Anxiety and Polyvagal Theory

By Martin Truscott, NCPS Accredited Counsellor and Polyvagal-Informed Practitioner · Three Oaks Therapy · May 2023 (updated 2026)

📝 Editor's note: This is a substantially updated version of a post originally published in May 2023. The original introduced polyvagal theory and anxiety in brief. This version goes deeper — reflecting how my understanding and way of working have developed. The URL is unchanged to preserve search history.

Why Anxiety Lives in the Body, Not Just the Mind

If you've ever been told that your anxiety is 'just in your head', you probably already know that doesn't feel quite right. The tight chest before an important meeting. The racing heart when your phone rings with an unknown number. The sense of dread that arrives before you've had a single conscious thought. These aren't imaginary. They're real, they're physical, and they're happening in your body before your thinking mind has caught up.

The Nervous System Has Three Gears, Not Two

Most of us were taught a simple version of the nervous system: fight-or-flight when we're stressed, rest-and-digest when we're calm. That's useful as far as it goes, but it misses something important.

Polyvagal theory, developed by neuroscientist Dr Stephen Porges, describes three distinct states of the nervous system — arranged in a hierarchy, and each with its own characteristic quality of experience.

The first is the ventral vagal state — the state of safety and social engagement. When you're here, the body is settled, the mind is clear, and you feel most like yourself. You can think well, connect with other people, and handle difficulty without it feeling like a threat. This is the state that good therapy — and good relationships — aim to support.

The second is the sympathetic state — the fight-or-flight response. This is the one most people associate with anxiety: the racing heart, the shallow breathing, the urgency and restlessness and sense that something is wrong. It exists to protect you from threat. The problem is that it can be triggered by things that aren't actually dangerous — a difficult conversation, an overflowing inbox, a worry about the future. The body responds the same way regardless.

The third is the dorsal vagal state — the oldest and most extreme protective response. When the nervous system decides that fighting or fleeing isn't possible, it shuts down. This is the freeze response: numbness, flatness, disconnection, the sense of going through the motions without really being there. Anxiety doesn't always look like panic. Sometimes it looks like this — like an inability to feel much at all.

Why Anxiety Isn't a Thinking Problem

One of the things polyvagal theory helps explain is why telling yourself to calm down so rarely works.

When the nervous system has shifted into sympathetic activation — when fight-or-flight is running — the thinking brain is no longer in charge in the way it normally is. It's working in service of the alarm, not against it. The rational part of you that knows you're safe can't simply override a body that has already decided otherwise.

Porges calls the nervous system's threat-detection process neuroception — a below-conscious scanning of the environment that happens faster than thought. Your nervous system makes its assessment before you've had a chance to think about it. This is why you can feel anxious without knowing why. Your body has already decided.

This is also why approaches that focus only on changing thoughts — though they have real value — sometimes feel limited for people with anxiety. The body needs to learn safety, not just hear about it.

What Polyvagal Theory Points Toward

If anxiety is fundamentally a nervous system state rather than just a set of thoughts, then working with it means working with the body as well as the mind. Not instead of — as well as. Both matter.

In practice, being polyvagal-informed means I pay attention to what's happening in the body in sessions — not just what's being said. The quality of breathing, the moments of settling or activation, the physical signals that often arrive before words do. The body holds a lot of information that hasn't yet made it into conscious thought.

It also means understanding that regulation — returning the nervous system to a ventral vagal state — isn't just about techniques. It's about felt safety. And one of the most powerful sources of felt safety for a human being is the presence of another regulated human being. This is one of the reasons the therapeutic relationship matters so much — not as a backdrop to the work, but as part of how the work actually happens.

As a person-centred counsellor, I've always understood this intuitively. Polyvagal theory gave me the language to understand why.

Some Things That Can Help

There's no single technique that works for everyone — and one of the values of working pluralistically is that we find what's actually useful for you, rather than applying a standard set of tools. That said, some things have a fairly reliable effect on the nervous system, and are worth knowing about.

Slowing and deepening the breath — particularly lengthening the out-breath — directly stimulates the vagus nerve and begins to shift the nervous system toward a more settled state. This isn't just relaxation. It's physiological regulation.

Social connection is one of the most powerful regulators the nervous system has. Being with people who feel safe — or having a conversation where you feel genuinely heard — can shift your state in a way that solitary techniques often can't.

Movement, time in nature, and physical activities that bring you into your body can all help discharge sympathetic activation and support the return to ventral vagal. These aren't alternatives to therapy — they're things that support it.

And sometimes — particularly for people whose anxiety is longstanding, or whose nervous system has been in a state of chronic activation — the most useful thing is to work with someone who can help you understand the patterns underneath the anxiety, where they came from, and what they're protecting you from.

If This Resonates

Anxiety is one of the most common reasons people come to see me, and it's something I understand both professionally and personally. The experience of a nervous system that won't switch off — that keeps firing the alarm even when there's no danger — is exhausting, isolating, and deeply frustrating.

But it is workable. The nervous system learns, and it can also unlearn. With the right support — working with the body and the mind together, understanding what's driving the anxiety and building genuine felt safety over time — things can and do change.

I work with individuals only, and I offer a free initial consultation if you'd like to talk about whether working together might be right for you.

You can read more about my approach on the polyvagal-informed counselling page.

I’d love to have a conversation about what’s going on for you and how I might be able to help. Book a free 20-minute chat — in person at Broughton Gate, Milton Keynes, or online anywhere in the UK.

Find out more about polyvagal-informed counselling and how it shapes my sessions.

Phone: 07368 155826
Email: [email protected]
Enquiry form: threeoakstherapy.co.uk/#contact
Martin Truscott · Dip CST & Prof.DipPsy.C · NCPS Accredited · Person-Centred · Pluralistic · Polyvagal-Informed
Broughton Gate, Milton Keynes MK10 · In-person and online

A note on AI: This updated version of the post was written with the assistance of AI, based on my own professional knowledge, training, and experience as a counsellor. All content reflects my own views and approach. The header image was also created using an AI image generation tool. I like to be transparent about both.