The Polyvagal Theory under fire
DESCRIPTION:
The Polyvagal Theory (Stephen Porges): Paul Grossman refutes it as likely to be incorrect. What remains of the theory of the vagus nerve and social engagement in trauma therapy when the neurobiology is shaky.
Polyvagal theory debunked: What Grossman and 38 other researchers said about the nervous system in 2026, and what remains of the hypotheses about the vagus nerve
In February 2026, Paul Grossman and 38 co-authors declared the polyvagal theory to be ‘untenable’ in Clinical Neuropsychiatry. Stephen Porges responded to the same issue with his characteristic, insubstantial arrogance. Yet whilst the English-speaking trauma community debates the issue at length, there is a striking silence in the German-speaking world, and that is precisely the point here.
What has actually changed about the Polyvagal Theory in 2026?
It is not the theory that has changed, but its assessment. Paul Grossman, its most persistent critic for over two decades, published a collective critique in February 2026 together with 38 other researchers from the fields of neurophysiology, vagus nerve research, comparative anatomy and vertebrate evolution. Title: “Why the Polyvagal Theory is Untenable”. Published in *Clinical Neuropsychiatry*, and discussed in parallel in *Biological Psychology*. Porges responds in the * * in the same issue with the essay “When a Critique Becomes Untenable”, which discusses the role of his “vagus system”.
This is no Twitter storm. It is a frontal assault from within the field of biological psychology on the very theory that has been regarded as the established doctrine in the Western trauma community for the past fifteen years. It features in yoga teacher training courses, in somatic coaching programmes, and in psychotherapy curricula. And it features in every other Instagram Reel about ‘nervous system regulation’.
Anyone who ignores this controversy must now, at the very latest, explain why they continue to work with a model whose neurophysiological foundations are deemed untenable by the majority of relevant experts.
Who is Stephen Porges, and what does his polyvagal theory claim?
Stephen Porges first spoke of a “polyvagal perspective” in a famous inaugural lecture to the Society for Psychophysiological Research in 1994. His central proposition is that the autonomic nervous system consists not of two (sympathetic and parasympathetic) but of three functional systems. According to this, an evolutionarily ancient dorsal vagus branch is said to control immobilisation and shutdown, the ‘frozen’ state of ‘playing dead’. A more recently evolved ventral vagus branch, linked to facial expressions, the voice and the muscles of the middle ear, organises ‘social engagement’. In between lies the sympathetic nervous system with its fight-or-flight response.
The compelling thing about this model is that it translates states of trauma into an anatomically sounding narrative framework. ‘I can’t go on’ becomes ‘dorsal shutdown’. ‘It’s all too much for me’ becomes ‘sympathetic activation’. ‘I finally feel connected’ becomes ‘ventral security’. Patients no longer see themselves as broken, but as physiologically regulated.
Clinically speaking, to be honest, this is a godsend. And that is precisely the problem.
What exactly do Grossman and his colleagues accuse the polyvagal theory of?
The criticism from the 39 researchers has three strands, and it is worth separating them, as the German-speaking reception tends to lump everything together under the heading ‘evil scientists versus lovely trauma therapy’.
Firstly, the anatomical distinction between an ‘old’ dorsal and a ‘new’ ventral vagus nerve does not exist in the pure form postulated by Porges. All mammals, including primitive ones, already possess the structures that Porges presents as evolutionarily new and specific to mammals. Reptiles, according to the authors, also exhibit more complex social behaviours than Porges’ model allows for.
Secondly, Respiratory sinus arrhythmia, i.e. the variability of heart rate with the respiratory rhythm, is not a clear-cut marker of ‘ventral’ vagus activity. It is physiologically more complex, respiration-dependent and not linearly linked to a single vagus nucleus. Anyone who interprets HRV values as a safety score is oversimplifying matters.
Thirdly: The evolutionary narrative put forward by Porges – that reptiles are rigid and mammals are social – is, in this form, anatomically incorrect. It makes for a good story, but it is poor developmental biology.
How does Porges respond to the same issue?
Porges’s reply is entitled ‘When a Critique Becomes Untenable’ and argues on a meta-level: Grossman et al. did not criticise his theory, but rather a ‘simplified reconstruction’ of it. He insists that his polyvagal theory is a ‘holistic model’ of autonomic state regulation and not a collection of individual anatomical claims that cannot simply be refuted piecemeal.
This is rhetorically skilful, but epistemologically precarious. A theory that immunises itself against any concrete neurophysiological refutation by invoking its ‘systemic nature’ loses precisely the characteristic that defines a scientific theory: falsifiability. Karl Popper sends his regards.
The dispute is also so bitter because it is not new. As early as 2007, Grossman and Taylor had published their first objections; Porges had responded; the dispute smouldered for two decades. The 2026 collective critique now brings together the accumulated scepticism of 39 specialists from several disciplines. This is a different format from a single critical essay.
Why is the German-speaking world silent?
An honest answer: because Polyvagal Theory has become an identity-forming doctrine in German-speaking trauma discourse. It features in the curricula of somatic therapy training programmes. It shapes the language of coaching programmes. It sells books, online courses, workshops and academies. Anyone who questions its foundations is undermining an identity – and a business model.
In the English-speaking world, the debate is being fought out on Substack, with Sukie Baxter (“Polyvagal Theory is Dead”). Now What? A question that concerns social engagement and the regulation of our emotions. The trauma therapists behind “mytherapist” (Lauren Auer), Pria Alpern, MC McDonald, and Ana Lund all emphasise the importance of Polyvagal Theory. Arielle Schwartz publishes “Clinical Reflections on the Critique of Polyvagal Theory Proposed by Grossman et al.” In April 2026, George Bonanno argues in Psychology Today on his blog “The Hope Circuit”: the theory has not been “debunked” but “challenged”, which requires a deeper discussion of the RSA.
In German-speaking countries, a few academic statements, otherwise silence. That is a cultural diagnosis.
Isn’t this all just scientific nitpicking? What does it matter for trauma therapy?
Yes, it does matter. Because the language of therapy has changed over the last ten years. Clients now come in saying things like “I was in dorsal shutdown”, “My ventral vagus is offline”, “My nervous system is dysregulated”. That is polyvagal language. And it suggests a level of anatomical precision that the model – if one takes Grossman et al. seriously – cannot possibly provide.
Clinically, this makes a difference. Anyone using an HRV app who believes they can tell from a number whether they are ‘safe’ is confusing an averaged physiological variable with a subjective state. Anyone who hears ‘dysregulation’ as a diagnosis believes they are being told an objective fact, when in fact it is a theoretical description within a model that is currently under fire.
The consequence is not that breathing exercises become ineffective. They do work. The consequence is that we must justify their effectiveness differently, particularly taking into account the regulation of the nervous system.
What remains of the tool when the theory falters?
This is where it gets interesting, and this is where cultural views diverge. Anyone who has ever practised 4-7-8 breathing knows that slow, prolonged exhalation modulates vagal activity. This has been known for decades, long before Porges. Anyone who has experienced a moment of co-regulation with a calm voice, a warm gaze and a friendly face knows that it is soothing. This is mammalian biology, not a polyvagal discovery.
In other words: the techniques marketed under the ‘polyvagal’ label – breathing exercises, co-regulation, facial expressions, voice, singing, humming, slow movement – do work. But they do not work because a specific vagus nerve branch activates specific middle ear muscles in a specific evolutionary sequence. They work because the calming of several interlocking autonomic and social systems works.
Clinically, therefore, almost everything that has been used to date remains. What is at stake is the narrative intended to justify it all. That is the difference between science and storytelling.
In what broader context does this dismantling take place?
In recent months, this Wikiblog has revisited several classics whose scientific veneer is beginning to crack. Bessel van der Kolk’s book *The Body Keeps the Score* has remained a bestseller, yet his claims about repressed, physically stored trauma memories have been consistently refuted by memory research. Joe Dispenza sells meditation as a gateway to a ‘quantum field’, which is physically nonsensical but clinically shows measurable effects through placebo effects. Dan Ariely’s data on ‘honesty’ was exposed as a fabrication; the entire subdiscipline of behavioural economics has been reeling ever since.
The debunking of the polyvagal theory belongs in this series. This is not at all about a scandal surrounding a single scientist, but about a stress test of a body of theory that has built a broad cultural umbrella on a narrow empirical foundation. This is not unusual in the history of psychology.
How should those affected deal with the new situation?
Don’t panic. A breathing exercise that has helped you for the past three years will still help you next week. The question is not whether you should continue using the technique, but whether you have to go along with the narrative with which it was sold.
A second piece of advice: if a therapist or coach claims to be able to objectively determine what ‘state’ you are in based on an HRV reading, a heart rate or ‘vagus tone’, be wary. Subjective experience is subjective experience. It cannot be represented by a single marker, and certainly not by one whose physiological significance is the subject of international debate.
A third recommendation: the self-diagnostic language found on Instagram Reels (“my nervous system is dysregulated”, “I’m in the ventral vagus”) is not a valid diagnosis. It is the marketing vocabulary of a self-help industry. A therapeutic assessment operates on a different level.
What does the refutation of the polyvagal theory say about our culture?
It says something uncomfortable. The Western trauma world has an intense longing for a physiological explanation. We want to know that our suffering is “real”, and in late modernity, “real” means: measurable, anatomical, neuronal. Polyvagal theory delivers exactly that. It promises a bridge between subjective experience and objectifiable biology. It turns the vague “I’m not feeling well” into a concrete “My dorsal vagus is overactive”.
This longing is understandable, but also problematic. For it makes us susceptible to theories that promise more than they can deliver, and it closes our eyes to the cultural function of such theories: they legitimise a market of courses, coaching sessions, academies and books.
The 39 researchers have not merely published a scientific correction. They have, unwittingly, held up a mirror to Western culture.
What happens next?
Scientifically, the debate will continue. Porges responded in 2007, published his current state of the theory in Clinical Neuropsychiatry in 2025, and responded again in 2026. The model will presumably be revised, formulated more precisely, with less evolutionary pathos, and with clearer conditions for falsification.
Clinically, little is likely to change, because what works is not due to the theory anyway, but to centuries of accumulated experience with breathing, touch, voice, co-regulation and social security, some of which dates back to the earliest concepts of Indian medicine from the Vedic period, from around the middle of the 2nd millennium BC. What should change is the level of ambition in the claims, particularly regarding the complex mechanisms of regulation. A language that pretends to be less anatomically precise and describes more clinical reality would be a gain.
In German-speaking countries, it would be helpful if the debate were acknowledged and addressed. Suppression is also a stance, but rarely an intellectually credible one.
An overview of the key findings
· In February 2026, Paul Grossman and 38 other researchers published a collective critique, “Why the Polyvagal Theory is Untenable,” in Clinical Neuropsychiatry.
· Stephen Porges responds to the same issue in “When a Critique Becomes Untenable” and argues that the critique is based on a simplified reconstruction of his theory.
· The core criticism concerns three areas: the anatomical separation of the dorsal and ventral vagus branches, the significance of respiratory sinus arrhythmia, and the evolutionary narrative regarding reptiles and mammals.
· Clinical tools such as breathwork, co-regulation, voice and touch continue to be effective, but not for the reasons claimed by the polyvagal theory.
· The German-speaking trauma community has largely ignored the debate so far. This is a cultural, not a scientific, stance.
· In the English-speaking world, Arielle Schwartz, Sukie Baxter, George Bonanno (Psychology Today), Lauren Auer (‘mytherapist’) and others are openly discussing the consequences.
· The dismantling of the polyvagal theory is part of a broader critique of Bessel van der Kolk, Joe Dispenza and Dan Ariely: classics are being re-examined, their empirical basis scrutinised, and their cultural function brought to light.
· Self-diagnostic language from social media (“dorsal shutdown”, “ventral safety”) is no substitute for a therapeutic assessment.
· HRV values are not safety scores. Subjective experience cannot be captured by a single physiological variable, but requires an understanding of vagal regulation.
· What remains: techniques that work. What goes: the anatomically sounding narrative with which they were sold. This is not a minor, but a crucial difference.
What remains after the refutation of the polyvagal theory? Frequently asked questions
The following Q&A section compiles the questions that patients and colleagues have most frequently asked in practice since February 2026. They are answered here consistently from the perspective of Grossman’s critique, i.e. without the usual clinical sugar-coating that artificially props up the polyvagal narrative by defending it as ‘heuristically helpful’. The answers consistently distinguish between three levels: the actually existing vagus nerve (anatomy and physiology), the polyvagal theory as a scientific model (refuted), and the vagus wellness industry (commercial folklore).
Is EMDR based on the polyvagal theory?
No. EMDR (Eye Movement Desensitisation and Reprocessing) was developed in 1987 by Francine Shapiro and is theoretically based on the Adaptive Information Processing model, not on the polyvagal theory. Both theories emerged later or developed in parallel, and some EMDR trainers in the 2010s subsequently attempted to marry EMDR with Porges’ vocabulary. This is a commercial follow-up movement, not a theoretical necessity. EMDR works or does not work, regardless of whether one tells dorsal-vagal stories about it.
Does EMDR use polyvagal theory?
Not in the original conception. Some contemporary EMDR curricula work with concepts such as the ‘tolerance window’, which are tinged with polyvagal theory; this is marketing vocabulary designed to make the method compatible with the current discourse on trauma. Bilateral stimulation, the core of EMDR, has no explicit vagus mechanism and does not require one. Anyone practising EMDR can do so without a single polyvagal concept.
Why do some therapists dislike EMDR?
For several reasons, none of which have anything to do with polyvagal theory. Firstly, the mechanism of action is unclear. Studies suggest that bilateral stimulation may merely be a contextual element alongside exposure and reprocessing components. Secondly, research by Richard McNally and others has shown that the method's specific claims are often unsupported by data. Thirdly, some practitioners are put off by the almost quasi-religious enthusiasm of some users.
What psychological theory is EMDR based on?
Based on Francine Shapiro’s Adaptive Information Processing model. It posits that traumatic memories remain ‘frozen’ in a non-integrated state and that bilateral stimulation enables ‘reprocessing’. Empirically, the specific AIP assumption is not compelling; many efficacy studies can also be interpreted as modified exposure therapy. This has nothing to do with the polyvagal theory.
What is the controversy surrounding the Polyvagal Theory?
It has two layers. The older layer dates back to 2017, when Paul Grossman first formulated systematic objections to the anatomical and evolutionary biological claims. The current layer is the collective critique, “Why the Polyvagal Theory is Untenable,” by Grossman et al., published in February 2026 in Clinical Neuropsychiatry, signed by 39 neuroscientists. It argues that the clear distinction between the dorsal and ventral vagus branches is untenable, that respiratory sinus arrhythmia, as “vagus tone”, does not capture what Porges claims, and that the evolutionary history from reptilian shutdown to mammalian safety is not supported by empirical evidence.
What are the symptoms of a weak vagus nerve?
‘Weak vagus nerve’ is not a medical diagnosis, but a wellness invention. The vagus nerve is a cranial nerve that sends parasympathetic fibres to the heart, lungs, gastrointestinal tract, and vocal cords, and transmits numerous signals back to the brain. Genuine vagus nerve dysfunction manifests clinically as specific conditions: gastroparesis in diabetes, vocal cord paralysis following surgery, orthostatic dysregulation with low blood pressure, and vasovagal syncope in cases of fainting. What Instagram markets as a ‘weak vagus’ – anxiety, exhaustion, sensory overload, digestive problems, sleep issues – is a non-specific list of symptoms that fits a hundred different scenarios and cannot have a single nerve as its cause.
How can I tell if my vagus nerve is having problems?
Symptoms that a doctor can diagnose: recurrent fainting when standing up, difficulty swallowing, persistent nausea after meals, and a markedly slow heartbeat (bradycardia). You cannot tell by a vague feeling of exhaustion. Anyone who cites ‘their vagus nerve’ as an explanation for feeling tired, irritable and anxious has adopted a simplified wellness narrative, not medically valid self-observation. If exhaustion and irritability persist, this requires a differential diagnosis rather than a breathing workshop.
What is the 21-day vagus nerve reset?
A commercial programme originating from the vagus wellness industry. It typically combines breathing exercises, splashing cold water on the face, humming, slow exhalation and self-massage. None of these elements resets anything that was previously broken, and certainly not in 21 days. The individual techniques can be subjectively helpful in moments of stress, as a way to redirect attention, calm the breathing, or take a break. They work not because they ‘reset’ the vagus nerve, but because conscious breathing and taking a break work in any theory. The 21-day promise is marketing.
Which doctor is responsible for the vagus nerve?
There are no ‘vagus nerve specialists’. Depending on the symptoms, the relevant departments are neurology, cardiology, gastroenterology or ENT. Anyone who believes a wellness provider opening their own ‘vagus nerve practice’ is buying into pure mythology. Anyone with genuine medical vagus nerve symptoms – such as repeated fainting, unexplained delayed gastric emptying, or unilateral hoarseness following surgery – should be seen by the relevant specialist.
What does an overstimulated vagus nerve feel like?
This is a formulation typical of polyvagal theory, which assumes what it is supposed to prove. The theory claims that ‘too much’ activation of the dorsal vagus nerve leads to shutdown, dissociation and freezing, acting as an emergency brake for an overwhelmed nervous system. The anatomical and physiological foundations of this narrative are precisely what Grossman et al. 2026 identified as untenable. What actually occurs is a vagal reflex response in vasovagal syncope: a sharp drop in blood pressure, bradycardia, and a brief loss of consciousness. This is a clearly defined medical mechanism, not a lifestyle mode.
Is there a polyvagal theory of ADHD?
In a scientifically rigorous sense, no. What does exist are attempts by trauma coaches to reinterpret ADHD as a ‘dysregulated nervous system’ and frame it using polyvagal terminology. The established neurobiology of ADHD is based on dopamine and noradrenaline or serotonin, with ‘prefrontal-striatal circuits’ at its core. Stimulants act via precisely these neurotransmitters, not via the vagus nerve. Anyone who presents ADHD as a vagus nerve problem shifts the discussion into a vocabulary that obscures the specific neurobiology and the specific cognitive deficits.
What is the 24-hour rule for ADHD?
A TikTok heuristic with no research basis. Several versions are circulating: do not make impulsive decisions within the next 24 hours, do not make purchases without 24 hours’ reflection, and do not send emails whilst in an emotional state. As a pragmatic self-regulation rule, this can be useful. The specific 24-hour figure has no scientific basis and is unrelated to polyvagal theory. Sometimes the rule is dressed up as polyvagal; this is a linguistic embellishment without any empirical benefit.
Do vagus nerve stimulators help with ADHD?
Vagus nerve stimulation (VNS) is FDA-approved for treatment-resistant depression and for certain forms of epilepsy. There is no approved VNS indication for ADHD and no robust evidence base. The non-invasive devices marketed as ‘vagus stimulators’ for use on the ear or neck are largely unproven in clinical efficacy. Anyone using them for ADHD is doing so without a scientific basis and, as a rule, at considerable expense.
What is the controversy surrounding the polyvagal theory?
See above. In short, Grossman et al. (2026) argue that the theory’s central anatomical, physiological, and evolutionary claims are not empirically tenable. Porges’s reply to the same issue concedes that refinements are needed, but maintains the theory’s clinical utility. The scientific community is increasingly moving towards a position where the theory is considered outdated, whilst clinical practice retains some of the terminology because it is convenient.
Can ADHD cause hypoarousal?
The underarousal hypothesis of ADHD has a long history and is partially supported by empirical evidence. The assumption is that people with ADHD chronically have too low a level of arousal and compensate through stimulation-seeking, risk-taking behaviour and hyperactivity. Stimulants help because they increase arousal. This research follows the tradition of the arousal theories of Sergeant and van der Meere, not the tradition of polyvagal theory. ‘Dorsal shutdown’ is not a useful concept here; the established terms are arousal level, vigilance and reward sensitivity.
What is the 30-Day Vagus Nerve Reset?
A longer-term counterpart to the 21-day reset. The logic is the same: a set of exercises, a promise of transformation, a timeframe that signals discipline. The scientific basis remains the same, namely, none. Anyone who practises breathing exercises, cold exposure and mindfulness over 30 days may experience subjective improvements. These stem from well-known mechanisms: regular focus of attention, parasympathetic activation through slowed breathing, and a sense of self-efficacy. They are neither reset-specific nor vagus-specific.
What is the quickest way to reset the vagus nerve?
There isn’t one because ‘vagus reset’ isn't a scientific category. What you can do when the sympathetic nervous system is currently dominant: breathe out slowly, lower your shoulders, take stock, and drink water. This works via known parasympathetic reflex arcs, not via a reset. The question itself is symptomatic of the ‘wellnessification’ of physiological phenomena: it assumes that a complex cranial nerve functions like a router that can be restarted.
Can semaglutide influence the vagus nerve?
This is one of the few physiological points where the question becomes a reality. GLP-1 receptor agonists, such as semaglutide, act, among other things, via vagal afferents. Vagal fibres carry satiety signals from the gut to the brainstem, and GLP-1 modulates this transmission. This is well-established physiology and belongs in the fields of gastroenterology and endocrinology, not in the polyvagal world. Anyone who claims that semaglutide ‘weakens the vagus’ or makes it ‘dysregulated’ is translating a pharmacological mechanism of action into wellness jargon and losing precision in the process.
Which vitamin is good for the vagus nerve?
None that are specific. General neurological function benefits from sufficient levels of vitamins B12, B6, folic acid and vitamin D, where a deficiency has been confirmed. Those without a deficiency gain nothing from supplementation. “Vagus vitamins,” as a separate product category, is a marketing construct. The vagus nerve is a nerve; it does not require specific nutrients. A balanced diet and the treatment of actual deficiencies are the only sensible approaches.
Is the vagus nerve linked to vasovagal syncope?
Yes, and this is one of the few instances where the term “vagus” has a clear medical meaning outside the world of wellness. Vasovagal syncope is a reflex: a trigger (e.g. blood test, prolonged standing, acute pain, emotional shock) leads, via vagal activation, to a sudden drop in blood pressure and a slow heart rate (bradycardia), resulting in a brief loss of consciousness (syncope). This is a well-defined neurocardiogenic mechanism and not evidence of the ‘polyvagal hierarchy’. Diagnosis and treatment lie within the fields of cardiology and neurology, not in a breathing workshop.
What is the bottom line?
The vagus nerve exists, is anatomically describable, has clearly defined physiological functions and is associated with a handful of real-world medical dysfunctions. The polyvagal theory has spun a narrative out of this sober anatomy, in which ‘ventral safety’, ‘sympathetic mobilisation’ and ‘dorsal shutdown’ organise an entire clinical language. After 2026, this language will no longer be empirically tenable. What remains are the effective techniques that work even without the polyvagal narrative, and the task of describing them honestly, rather than selling them with anatomically sounding fiction.
Sources:
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
https://pubmed.ncbi.nlm.nih.gov/41768017/
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.
Related