What Makes Psychotherapy Possible

Clarifying the Fundamental Task of Therapy

Stephen Porges is a leading expert in developmental psychophysiology and developmental behavioral neuroscience. Yep, it’s a mouthful, but his work has direct relevance to what we do in the consulting room and how we can do it better.

In his groundbreaking book The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation, Stephen makes it clear that hard scientific evidence now exists for what most therapists instinctively know: successful therapy depends utterly on establishing a safe, caring, mutually trustworthy, stable relationship with a client.

“When threatened,” Stephen explains, “humans are similar to other mammals. When they shift states to defend themselves, they become more reptilian, and lose access to their social communication skills. By understanding this adaptive reaction to danger, we’ve uncovered a neurobiological mechanism that enables us to better understand and treat mental disorders. Even in the intimacy of the clinical encounter, the relevance of evolutionary adaptation is being played out in therapists’ offices every day.”

In this brief video clip, Stephen tells us about one way Polyvagal Theory has helped changed many therapists’ approach in the trauma field. “What Polyvagal Theory provided,” he says, “was an understanding that trauma survivors use a very ancient defense system to survive, one that’s not easy to get out of. And that’s why they’re in clinical treatment. Understanding both the difficulties of moving out of that evolutionary state of defense while also understanding that it’s also a heroic state that helped them survive is a key to doing effective psychotherapy.”



Rich Simon

Richard Simon, PhD, founded Psychotherapy Networker and served as the editor for more than 40 years. He received every major magazine industry honor, including the National Magazine Award. Rich passed away November 2020, and we honor his memory and contributions to the field every day.