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A 2026 paper calls polyvagal theory "untenable"—but only its mechanisms, not its clinical tools.

Somatic trauma therapies and co-regulation practices work independently of the theory's mechanism.

When effective frameworks are abandoned over theory disputes, patients pay the highest price.

There has been a bit of a kerfuffle around polyvagal theory lately. Here’s what happened: a group of 39 researchers—neurophysiologists, evolutionary biologists, and autonomic scientists—published a paper declaring polyvagal theory "untenable." Social media (and some real media outlets) ran with this as confirmation that the whole framework has been "debunked." Before clinicians and clients begin dismantling approaches that are genuinely helping people, it's worth understanding what the critique actually says—and maybe more importantly, what it doesn't.

What Polyvagal Theory Actually Claims

Developed by Stephen Porges in the 1990s, polyvagal theory proposed that the autonomic nervous system is more complex than the classical two-branch model of sympathetic and parasympathetic suggested. Porges identified a hierarchical three-tier structure: a ventral vagal state supporting social engagement and felt safety; sympathetic activation driving fight-or-flight; and a dorsal vagal shutdown state associated with collapse, freeze, and dissociation. The theory also introduced the concept of neuroception—the nervous system's continuous, below-conscious scanning for cues of safety or threat.

These ideas gave clinicians something they had long needed: a neurobiological framework for understanding why trauma survivors get stuck in dysregulated states, why "irrational" responses to safe situations are anything but irrational, and why the therapeutic relationship itself functions as a regulating environment. It is worth noting that Porges is not a fringe figure. He is a Distinguished University Scientist at Indiana University's Kinsey Institute, Professor of Psychiatry at the University of North Carolina, and the author of more than 400 peer-reviewed publications. His first paper, published in 1969, was the first to link heart rate variability with autonomic function—foundational work that underlies modern biometric monitoring (e.g., the Oura Ring, Apple Watch).

What the Critics Are Actually Arguing

The 2026 critique takes aim at the neurophysiological and evolutionary foundations of the theory, not its clinical applications. The researchers make three core arguments: that the evidence for polyvagal theory's evolutionary claims is weak; that the anatomical distinctions Porges describes between ventral and dorsal vagal pathways are not as clean as the theory requires; and that respiratory sinus arrhythmia—the key measurement the theory relies on as a proxy for vagal tone—is not reliable across different physiological conditions.

In plain terms: The specific neurological architecture the theory depends on may not work precisely the way Porges describes. These are legitimate scientific critiques, and they deserve rigorous engagement. It is also worth noting that versions of these critiques have circulated in the peer-reviewed literature since at least 2007, and Porges has responded to each iteration—including this most recent paper. That ongoing exchange is not a sign of a theory in collapse. It is science working as it should.

The Distinction That Matters

When scientists declare a theory "untenable," they mean something specific: The mechanistic claims are not adequately supported by current evidence and need to be revised, refined, or abandoned. This is categorically different from saying that everything built on or inspired by that framework is without value. Conflating the two causes real harm—to practitioners, to the field, and most importantly, to the people being treated.

Consider the history of aspirin. For decades, physicians prescribed it reliably for pain, fever, and inflammation without any understanding of its mechanism. It wasn't until the early 1970s that John Vane identified how aspirin inhibits the COX enzyme to interrupt prostaglandin synthesis—work that earned him the Nobel Prize in 1982. The therapeutic effect was never in question. Only the explanation was missing. The gap in the scientific account did not create a gap in the medicine.

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The parallel with polyvagal-informed clinical practice is direct. We have robust evidence that extended exhale breathing reduces physiological arousal. We have strong evidence that social connection and co-regulation decrease sympathetic activation. Research consistently shows that rhythmic movement, humming, and prosodic vocalization affect autonomic state. None of this evidence depends on polyvagal theory being mechanistically correct. These findings stand independently. What polyvagal theory provided was an organizing framework—a coherent story that helped clinicians understand why these interventions work and helped patients understand why their responses to trauma were not failures of will or character.

What This Means for Practice

The interventions that grew from polyvagal-informed work—somatic approaches to trauma, titrated exposure, paced breathing, attention to the regulating function of the therapeutic relationship—have documented efficacy that does not rise or fall with the mechanistic debate. Polyvagal-informed frameworks have been applied across trauma treatment, chronic pain, functional neurological disorders, pediatric care, and educational settings, with consistent reports of symptom reduction and improved regulation.

Good science is iterative. Theories are proposed, tested, challenged, and refined. Porges himself has updated the theory multiple times in response to critique, and the current debate is live and unresolved. The 39 authors of the critique paper are not the final word.

Practitioners can hold two things at once: Some of the specific neurophysiological claims of polyvagal theory are genuinely contested, and that debate deserves to play out in the scientific literature, and the clinical framework, the language of safety and dysregulation, and the interventions that emerged from this work continue to have documented value. Discarding them in response to a mechanistic dispute would not be evidence-based practice. It would be an overcorrection with real costs for real people.

The nervous system is real. Dysregulation is real. The need for safety is real. However this theoretical debate resolves, none of that changes.

Grossman, Paul & Ackland, Gareth & Allen, Andrew & Berntson, Gary & Booth, Lindsea & Burghardt, Gordon & Buron, Julie & Dinets, Vladimir & Doody, J. & Dutschmann, Mathias & Farmer, David & Fisher, James & Gourine, Alexander & Joyner, Michael & Karemaker, John & Khalsa, Sahib & Lakatta, Edward & Leite, Cleo & Macefield, Vaughan & Zucker, Irving. (2026). THE POLYVAGAL THEORY IS UNTENABLE An international expert evaluation of the polyvagal theory and commentary upon Porges. Clinical Neuropsychiatry. 23. 100–112. 10.36131/cnfioritieditore20260110.

Porges SW. Polyvagal Theory: Current Status, Clinical Applications, and Future Directions. Clin Neuropsychiatry. 2025 Jun;22(3):169–184. doi: 10.36131/cnfioritieditore20250301. PMID: 40735382; PMCID: PMC12302812.

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