Polyvagal Theory states that to regulate the nervous system, one must feel safe. The vagus nerve subconsciously evaluates and responds to cues of safety or danger in the environment. Engaging the ventral branch of the vagus nerve allows a shift from states of mobilized or immobilized fear to a state of safety and social engagement.

The client becomes self-empowered with tools to shift from sympathetic nervous system dominance toward a feeling of safety and social engagement by activating the ventral branch of the vagus nerve.

Female, age 31. Private equity junior executive, in the process of taking a new, higher stress job. She lives in NYC, with her fiancé and their young dog. A kitchen and bath home renovation requiring relocation out of the apartment for several months will begin in six weeks. General good health. Exercises regularly: Pilates, plays tennis, power yoga, long walks in park with dog. History of migraines and TMJ. Overall healthy diet. Client has a strong social support network.

The plan was to enable the client to notice when she is experiencing sympathetic dominance and give her an opportunity to try out some techniques to balance her nervous system and shift towards calm. The intention was for her to incorporate these techniques into her daily life, possibly adding a consistent practice to daily routines she already has. The first step was to explain the stress response and how polyvagal theory addresses relieving the stress, restoring balance and calm. The client would then explore how she feels in various work and home life situations, distinguishing situations that create a sense of safety and confidence from those where she feels unsafe and tense. She would choose among these techniques and practice them for three weeks with weekly check-in meetings over that time.

Hatha Mindful head, neck and spinal movements connected with the breath. Pranayama, brahmari breathing.

Raja Sutras 1.27-1.29, The expression of Ishwara is the mystic sound of OM. To repeat it in a meditative way reveals its meaning. From this practice, the awareness turns inward, and the distracting obstacles vanish. Sutras 1.30-1.32, Distractions of the mind-stuff as obstacles, including restlessness. Sutra 4.3, Potentialities naturally express when obstacles are removed. Sutra 4.5 Although the activities of the individualized minds may differ, one consciousness is the initiator of them all. Translations from Inside the Yoga Sutras by Reverand Jaganath Carrera

Japa A-U-M-[silence] mantra repetition.

The client presented upbeat, yet pale, and fatigued with shadows under her eyes. She was in constant motion, tapping or shaking a foot. She was eager to try out calming techniques, more interested in techniques than the why of polyvagal theory. She feels safest and calmest is at home with her fiancé and dog. She feels the least safe interviewing, during work travel, at board meetings, and walking in some neighborhoods of NYC.

She chose to practice A-U-M-Silence mantra and brahmari breathing. In collaboration, she chose to add these practices to her established morning prep and nighttime sleep routines. After Week 2, she began sprinkling them in at other times when she felt tense. She asked for a movement practice to do after walking her dog. We settled on some mindful spinal movements with extended exhale and core activation. I was encouraged by the initiative she took.

• Stick with these techniques. Notice if she is reverting to old tendencies and take action to create more balance and ease for herself.
• Acknowledge the efforts she made in this regard and the results of her efforts.
• Remember how she feels after practicing the polyvagal techniques.
• As she becomes curious, explore new techniques while staying steady with at least one or two of the practices she established during our yoga therapy time together.
• Remain open to her creative spirit.

The plan was carried out as conceived and the goal was achieved thanks to the client’s consistent efforts. The client became confident in her ability to create a sense of safety, calm, and clarity in herself to varying degrees when experiencing ongoing or intense stress and while faced with uncomfortable situations or environments.

Adaptations. We added a movement practice and weekly reflective journaling upon the client’s suggestion.

Lessons.
• A trusting relationship between yoga therapist and client creates space for the client’s creativity to flourish and invites curiosity.
• The techniques are tools. The therapeutic relationship facilitates the client’s willingness to try new things.
• Conduct my yoga therapy sessions as selfless service.

This approach addressed the client’s goals well. I would repeat it.

The client practiced consistently. She gained greater awareness of her responses to her surroundings. With this awareness she was able to employ the techniques she learned to engage the ventral branch of the vagus nerve and shift toward a state of safety.

She began writing weekly reflections. Realizing how much she missed writing, she added creative writing to her journaling.

If meeting for longer, I would include eye movements, a short asana flow, and a restorative supportive chest opener.

The client’s profession requires productivity under high stress, with high expectations. She takes little time for self-reflection. Our sessions, along with her at home practices, gave her an opportunity to take stock of how infrequently she de-stresses without collapsing in a state of immobilization or sickness. She was empowered by her ability to induce a sense of calm, safety, and clarity. At our last session she appeared more still and at ease. The client’s creative spirit emerged when she gave herself time for quiet self-reflection. This was inspiring for the client and for me.