Virtually every patient I’ve met who has suffered from chronic illness presents with some aspect of neurological dysfunction related to the regulation of the autonomic nervous system (ANS). As a simplified discussion, the ANS is the body’s system for determining when there’s a threat (and the need to flee or freeze up/play dead) vs. the state of being where the body can focus on rest and digestion. A cranial nerve called the vagus nerve is responsible for the neural regulation of the face, head and viscera (organs). The vagus nerve has 3 primary functions:
- Parasympathetic functions – the nerve is responsible for metabolic processes, heart rate, digestion, urination, sexual arousal, and salivation—our main bodily functions that occur while resting/feeling safe.
- Sensory – the nerve processes sensory information from the heart, lungs, throat and abdomen, and has special functions related to taste behind the tongue.
- Motor functions – the nerve provides movement to the neck muscles responsible for swallowing and speech.
The vagus nerve has a direct influence on the salivary glands, heart rate, bronchi constriction, peristalsis and digestion, bile secretion, and bladder activity. When this nerve is not functioning properly, patients may find themselves more in Sympathetic-dominant neural regulatory states which can lead to increased fight or flight and freeze reactions, often to benign stimuli. Emotional factors including history of trauma and PTSD are closely connected to a dysfunctional nervous system status that is Sympathetic-dominant.
The great news is, we can reverse and re-set these neural pathways, even when they’ve been dysfunctional for decades. There are a number of programs and treatment interventions available to patients to assist in improving the Parasympathetic (rest and digest) state and decreasing the adrenaline-filled Sympathetic (fight or flight/freeze) state, and this is a really key component to overall healing and well-being.
I recommend a minimum of the following:
- Daily meditation
- Daily breathing exercises
- Choosing to integrate of one of the “official” programs or approaches into your treatment plan (see table below)
- Addressing the presence of trauma with a mental health professional as an adjunct to addressing the nervous system in other ways
The vagus nerve runs through the esophageal hiatus of the diaphragm, the dome-shaped muscle under the ribs that expands when we take a deep breath. Movement of the diaphragm around the vagus nerve helps stimulate “rest and digest” tone. Breathing exercises should incorporate a longer exhale than inhale time, because inhaling increases the heart rate and Sympathetic nervous system stimulation, and exhaling increases Parasympathetic nervous system tone. Deep diaphragmatic breathing is also helpful as this stimulates the vagus nerve.
Gargling, singing, humming, and chanting can also stimulate the vagus nerve and are encouraged in this process. Some also believe that drinking cold water and taking cold showers or splashing cold water on the face positively impact the vagus nerve. You can also imagine a juicy lemon and fill your mouth with saliva, submerging your tongue for a short time in order to experience a hyper-relaxing vagal response. Connecting with others in meaningful conversation and, believe it or not, extended hugs and embraces are also supported by experts to improve vagal tone.
Journaling, exercise, reading, mindfulness, prayer, yoga, tai chi, massage, laughter, coloring, playing with kinetic sand, doing a puzzle, and other calming activities are also strongly encouraged and should be prioritized. Slowing down is key!
The following table is not all-inclusive, but it contains a summary of some of the “official” options out there available to patients to help re-train the nervous system. I have not tried all of these personally and cannot attest to most of the claims made about any of these programs. There is no “right approach” and many patients find that trial and error is necessary until they find an approach that best suits them. Some patients prefer the self-guided video approach, while others appreciate a more tangible or tactile experience.
Nervous System-Focused Treatment Approaches:
| Approach | Pros & Cons | Resources |
| Annie Hopper’s Dynamic Neural Retraining System (DNRS) | Limbic system-focused home program with DVDs. Neuroplasticity seminars also available.
Pros: patients report improvements in nervous system as well as chemical sensitivities Cons: time-intensive (1 hour a day for 6 months, or less time for longer duration) and requires conscious interruption of trauma cycles; $$ ($249-$315) |
www.retrainingthebrain.com |
| Gupta Program Brain Re-Training | Video sessions, audio exercises, meditations, coaching webinars, Facebook group, and other online resources.
Pros: free 28-day trial available to test the program out Cons: $$ ($349 cost plus $50 annual fee) |
www.guptaprogram.com |
| Safe & Sound Protocol (SSP)*
(5-day auditory therapy) |
Auditory therapy that strengthens middle ear muscles to improve parasympathetic state, social engagement, sensitivities, etc.
Pros: shorter duration treatment (5-10 days total) Cons: approach must be utilized with a trained practitioner, but can completed via telehealth |
www.integratedlistening.com |
| Wim Hoff Method | The three pillars of this approach include breathing, focus, and controlled exposure to cold. Online videos are available, including one free mini course, or a ten-week program ($199, currently has 50% discount)
Pros: more manageable schedule; simple focus on three pillars, more affordable Cons: some patients are unable to tolerate cold showers, but this can improve over time |
www.wimhofmethod.com
|
| Abdominal Massage & Yoga Twisting Postures/Breath Work | A combination of gentle abdominal self-massage and reclined spinal twists can help stimulate the vagus nerve. Yoga breathing techniques also increase vagal tone.
Pros: simple, easy to learn; often free and performed at home Cons: discomfort possible during abdominal massage for individuals with GI inflammation/swelling |
https://chopra.com/articles/reducing-inflammation-starts-with-the-vagus-nerve |
| Tension & Trauma Releasing Exercise (TRE) | TRE is an innovative series of physical exercises that activate a natural shaking reflex which helps dissipate Sympathetic nervous system tone.
Pros: does not address trauma history consciously; patients learn how to do it on their own at home Cons: Initial session(s) need to be with trained practitioner |
https://traumaprevention.com/ |
| Heart rate variability (HRV) training | Heart rate variability is the variance in time between each heartbeat. Individuals who have an imbalanced nervous system will have a measurably low HRV, whereas individuals in good health tend to have a higher HRV and better adaptability and responses to external factors. Improvements in HRV correlate with improvements in Parasympathetic (rest and digest) nervous system tone. A number of different companies make devices that measure your heart rate variability; these devices can be used in conjunction with a separate treatment approach (such as breathing exercises, yoga and other therapies) to receive biofeedback on your overall progress over time. The information can also be used to determine how hard to push the current day’s physical activity.
Pros: objective data helps motivate patients to create new lifestyle habits for nervous system re-training Cons: requires initial purchase and sometimes has monthly fee; not everyone prefers to have daily feedback on biometric analyses |
Elite HRV, Whoop, and Oura are some popular brands. Some of these devices also have connected phone apps to track progress. |
| Neuvana Zen*
(auditory device) |
Vagus nerve stimulation headphone device created by a neurologist.
Pros: portable, self guided Cons: $$ ($399 USD) |
www.Neuvanalife.com |
| Parasym*
(auditory device) |
Vagus nerve stimulation machine with one earbud.
Pros: different frequency programming depending on your own needs/focus Cons: $$$ ($599 Euros) |
www.Parasym.co
|
| Handheld vagus nerve stimulators
(like gammaCore)
|
Handheld device for gentle electrical stimulation to the neck area.
Pros: GammaCore is FDA-approved for migraines and cluster headaches; some other devices are more specific for epilepsy Cons: typically available by prescription only |
www.Gammacore.com |
*It’s important that listening/auditory programs are begun with the guidance of a professional, as the process of re-training muscles in the middle ear can sometimes elicit symptoms the require modification or adjustments. While auditory devices may be more easily integrated for a general population, patients with a history of chronic illness and/or trauma need to be carefully monitored.
As a practitioner, I work with clients and guide them through the Safe & Sound Protocol (SSP) and have witnessed profound changes within the 5-day treatment window, as well as in the months that follow. Emotional Freedom Technique (EFT), Brain Spotting, and other biofeedback programs can also be very effective for addressing the mind-body impact of trauma. As I mentioned, there is no silver bullet for re-training the nervous system successfully. It requires significant time and patience, but it can have a profound impact on the quality of life for patients with chronic illness.
