Lecture 7: Polyvagal + Cognitive Trauma Theory

• Cognitive (Trauma) Theory is based on Ehlers & Clark's (2000) model of PTSD

Key Evidence for Cognitive (Trauma) Theory

• "The 5 Pathways Study" by Barlow et al. (2017) involved 466 university students

• Child maltreatment was indirectly linked to PTSD via 5 trauma appraisal/emotion regulation pathways (e.g., betrayal, shame, fear, self-blame)

• All maltreatment domains interacted, producing unique effects based on type

• "Negative Beliefs and Psychopathology" by Beck et al. (2015); Conway et al. (2016); Lilly & Lim (2013) links trauma exposure to negative cognitions about the world, self, and others, increasing the risk for various psychopathologies

• "Worry Helps Me?!" by Myers & Wells (2015) connects emotional abuse (but not other traumas) to maladaptive metacognitive beliefs

• Examples of maladaptive metacognitive beliefs include "Worrying helps me avoid problems" and "It's bad to think certain thoughts."

• "The Online Cognition Study" by Germine et al. (2015) includes over 5,000 adults across 6 countries

• Child maltreatment, especially physical abuse & domestic violence, is associated with Reduced Theory of Mind (ToM), low social motivation, parental neglect leading to low motivation, and parental dysfunction leading to poor social cognition

• Cognitive (Trauma) Theory explains trauma's cognitive effects like negative appraisals and maladaptive beliefs

• It is supported by a variety of data, including self-reports, cognitive tasks, and neuropsych evidence

• It interacts with biological and social systems (Germine et al., 2015)

Strengths of Cognitive (Trauma) Theory

• This theory explains how trauma becomes embodied
• It is backed by physiological data (HRV, co-regulation)
• It offers practical interventions like breathwork and yoga

Limitations of Cognitive (Trauma) Theory

• Less focus on non-trauma environmental influences
• Heavy reliance on self-report methods
• May miss developmental timing of cognitive changes post-ACEs

Polyvagal Theory by Stephen Porges (2009, 2011)

• "Mum's Voice Calms Me” by Rand & Lahav (2014); Uchida et al. (2018) shows that a mother's voice reduces infant heart rate and increases brain activity (frontal lobe, respiration)
• Safety is experienced physiologically in connection with caregivers
• "Still Face Effect" by Moore et al. (2009); Tronick et al. (1978) shows that infants react physiologically to a lack of emotional attunement (Still Face Paradigm)
• Disrupted co-regulation impacts stress systems (e.g., vagal tone)
• "Touch Matters” by Tanaka et al. (2021) shows that physical affection from mothers reduces avoidant behaviour and increases exploration
• Social safety builds regulation capacity
• “The HRV Trauma Link” by Meyer et al. (2016); Bakema et al. (2020) notes that lower heart rate variability (HRV) and baroreflex sensitivity (BRS) are found in people with PTSD/BPD and those with child abuse histories
• "The Yoga Nerve” by Gerritsen & Band (2018) shows that vagal nerve stimulation (via yoga, breathwork, and mindfulness) improves mental & physical health

Strengths of Polyvagal Theory

• It explains how trauma becomes embodied
• It is backed by physiological data (HRV, co-regulation)
• It offers practical interventions like breathwork and yoga

Limitations of Polyvagal Theory

• Exact brain-body integration (CNS-PNS link) is still unclear
• Some social engagement mechanisms are under-researched
• It doesn't fully explain why certain responses occur in different people

Integration of Theories

• Cognitive trauma theory focuses on negative appraisals and uses CBT, metacognitive therapy
• Polyvagal theory focuses on embodied trauma responses and uses mindfulness, yoga, breathing
• Attachment theory focuses on early relationships and uses interpersonal therapy
• Neurobiological theory focuses on brain/medication-based approaches and uses medication and neurofeedback

Summary for Quick Recall

• Cognitive trauma theory: "It's my fault" thinking explains why people blame themselves (supported by cognitive and social psychology research)
• Polyvagal theory: "My body doesn't feel safe" explains why trauma gets stuck in the nervous system
• Both theories are backed by empirical studies, offering insights for therapy
• A holistic approach that blends thinking + physiology + relationships is most effective for addressing the effects of ACEs