The Theory That Conquered Therapy and the Wellbeing Industry Is Wrong

For years, people asked us: why don't you talk about polyvagal theory? Our answer was honest. We simply did not recognise it in practice. The classical description of the autonomic nervous system was recognisable, applicable, and reliable. Now we understand better why.

39 experts. One conclusion.

These are not outsiders or critics who have never studied the PVT. Thirty-nine leading scientists, specialising in the physiology and evolution of the vagus nerve and in the social behaviour of vertebrates, recently published a joint article. Many of them are cited within the PVT literature itself as evidence supporting the theory. With one exception, all of those invited accepted and co-authored the paper.

"The core tenets of polyvagal theory are not supported by scientific evidence, and in several instances are outright inconsistent with the broader evidence base."

What is wrong with it?

The scientists tested five central elements of the PVT against the current state of knowledge. On none of these points did the theory hold up:

• The claims about the vagus nerve

• The evolutionary narratives

• The neuroanatomy

• The claims about the exclusivity of social behaviour in mammals compared to other vertebrates

• The interpretations of earlier landmark research

  
  

Metaphor, map, or framework: it does not matter if the foundation is missing

Some defend the PVT by saying it is merely a metaphor, a map, or a framework rather than strict science. But that reasoning does not hold either. A metaphor presented as scientific reality to patients or clients is misleading, regardless of the good intentions behind it. A map is only useful if it bears some resemblance to the actual territory. When the landmarks have no scientific basis, that map will get you lost. 

What does this mean for heart coherence and HeartMath?

This also touches on broader claims within the wellbeing industry. Much of what is said about heart coherence and HeartMath rests on the assumption that RSA is a direct measure of vagal tone. Recent expert evaluations show that this is an oversimplification.

WHAT ARE RSA AND VAGAL TONE?

RSA (Respiratory Sinus Arrhythmia) is the natural variation in heart rate during breathing. Heart rate rises slightly during inhalation and drops slightly during exhalation. RSA is not a measuring instrument but a physiological phenomenon that is measured as part of HRV.

Vagal tone refers to the level of activity of the vagus nerve at rest. Higher vagal tone is generally associated with better emotional regulation and recovery from stress.

The problem: RSA is strongly influenced by breathing rate and depth. Someone who breathes slowly and deeply will automatically show higher RSA, regardless of what their actual vagal tone is doing. RSA is therefore at best an indirect, rough index of vagal involvement, not a direct measure.

Devices such as those made by HeartMath do genuinely measure HRV patterns, but the coherence score is primarily a measure of how regular and breath-synchronised the heart rhythm is, not of vagal tone or a sense of safety. The physiological benefits of these protocols likely arise from slow, rhythmic breathing and general HRV biofeedback. A simpler model suffices for that than the elaborate vagus-and-safety narrative that is so often invoked in the world of heart coherence and polyvagal theory.

What does this mean for practice?

None of this means that body-oriented therapy, attention to the nervous system, or working with embodied experience is without value. Quite the opposite. But it does argue for using more accurate explanations of the autonomic nervous system when physiological knowledge forms part of the work. Those explanations exist, though they require some effort to make your own.

We continue to work with the classical description of the autonomic nervous system.

We continue to work with the classical description of the autonomic nervous system.

Not out of habit. But because it is accurate. Good care deserves a solid foundation, and that foundation deserves the best available knowledge.

"The classical description of the autonomic nervous system is not outdated. It is accurate."