Tag Archives: 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 Women and Children First Podcast #89 – Trenna Sutcliffe, MD – Autism and Development

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Today we are joined by a remarkable guest, Dr. Trenna Sutcliffe, a board-certified developmental-behavioral pediatrician and the founder of the Sutcliffe Clinic in the San Francisco Bay Area. Her educational history is impressive. She completed her undergraduate education in Molecular Biology and Medical Genetics followed by a masters degree in Biophysics at The University of Toronto. She obtained her Medical degree at McMaster University before her pediatric residency and training finished at the Hospital for Sick Children in Toronto. And oh by the way, she then did a year of pediatric Neurology residency and a Fellowship in Developmental Pediatrics. And finally, another Masters degree in Epidemiology at Stanford University. Thus, her educational path has allowed her to see the developmental landscape through a wider lens covering many disciplines. Dr. Sutcliffe started the first Developmental Pediatrics Clinic at Stanford and played the role of trailblazer throughout her career.

With over 25 years of experience, Dr. Sutcliffe specializes in supporting children with autism, ADHD, and anxiety, offering a multidisciplinary approach to diagnosis and treatment. In this episode, she’ll share her insights on the rising prevalence of these conditions, the importance of personalized care, and practical strategies for parents navigating developmental challenge. Fundamentally, Dr. Sutcliffe is a going to educate us on a better way to deliver whole person care to the developmentally challenged and beautiful children of this country.

Two words encapsulate her work: empowering and thoughtful.

Let’s dive into this conversation with Dr. Sutcliffe to learn how we can help our children thrive!

Dr. M

Dr. M’s Women and Children First Podcast #80 – Deborah Tate, PhD – Studying the Obesity Epidemic

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Obesity and Change – The Tech Intersection

Welcome to the podcast! Today, I am thrilled to host Dr. Deborah Tate, a distinguished professor in the Department of Nutrition at the University of North Carolina in Chapel Hill, with joint appointments in Health Behavior and Nutrition. She also holds a faculty appointment at the Nutrition Research Institute in Kannapolis, North Carolina where she explores innovative approaches to improve lifestyle behaviors that impact obesity, diabetes, and chronic disease risk. Dr. Tate is a behavioral scientist, receiving her Ph.D. in Clinical Psychology at Virginia Tech. Her research focuses on two main areas: (a) strategies for improving both short and long-term body weight regulation to reduce disease risks and (b) the development and translation of programs as alternatives to clinic-based care using digital and wearable technologies. She is known internationally for her work has published many papers in major nutrition and medical journals. Her work spans the intersection of behavioral health and obesity whereby she is a pioneer in digital health interventions. Her work has been pivotal in developing digital tools and online programs that support sustainable health changes, making access to wellness resources more inclusive and effective.

Dr. Tate has been at the forefront of harnessing technology to create lasting change, blending behavioral science with digital advancements to empower individuals and families to make improved choices. Her contributions have transformed how we think about health interventions in today’s digital age, offering scalable solutions that reach beyond traditional boundaries. Get ready for an insightful conversation with Dr. Tate as we dive into the science and the potential of digital health to foster resilience and well-being.

Enjoy,

Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 14 Issue 36

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Section I

Literature Review

1) Long Covid in children – the symptoms are getting more clarity in who has what . From JAMA: 898 school-age children (751 with previous SARS-CoV-2 infection and 147 without) and 4469 adolescents (3109 infected and 1360 uninfected) were included in the analysis. The time between infection and symptom analysis was 1.5 years. In models adjusted for sex and race and ethnicity, 14 symptoms in both school-age children and adolescents were more common in those with SARS-CoV-2 infection history compared with those without infection history, with 4 additional symptoms in school-age children only and 3 in adolescents only. These symptoms affected almost every organ system. The cumulative data shows us that neurocognitive (Headache, attention concerns, sleep dysregulation), pain, and gastrointestinal symptoms in school-age children were common, but changed to loss of smell and/or taste, body aches and pain, focus struggles and fatigue related symptoms in adolescents. (Gross et. al. 2024) Age has a huge effect on these outcomes as the older population has more frequent and problematical disease findings. Mood disorder is highly associated with worsened findings. I suspect from the historical data set over the last four years that children with chronic mental stress, poor quality diets, sleep issues, and poor activity levels at baseline have worsened acute and long term prognosis.

Plus a section on a book review for Change Your Genes, Change Your Life.

Enjoy,

Dr. M

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