Behavior

Dr. M’s SPA Newsletter Volume 15 Issue 31 – Poly Vagal Theory, Stephen Porges, PhD

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I think that this is an important time to pause and relook at Polyvagal Theory before continuing with Beyond Behaviors.

Polyvagal Theory: Current Status, Clinical Applications, and Future Directions (Porges, S. 2025)

“Social behavior and the capacity to manage challenge are dependent on the neural regulation of physiological state.” S. Porges


When I dove into Stephen Porges’s 2025 review of the Polyvagal Theory (PVT), I felt like I’d stepped into a crossroads where neurobiology, clinical practice, trauma science, and human experience collide. This paper isn’t merely a summary of three decades of work (all of which I have read); it’s a spirited defense of a paradigm that’s been both celebrated (by me) and contested (by others). What follows is an honest appraisal of what the article teaches us, where it sparks real insight, and where it may fall short, especially through the lens of evidence-based medicine and developmental neurophysiology. (I also went deeper into his 2022 paper in Frontiers in Integrative Neuroscience for the biophysiology of the ANS)

At its heart, the article argues that the autonomic nervous system (ANS), through a set of hierarchically organized circuits centered on the vagus nerve, is not just a background player in stress and homeostasis, but a core regulator of social engagement, physiological flexibility, and behavior. Dr. Porges situates his theory as an alternative and expansion to classical views that treat sympathetic (fight/flight) and parasympathetic (rest/digest) branches as functional opposites. Instead, he proposes a three-component hierarchy: the ventral vagal complex (VVC) supporting social engagement, a mobilization circuit mediated by the sympathetic nervous system or fight or flight state, and a dorsal vagal circuit that facilitates shutdown or immobilization under extreme threat…..

Enjoy,
Dr. M

Dr. M’s Women and Children First Podcast #69 Repost – Stephen Porges, Ph.D. – Polyvagal Theory


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This week I sit down with Dr. Stephen Porges, a Distinguished University Scientist at Indiana University where he is the founding director of the Traumatic Stress Research Consortium. He is Professor of Psychiatry at the University of North Carolina, and Professor Emeritus at both the University of Illinois at Chicago and the University of Maryland.

He served as president of the Society for Psychophysiological Research and the Federation of Associations in Behavioral & Brain Sciences and is a former recipient of a National Institute of Mental Health Research Scientist Development Award. He has published more than 400 peer-reviewed papers across several disciplines including anesthesiology, biomedical engineering, critical care medicine, ergonomics, exercise physiology, gerontology, neurology, neuroscience, obstetrics, pediatrics, psychiatry, psychology, psychometrics, space medicine, and substance abuse. In 1994 he proposed the Polyvagal Theory, a theory that links the evolution of the mammalian autonomic nervous system to social behavior and emphasizes the importance of physiological state in the expression of behavioral problems and psychiatric disorders. The theory is leading to innovative treatments based on insights into the mechanisms mediating symptoms observed in several behavioral, psychiatric, and physical disorders.
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He is the author of multiple books on his Polyvagal Theory: including the Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation, as well as Polyvagal Safety: Attachment, Communication, Self-Regulation. His newest book cowritten with his son is called Our Polyvagal World, How Safety and Trauma Change Us. Dr. Porges is the creator of a music-based intervention, the Safe and Sound Protocol ™ (SSP), which is used by therapists to improve social engagement, language processing, and state regulation, as well as to reduce hearing sensitivities.

This is such a fascinating conversation. He brings the worlds of psychiatry and anthropological physiology into union for us to understand the why of trauma reactions and the future unwinding that is now possible. This is a must listen to conversation if you know anyone with trauma history.

Please enjoy my conversation with Professor Porges,
Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 30 – Beyond Behaviors Part 2, Mona Delahooke, PhD

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Review of Chapter 2 of Beyond Behaviors
by Mona Delahooke, PhD


“Social behavior and the capacity to manage challenge are dependent on the neural regulation of physiological state.” S. Porges

Top Down or Bottom Up?

“Before We Respond to Behavior, We Need to Understand Its Origin.”

With a deceptively simple observation, Dr. Delahooke reshapes the entire field of behavioral intervention: children’s actions come from two very different places in the brain. Some behaviors are top-down, intentional, planned, thoughtful. But many, especially the ones adults find most perplexing, arise bottom-up from stress responses generated by the body’s autonomic nervous system. We often think of this state in terms of fight or flight, however, it is not that simplistic. It is truly any significant response to the outside environment that leads to a neuroceptive reaction that is not governed by the neocortex, top down. If we don’t distinguish the source, our interventions are guesswork at best and often counterproductive at worst.

She illustrates this through a case, a child whose impulsive, disruptive behaviors were treated as failures of will or desire. School teachers and teams repeatedly urged him to “use his words,” as though language were a faucet he simply refused to turn on. What no one stopped to ask was the foundational question: Was his nervous system regulated enough to access language at all? Was he gated at the level of the amygdala blocking the ability to use his mind consciously and even have the opportunity to respond to a meaningful request? Is he capable of the ask, not in terms of willingness, but in terms of physiological access to the skill itself?
….. and more

Enjoy,
Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 29 – Beyond Behaviors, Mona Delahooke, PhD


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Review of Chapter 1 of Beyond Behaviors
by Mona Delahooke, PhD


“When we see a behavior that is problematic or confusing, the first question we should ask isn’t “How do we get rid of it?” but rather “What is this telling us about the child?” (MD 2019)


The opening chapter sets the stage for a quiet revolution in how we understand children who struggle. Dr. Mona Delahooke invites us to take a step back from the culturally and medically ingrained belief that children’s outward actions are reliable windows into their inner intentions – or what they really mean and want based on their actions. Instead, she asks, nay implores, us to adopt a more biologically accurate, compassionate, and clinically effective lens from which to view each child as they present themselves. Their behavior is communication from a developing nervous system striving for regulation and often stuck somewhere else, either frozen or in flight…..
Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 22/23/24 – Acetaminophen and Autism

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Review Part III – after the Attia Podcast

After completing the interview with Dr. William Parker and now listening to Peter Attia’s analysis, let us look again at this question. I repeat that the initial question has not changed for me. The first and most fundamental question to ask is this: What is the true value of acetaminophen in health compared with the potential risk if the associated findings are indeed correct?

My response to this question has been altered by the analysis so far.

I love this from Dr. Attia: “Some people might be wondering, why did you just take so long to explain all this to us? Why don’t you just give us the answer? I just want the sound bite, man

Peter’s reply, “If you just want sound bites, you’re never going to learn.”

Honestly, if you just want sound bites, this isn’t the podcast for you. But if you actually want to be able to learn to think for yourself, then that’s what we’re here to do. And that’s the reason we killed ourselves over the past week to put together the most thorough gathering of all the data we could find and the most intense night-weekend analysis possible. “

I agree! I believe that the science and data are key. So here goes – round three!…..

Dr. M

 

Dr. M’s Women and Children First Podcast #92 – Kristin Jones, OT – A Therapists View of the World Today

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Welcome back to Dr. M’s Women and Children First podcast where we look at the world of Women and Children’s Health through an anthropological lens with the humble understanding that we have a lot to learn.

Today, we’re honored to welcome Kristin Jones, a seasoned occupational therapist from Mooresville, North Carolina, whose career reflects both deep compassion and bold innovation in the service of neurodivergent children. Kristin brings 24 years of clinical and educational experience, including the past 14 spent working in a K-12 public charter school. Recently, she shifted gears in the most personal of ways—taking time away from school-based therapy to homeschool her daughter, who has Down Syndrome.

Kristin earned her Master of Occupational Therapy from Misericordia University in 2000 and has spent her career supporting children and families across a broad spectrum of settings from early intervention and outpatient sensory clinics to schools and feeding therapy. Her passion lies in translating complex concepts from brain development and the Autistic lived experience into practical, accessible strategies for educators.

In addition to her clinical work, Kristin is committed to the education of future therapists. She serves as adjunct faculty at Misericordia University and teaches with Education Resources Inc. Her presentations with the Therapist Neurodiversity Collective reflect her ongoing mission to uplift neurodivergent voices and move beyond outdated therapeutic norms.

Kristin’s voice is one of clarity and respect for children, for families, and for the evolving science of how we learn, communicate, and thrive.

Let’s dive in,

Dr. M

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Dr. M’s SPA Newsletter Audiocast Volume 14 Issue 18

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Unraveling the Mysteries of the Amygdala: A review of a section of the book Behave by Robert Sapolsky
In the world of neuroscience, Robert Sapolsky stands as a luminary, a maestro of unraveling the intricate dance of our brain’s circuitry. Among the many deep dives that he delves into, his perspective on the amygdala resonates profoundly for me. The amygdala emerges not as a mere anatomical curiosity as he decides that rather than reducing the amygdala to a simplistic seat of fear and aggression, he highlights its diverse functions, emphasizing its involvement in the vast array of behaviors and experiences. It is a narrative view of the why the brain developed as it did to aid us in the fight against pathogens, predators and stress. Sapolsky’s take on the amygdala is nothing short of revelatory, akin to a seasoned detective peeling away layers of a perplexing case. There are diverse neuronal pathways in this almond-shaped structure nestled deep within our temporal lobes and they have profound purpose. The amygdala emerges not merely as a primal seat of fear and aggression, but as a nuanced orchestrator of our emotional lives. All mammals have emotional responses that are split second to threat, joy and relationship. This is mediated……Plus a section on DNA and memory. Finally, a recipe.
Enjoy,
Dr. M

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