kind of wanna get small and hide, but also part of me wants to flee. Mm-hmm. Right. So right there we could, you know, identify those nervous system states. If we're feeling into that immobilization with a sense of peacefulness and calm, and that felt emotional safety.
That can look like cuddling with somebody. It could look even a dog or a cat I love. Dr. Porges will say when we're co-regulating or connecting to another, any mammal will do. So for those of us who love our pets and find comfort in our pets, that's certainly an option. But that stillness in safety.
Again, can look like meditation or a quiet, reflective activity maybe of writing or yoga or the end of yoga class or prayer time spent in prayer. So I think it's important to know that with each of these three states. We can experience when feeling safe and when we don't feel quite so safe. And it is the vagus nerve that modulates our inter our experience in the world.
Where were Dr. Porush uses the word neuroception, so it's not a perception. It's, it's a neuro meaning. The nervous system is assessing how I feel in the world and the p and with the people in it. Do I feel emotionally safe or not safe?
Anna: Oh, that's fascinating. So safety is, is a big part here, right? A big component of this. And I find it so interesting that like normally even as clinicians, we think of that sympathetic state as fight or flight. But no, it, if you feel safe in that sympathetic state, you can be mobilized in a positive way. And same with the dorsal. If you feel safe, it can be relaxed in a, in a positive way.
Amy: Yes. Yeah. Okay. And then I like to look at the two ends of that. Deb calls ventral is sort of this state of peacefulness. I look at it as, 'cause Dr. Por just calls it social engagement. So, I like to look at that spectrum of social engagement and really help us assess our relationship. So, when I sit down with a client to explore their relationships, I have a little and, and I've learned to use continuums from Deb 'cause they're so helpful.
But I put that whole social connected piece on a continuum and help people start to identify, yes, I feel safe with these people, but sometimes I don't. Right? I like to use a pretty simple example, and it's not that I don't feel emotionally safe. But when my husband and I sit down to eat, I hear him chewing.
Like I hear all the sounds and it, I'm like, you, it kind of gets me irritated and that's not, there's no need for a fight about that. I could yell or can you not chew like a cow or whatever. And instead we just put on some music or a television program and that. Cuts that out and then we kind of laugh about it now.
So there's this moment of irritation and so I might move more to an unsafe feeling with him. I certainly don't wanna like hug him or cuddle him when I, when I hear that, but when we make an adjustment, we can move back to the other side, feeling more safe on that continuum.
Anna: Oh, I love that. Yeah. Once again, that, that sense of safety, which like you said, is not just physical safety, but more of an emotional safety.
Yes. And you said that all of that is regulated by the vagus nerve. It is. And if I remember my polyvagal theory introduction correctly, the vagus nerve, as I think it's the second largest nerve in the body, it starts like near our ears and jaw and goes all the way through our chest, through our stomach.
So maybe you could tell me more about the vagus nerve.
Amy: Yeah, so it's one of 12 cranial nerves. It's the 10th cranial nerve and it's the only cranial nerve that leaves our head and serves other parts of our body. So, the vagus nerve and, and the reason we use the term polyvagal is that Dr. Porges realized that in mammals, so humans are mammals, and then in other animals that are classified as mammals, there's a second branch to the vagus nerve that serves a different purpose.
So, the original or oldest vagus nerve that we might see in like a reptile, for example, that vagus nerve in a reptile is only modulating a flea or fight or shut down. Behavior or experience mm-hmm. In mammals, because all mammals are more social with each other. There is that second branch that also leaves the brainstem.
It exits that nerve exits at the brainstem and moves has one branch that comes to the heart. It is the vagus nerve that regulates our heart rate variability in part, and then part of that branch comes back up into the head and it helps us hear, it helps us speak, and it helps modulate the muscles of facial expression, especially around the eyes, which has been really fascinating for me to learn because I tend to think of.
The lower part of the face as really giving expression. And COVID taught me one thing while we were all masked, which is to find people's eyes.
Anna: I remember doing work with clients at right at the end tail of COVID, and we still wearing masks. We're already in person and yeah. How do you smile with your eyes?
Amy: So that second branch of the vagal nerve, the vagus nerve. Modulates how we interact with each other. So for example, I was nervous coming on the podcast tonight, and then as soon as I saw you and you smiled at me and you, you said something like, okay, here we are. I just went, ah, I felt calmer because your tone of voice was inviting and kind.
Your expression on your face was kind and inviting, and so that's the co-regulation. And if I had come on and you were like, okay, we're gonna get started now. Do you have your micro, I would've been like, oh no. Right. Absolutely. And, and more than the words, it is the tone of voice.
Dr. Porges says that the voice is the tattletale of our emotional state, and when we start to pay attention, we can see. And, you know, if you've ever been around kids that you have to discipline, you know, my kids used to say, don't yell at me. And I'm like, why are they selling that? Because my volume hadn't increased.
But what was more accurate was that my tone of voice left them feeling uncomfortable.
Anna: Ah, yes. Yelling without yelling. I think my kids are familiar with that too.
Amy: We call it toning.
Anna: Okay, so the tone of voice the expression around the eyes. Is there any other kind of cues of safety that, that people can experience?
Amy: Yeah, for sure. And what's really interesting about our nervous system work is that every single nervous system is assessing for safety in the world and safety with the people around them. However. How we interpret those cues of safety or not. Then, the cues that don't bring safety is really dependent on our life experience, so.
For me personally, I'm the youngest of 10 kids, and if I wanted any kind of attention, I had to be loud and funny. Really worked. So, I think part of that became my personality and I, I have said before, if somebody wants to be my friend, they should just laugh at my jokes because that's how I learned to, to feel connected to others.
So when you look back, can you see something in your life that is like, oh, when somebody does that or responds in that way, I feel safer.
Anna: Hmm. I would say so I grew up in Russia where if you know anything about Eastern European culture, we don't smile a lot, right? So I remember when I came here to the US it was like a big adjustment at first to see people smiling because my initial reaction was like, kind of like, what do they want from me?
Yes. Why are they smiling at me? And then I grew to realize that, oh, they're being friendly. It's not that they want something from me, it's that they're trying to express their friendliness. Yes. So I think I've, yeah, I've experienced that firsthand.
Amy: Right. So there are cultural components to how we feel safe.
There are community components, there's family components, you know, in how we grew up. So. The fun of the polyvagal work for me is helping each individual find where their safety lives. And then how do they embody that and facilitate more of that for their life. Because once you're feeling safe, there's a lot of options for how to live and be in the world.
Anna: Okay. Yeah. So that, that key really here is that feeling of emotional safety. Yes. Which I imagine, you know, as a clinician, I know this to be true, that you can be physically safe, like let's say in your therapist's office, but you don't always feel emotionally safe even though your physical body is safe.
Amy: Yes. And that, you know, with people who have experienced trauma. Most times those signals are mixed up. So they, if they have unprocessed trauma, it's kind of hanging around and you could maybe speak in a tone that I'm like, oh. What is that? Because it reminds me of something that was hard for me, or stressful or traumatic for me in my life, so, right.
We use, in our practice, we use a lot of expressive arts. We use a lot of somatic movements, so not like get up and dance, although dancing is great for us. And for our nervous systems it could be just a simple shift in posture. To see if that brings a change to somebody's emotional state. And the biggest one I see in my office is people who sit on the couch but don't lean all the way back.
Or they lean forward elbows on their knees.
Anna: Yeah.
Amy: And sometimes when it feels appropriate, I'll say, what would it feel like if you, if you notice your back touching the couch cushion? And it's such a small movement, but the, the. The emotional state that follows can be so significant.
Anna: That's true. I know myself, like I tend to hold tension in my shoulders. Yeah. So throughout the day I've learned to, to ask myself, where are my shoulders? Are they near my ears? Yeah. And if they are, then I will take a breath and relax 'em down. And there is such a big difference when you make that small adjustment.
And you mentioned expressive arts too, so can you tell me more about that? Because I know that when it comes to healing trauma, if you just sit there and talk about it over and over again, it's not going to result in healing. So tell me more about how you use expressive arts.
Amy: I always say that, that talk therapy doesn't heal trauma, right?
Anna: Mm-hmm.
Amy: Something's gotta move, gotta shift. We have to have a focus on the body and on the nervous system 'cause that's where it lives. Mm-hmm. Right? And it's so evident when you know, we see those kind of big cases of trauma, like somebody coming back from war and hearing fireworks and how that, you know, moves in the body.
But those kinds of things happen in many, many ways. So, for us using expressive arts, we know that the part of the brain that functions in language is our frontal cortex. The frontal cortex is responsible for executive functioning, logic, reason, all those important pieces, trauma, stress, emotions, live more in the limbic system, in the amygdala.
And that part of the brain does not function in language. Right. It functions in feelings and pictures. So when we say expressive arts, we're not setting up easels and having people paint, although we would if, if that was something that interests them. But more so we're using images. We might do some drawing or creating around the polyvagal theory.
I have a, a mapping system that I created, so it's like a roadmap that separates those three states, and then there's a safe side and an unsafe side, so we'll use that. With well, they might write words, but they're gonna choose a color that represents that. We also encourage 'em to maybe draw a symbol or a picture that represents what they're experiencing in each of those states.
So that's a pretty basic one. We have decks of cards that represent people in different poses and different situations. And we can kind of curate maybe a stack of 10 or 15 of those. And then I'll ask a client, you know, which card represents you as a kid? Which card represents you? Now which card? Are you working towards?
And it starts to create more of a picture for them. Mm-hmm. And so often the picture shows what they can't really say or even imagine for themselves. Hmm mm-hmm. Sometimes it's simple scribbling. You know, and that can mimic bilateral stimulation, which is what we use in EMDR, right. To process the trauma.
For us in my practice, and I, I have eight therapists that work with me and we all work from the nervous system perspective. Our first four to six weeks with our clients is just finding out about their nervous system. Orienting them to it, learning about it, learning what they experience, and how they can shift.
And once that's developed, then we do whatever other work we're gonna do with them. So, it might be EMDR or accelerated resolution therapy or some expressive arts. We have a drama therapist joining our practice next month. So, I know she'll bring a lot of interactive kinds of things. And the other thing we do is use those ideas in every team meeting that we have.
So, we meet weekly and we practice those today. In fact, somebody brought information about how dancing specifically really helps with depression. Mm-hmm. And so during the meeting today, we all picked our own song. We put ourselves on mute on the Zoom meeting. We all picked our own song and danced for two minutes.
I love it. Always seeking to practice what we preach.
Anna: Mm. Yeah. So, you had yourself a little silent disco. Yeah. Well, we could hear our own songs.
Amy: Mm-hmm. Right. Yeah. Right.
And then what we'll do with that is, we'll, we'll actually put that on our website. Right. We'll note the article, we'll do a social media post about it and share some of our favorite songs.
So that's one of the ways we're always trying to make this useful and practical.
Anna: Oh, I love that. Yeah, because I think you know it, it can be intimidating to come to therapy, especially if it's a person's first time going to therapy and knowing what to expect from this particular clinician, and that that's the approach they take.
They are gonna talk about your nervous system. They might ask you to do some creative stuff, but still respecting your, your boundaries and your comfort, because like you said, it's all about safety. That's great. I love that.
Amy: We actually created a client journey and we, it's on our website, right? Really specifically, this is what you can expect when you come to our office and we talk about the nervous system information and the psycho ed that happens upfront.
Anna: Oh, that's great. Love it. Yeah. As a clinician, I'm like, yeah, I need a client map, like on my, on my website saying this is what you can expect. Yeah. Wonderful. Okay, Amy, I wonder if you can maybe give us some simple ways that people can start using polyvagal theory for themselves. Like how can they apply all this knowledge?
Amy: Yeah, that's a great question. So you can Google “What helps stimulate your vagus nerve,” you're gonna get a bunch of information, which is loosely supported through research, but what I'm gonna tell you is what comes from Dr. Porges and from Deb Dana and is biologically sound in helping regulate our autonomic nervous system.
So, idea number one. None of these things will work for everybody. Everything I'm about to share needs to be done on a trial and error basis, and these things should be tried when we're mildly very mildly irritated, anxious, angry, whatever. I'd love to tell people to practice these things when they're not activated in their nervous system.
Yeah. 'cause the body creates memory. And when we practice a breathing pattern or humming or discharging by, like maybe shaking our arms or something, the, when we are activated. Those will work better if we've been practicing them. Right? Of course. So, one way is humming is great.
It stimulates the back of our throat and that triggers the vagus nerve into calming, right?
Breathing. A simple pattern where the exhale is longer than the inhale. So you can do that by, you know, breathing into four, breathing out to eight or singing does that for us. Very naturally. A lot of notes are held on the exhale playing wind instruments does the same thing for us. So, Dr. Porges played the clarinet growing up and he talks about his experience with that.
People talk about cold. Like I've seen people on social media putting a cold pack right here. The vagus nerve is really back here. And it goes into the body and up. So I'm not a huge, huge fan of that.
Other things we can do with other people holding a nice eye gaze is very calming to our system because that is intense co-regulation. But practicing that and getting longer, it can be so helpful in strengthening a relationship.
So, playing can really bring a sense of calm to our vagus nerve. I didn't realize this until I learned about polyvagal theory, which for me was I. Around 20 years ago I first was introduced to the polyvagal theory as an infant massage therapist. Right? I, I told you that Dr. Porges did his original work in the NICU and that information was brought to me again about 20 years ago.
I think it's been about 30 years since he first published and spoke about it. Wow. So, learning those cues even with babies. So, bringing in the components that we think about when we're co-regulating with our babies. So rocking side to side can help regulate our vagus nerve, or even back and forth, being in a rocking chair, being on a swing.
I know my daughter, when she was little, and actually through high school swinging was we, I remember when my husband decided she was too old for the place at and took it down and she came home and she was like, where is my swing? And I was like, what do you mean? I didn't realize he had taken it down, so we had to go buy a new one.
Just a very simple one, just so she had that swing because it was so important to her. So again, humming, breathing, wind instruments good eye gazing. Any kind of shaking or discharge can be helpful. The movement by rocking or swaying swinging can be really helpful. Mm-hmm. But again, it's important to try 'em out and see what works for each individual.
Anna: Right. Oh, I love all of those suggestions. You talking to you is making me wanna go hum and go dance because that's two things we've talked about. Yes. Yeah. Awesome. So after this recording, I might be doing that. I might be doing weird things that are gonna make me happy. Yeah. I love it.
Okay. And Amy, I know you are working on a book. Can you tell me a little bit about that? Yeah.
Amy: Yeah, so Deb, Dana, right? Who was really the guru and how do we use polyvagal theory and counseling was approached. Norton Publishing has published all of her books, and she was approached to write a book about using the polyvagal theory with kids, and she said, it's not really my thing.
Call Amy. So very, very blessed to be given that gift from her. And I have worked with kids, but I don't currently work with kids, so I spoke to one of my team members who's worked with kids for years and years and said, Hey, would you like to co-author this book with me? I really bring forward the polyvagal.
Knowledge and experience and using it as a counselor and supervising counselors through that lens. And Carrie really brings the information about how do we do this with kids, with parents, with families. So we're working together this calendar year on that book. I love it. Our due date is. December 31st, we're hoping to have it there sooner.
And from what I understand, it can take up to another year before it's published. So I see. Yeah, we're probably a year and a half away, but it's gonna be great. Carrie is so brilliant and has such a way with words that I just can't wait for it to be published.
Anna: Oh, that, that sounds lovely. Sounds like very important book to be published because this work about emotional safety and how do you make children feel safe that way. I'm sure it's going to be very valuable to a lot of therapists out there. Yeah. And Amy, I believe on your website you also have trainings for mental health professionals.
Amy: Yes.
Anna: Tell me about that.
Amy: Yeah. So right now I'm actually working on two for PESI. How do you use polyvagal and supervision of counselors. And then another one kind of expanding the idea of mixed states, like what is it like to be sympathetic or mobilized and safe? And, and doing a, a training there.
We're waiting to hear if we have enough people signed up, but Carrie and I were approached by a counselor in Turkey who would like for us to offer a training on the book title, which we're ready to go with that. Even though the book's not written, it's. It's here. So if they get enough people signed up, we'll be doing that soon.
And then as trainings come up, I don't have a schedule set for myself. And because I don't, Deb does it, she does it great, you know? But if other things come up and people approach me and, and want to have me come in and train on it, I do.
Anna: Wonderful. Okay, so book is in the works. Yeah. There are trainings available to work with you, and then of course people can come work with you as a clinician or with any one of the clinicians at your practice in Cincinnati.
Yeah. Okay. Yeah, that's great. I'll make sure to include all of the links to, to all of that goodness in my show notes. Thank you, Amy. Thank you so much for stopping by today. I really enjoyed talking with you and learning more about Polyvagal Theory.
Amy: Thank you. I appreciate you having me. I. Hmm.
Anna: And for all of you listening, I hope you leave feeling a little more informed and empowered today.
And remember, healing takes time and you're exactly where you need to be. Take care of yourselves and until we meet again, be kind to your heart.
