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Stress, Anxiety, Pain, Polyvagal Theory, and SMR Therapy

Updated: Mar 31

It is generally understood that emotional stress can lead to stomachaches, irritable bowel syndrome, and headaches. Still, people might not know that it can also cause other physical symptoms, such as chronic pain.

Polyvagal theory helps describe the link between trauma, stress, behavioral adaptations, anxiety, muscle tension, cortisol resistance, inflammation, and chronic pain.

For years while treating chronic pain with Neurokinetic Therapy, I recognized patterns of clients I couldn’t help and suspected the root cause of their symptoms was stress or trauma related. I realized the need for a treatment style that would address stress in the nervous system for these clients. As I developed SensoriMotor Repatterning (SMR), I started to look for ways to address the mind-body connection between stress and pain.

As an RMT, I treat physical dysfunction in soft tissue, a side effect of which can be a decrease in stress and anxiety levels. There is usually a physical manifestation of stress, trauma, and anxiety in the body that can be identified and treated through manipulation of the acupressure points (a great read on the mind-body connection is “The Body Keeps the Score” by Bessel van der Kolk).

“Clinical Application of Polyvagal Theory” by Dr. Stephen Porges was one of the pivotal books I read in my quest for a solution for stress causing chronic pain. Polyvagal Theory was developed by Dr. Porges in 1994, whereby it modifies the pre-existing theory of the sympathetic nervous system (fight-or-flight) and parasympathetic (rest-and-digest) system. Porges added a second, more primitive role to the parasympathetic nervous system, a protective inhibitory mechanism (freeze).

Evolutionarily, primitive reptiles under threat had only one neurological response, which was to activate what is now called the dorsal vagal nerve pathway. The activation of this pathway causes immobilization behaviors such as reduced metabolic output, which conserves energy. Through the transition from primitive reptiles to mammals, this neural pathway adapted into a primitive defense system that would cause the mammals to act dead, numb, faint, and dissociate.

The stress-adrenal system came later in the mammalian evolution and is a more sophisticated defense mechanism; the fight-or-flight response.

The last evolutionary stage of development was the ventral vagal nerve pathway, our “social engagement” system. The ventral vagal nerve pathway regulates the stress response and is sometimes referred to as the “vagal brake.” It dampens the effect of the fight-or-flight system, making us feel safe, and thus facilitates social behavior, social communication, and regulation of the body to efficiently promote growth and restoration.

Interesting fact: Our intrinsic heart rate is about 90 beats per minute. The vagal break reduces the heart rate to around 60 beats per minute by dampening the fight-or-flight mechanism.

We cannot have normal social interactions, efficient growth, and immune function if we operate in a fight-or-flight or freeze response.

Note that our nervous system defaults to the fight-or-flight mechanism during stress, but if this mechanism fails, the nervous system will default to the more primitive “freeze” response of the dorsal vagal pathway, which is a downregulation mechanism, causing dissociation, numbness, helplessness, depression. When triggered into stress by a perceived threat from past trauma, the nervous system will often default to the state it adopted in the initial trauma.

Psychologists who implement Polyvagal Therapy into their treatments have moved away from the model of having clients re-emerge into their trauma; research has shown this has the potential to re-traumatize the client instead of causing them to climatize to the initial trauma (which is the old model).

Instead, the psychologist identifies which state the client tends to move into when the stress response is triggered. It is important to bring awareness to this response, as people often don’t know they have been triggered into a past trauma state. The phycologist will then bring them gently in and out of the stress response allowing the client to learn how to self-regulate the stress back into a state of calmness and safety.

If you feel stress is a factor in your pain, SMR can help. However, it is always suggested to seek professional help from a Psychologist/Registered Clinical Counsellor if you haven’t previously addressed trauma with a registered therapist.

References and resources:

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