Polyvagal Theory, developed by Stephen Porges, provides a neuroscience framework that explains many aspects of chronic pain in terms of the nervous system's safety-detection mechanisms.
The Three States of Polyvagal Theory and Chronic Pain
Ventral vagal (safe and social): Optimal state for connection, learning, and chronic pain management
Sympathetic mobilization (fight or flight): Anxiety-type chronic pain responses
Dorsal vagal shutdown (freeze/collapse): Depression and dissociation-type chronic pain
Neuroception and Chronic Pain
Neuroception — the body's unconscious safety-detection — can be dysregulated in chronic pain, causing false alarms (sensing danger when safe) that drive chronic pain responses.
Polyvagal-Informed Chronic Pain Treatment
Therapy that acknowledges the body's state — helping clients move into ventral vagal 'safe and social' — transforms chronic pain management.
Safe relationships, co-regulation, and body-based practices are particularly emphasized.