Feeling Safe: A Comprehensive Systematic Literature Review of Psychiatric Disorders through the Lens of Polyvagal Theory

Abstract

Safety on a psychological level is progressively renowned as fundamental to mental health issues and psychological well-being. The concept of feeling safe based on polyvagal theory, proposed by Stephen Porges (2011), has emerged as a comprehensive structure for understanding the autonomic nervous system's role in regulating social behavior, emotional processing, and physiological reactions. This review aims to explore the application of polyvagal theory in the understanding of psychiatric disorders, with a focus on how autonomic nervous system dysregulation influences emotional and behavioral manifestations, thereby contributing to the development of effective therapeutic interventions aimed at enhancing feelings of safety and well-being in the patients suffering from psychiatric disorders. The systematic literature review technique based on the PRISMA model was used for this purpose. Sources were obtained through PubMed, APA PsycArticles, PLOS, Research Gate, Google Scholar, and PubMed Central (PMC) database, using different keywords as the primary descriptor and limiting the sources to English-language articles published in the last ten years from 2013 to 2023. The review synthesized findings from various studies investigating the association between the polyvagal theory and psychiatric disorders, including anxiety disorders, depression, psychotic disorders, post-traumatic stress disorder (PTSD), borderline personality disorder, and childhood disorders including conduct disorder, attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). The results exhibit that individual suffering from these psychiatric disorders frequently displayed autonomic nervous system dysregulation, as proposed by the polyvagal theory, which seems to be a shared feature in many psychiatric disorders. The systematic review highlighted the significance of physiological aspects of mental health and indicates that interventions focusing on autonomic regulation may hold the potential to assuage the basic symptoms relevant to psychiatric disorders. Additional research work is defensible to clarify the primary mechanisms and improve the implication of interventions which are based on polyvagal theory for better clinical outcomes.

Keywords

• autonomic nervous system, mindfulness, psychological safety, psychiatric disorders, vagus nerve