Debating the Validity of Polyvagal Theory

The Polyvagal Theory made headlines recently following a paper published in Clinical Neuropsychiatry in 2026 by a group of 39 scientists who called Polyvagal Theory “untenable.”

The online discourse has been loud and filled with rampant mischaracterizations of the actual theory itself, creating confusion about a framework that has helped inform clinical practice in areas like trauma treatment, chronic pain, sensory processing differences, gut disorders, inflammatory conditions and more over the past thirty years.

The critique itself is not new, but the virality surrounding it is novel and is being fueled by clickbait headlines and social media soundbites that lack nuance and critical context.

The paper was spearheaded by Paul Grossman, who self-selected the paper’s 38 co-authors and has long been an outspoken critic of Polyvagal Theory.

Dr. Stephen Porges, the founder of Polyvagal Theory, has been publicly transparent about critiques of the theory since its inception and has openly discussed and responded to the critiques by Grossman and others, most recently publishing a rebuttal in the same issue of Clinical Neuropsychiatry.

Online chatter aside, scientific theories are meant to be questioned, tested, refined, and revised, so the critique of Polyvagal Theory is important, especially for clinicians and practitioners who use it to inform treatment, practice and care. 

What is Polyvagal Theory?

Polyvagal Theory was proposed by Dr. Stephen Porges in 1994 and provides an evolutionary framework to understand how our body and mind work together to respond to safety and danger.

The theory identifies three primary physiological states that are organized into a hierarchy. These autonomic states help shape behavior and guide our ability to connect and socially engage.

While the autonomic hierarchy is often the only pillar that gets highlighted, Polyvagal Theory in fact outlines three main defining principles:

1. Autonomic Hierarchy: the autonomic nervous system has three main response states that are organized as a hierarchy and mediated by the vagus nerve. These three states are not completely separate, but work on a continuum and also include blended states that are linked to behaviors like freeze, stillness, and play.
2. Neuroception: the nervous system’s built-in surveillance system that continuously and unconsciously scans our internal landscape, our external environment, and other nervous systems for cues of safety or danger.
3. Co-regulation: a biological necessity. In simple terms, it’s our ability to connect and feel safe with others that allows us to not merely survive, but to thrive.

A compassionate reframing of chronic stress and trauma

Polyvagal theory has been widely embraced in the fields of psychology, education and public health for providing a supportive framework that helps destigmatize and depathologize natural responses to trauma and chronic stress.

From a polyvagal lens, the way you react to danger is not a weakness, moral failing or flaw. It is an adaptive and unconscious physiological survival response.

In other words, you don't consciously choose to fight or flee or freeze or fawn or shut down – the wisdom of your nervous system chooses for you. This reframing has been instrumental in helping many trauma survivors (who are too often questioned and judged for why they didn't leave, or run or fight back), to replace shame with a lens of compassionate understanding that helps normalize coping responses as remarkable nervous system strategies. 

Dr. Porges’ more recent work has focused on advocacy for replacing the harmful, outdated concept of Stockholm Syndrome (often used to describe the responses of survivors of human trafficking, sexual abuse, and abduction), with the term appeasement, which he calls a “very skillful neurobiological strategy of survival” and the “result of a nervous system that has developed a remarkable ability to adapt and survive through challenging or life-threatening times.” (Porges, 2023).

Porges research and work on appeasement offers a much-needed reparative perspective that is in stark contrast to the patriarchal system built around victim-blaming and shaming. 

What’s currently being debated?

The current debate surrounding Polyvagal Theory is focused around the following points:

• Respiratory Sinus Arrhythmia (RSA): Grossman argues that RSA is not a specific measure of cardiac vagal tone and that heart rate fluctuations can be due to shifts in breathing patterns.
• RSA is not uniquely mammalian
• Dorsal vagus is not proven to be responsible for freezing or dissociation
• Observations that non-mammals like fish and reptiles show social behaviors

Porges’ Response

• Porges argues that the above critiques misrepresent the original theory itself, distorting and exaggerating its original claims.
• Polyvagal Theory does not suggest that vagal regulation is exclusive to mammals and the critique ignores or collapses distinctions between key vagal structures.
• Porges argues that mammals evolved a Social Engagement System that integrates with facial expression, vocalization, and social communication and does not dispute that non-mammalian species like reptiles or fish may also show social behaviors.
• Porges also argues that the RSA discussion centers around a misrepresentation of RSA measurement using flawed and outdated metrics, which undermines valid empirical tests of PVT.
• Porges also calls out editorial or interpretive bias embedded in the critique. He notes that two primary critiques of PVT were published in a special issue of Biological Psychology, which was edited by Grossman and excluded an opportunity for rebuttal. Furthermore, Porges argues that Grossman and his self-selection of 38-co-authors, frames the most recent critique as scientific consensus, but no formal consensus process (such as a Delphi panel, professional society endorsement or systematic meta-analytic adjudication) was established.
• Porges stresses the importance of restoring scientific accuracy and analytic accountability into the discourse surrounding PVT.  

What’s not in dispute?

There are key pieces of the theory that are currently supported by scientific literature, which include the observation of two distinct vagal branches (Strain 2024; Jalil 2023), and the pathways of the Social Engagement System (Porges 2025; Jalil 2023). 

Polyvagal Theory’s emphasis on safety, co-regulation, connection and belonging is also backed by an enormous body of research that extends widely beyond Polyvagal Theory itself.  

Bottom-up interventions that emphasize the mind-body connection, including mindful breathing, yoga, tai chi, qigong, and other mind-body practices have long existed before Polyvagal Theory and continue to be supported through a growing body of research.

Polyvagal Theory’s clinical relevance is also validated by bottom-up interventions like the Safe and Sound Protocol (Heilman et al., 2023), which modulate the ventral vagal pathway and yield measurable improvements in regulation and social behavior (Porges, 2025). 

Finally, when examining the main critiques, it’s important to note that they focus almost entirely on the first organizing principle of the theory and do not refute the other two guiding principles. This leads to the question of is it fair to throw out an entire theory based only on a partial evaluation?

So where does this all land?

In short, the Polyvagal Theory has not been debunked. There are neuroanatomical features and mechanisms still being rigorously and scientifically debated and areas where more research and room for revisions to the theory exist.

These debates are not yet resolved and both sides have presented peer-reviewed papers to support their views.

As the debate continues, we have the opportunity as polyvagal-informed practitioners to clarify concepts and shift our language where appropriate to reflect the current discourse.

We also have an opportunity to expand our lens beyond the vagus nerve into the entire sensory system, which includes work with the vestibular system, proprioception, interoception and more.  

We can push for more scientific clarity, while also acknowledging that the practical application of the Polyvagal Theory provides a useful and supportive framework that empowers people who are healing from trauma to build self-efficacy while expanding their capacity for safety and connection.

Healing happens from the softening of shame, the shift to self-compassion and social connection, and a deepening of self-awareness and self-relating. Safety, belonging, connection and co-regulation is the treatment.

Guiding Questions to Ask

Does the Polyvagal Theory have room for revision and refinement? Yes. Should we be willing to evolve as practitioners as the science evolves? Absolutely.

And it’s also worth asking, what does the delight in “debunking” a theory or the urge to ferociously attack a theory reflect about our own nervous system state? On the flip side, what does a blind defense or acceptance of a theory without question say about our own nervous system state?

I have personally found myself using this debate to get curious about my own biases and nervous system’s signals of urgency. I have found immense value in using my internal cues to pause and reflect instead of immediately react. It’s an opportunity to get curious and practice regulation in real time.

We can both appreciate the debate as it helps move science forward, while also deeply valuing the rich contributions Polyvagal Theory has offered in helping people better understand their autonomic states, untangle shame, and make the transformative shift from pathologizing survival responses as dysfunction to reframing them as adaptive nervous system strategies.

It's a hopeful framework that offers us a path to creating deeper safety, connection and belonging in ourselves, our communities and our world.

References

Porges, W.S. (2026). When a Critique Becomes Untenable: A Scholarly Response to Grossman et al.’s evaluation of Polyvagal Theory. Clinical Neuropsychiatry, 23(1), 113-128. doi.org/10.36131/cnfioritieditore20260111 

Grossman, P., Ackland, G.L., Allen, A.M., Berntson, G.G., Booth, L.C., Burghardt, G.M., Buron, J., Dinets, V., Doody, J.S., Dutschmann, M., Farmer, D.G.S., Fisher, J.P., Gourine, A.V., Joyner, M.J., Karemaker, J.M., Khalsa, S.S., Lakatta, E.G., Leite, C.A.C., Macefield, V.G., …& Zucker, I.H. (2026). Why the Polyvagal Theory is Untenable. An international expert evaluation of the polyvagal theory and commentary upon Porges, S.W. (2025). Polyvagal theory: current status, clinical applications, and future directions. Clin.Neuropsychiatry, 22(3), 169-184. Clinical Neuropsychiatry, 23(1), 100-112. doi.org/10.36131/cnfioritieditore20260110

Porges SW. Polyvagal Theory: Current Status, Clinical Applications, and Future Directions. Clin Neuropsychiatry. 2025 Jun;22(3):169-184. doi: 10.36131/cnfioritieditore20250301. PMID: 40735382; PMCID: PMC12302812.

Bailey R, Dugard J, Smith SF, Porges SW. Appeasement: replacing Stockholm syndrome as a definition of a survival strategy. Eur J Psychotraumatol. 2023;14(1):2161038. doi: 10.1080/20008066.2022.2161038. PMID: 37052112; PMCID: PMC9858395.