Tag Archives: parenting

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 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 #102: Jeremy Goldberg – Life Begins


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This weeks Guest is Dr. Jeremy Goldberg. He styles himself as a compassion cultivating day making change agent/empathy collecting not quitting word wizard/chief burrito appreciator aspiring to inspire/struggle overcoming ranter in charge/ferocious idealist/never giver upper/a love bombing kindness pirate. What he really does, in my mind, is write and teach the world to project love and kindness where it is not layered enough. On his website he writes: My mission is to make kindness cool, empathy popular, and compassion commonplace. As part of that purpose, I write articles, send emails, host retreats and workshops, give TEDx talks, coach clients, host a podcast, write books, and make spoken word poetry videos. My name is Jeremy, I founded Long Distance Love Bombs, and I am fucking stoked to meet you. Send me an email and let’s get going: LongDistanceLoveBombs at gmail dot com. We breakdown words, relationship, connection and being happy in a world of silly tribal divisiveness!

In this conversation we discuss his experience as a new father and the initiation of fatherhood. “I have been wiped out and annihilated by parenting and the initiation of fatherhood. Hands down, brutally, face dragged along the hot coals of the initiation….” There are so many real, honest, open truths dropped along the winding road of this discussion. If you are young and ready to understand the world of fatherhood, this is a conversation for you!

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 26 – Back To Sleep

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Back to Sleep and Sudden Infant Death Syndrome (SIDS)

Sudden Infant Death Syndrome (SIDS) is defined as “the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including a complete autopsy, examination of the death scene, and review of the clinical history.”

During my time at the University of Virginia, I trained under neonatologist Dr. John Kattwinkel, a champion for newborn health and one of the leading figures in shaping national safe sleep policies. In the early 1990s, he chaired the American Academy of Pediatrics (AAP) Task Force on Infant Sleep Position and SIDS, which laid the foundation for the landmark Back to Sleep campaign.

At that time, SIDS claimed roughly 14 infants per 10,000 live births in 1988. Following the campaign’s launch in 1994, the rate plummeted by over 60%, reaching about 5 deaths per 10,000 live births by 2006. Despite this dramatic improvement, recent data suggest that the decline has plateaued…..

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 25 – Tough Conversations

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Speaking Truth in Love: The Weight of Avoidance in Pediatric Metabolic Health

After completing the second round of our Asthma and Obesity Metabolic Pilot Program at Salisbury Pediatrics, I left the clinic reflecting deeply on what I witnessed. It crystallized a truth that is uncomfortable but undeniable: the greatest health threats to our children today are not infectious or accidental, they are metabolic. Diseases once reserved for adulthood: insulin resistance, fatty liver, hypertension, early vascular aging are now appearing in children who should be free to run, play, and thrive.

In modern society, conversations about weight and metabolic dysfunction have become relatively taboo. This is not to say that children of normal or low weight are immune; they, too, can be at risk. However, the excess-weight group carries the highest statistical burden. Too often, clinicians hesitate to speak truth to families for fear of offending, shaming, or overstepping. In doing so, we risk silence becoming complicity and allowing preventable disease to take root in the very children we are charged to protect.

Much of this epidemic is not born of individual failure but of systemic neglect. Government-funded, poor-quality school meals, cheap processed foods, and relentless marketing of sugar and refined carbohydrates have built an environment where metabolic injury is almost inevitable. When a child’s daily fuel is engineered for shelf life instead of cell life, the outcome is not accidental, it is predictable. Our pilot program lab results are a painful window into that truth…. and a literature review on eczema and anaphylaxis.

Enjoy Dr. M

Dr. M’s Women and Children First Podcast #96 Joel Warsh, MD Vaccines – What Do We Know in 2025?

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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, I’m joined by Dr. Joel “Dr. Gator” Warsh, a pediatrician, author, and advocate for a whole-child approach to healthcare. Dr. Warsh earned his medical degree from Thomas Jefferson Medical College and completed his pediatric residency at Children’s Hospital of Los Angeles. Along the way, he also obtained a Master’s degree in Epidemiology and Biostatistics from Queen’s University in Canada, giving him a strong foundation in both clinical care and population health. These educational pursuits make him uniquely suited for today’s conversation on vaccines.

He is the author of Between a Shot and a Hard Place. In his own words, he says: I’ve dedicated my career to helping families navigate complicated health topics with clarity. My book addresses vaccine questions in a calm, data-driven, and practical way, offering parents guidance that steers clear of extremes. Parents face unprecedented pressure to make the “right” choices, often without enough balanced information. He has been featured on major platforms sharing his message with more than 400,000 parents through social media. We discuss his passion for empowering families to make informed, individualized decisions, including in areas that have been challenging or even taboo to discuss.

Today, we’ll dive into his latest work, his perspectives on vaccines and preventative care, and how he envisions a future of pediatrics that is proactive rather than reactive. This is a conversation about rethinking the foundations of child health and it’s one you won’t want to miss.

Enjoy,

Dr. M

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