What Every Chiropractor Can Learn From Dr. Stephen Porges
Polyvagal Theory and Chiropractic: What Every Chiropractor Can Learn From Dr. Stephen Porges
Polyvagal Theory has transformed how many healthcare professionals understand stress, healing, human behavior, and nervous system regulation.
In this episode of The Informed Chiropractor Podcast, Dr. Don MacDonald sits down with Dr. Stephen Porges, the creator of Polyvagal Theory, to explore how the nervous system influences patient outcomes and why safety may be one of the most important clinical concepts in modern chiropractic.
Their conversation explores neuroception, vagal regulation, trauma, patient communication, and how chiropractors can create environments that support healing rather than simply addressing symptoms.
Who Is Dr. Stephen Porges?
Dr. Stephen Porges is a distinguished neuroscientist and the creator of Polyvagal Theory.
His research transformed how healthcare providers understand the autonomic nervous system.
Rather than viewing the nervous system as a simple balance between sympathetic and parasympathetic responses, Polyvagal Theory describes a hierarchy of physiological states that influence behavior, communication, connection, and healing.
His work has influenced:
- Chiropractic
- Psychology
- Trauma therapy
- Physical therapy
- Occupational therapy
- Medicine
- Education
Today, Polyvagal Theory continues to shape conversations about safety, resilience, and human performance throughout healthcare.
What Is Polyvagal Theory?
Polyvagal Theory provides a modern understanding of how the autonomic nervous system functions.
Most healthcare professionals were traditionally taught that the autonomic nervous system consists of two branches:
- Sympathetic (fight-or-flight)
- Parasympathetic (rest-and-digest)
Polyvagal Theory expands this model by describing a hierarchy of nervous system states that influence how people think, feel, communicate, and respond to the world around them.
According to Polyvagal Theory, the nervous system constantly evaluates whether an environment is safe, dangerous, or life-threatening. These evaluations happen automatically and often outside conscious awareness.
The Three Primary States Include:
Ventral Vagal State
The state of safety, connection, learning, healing, and social engagement.
Sympathetic State
The state of mobilization, stress, anxiety, fight, or flight.
Dorsal Vagal State
The state of shutdown, withdrawal, collapse, or conservation. This state can influence how a person moves, communicates, heals, and responds to care.
Understanding these states gives chiropractors a deeper framework for understanding why patients respond differently to similar clinical interventions.
Why Safety Is Central to Healing
One of Dr. Porges’ most important contributions is the understanding that safety drives physiology.
When the nervous system perceives safety:
- Muscle tension often decreases
- Breathing patterns improve
- Digestion functions more efficiently
- Communication becomes easier
- Adaptability increases
- Healing environments become more effective
Without safety, the nervous system often shifts toward protection.
Many chronic symptoms can be viewed through this lens. The body may not be malfunctioning. Instead, it may be responding to perceived danger.
This perspective provides chiropractors with a new way to understand patient experiences beyond biomechanics alone.
How Neuroception Influences Chiropractic Outcomes
Neuroception is the nervous system’s unconscious detection of safety or danger.
Before patients consciously process their environment, their nervous systems are already evaluating:
- Facial expressions
- Tone of voice
- Body language
- Clinical environment
- Physical touch
- Timing and pacing of interactions
This helps explain why two patients can receive the same adjustment yet experience very different outcomes.
Their nervous systems may be operating from entirely different physiological states.
A patient who feels safe may become more adaptable and responsive, while a patient experiencing protection may remain guarded despite receiving excellent care.
Understanding neuroception helps chiropractors appreciate the role that communication and environment play in patient outcomes.
The Vagus Nerve and Chiropractic Care
The vagus nerve plays a critical role in many functions associated with regulation and recovery.
These include:
- Heart rate regulation
- Digestion
- Emotional regulation
- Social engagement
- Recovery and restoration
- Adaptive stress responses
Dr. Porges explains that vagal function is closely related to how humans experience safety and connection.
This understanding helps chiropractors view patient care through a broader neurological lens rather than focusing exclusively on structural findings.
While chiropractic care and vagal function remain active areas of discussion and research, Polyvagal Theory offers chiropractors a valuable framework for understanding regulation and resilience.
The Social Engagement System
One of the most influential concepts within Polyvagal Theory is the Social Engagement System.
This system coordinates:
- Eye contact
- Facial expression
- Voice tone
- Listening
- Human connection
- Emotional communication
When this system is active, people generally feel safer.
Communication improves.
Trust develops more easily.
Patients often become more engaged in their care.
Dr. Porges’ work highlights how the quality of human interaction can directly influence nervous system regulation and patient experiences.
What Chiropractors Can Learn From Dr. Porges
This interview offers several practical lessons chiropractors can immediately apply in practice.
Create Safety Before Treatment
Patients regulate before they heal.
Creating environments that support safety may improve patient experiences and outcomes.
Improve Communication
The nervous system responds not only to what is said but how it is said.
Tone, pacing, and presence matter.
Observe State
Patient behaviors often reflect physiology.
Understanding state helps clinicians respond more effectively.
Focus on Regulation
Better regulation often creates greater opportunities for healing, learning, and adaptation.
Value Human Connection
Relationships influence nervous system function.
Strong therapeutic relationships may help patients feel safer and more supported.
Polyvagal Theory and the Future of Chiropractic
Polyvagal Theory provides chiropractors with a framework that helps explain many observations clinicians have made for decades.
Patients are more than biomechanics.
They are nervous systems continuously interacting with their environments.
As chiropractic continues evolving, integrating neuroscience, communication, and regulation may help practitioners create more meaningful patient experiences and stronger clinical outcomes.
The future of chiropractic may involve not only understanding structure and movement but also understanding safety, connection, and nervous system regulation.
Key Takeaways From Dr. Stephen Porges
- Safety influences physiology.
- Neuroception drives behavior.
- The vagus nerve plays a major role in regulation.
- Human connection affects healing.
- Communication is a clinical skill.
- Chiropractic care can be viewed through a nervous-system-centered lens.
- Patients respond differently based on physiological state.
- Regulation creates opportunities for adaptation and healing.
- Understanding Polyvagal Theory can improve patient experiences.
- The future of healthcare may increasingly focus on safety and nervous system regulation.
- How Dr. Porges describes the polyvagal theory. [5:03]
- What drew Dr. Porges to commit his academic life to this theory. [6:35]
- Descriptions of the sympathetic and parasympathetic systems. [8:31]
- The dorsal vagas and its role as the ‘old vagas’. [9:36]
- How and why the body exits dorsal collapse. [12:02]
- Why we don’t remember trauma. [14:00]
- Navigating defensive states by using vagal activity. [14:53]
- The Safe and Sound Protocol. [17:46]
- The long road to creating a theory of neural modulation. [20:58]
- Returning autonomy to patients through polyvagal manipulation. [22:00]
- How our society keeps us locked in states of defense. [25:00]
- Creating a state of ease through awareness. [27:10]
- Activating the ventral vagal process through neural exercises. [28:00]
- Explaining co-regulation and how it works. [30:16]
- Proprioception through Chiropractic care and improving safety. [34:02]
- Understanding the mind/body relationship and feedback loops. [36:20]
- Why client interaction is key to creating safe spaces. [39:50]
- Alleviating the burden of responsibility and creating bodily awareness in patients. [43:10]
- How Dr. Porges conducts his research. [43:55]
- Case studies of long hauler COVID sufferers and how vagal stimulation can help them. [47:28]
- The importance of self-compassion and self-care for Chiropractors out there. [50:51]
Frequently Asked Questions About Polyvagal Theory and Chiropractic
What is Polyvagal Theory?
Polyvagal Theory is a neuroscience-based framework developed by Dr. Stephen Porges that explains how the autonomic nervous system responds to safety and danger.
Who is Dr. Stephen Porges?
Dr. Stephen Porges is a neuroscientist and the creator of Polyvagal Theory. His work has influenced healthcare, trauma therapy, psychology, chiropractic, and education.
How does Polyvagal Theory relate to chiropractic?
Polyvagal Theory helps chiropractors understand how nervous system states may influence healing, communication, stress responses, and patient outcomes.
What is neuroception?
Neuroception is the nervous system’s unconscious process of detecting safety or danger before conscious awareness occurs.
Why is safety important in chiropractic care?
Patients often respond more effectively to care when their nervous systems perceive safety and regulation.
What role does the vagus nerve play?
The vagus nerve influences heart rate, digestion, emotional regulation, social engagement, and recovery.
Can chiropractic care support nervous system regulation?
Many chiropractors believe chiropractic care may help support nervous system adaptability and regulation when combined with effective communication and patient-centered care.
What is the Social Engagement System?
The Social Engagement System is part of Polyvagal Theory and involves facial expression, voice, listening, eye contact, and human connection.
Why do some patients respond differently to the same adjustment?
Polyvagal Theory suggests that patients may respond differently because they are operating from different physiological states within their nervous systems.
How can chiropractors apply Polyvagal Theory in practice?
Chiropractors can apply Polyvagal Theory by creating safer clinical environments, improving communication, understanding patient state, and supporting nervous system regulation throughout care.
Continue Learning
- The MacDonald Safety Corridor Protocol
- What Is Polyvagal Chiropractic?
- Polyvagal Theory for Chiropractors
- Nervous System Regulation
- Neuroception for Chiropractors
- Vagus Nerve and Chiropractic Care
- Chiropractic Communication
- Patient Retention and Trust
- How to Improve Adjustment Readiness in Chiropractic Care - July 6, 2026
- Why Patients Do Not Heal as Expected - July 4, 2026
- Chiropractic and Emotional Wellbeing - July 1, 2026
