Polyvagal Theory: How Survival Wiring Shapes Chronic Illness

Our nervous system is ancient. Long before modern life, before chronic illness was even a concept, it evolved to do one thing above all else: keep us alive. Polyvagal Theory—developed by Dr. Stephen Porges—gives us a deeper understanding of this survival wiring. It explains how our body constantly scans for safety or danger, and how those signals determine whether we rest, connect, or shut down.

For people living with chronic illness, trauma, or ongoing stress, understanding these survival states is often the missing piece. It helps explain not only why symptoms flare, but also why the body sometimes struggles to heal.

The Three States of Survival

Polyvagal Theory describes three distinct states of the autonomic nervous system, each linked to our primal survival instincts.

1. Ventral Vagal – The State of Safety and Connection

• Evolutionary Role: This is our “safe and social” state. When our nervous system detects safety, we can rest, digest, and connect with others. Humans are wired for connection, it was essential for cooperation and survival in groups.

• How It Feels: Calm, grounded, open, engaged. Your body feels stable and capable.

• Symptoms When Active: Normal digestion, steady energy, strong immunity, emotional balance. Healing thrives here.

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2. Sympathetic – Fight or Flight

• Evolutionary Role: This state evolved to help us survive immediate threats. Imagine our ancestors spotting a predator, heart rate quickens, muscles tense, senses sharpen, blood flow moves to the limbs. All energy is diverted to either fight or run.

• How It Feels: Alert, restless, hypervigilant, anxious, irritable.

• Symptoms When Chronic: Racing heart, high blood pressure, muscle tension, insomnia, poor digestion, hormonal imbalance. Many with chronic illness feel “wired but tired” when stuck here.

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3. Dorsal Vagal – Freeze and Shutdown

• Evolutionary Role: When escape isn’t possible, like being trapped, this state helps conserve energy by shutting the body down. It numbs pain, slows systems, and creates dissociation. For prey animals, “playing dead” could mean survival.

• How It Feels: Exhausted, disconnected, heavy, numb, depressed.

• Symptoms When Chronic: Chronic fatigue, brain fog, digestive shutdown, low immunity, emotional flatness. Many trauma survivors and people with long-term illness know this state well.

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When Survival Becomes a Way of Life

These states are not “bad.” They kept humans alive for millennia. The problem comes when the nervous system gets stuck in survival mode, unable to return to the safety of the ventral vagal state.

Modern stressors, financial worries, trauma, illness, toxic environments, don’t look like predators, but the nervous system doesn’t always know the difference. The body reacts as if danger is still present.

For some people, this cycle lasts not just days or months, but years:

• Stuck in Sympathetic (fight/flight): The body never turns off the alarm. Symptoms like anxiety, inflammation, poor digestion, and insomnia become the new normal.

• Stuck in Dorsal Vagal (shutdown): The body gives up on fighting and collapses into exhaustion. This can look like chronic fatigue, depression, or a feeling of being “frozen” in life.

Over time, this chronic dysregulation weakens the body. Healing, repair, and regeneration all require the ventral vagal state of safety. Without it, symptoms compound, and people often feel trapped in a loop they can’t explain.

The Cost of Long-Term Survival Mode

Living in survival mode too long has ripple effects across every system:

• Immune system: Stuck in high alert or collapse, leading to autoimmune flares, frequent illness, or inability to fight infections.

• Digestive system: Blood flow is diverted away from digestion during stress, creating IBS, reflux, or food sensitivities.

• Endocrine system: Chronic cortisol and adrenaline release disrupts hormones, thyroid function, and energy regulation.

• Brain function: Survival states hijack the higher brain, impairing focus, memory, and decision-making.

• Pain perception: Nervous system dysregulation can amplify pain signals, fueling fibromyalgia or neuropathic pain.

In essence, what once kept us alive becomes what keeps us unwell when the nervous system can’t find its way back to safety.

Finding the Path Back to Safety

The goal isn’t to erase these survival states, they are part of our biology. The goal is to help the body learn to shift out of survival and return to ventral vagal safety more often.

A powerful step in regaining control over your health is learning to identify your nervous system state. Symptoms that feel scary—like feeling agitated, having shallow breathing, or having muscles that can't relax—are not random; they are clear signals that your body is locked in the Sympathetic "fight or flight" response. Conversely, feeling disconnected, numb, or an overall sense of weakness often signals the Dorsal Vagal "shutdown" state. Simply recognizing these body signs can immediately bring comfort, making the symptoms seem less frightening and reducing the overall threat signal. This process is a core component of certain brain retraining programs, as it allows you to consciously "nudge" your system out of a survival mode and gently guide it back to the Ventral Vagal state, the only place where true healing and relaxation can take place. By repeatedly catching and redirecting your state, you are actively retraining your nervous system to recognize safety, helping you move beyond chronic fight/flight or shutdown.

A New Understanding of Chronic Illness

Polyvagal Theory shows us that many symptoms of chronic illness are not random, they’re the natural result of a survival system doing its job too well. The challenge is that in modern life, this survival wiring can get “stuck,” trapping people in years of fight, flight, or freeze.

Healing begins when we understand this. By working with the nervous system, not against it, we can create the conditions where the body feels safe enough to do what it’s designed to do: heal, restore, and thrive.

👉 At Chronic Coach, we explore these hidden layers of illness and healing, bridging science, survival biology, and practical strategies for creating safety in the body.