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GUEST EXPERTS
Microbiome and Your Parasympa-
thetic State with Kiran Krishnan
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Disconnection Syndrome and

Your Parasympathetic with David
Perlmutter, MD, FACN, ABIHM
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The Polyvagal Theory: Insights Into

Resilience with Stephen Porges, PhD
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Practical Overview: Your

Parasympathetic State with Jodi
Cohen, NTP
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Microbiome and Your
Parasympathetic State
Kiran Krishnan
Jodi: Hi, I’m Jodi Cohen, and I’m super excited
to welcome Kiran Krishnan. He is a research
microbiologist with extensive experience in
probiotics and microbiome-related clinical
research, including formulating what, I think,
is the best probiotic on the market, the
MegaSporeBiotic from Microbiome. So thank you
and welcome.
Kiran: Thank you so much for having me, Jodi.
It’s great to be with you. And I love this topic. It is
so relevant and so important, whether we’re in a
crisis or not, because this whole parasympathetic/
sympathetic balance is a critical aspect for human
existence.
Jodi: Yeah, and I don’t think they realize—they
get that there is a gut-brain connection—but
they don’t realize that it’s bi-directional. And I was
hoping that you could speak to that a little bit and
really talk about the role of the microbiome in
activating the vagus nerve and parasympathetic
state.
Kiran: Yeah. So what’s really interesting about
it, when you break it down, is you’ve got the
autonomic nervous system, which really houses
the parasympathetic and sympathetic aspects
of the nervous system. And the biggest nerve
involved in all of that is the vagus nerve. It’s the
longest nerve in the body. And it directly connects
the gut to the brain. And in the middle, it connects
to the heart, and the lungs, and all kinds of
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other areas, too, because it has to trigger all of
these physiological responses based on what’s
happening in the environment around you.
And what’s interesting about the vagus nerve is it
connects directly to the enteric nervous system,
which is the nervous system that covers the entire
lining of the gut. And the enteric nervous system
has the second most nerve endings in the body,
next to the brain. It has even more nerve endings
than the spinal cord. So it’s a very, very, elaborate
neurological system that provides direct access to
the brain, itself, through the vagus nerve. And the
microbes in your gut have full access to it. So they
have autonomous access to it, meaning outside of
our own control in many ways.
So there’s a few things we can talk about, but
ultimately, I think, why we are designed that way
is because of the same reason we have 70%,
80% of our immune tissue in our gut is our gut
is the largest sampling site for what exists in our
environment. Everything in the body--
Jodi: I love that.
Kiran: Yeah, that’s how your body and your
immune system figures out what you’re being
exposed to on a regular basis. Our skin, which
is the largest outward organ acts as a barrier
really. It’s not a very good sensing tool because
remember the layers on top of the skin, they’re
dead layers. They’re dead cells that come all
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the way out to act as like a buffer, a barrier, a
protector. But they’re not sensing a whole lot of
things.
What is sensing things that’s around you is
your digestive tract. And think about where
everything enters into your bodies. The most part,
it’s through your mouth, your nose, your eyes,
potentially your ears, but somewhere in your
mouth, nose, and eyes area. This is very relevant
now with pandemics going on, we keep talking
about don’t touch your face because that’s the
main way the virus enters your system. And all of
these areas drain into your gut.
So even your ears, the eustachian tubes in
your ears drain into the back of your throat to
go into your gut. Your sinuses and your upper
respiratory tract drain into your gut. Your lungs
have something called the mucociliary elevator.
So they’ve got these cilia in your airwaves that
move mucus up from the lungs to drain into your
digestive tract.
Everything gets exposed into your digestive tract.
That’s where most of your immune system is.
That’s where your microbes are. So your body
has designed itself to be able to sense the world
around it, in large part, through the digestive tract.
And then the microbes that exist in the digestive
tract are the orchestrators and controllers of
how your body responds to those things that are
coming, whether it’s an immunological response
or a neurological response.
So they have direct access to your brain. They
have direct access to your heart. They have direct
access to your lungs, to your skeletal muscle
system through this vagus nerve where they can
send signals, good and bad signals to trigger
physiological response.
Jodi: It’s amazing, I’ve heard you speak before,
but I’ve never heard you say it in a way that was
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so incredibly clear. Thank you, that was a brilliant
explanation.
Kiran: You’re welcome. And that’s where this
whole gut-feeling aspect comes from. Everybody
knows this. Everybody’s experienced this. We’ve
talked about this for centuries where people say,
“I get a gut feeling about something or my gut’s
telling me that’s not the right move.” That’s the
instinctual part about it.
And then there’s a physiological change, too.
When you’re really nervous and anxious, you get
loose bowels. We know that. And we know that
digestive function completely gets attenuated in
some way when our mood is different. So we are
either A, because we’re feeling depressed and
anxious, we either eat too much to mitigate the
feeling, or we have no appetite at all. It’s right of
those two extremes.
Jodi: Right. Well, I think, that has to do with the
whole safety. When you’re feeling like you’re in
danger, digestion is downregulated as a priority.
Kiran: Yep, exactly, yeah. So the connection
between the gut, and the microbiome, and your
sympathetic/parasympathetic nervous system is
so intimate we can’t overemphasize it.
Jodi: Can we dig deeper into the role of
the microbiome and especially diversity of
microbiome in signaling the vagus nerve?
Kiran: Yeah. So there’s lots of ways that the
microbiome, itself, sends signals up in the
vagus nerves and balance that, what we call,
sympathovagal tone or the parasympathetic
tone or sympathetic tone. So that balance.
And we need the balance. We need both the
parasympathetic and the sympathetic to function.
The problem is we tend to be in a very high
sympathetic state in the Western world. We’re
always activated in that sense. And we’re not
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getting the rest and digest part of the nervous
system activated enough.
The microbiome is interesting in that there are
products of the microbiome that we can only get
from the microbiome that have a real significant
effect on the balancing between those two
systems. One of them is short-chain fatty acids.
So butyrate, propionate, acetate, these fatty acids
that are made as a result of fiber and resistant
starch digestion in the colon. These short-chain
fatty acids have a profound role on balancing
metabolism and balancing sympathetic and
parasympathetic activities.
In fact, when you start digesting, the process of
digesting, is supposed to elicit the production of
these, what we call, postbiotics. They’re called
postbiotics because any time the microbes in your
gut digest food and create a new active ingredient,
that new active ingredient’s called a postbiotic. So
we’ll refer to them as postbiotics for clarity sake.
So say you eat something. Just from eating
something, your parasympathetic is supposed
to be activated because at this point, you’re
supposed to go, “Hey, I don’t need to elevate my
heart rate. I don’t need to elevate my breathing
rate. I don’t need my skeletal muscles to be
activated. I need to rest and digest.” That’s the
whole process of it.
One of the ways your microbiome triggers that is
when the food enters into the digestive tract, they
metabolize portions of the food, they produce
these short-chain fatty acids. The short-chain
fatty acids are released from the gut into the
circulation. And then they go and trigger parts
of the brain that create a parasympathetic state.
They help you actually turn on that resting state.
And that’s all from signals from the microbiome.
And then another one is serotonin. Serotonin is a
very important part of the parasympathetic state.
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The production of serotonin, 90% of serotonin’s
produced in the gut. That’s just another example.
There are cells called the enterochromaffin cells
within the gut that are stimulated by the presence
of certain amino acids and food like the presence
of tryptophan. And then they get stimulated. And
then they start producing 5-HTP, which then gets
converted into serotonin, and then released into
the system.
Serotonin also helps the bowels move. So it has
dual effects where it tells the body, “Hey, we need
to go into a parasympathetic state. We need
to relax, chill out. And I need to get the bowels
moving so we can have effective digestion.” So
all of those systems are intimately connected.
Lots of them are triggered by signals from the
microbiome from digesting things. And that’s the
key.
Now, why does diversity play a role with that? So
the important thing to note is that when we have
increased diversity in the microbiome, we have
more players that can do these types of functions
for us. They can create more of these postbiotics.
What we see, across the board, in studies is as
diversity shrinks, you get lower production of
postbiotics.
Important ones like short-chain fatty acids, like
serotonin, at nighttime, things like brain-derived
neurotrophic factor, GABA, these are all really
important microbiome-derived components that
we need to activate our parasympathetic. Those
don’t get produced at high enough levels when
our diversity is low.
When our diversity is high, we’ve got more
players. They are in the microbiome factory. And
they’re making all the stuff we need. So diversity is
paramount to all of this.
And then, ultimately, what happens is when you
don’t have diversity and you don’t have good
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ecological forces that maintains a nice balanced
ecosystem, you start to get overgrowth of
problematic bacteria because there are lots of
bacteria in your gut that can also make postbiotics
that activate the sympathetic part of your nervous
system.
For example, campylobacter, campylobacter
makes a toxin that creates all of sudden really
profound panic attacks in people. Campylobacter
is a contaminate in poultry. It’s the second
most common contaminate in poultry next to
salmonella. And campylobacter infection in
people will result in some degree of diarrhea
and gut issues, but it will also result in a sudden
onset of anxiety and panic disorders. So there
are microbes that produce toxins that do the
opposite effect. Those need to be kept in check by
increasing diversity.
Jodi: This might be an oversimplification. But what
it sounds like you’re saying is that the good bugs
breed the parasympathetic response and the bad
bugs breed sympathetic.
Kiran: Yeah. And I feel hesitant to name them
good and bad because the bad ones still have
important functions. We do have to have some
sort of sympathetic tone.
Jodi: The imbalance.
Kiran: It’s the imbalance, that’s the key. This
is an ecosystem. And with any ecosystem, we
want to have balance. We also see the opposite
effect. If you have too many of the good bugs,
and this almost never occurs physiologically in
humans, but you can view this in mice, where
you completely eliminate all those other bad
bugs and you only have the good bugs, then they
completely lose any sort of fear response.
So they do this in mice where they can just put
in certain groups of good bugs. And then they
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release the mice. And the mice have no fear
response. And they just walk right into traps and
things that they know will kill them.
Jodi: I have a child like that. No fear response, it
was scary.
Kiran: That may be the explanation for like crazy
dare devil people who are trying to stoke that
response. And again, that in a practical sense,
that always never happens in humans because
we typically have a good amount of the toxin-
producing bacteria. But the big message here
is, it’s about balance. And the only way to strike
balance, that we know of so far, is to do things
that increase diversity in the microbiome. And,
also, we have behaviors that throw off that
balance.
So like you said in the beginning, this is a bi-
directional system. There are things we can do
consciously that actually has an effect on that
microbiome population, as well.
Jodi: I love that you can signal the gut from the
brain and the brain from the gut. And I want to
make sure we land on leaky gut and how that
compromises that communication.
Kiran: Yeah. So that’s one of the biggest things.
First thing, we found in the research is that our
way of dealing with stress—let’s say that you are
a stressful person. Clearly, that is a sympathetic
activation. But if you continue to allow yourself
to be always stressed and activated, that signal
from your brain releases things like cortisol,
epinephrine, norepinephrine.
What those three compounds do is they actually
increase the growth of more virulent bacteria in
your microbiome. So there are microbes. These
are what we call opportunistic pathogens. They’re
called opportunistic because they have pathogen
qualities meaning they can make you sick. But
 5
they’re weak enough pathogens that they wait to
do that until your system is compromised. So they
have evolved to wait for these stress signals to
start producing the toxins because they know--
Jodi: [crosstalk 14:08].
Kiran: Right, isn’t that amazing when you think
about these microbes. And these are viruses, too.
Like cytomegalovirus virus, Epstein-Barr virus,
these are viruses that exist in us forever—we can’t
get rid of them—herpes virus like cold sores. We
know that people who have herpes, oral herpes,
when they’re stressed, a cold sore pop up, right?
Jodi: Right.
Kiran: And we’ve seen that all day. Everybody
knows that. And we’ve known that. Even in high
school, you could tell. In the winter months
when people’s getting less vitamin D, and their
immune’s system’s compromised, they’re more
stressed from the cold and so on, a cold sore pop
up.
Jodi: That explains that whole like, “the straw
that breaks the camel’s back,” of like how stress
becomes the trigger. Or suddenly, they get a tick
bite, and they have Lyme, and all these things
pop up, it’s that there were these opportunistic
bacteria that weren’t activated until all of a
sudden you were an easy target.
Kiran: Yeah, your system is compromised. And
they have learned to sense that. Most of them
sense it through the production and circulation
of stress hormones. So Epstein-Barr virus,
streptococcus, prevotella, all of these types
of opportunistic bacteria and viruses, they sit
around, and they keep their numbers fairly low
so the immune system doesn’t detect them and
cause problems for them.
And then the moment they detect cortisol,
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epinephrine, norepinephrine is high, then they go,
“Hey, guys, this is our time. This system is weak.
Let’s do what we do.” And then they multiply
quickly. And they release all the toxins.
So our own behavior, our inability to deal with
stress, and not working on simple mindfulness
work will give them the opportunity to be
pathogenic.
Now, when they start to become pathogenic, it
is a feedback loop because one of the ways that
they service themselves is by increasing toxins
that create more stress hormones because--
Jodi: Oh, it becomes a vicious cycle.
Kiran: It’s a cycle, yeah. Our stress allows them
to proliferate and grow. And then the result of
them proliferating and growing is they create
more stress hormone release. So we go on
this downward spiral. And that’s good for the
microbes in the system, but it’s not good for us as
the host.
And then the other thing that stress causes is
the leaky gut. That’s one of the biggest drivers of
leaky gut. In fact, a 2015 publication in Frontiers
in Immunology, they went through and reviewed
all the papers around this. And they, actually,
concluded that stress-associated leaky gut was
the number one cause of morbidity and mortality
worldwide.
Jodi: Wow!
Kiran: The biggest killer of humans is stress-
related leaky gut because…So what tends to
happen, when you’re stressed, you release all
those hormones. The hormones then crate
dysbiosis in the gut. So it increases the presence
of certain pathogens, which then, of course, cause
you to release more hormones and starts causing
inflammation in the lining of the gut.
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When inflammation in the lining of the gut is
realized, the tight junctions in the lining of the
gut open up. Now, your gut is permeable and you
get constant leaking in of a profound toxin called
lipopolysaccharides. This is a bacterial-derived
toxin that exists in the gut. But once it’s in the
lumen, which is in the intestine, the tube in the
intestine is fine, if it’s allowed to leak through,
and into the circulation, it becomes a profoundly,
significant issue. And it’s very common. It then
becomes the foundation for the vast majority of
chronic illnesses that we have.
Jodi: Interesting.
Kiran: So it’s stress-induced dysbiosis, stress-
induced leaky gut, then becomes the foundation
for clinical depression, for age-related disorders
like Alzheimer’s and Parkinson’s, heart disease,
diabetes, hypertension, cancers, all of these
things. And there’s tons of studies on this. So
that mindfulness work becomes so important to
stop that feedback loop. And then doing things
therapeutically to modulate the gut microbiome
and stop the leakiness in the gut becomes a really
important therapeutic target, as well.
Jodi: Can we talk about that? About what you
recommend, how you recommend activating the
vagus nerve, stimulating the vagus nerve, calming
the thoughts? And then, also, it’s almost like a
one-two punch, you’re hitting it at the gut and at
the brain.
Kiran: You have to do both, yes.
Jodi: Yeah.
Kiran: You can’t do one with the other because it’s
a feedback loop. It’s a continuous circle, right?
Jodi: Right.
Kiran: So if you’re healing the gut and tightening
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up the tight junctions, but you’re allowing yourself,
from a stress perspective, to continue your stress,
that will keep dislodging the healing that you’re
doing. If you’re only doing the mental thing and
your gut is still leaky, you’re going to continuously
feed the disruption and the stress hormone. So
you have to do both.
The simplest way, and I’m sure you’ll have lots of
brilliant people on your summit that do a better
job of talking about the mindfulness side of the
work, but some of the things that I do, personally,
that I find to be extremely effective, for me, is just
simple breathing work. When you do really deep 
diaphragmatic breathing, it actually counteracts
the release of stress-based hormones, deep
diaphragmatic breathing and increasing the time
between inhale and exhale. So that’s where the
[crosstalk 19:25] comes from.
Jodi: Yes, because that activates the vagus nerve.
Kiran: It does. That’s the biggest activator of the
vagus nerve. The really rapid breathing, which
is associated with panic, that is the deactivation
of the parasympathetic and the activation of the
sympathetic. It releases all the steroids, and the
cortisol, and all that stuff to, yeah, increase basal
constriction, and increase heart rate, and so on.
So what you want to do is do deep diaphragmatic
breathing rather than shallow breathing and you
want to increase the time between inhale and
exhale. Just that simple.
Jodi: You just said something really interesting
that when you’re doing the shallow breathing, it
dilates. And that’s another interesting thing. So
what you’re saying is that breathing correlates
with blood flow. And if [crosstalk 20:07]--
Kiran: Absolutely, yes.
Jodi: calm. And blood flow’s also important with
the vagus nerve and the signaling.
 7
Kiran: Absolutely. So one of the reasons why
you’ll get basal constriction when you’re breathing
shallow is that your heart rate goes up because
your heart is trying to keep up with oxygen
demand because in your body’s concept, when
you’re breathing like that, it’s a fight-or-flight
response. There’s something that’s going to kill
you,--
Jodi: Yes.
Kiran: then you’re designed to be able to run
away from it. So your body’s trying to constrict
blood flow to skeletal muscles.
Jodi: Right, it’s rationing it’s resources.
Kiran: Exactly, yeah. And so it’s losing compliance
in the vessels trying to keep blood pressure high
so that the blood is forced deeper into skeletal
muscles, which is a hard place to get the blood
flow to go to. That’s why when you’re exercising, it
takes a little while to warm up. They say you can
injure a muscle if you don’t warm up adequately
because the capillaries that service all of these
skeletal muscles are really fine.
Some of them are so small only one red blood
cell can go through it one at a time. So to activate
all of them, you really need to take some time to
warm up. The way the body activates that quicker
is by increasing blood pressure, the pressure
of the fluid. And the way that it increases the
pressure is to constrict the vessels. So that the
tighter the vessels are, the more of the pressure is
going through the vessels.
Jodi: I love that.
Kiran: So that’s a normal response, right?
Jodi: Right, right.
Kiran: But it’s the response we need to run away
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from a Saber-tooth tiger. It’s not the response we
need when we wake up in the morning. That’s not
a good thing.
Jodi: Or to heal our gut, we need our blood flow
going to our digestive organs.
Kiran: Absolutely. And, in fact, lots of now primary
digestive conditions can be related to attenuated
blood flow into the gut, itself. The cells in the gut
and the smooth muscle cells that constrict that do
the contractile force for the digestion, all of that
gets restricted because blood is going elsewhere
in the body, primarily to the muscles and the
heart to try to get you to run away.
Now, when you wake up in the morning, if you are
in that state, that flight-or-fight state, then your
nervous system and your digestive system’s going
to suffer for the rest of the day.
One of the things I try to do is when you wake
up in the morning, the first thing you should do
before you ever pick up these things and start
looking at articles and so on, which is a tendency
that we all have—like, “What did I miss in the
morning?” And I’m looking at it, especially now,
when we are hypervigilant with pandemics, and all
that stuff—the first thing you should do is just do
like three minutes of some deep breathing just to
get yourself back into the more parasympathetic
state. Bring down the flight-or-fight response.
And then if you can, before you ever look at your
phone, wake up, go to the bathroom, and just
splash your face with cold water.
Jodi: To activate your vagus nerve, right?
Kiran: Activate the vagus nerve. So between
the breathing and splashing of your face, those
two are two things that are absolutely great and
powerful for activating the vagus nerve. It starts
activating your digestive system. It starts releasing
more of the calming hormones like the brain-
 8
derived neurotrophic factor, and the serotonin,
and all these goods things so you’ll start off your
day in a more relaxed state. And that’s really
important for your gut and your microbiome.
So that’s one of the simple ways you can…Just two
things that you can do to reduce your sympathetic
tone from a lifestyle, perspective.
Jodi: Right, bring it down.
Kiran: Bring it down. And the other thing is
exercise. There’s a good number of studies that
show that actually the stress associated with
exercise, the need for your body to increase heart
rate and keep up with blood flow to the muscles,
actually when you stop exercising will have the
absolute countereffect going to completely
reducing sympathetic tone and upregulating
parasympathetic.
So think about it this way. Back in the day when
we actually had real flight-or-fight reasons--
Jodi: [crosstalk 24:12].
Kiran: Right, our flight-or-fight response was
developed to keep us alive from things that would
literally kill us like predators. And we don’t have
that so much anymore. Now, we are having flight-
or-fight response to things that are not even going
to damage us in any way. It’s what did this person
say, or what did that person say, or a comment on
Facebook?
Jodi: Yeah, it’s anticipatory and emotional.
Kiran: It’s totally emotional and anticipatory. And
so think about the evolutionary connection. It’s
like you were walking down this path. And then
all of a sudden, you saw a predator. Your instincts
kicked in. Your sympathetic system kicked up.
And then you start running to save yourself. Save
your life. So your heart rate goes up. Your body is
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flooding a bunch of oxygen and nutrients to your
skeletal muscles to get you out of that danger.
The moment you are clear of the danger, because
that’s an unhealthy state to be in, your body
automatically triggers to parasympathetic in
a much more profound way to bring you back
down--
Jodi: Where we get stuck. And I love that you
really addressed the brain down. Can we talk
about the gut up? Like Terry Wahls says to eat 200
different vegetables a year, which is challenging
for some people. They need an assist. You have
an amazing tool. Can you speak to how you can
support the diversity in your health and the health
of your gut microbiome?
Kiran: Yeah. So when we started working on
probiotics and the microbiome, in general, we
had two goals, two big goals in mind. One was
to find a way to increase diversity that was more
practical. You should always try to continue to get
it through food. I’m a big advocate of that. You
always try to add in more foods into your diet.
That’s always a good thing. But like you said, that’s
a hard thing for lots of people.
But we wanted to see, “Okay, is there a way we
can utilize a probiotic and/or prebiotic to increase
diversity? Number two, can we stop leaky gut?”
Because leaky gut is such a driver, not only of
dysbiosis in your microbiome, inflammation in
your body, but then it is counterproductive to all
of the sympathetic/parasympathetic activation
you’re working on doing because it increases
adrenaline, it increases cortisol, it increases
epinephrine and norepinephrine.
So what we found is that the spore-based
probiotics that we work with…And these are
interesting because we started looking at the
environment for clues as to the types of bacteria
that can really help because there’s all of this data
 9
on gardening therapy. How gardening therapy
actually increases parasympathetic activation,
makes you more calm, being something
associated with the soil and the dirt. There’s
also all these empirical studies showing that
populations that exist closer to nature actually
have better mood and better mental cognitive
response versus people that live in cities and are
more clustered.
So we started looking at the environment and
saying, “Are there bacteria in the environment
that can trigger the influx of diversity and can
also seal up the gut lining?” And then we found
these spore-based probiotics that are commonly
ubiquitous in the outside environment, but also
act as commensal bacteria in the gut.
And so what we’ve started seeing is that when you
take them, they enter into the gut and they read
the microbial environment using something called
quorum sensing. And just from that, alone, they
can start modulating the rest of the microbes.
They will sit next to--
Jodi: Wow, they’re leaders!
Kiran: They are. They are like…I started calling
them early on, “the Seal Team 6 of the gut or the
Orchestrators of the Gut,” because they will go in
and they will hone in on overgrown problematic
bacteria. They will sit next to them. And they
will produce antimicrobials in that little micro
environment to bring down those bacteria. At the
same time, they produce postbiotics that feed lots
of groups of good bacteria. So we saw, in a three-
week study, in that period, almost a 30% increase
in the diversity of your microbiome just by adding
in the spores, without even changing the diet.
Jodi: That’s amazing. Like for anyone who’s
listening who suffers from anxiety or has a
kid with anxiety, if they can just teach them to
breathe, splash their face, and take this…How
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often do you recommend they take MegaSpore?
Kiran: So they do it once a day. That was plenty.
And in that three-week study, it was just once a
day, the equivalent of two capsules a day. And
then you combine that with an increase in your
diet, in the diversity of your diet. And you’ll see
profound changes. You’re stopping one big part of
the cycle of anxiety, depression, mood disorders.
And the gut is playing that really important role in
perpetuating it, but you can instead change the
gut so that it orchestrates calmness. And then
that serenity feeling, and that feeling that you’re
grounded, all of that stuff comes, in large part,
from the gut. And, of course, you have to work on
that mentally, as well.
So one of the things that I love about programs
like yours like this summit is that lots of practical
things are going to come out of it for people.
Jodi: Yes, everyone should go buy MegaSpore.
Forget the toilet paper [crosstalk 29:36] that’s
what you mean?
Kiran: Exactly, right. And the thing is, you’ll have
much cleaner bowel movements where you need
less toilet paper to clean yourself when you use
the probiotics. So that’s the important thing is that
as you learn other things, in a summit like this,
where you have all these practices you can do to
try to improve your stress response, activate your
vagus nerve, and all that, all of that stuff becomes
more profound and effective if you, also, are
focusing on healing your gut because if your gut is
not healed, it’s going to keep pushing that cycle.
Jodi: That’s what I found, actually. I call it layering.
But if you can attack the problem from more than
one angle, it resolves itself much more quickly.
Kiran: Yes, it does. There’s one of the more
common and sinister categories of antibiotics, the

most recent ones that cause the tendon rupture
and so on…
Jodi: Oh, flora, it’s like Cipro.
Kiran: Yeah, like Cipro, for example, one of their
very well-documented side effects of taking them
is anxiety. So you take this antibiotic, because
it causes such profound dysbiosis in the gut, it
gives the chance for certain types of opportunistic
pathogens to proliferate. And then they, in turn,
produce toxins that cause anxiety.
So there’s so much data on the role of the gut
microbiome, leaky gut, the systemic inflammation
associated with that, and mood disorders, and
sympathetic/parasympathetic balance. And our
gut wants us to be in a relaxed state because
that’s better for the microbiome, because in
that relaxed state, we’re going to be feeding it,
and we’re going to be providing it with food, and
we’re going to be providing resources to be able
to help them digest the food. And so a diverse
healthy microbiome tries to keep you in that
parasympathetic state, more often, than not.
Jodi: Thank you so much. I am so grateful. You did
such an amazing job making a very complicated
topic very accessible. And I’m sure everyone’s
going to want to learn more from you. How can
they find you?
Kiran: Yeah, please visit MicrobiomeLabs.
com, our website. If you Google my name,
either YouTube or Google, itself, you’ll find
loads of interviews, and articles, and talks, and
presentations. I do all kinds of talks on all types
of topics surrounding the microbiome. But come
visit our site, too. Come to MicrobiomeLabs.com.
We have a number of webinars and write ups on
there, as well. And I do about 150 talks a year.
Jodi: Oh, my, goodness, that’s like every other day.
Wow!
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10
Kiran: Literally, yeah, it’s amazing. I absolutely
love it. There’s nothing I love more than sharing
knowledge. None of this stuff is helping anybody
sitting in my head. So I need these kinds of
opportunities to share it with people. And so I
appreciate this opportunity to be able to do that.
Jodi: Well, and this was amazing because it gave
people a really easy bidirectional strategy, too.
Kiran: Yep, and you have to do that. You have
to attack with a two-pronged approach because
one will negate the other if you only do one of
them. And that’s why people don’t have as much
success in treating mental illness, and cognitive
dysfunction, and so on, because we’re always
going after one or the other. Typically, it’s the
top down. And certainly, all of the drug-related
therapies are focused from the top down when
it’s really a systemic issue. And its coming from
both ends.
Jodi: Well, and, also, not all probiotics are created
equal. I love that you created spore-based
solution because I think that’s really effective.
Kiran: It’s the only one in published clinical trials
that has been shown to increase diversity in the
microbiome and reduce leaky gut, which are the
two things that you need from the gut to help
you get over the issue of sympathovagal tone,
and activate the vagus nerve, and activate the
parasympathetic. Those are the two important
things is that diversity and stopping that leakiness
in the gut, and we’re able to do both.
Jodi: That’s amazing. Thank you.
Kiran: My pleasure. Thank you so much.
 11

Disconnection Syndrome
& Your Parasympathetic
David Perlmutter, MD, FACN, ABIHM

Jodi: Welcome to the Parasympathetic Summit. I
am your host Jodi Cohen. And today’s guest, Dr.
David Perlmutter, is a board-certified neurologist,
five-time New York Times bestselling author, and
he serves on the board of director and is a Fellow
of the American College of Nutrition. And I’m
really excited to be talking about some of the
topics he’s covering in his new book Brain Wash,
specifically, this idea of disconnection syndrome.
Can you please speak to that?
Dr. Perlmutter: Certainly. So it actually is a bit of
an encompassing term. We take it from the brain
physiology meaning all the way to the societal
meaning of the term of being disconnected.
And let’s start small. And then we’ll generalize.
From the brain perspective, early on in the book,
we described two very important areas. One is
called the amygdala. And this is a primitive brain
center that’s involved in things like impulsivity,
and the making of decision just impulsively, self-
centeredness, narcissism, anger, fear, tribalism,
and is in contrast to another area of the brain
called the prefrontal cortex that sits up behind
your forehead.
And this is really a human attribute. At least
having such a large prefrontal cortex. And that’s
an area of the brain that is involved in things
like planning for the future, thinking about our
decisions in terms of how they’re going to play
out, what will their consequences be for us, for
our neighbors, for others, empathy, how we feel
towards our future selves, how we feel towards
others, how we care for the planet.
And importantly, this adult in the room, this
prefrontal cortex exercises control over the
amygdala. So it calms down impulsivity. It calms
down the sense of, “I’m right and you’re wrong.”
And that connection is so incredibly valued for
exactly that reason. And what we’ve identified is
that so many features of our modern lives are
disconnecting us from this prefrontal cortex,
disconnecting us from thinking about tomorrow,
thinking about other people, thinking about our
planet, thinking about our future selves. And
that is, at least, from the brain perspective what
disconnection syndrome’s all about.
We’ve come to realize, in our modern world of
being told to socially distance, that we need to still
be very much connected to other people. We are
social beings. Our health absolutely is influenced
by the degree of social connectiveness that we
experience. What is our social capital? How do we
measure that? And that social isolation is indeed
very common, especially in urban environments,
and is associated with risks for some really bad
other issues like cancer, diabetes, Alzheimer’s,
weight gain, coronary artery disease, to name just
a few.
So our health depends on our ability and our
efforts to interact with other human beings in the
best way that we can. And that when we become

The Parasympathetic Summit


more locked in to the amygdala—and we’ll
talk about how we do that—we become more
isolated. And that has health consequences. And
these days, we’re seeing anger, and self-interest,
and lack of empathy being played out on a global
scale like never before.
Jodi: Exactly, exactly. And the other thing that
you bring up is this idea of safety and when your
amygdala’s running the show and making you
feel unsafe, that throws off your parasympathetic
system and your vagus nerve. Can you speak to
that a little bit and the impacts of health?
Dr. Perlmutter: Well, absolutely. So this constant
fanning of the flames of fear and anger that is
part of our world, but we don’t have to choose
to make it part of our world, but by-and-large,
based upon what we see on the evening news
or for those who are on the news 24/7 watching
their social media, watching their newsfeeds on
their computers, this continues to enhance our
connection just to this fear area of the brain, the
amygdala, and powerfully augments our sense of
being stressed.
And this stress that we experience, because
we know that the world is out to get us and
the fear that’s instilled in us, enhances our
stress response. So our levels of, for example,
cortisol, the stress hormone cortisol, go up.
And that has profound consequences on us.
It leads to things like not being able to deal
with sugar appropriately, it compromises our
immune systems, and enhances, fundamentally,
something called inflammation.
Inflammation is the cornerstone of all of our
dreaded chronic disease. Inflammation further
threatens our connection to the prefrontal cortex,
and, ultimately, leads to worse decision making,
which means that we’ll not get to bed on time,
we’ll not eat the right foods, we’ll not get exercise,
get out in nature, do our meditation, and all those
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12
things that continue to connect us only to the
amygdala, away from the prefrontal cortex.
What happens? Our decision-making declines
even further. It degrades that we make worse
food choices, less good choices as it relates to our
sleep hygiene. And we create a situation where we
develop these chronic degenerative conditions.
Now, we wrote this book and published it in mid-
January of 2020 prior to what’s happened since.
Simply saying that our lifestyle choices affect our
immune systems.
Jodi: Yes, yes.
Dr. Perlmutter: And now we know that our
immune systems are front and center. Everything
is being talked about immunity, “I want to have a
good immune system.” And, in addition, we’re all
acutely aware that unrestricted inflammation kills
people in the context of COVID-19. So this idea
and these recommendations, they become far
more meaningful these days in the context of the
world in which we live.
Jodi: Yeah, and I love how you, as a neurologist,
brought in how the brain and what’s happening in
the brain can impact the body, the gut, the blood
sugar regulation. And you landed on inflammation
as being one of the things that can compromise
the communication between the amygdala and
the frontal cortex. Can you speak to some of the
other things that can throw off that balance?
Dr. Perlmutter: Well, let’s just say with
inflammation because there’s one other, I think,
really important mechanism that we, and it’s
a bit technical, but let me shorten it by saying
inflammation threatens our ability to have
adequate amounts of serotonin. We’ll leave it at
that. For those of our viewers who are in to this,
we’re talking about the kynurenic pathway, we’re
talking about the metabolism of tryptophan into
serotonin.

But, basically, inflammation leads to less
serotonin. And that inflammation can be caused
by not getting enough sleep, not eating anti-
inflammatory foods. We’re eating foods that
increase inflammation like ultra-processed foods
and foods with refined carbohydrates. Just those
two things, not getting enough sleep and eating
a crummy diet, amps up inflammation that
threatens your connection to the prefrontal cortex
and threatens the availability of serotonin for your
brain.
No wonder, people who don’t get enough sleep
have a much higher risk of things like depression.
No wonder, there’s this correlation between
weight gain and depression. You’re gaining weight
because you’re eating high-refined carbohydrate
foods. So everything starts to come together
and we begin to understand that we have some
understanding of a mechanism here with respect
to diet, and the gut organisms, and gut leakiness,
and inflammation.
And then we have some information over here
that depression is an inflammatory disorder
because inflammation markers are elevated
across the board. And now, these come together
where we can relate the gut to inflammation to
depression. And we can relate nutrition to the
gut to gut permeability and inflammation. And it
allows us to say, “You know, it turns out that the
food we eat can affect our mood. The food that
we eat affects how we see the world around us.”
So take that in the context of the globalization of
the Western diet that our Western diet of highly-
processed, higher-carbohydrate, high simple-
carbohydrate foods is spreading around the
globe. And that this diet amps up inflammation,
the cornerstone of all these degenerative
conditions, and the cornerstone of depression.
And that inflammation locks us into a mentality
that creates a sense of fear, that creates a sense
of us versus them, of thinking only about myself
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and about no others.
It compromises our ability to express empathy
that relates to the globalization of our Western
diet to a lot of what we’re seeing happening in
the world today with fear, with tribalism, with
excluding others from this or that, of us versus
them mentality simply from the change that’s
happened to our diet, unlike anything humans
have ever experienced in the entire hundreds of
thousands of years that we’ve been on the planet.
Jodi: Yes. And I’m very grateful between Grain
Brain and this book, you give a lot of great recipes
to help calm inflammation through diet. You also
offer a lot of other really thoughtful suggestions.
Can you speak a little bit to how to change the
brain’s circuitry, and restore, and rewire a healthy
balance of communication?
Dr. Perlmutter: Sure. So, as it relates to
disconnection syndrome, there are many, many
onramps that we listed in the book, eight areas,
then we went into them at length, whether it’s
limiting your time in front of your computer
screen, getting enough sleep, reestablishing
relationship with nature, obviously exercise,
obviously diet, and meditation, etcetera. And,
I think, for our time together, I’ve focused on a
couple of these ideas.
And oddly enough, what may be surprising to
many of your viewers who are looking for the
secret sauce, it turns out that one of the biggest
players for reestablishing connection to the
prefrontal cortex back to the part of the brain
that balances the person, reduces the tribalism,
increases the empathy, helps make better choices
so that our immune systems will work better, is
getting a good night sleep.
Who knew? Who knew that something that we
should do for a third of our lifetimes…We talk
about exercise and diet. We don’t exercise eight
 14
hours a day, or we’re not eating eight hours a day,
but we should be sleeping seven to eight hours a
day. But it’s not just being in bed asleep for that
length of time, we do need to think about the
quality of our sleep.
And we live in a time where wearable devices are
very common that can give us that information in
terms of how long does it take to fall asleep, how
much time did you spend in REM sleep and deep
sleep, how was your heart rate during sleep, did
you awaken that you don’t remember, how many
times do you wake up in the middle of the night,
and what was your total time asleep last night?
And gee whiz, that technology doesn’t require
that you go to a sleep laboratory anymore and
have a, what’s called a polysomnogram. So very
important.
And so we not only emphasize how dreadfully
important it is to get enough restorative sleep,
but then what you can do to improve your sleep
if it’s not where you want it to be and recognize
that the research we described in the book shows
that even one night of non-restorative sleep is
associated with 60% increased activity in the
amygdala.
Why do you suppose it is if you’re up all night,
for whatever reason, that very next day you
make very bad food choices? Those choices are
impulsive. They’re not based upon what you darn
well know is good for you. It’s going to be the
glazed doughnut and a coffee. Face it, doesn’t that
sound really good? Well, it may not sound good
to you right now, but if you were up all night, it’s
going to look a lot better.
Jodi: Right.
Dr. Perlmutter: So what do we do? Well, we
recommend not having caffeine after 2 p.m.
Simple enough, right?
The Parasympathetic Summit
Jodi: Right.
Dr. Perlmutter: We recommend turning off our
digital devices by dinnertime so that we’re not
exposed to the blue light that these devices are
emitting that can compromise our sleep because
it reduces melatonin. Looking at things like
making your room quieter, more quiet, reducing
sound, a couple of degrees cooler, believe it or
not, or darker. Thinking about if there’s somebody
in your bed, might they have leg movements at
night, we call them these periodic leg movements
that may be awakening you. Or that person may
know darn well that he or she doesn’t sleep. And
they have sleep apnea. And they’re using CPAP or
whatever it may be.
You need to sleep so does it mean maybe you
put a pillow between you. Maybe it means, now,
twin beds instead of one king. Maybe it means
another room. In the end, you’ve got to get a good
night sleep. So I’m not trying to dismiss people
and break people up, I’m talking the value of sleep
in reestablishing your brain’s connection to the
prefrontal cortex, and allowing you to dramatically
reduce your risks for some really bad health
outcomes.
Jodi: Yeah, so there’s a lot to be said for those
biological rhythms. The circadian rhythms, and
how that ties to the digestion rhythm, and even
the normal balance of communication in the
brain.
Dr. Perlmutter: Well, that’s right. We have lived
in a powerful relationship with the cycles of our
environment. We call this Kronos Biology in terms
of when we slept, when we were awake, the
timing of our food consumption, our activities.
And for, virtually, the entire time we’ve lived on
this planet, we would go to sleep when it was
dark and we would wake up when it was light.
Now, that doesn’t happen. And all parts of our
physiology are based upon that diurnal cycle.

And now we see that we’re becoming out of
sync with that part of our biology by eating later
at night and going to sleep later at night. And it
really sets the stage for the manifestation of a
lot of issues, not the least of which is difficulties
with glucose metabolism, an increased insulin
resistance, very strongly correlated with many
parts of that desynchronize lifestyle.
So books have been written about that. Dr.
Satchin Panda wrote a wonderful book about this
whole notion of Kronos Biology, and timing of our
meals, and timing of our sleep, etcetera.
Jodi: Well, and I love that you talked about forest
bathing and time in nature because I think when
you align with nature, that helps reset your
natural biological clock.
Dr. Perlmutter: Well, that’s for sure. Again, for
virtually all of our time on this planet, we were
intimately relating to nature. And our bodies are
signaled by what we experience in nature by
various scents that we experience in the forest
and, certainly, by the day-night cycle that we are
intimately involved with when we’re in nature,
the calming of nature. And the fact that that’s our
history. That’s our legacy, as well.
And so lots are written of this relationship to
the extent that an intervention using nature as
something that is now being described. A lot of
that work coming out of Japan. They call it shinrin-
yoku where they are known as forest bathing, as
you characterized. And it’s not as if everybody has
access to a national forest. And you don’t need
that. Ideally, if you can get to a place where there
are some trees, even in an urban environment,
the research shows that that [crosstalk 18:04].
Jodi: Central Park. Yes, exactly.
Dr. Perlmutter: And if you can’t even get out of
your house for whatever reason, just a potted
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15
plant in your kitchen, or dining, or living room,
or whatever it may be. And if you don’t have the
green thumb, and don’t want to have plants in
your house, even a photograph of nature has
been shown to calm the amygdala and to lead to
less impulsive response. So that’s very valuable.
And it’s not in a prescription form. And it has great
play in terms of allowing us to reconnect.
Jodi: Yeah. And I feel like part of that is the
summit is the parasympathetic state in the way…
Well, I’ll let you speak to how the amygdala aligns
with that. But I feel like the amygdala puts us in
that sympathetic fight-or-flight state. And the
prefrontal cortex helps calm us down. Can you
talk to that a little bit?
Dr. Perlmutter: You’re exactly right. So when
we’re living off…And let me just retract for one
second or go back. There’s an upside to the
amygdala. That’s for sure. The amygdala allows
instantaneous response, which is a good thing
at times. Meaning that you put your foot on the
brakes because a kid was in your rear-view mirror
on a tricycle. And you didn’t think about that.
It wasn’t, “You know, this might well be a good
thing for me to go ahead, and take my foot off the
accelerator, and shift it over to the brake because
there’s a kid.” By the time you’ve done that, you’ve
got problems. So there is a great place for this
instantaneous response. That’s the role of the
amygdala. And that can be lifesaving. We need
sometimes fight-or-flight. That’s a good thing, but
not day in and day out.
And this day in and day out activation of our
fear syndrome, fight-or-flight, does two things.
Number one, it strengthens our connection to the
amygdala at the cost of reducing our connection
to the prefrontal cortex. And it does upset the
balance then between the parasympathetic
system, which is involved in our day-to-day
activities of digesting our food, and really the

maintenance work of our bodies, and more of the
sympathetic sudden fight-or-flight kind of activity.
We need both. But when we weigh the
sympathetic activity far more aggressively, then
it does tend to have negative consequences. And
that feeds into elevating cortisol. That damages
the gut lining by changing the array of organisms
in the gut. When we damage the gut lining,
that leaky gut, as it’s been called, augments the
process of inflammation in our bodies.
And that is something that we cannot let happen
because chronic elevation of these inflammatory
mediators is damaging to our DNA, it’s damaging
to various parts of the body, and certainly to
the immune system. It’s also associated with
Alzheimer’s, coronary heart disease, diabetes,
cancer, all of the chronic degenerative conditions
that are increased in risk because we’re constantly
under stress, and we’re activating our sympathetic
immune systems.
And then those functions sub-served by the
parasympathetic nervous system may not get the
attention they need. For example, digestion, when
we suddenly shunt blood away from the gut by
activating the sympathetic nervous system, well,
we need blood and we need gut motility to be
happening to extract nutrients from our foods to
have healthy digestion.
So when we constantly are bombarding our
bodies with stress and shutting that system
off, no wonder people have such issues with
respect to their guts these days. And interestingly
enough how profoundly correlative that is with
depression. What an interesting other side light
on the so-called gut-brain connection.
Jodi: Yeah, I know, it’s fascinating. And I love how
you connect the amygdala with the sympathetic
response and how you were talking about where
you put your attention is where it grows. So if
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16
you’re constantly in stress, that almost wires your
brain neuroplasticity to become more stressed in
the future.
Dr. Perlmutter: Yes, mam, it not almost wires
your brain, it does rewire your brain. So through
this process of neuroplasticity, the more you’re
tapping in to the amygdala, the stronger that
connection becomes. That happens. And the
opposite of that is the fact that when you’re not
using certain pathways, they tend to decline in
their efficacy.
In other words, when you’re not connecting to the
prefrontal cortex, this connection between the
prefrontal cortex and the amygdala that normally
would have calmed the amygdala down becomes
less effective. And we can’t have that. We need to
reestablish that connection. And then nurture it.
Jodi: Yes, it’s like the amygdala’s highjacked. It just
keeps running on its own.
Dr. Perlmutter: Yes, let the amygdala do your
job. “Your job is to alert us if we’re in clearly a
threatening situation. But otherwise, we need you
to calm down now. We need you not to be fearful
day in and day out. And sorry, amygdala, I’m sorry
I’ve been bombarding you with news from 24/7
exposure to TV and my screen.” What does that
do?
That strengthens the amygdala’s role. It says,
“Look, things are really, really bad. And it amps up
sympathetic activity, increases cortisol at the cost
of the parasympathetic nervous system, our heart
rate goes up, blood pressure goes up. All the
things that we’re trying to avoid are happening by
virtue of the choices that we make. We choose to
fan the flames of amygdala activity by watching
news nonstop, by engaging in fear-based social
media interaction. Put that stuff aside and go out
and walk in the forest, for crying out loud.

Jodi: Exactly. That’s the one thing I really want
people to land with in this. There’s so much
outside of our control, but we get to choose our
own choices, and we get to make choices that
can help us calm our amygdala, and activate our
frontal cortex, and drop into parasympathetic
state. And you have so many good suggestions.
I love diet focus, sleep. Are there any other tools
that you have found really helpful to help people?
Dr. Perlmutter: Meditation. Who knew? So
meditation is a very rapid fire way of immediately
calming the sympathetic nervous system,
letting the amygdala show out, and allowing
parasympathetic activity, allowing the prefrontal
cortex immediately to come on line, and do
its thing. We can demonstrate this on various
sophisticated brain imaging studies. And we
actually showed them in the book how meditation
immediately lights up the prefrontal cortex, calms
the amygdala. And the more you do it, the more
indelible that becomes.
And indeed, it lasts through this process of
neuroplasticity where we’ve strengthened this
connection. And it can be demonstrated that
long after the time of meditation, you remain
connected to the prefrontal cortex, the world is
less threatening, the immune system is better,
blood sugar control is good, blood pressure is
better, and it’s free. So what is the push back?
Jodi: No, exactly. This is so timely and so helpful.
Thank you so much for all of this amazing advice
and these great tools to help people shift. Is there
anything else that you’d like to talk about with the
amygdala and the prefrontal cortex?
Dr. Perlmutter: Well, let me just take a step back
in closing. And, I think, the whole mission of our
book and even our time together today, Jodi, is
the notion of self-empowerment.
Jodi: I love that.
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17
Dr. Perlmutter: That we tend to live in this world
that would have us believe we should live our
lives however we choose, moment to moment.
And that when, suddenly, we develop a condition,
there is a magic way of fixing it. And the reality is
that’s pretty far from the truth. And that we are
the arbiters of our health destiny, as it relates to
these chronic conditions.
And to a significant degree in these times of this
COVID-19 experience, that we have a lot to choose
in terms of how we are going to experience this
infection. It’s been estimated that between 60% to
80% of the global population is going to become
infected. Meaning that likely we’re going to be in
that group. And so that happens…
Jodi: Well, exposed, we’ll be exposed--
Dr. Perlmutter: Yeah, that’s right.
Jodi: but how our body reacts, we have choices.
Dr. Perlmutter: And we can be the arbiters of
that response based upon the lifestyle choices
that we make right now. We know that people
who have obesity or are significantly overweight
having diabetes, coronary disease, coronary heart
disease, other chronic, or general problems, which
are a manifestation of the lifestyle choices we
made previously, those issues speak to a worse
outcome. That’s clear.
And it’s not like, “Well, that’s what I have. End of
story. Too bad for me.” No, we can choose right
now to improve, for example, our blood sugars by
being on a diet that’s more restricted in refined
sugar. We can control our blood sugar by eating
less sugar. Who knew?
Jodi: Yes!
Dr. Perlmutter: Engage in exercise. Get a good
night sleep. All those things to work on those

mechanisms that would otherwise have led to
these diseases. Or if we already have one of those
diseases, we can reduce their severity. We now
see the data that shows that you can cure type 2
diabetes with a Ketogenic diet, for example. There
is no medicine on planet Earth that cures type 2
diabetes.
We have tons of medicines that will lower the
blood sugar. When you watch television, they say,
“Oh, gosh, I lowered my A1C. Aren’t I special?”
But you can cure type 2 diabetes and get off
medications, for example, by going on what’s
called a Ketogenic diet.
So what I would like to leave your viewers with is
really the notion of empowerment.
Jodi: I love that.
Dr. Perlmutter: That it’s not good enough to
outsource your health destiny to others. That we
have the tools. Today, we know the information
as to what we can be doing to reframe our future
in terms of our health and even in terms of what
would happen should we become infected with
this virus.
Jodi: Mindset is so important, and stepping out of
victim, and stepping into personal responsibility.
And, I think, that’s what Brain Wash is all about.
It’s really empowering people with very accessible
tools to make a difference in their health
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18
immediately. And it can be as simple as looking at
a photo of a plant. That’s amazing.
Dr. Perlmutter: Who knew? Those are all offered
up as on ramps to reconnection, whether it’s,
again, reconnecting with nature, however that
works for you, paying attention to your sleep.
Maybe getting a wearable device and seeing
where you are to start off with, then making
changes, and see how that impacts your sleep.
Yeah, as a matter of fact, aerobic exercise is
something we’ve all known is good for us. And
it is. As you mentioned, reconnecting to nature,
changing our diets, and reconnecting with other
people, very important. We need that.
Loneliness is a powerful risk factor for illness.
And finally, I think, working on tools to increase
our empathy. Keeping a gratitude journal. Saying
to others thank you for what you did. Apologizing
to others. All of these things reconnect our hearts
in a figurative way to others and to ourselves. And
that will strengthen our connection to those good
parts of the brain.
Jodi: That is so helpful, and so amazing, and so
timely. Thank you for everything you do.
Dr. Perlmutter: Oh, my, gosh, thank you.
Jodi: This was amazing. Thank you so much.
 19

The Polyvagal Theory:

Insights into Resilience
Stephen Porges, PhD

Jodi: Hello, and welcome to the Parasympathetic
Summit. I’m your host, Jodi Cohen, and I am
beyond excited to welcome Dr. Stephen Porges,
the father of the polyvagal nerve theory. He is a
PhD, a distinguished university scientist at Indiana
University, where he is the founding director
of the Traumatic Stress Research Consortium
in the Kinsey Institute. He’s also a professor of
psychiatry at the University of North Carolina,
a professor emeritus at both the University of
Illinois at Chicago and the University of Maryland.
He served as president of the Society for
Psychological Research and the Federation of
Associations in Behavioral & Brain Sciences and
is a former recipient of the National Institute of
Mental Health Research Scientist Development
Award. He is also the originator of the Polyvagal
Theory, a theory that emphasizes the importance
of psychological state in the expression of
behavioral, mental, health, and health problems
related to traumatic experiences.
Welcome, Dr. Porges, it’s such an unbelievable
honor to have you.
Dr. Porges: Well, thank you, and thank you for the
kind words. I’m pleased to be here today.
Jodi: Well, I’m excited. If you can share how the
autonomic state of the nervous system serves as
an enervating variable that biases our reactions
to others? Actually, before we get into that, could
you just give a layman expression of the Polyvagal
Theory for those people who are not familiar with
it?
Dr. Porges: Yeah, what we will try to do is keep
it within the constraints of the timing of this
interview because I could talk for a few days on
that. But, basically, let’s start with really your point
and that is physiological state is that intervening
variable between stimulus and response. The way
that our autonomic nervous system is functioning
in the state that it’s in, functionally determines
how we react to stimuli in the environment so
that when our autonomic system is in a state of
great resilience, then stimuli this bounces off of
us.
When our autonomic nervous system is in a
state where it’s fight or flight or defense, then
those stimuli result in a hyperreaction, an
aggressiveness, or a sense of being hurt. And
if our autonomic nervous system is in a state
of shutting down, we’re dissociated, we don’t
even recognize what’s being said to us. So the
physiological state is really what the Polyvagal
Theory focuses on.
And it says that we have these different states
that evolve through the evolution of vertebrate
or our autonomic system. So we have more
ancient systems, which are basically shutting
down systems. We have the newer one, which is
a mobilization or could be used for flight or flight.

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But we have this unique mammalian system,
which is a social system that says, “My goal in life
is to coregulate with another. To feel safe in the
arms of another person.
Jodi: Yeah, and if you could talk about how the
autonomic state serves as a neutral platform for
those different classes of behavior?
Dr. Porges: Yeah. Well, the different neuro
platforms are that when we’re in this safe state,
we have a neural platform that is regulated by a
newer, evolutionary newer vagal pathway, which
happens to be linked in the brain stem with the
nerves that regulate the facial muscles. So when
we smile and when we can hear people’s voices
in noisy environments, and when our voices are
melodic, we’re projecting our physiological state,
our vagal regulation of our heart to another
person. So we’re projecting it in our voice and in
our facial expression.
And that’s how mammals evolve to connect
with each other. So they didn’t have language,
but they had vocalizations. And what they were
doing were signaling the others that they’re safe
to come close to. And we do that all the time.
So we intuitively like people who talk in a more
melodic way. And we get away from people
who functionally yell at us, either they have a
high-pitched, anxious voice, or a low-pitched
dominating voice, either way, we don’t really want
to connect with those people.
But if the voice is melodic, our nervous system
catch that this is safety. And we want to be
closer and we want to learn more about that
person. And in polyvagal theory, that nervous
system detection is called neuroception because
it’s outside of the realm of cognition. So we
automatically like certain types of vocalization.
Like the mother’s lullaby, the baby doesn’t learn
that the melodic voice of a mother is calming, the
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nervous system is prepared to detect melodic
voices as calming cues. And if you have a dog or a
kitten, you don’t talk the same way to them, and
their nervous system will respond in the same
way.
In fact, all mammals have a frequency band in
which social communication of safety is conveyed.
And so we intuitively talk to our dogs and cats.
But serendipitously or fortunately, their frequency
band of social communication overlaps with ours.
Jodi: I should have asked this earlier on. But can
you talk about the different branches of the vagus
nerve and where they travel in the body?
Dr. Porges: Sure, yeah. The vagus, of course, is an
enormously large nerve. But we’re going to almost
use it as a metaphor because it connects the brain
stem with all the organs in the body. And so we
have this whole historical notion that the vagus is
first a motor nerve going to the organs, but 80%
of the fibers are sensory.
So it’s your surveillance system. It’s taking
information from your gut, from your heart, and
it is sending it to the brain cell, which is then
determining whether or not other portals of
your brain are open for cognitive processing, or
attention, or do you have to be hypervigilant and
react to the world.
So it’s a bi-directional system that is connecting
the brain with the body, but it evolved in an
interesting way. It’s actually extremely ancient. So
virtually, all vertebrates have a vagus. The ancient
vagus is really, we still have most of it and it goes,
primarily, to the organs below our diaphragm. So
even though, it’s connected to the organs above,
its primary role is to regulate your gut. And we’re
going to halt it right there because we’re going to,
basically, ask this question, “How many of your
listeners have gut problems?”
 21
Jodi: Yeah, pretty much everyone, even if they
don’t recognize it.
Dr. Porges: Right. And if you have a trauma
history, where is it going to be manifested? So
this comorbidity of the irritable bowel syndrome
or gastric destress with trauma is really telling
you that the vagus, going to the organs below
the diaphragm, is responding in defense. Now,
this comes from more ancient vertebrates,
because under challenge, the vagus was not this
protective, calming, loving nerve, it was a nerve
that said, “Reduce metabolic output or you’re
going to be in trouble. So defecate, get all the
food,” because digestion is metabolically costly.
So defecation was an adaptive way because
these early vertebrates had to hold their breath,
either under water, or whatever they were doing,
and appeared to be dead. So we have this very
ancient defense system of immobilization shutting
down. And again, in the world of trauma, people
experience this as disassociation, or freezing,
or literally getting out of their body, being
disembodied. And so the goal of health is about
being reembodied and feeling that we are part of
our body. And that’s really getting the vagus out of
defense modes.
So the ancient vagus originates in the area of
the brain stem that’s called—I’ll give you some
anatomical names that we can forget them in a
moment—it’s called the dorsal motor nucleus of
the vagus, but a lot of people now use the term,
“going dorsal.” And when this older vagus pathway
now becomes your prominent response, it means
shutting down. So when some clinicians say, “Hey,
you’re going dorsal,” they’re really saying this old
vagus is now taking over. So that for the initial
first stage of our evolutionary development of an
autonomic regulation system.
The second stage was the spinal sympathetic.
And we know this about mobilization. Now, all
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these systems are not always defense systems,
they can be utilized to support our homeostatic
functions, but when used in defense, it’s fight/
flight with the sympathetic, and it’s shutting down
with that old dorsal vagus. But now most have this
really unique mammalian branch to the vagus, in
which you can actually watch in embryology as
certain cells are of origin of the vagus nerve move
from the dorsal area, and move eventually to an
area that regulates to the muscles of the face and
head.
So now when we have a melodic voice that’s
coming, actually, from our laryngeal control of
vocalizations for intonation is actually to a nerve
called the recurrent laryngeal nerve. And that’s a
vagal nerve. So we have parallel vagal regulation
of vocalization and our heart. So now when
people are talking from their heart, we hear it, and
we know it, and we say, “Ah, that person is real.”
But what you’re really saying is the intonation in
their voice is triggering in your neuroception that
that person’s physiological state is calm, is loving,
and trusting.
So we have these three, but now the systems
work in a hierarchical way. This is really, I’m going
to use the term, the beauty of the mammalian
system because it means, in a hierarchal way,
it means that if we can get this newer, loving,
trusting system to work, it functionally regulates
the others, it contains them from going into
defense, it lets them do what they’re supposed
to do, which is support our health, growth, and
restoration.
So when we find safe relationships and trust, we
often are self-healing under those conditions. And
if we think about how we treat our children who
get hurt, we want to give them a hug. And what
we’re doing is creating that safe container so that
that newer ventral vagal circuit downregulates
their defenses, let’s their breathing come down,
let’s your metabolic activity, let’s them heal. And

if you had any form of disease, you’d want that
to occur, as well. You’d want the body to do its
job and not to fight off people, but to take care of
what’s going on inside.
So the newer mammalian vagal system is what
makes life worth everything. So it’s our portal for
coregulation. And it really emphasizes that we, as
a species, didn’t evolve to be isolates, we evolved
to be social creatures that coregulate, we’re
not self-regulatory all the time. And those of us
who have reasonable coregulatory options have
usually the capacity to self-regulate. And if we get
into the world that we’re all dropped in to, we’re,
basically, told that we have to self-regulate, and if
not, we’re not good people.
And this includes the school systems, they’re
missing the point. If you don’t have the capacity
to self-regulate, being told or being demanded to
self-regulate, you’ll fall apart. You need options
of coregulation to get the system organized
sufficiently to get enough resource to be a self-
regulator.
Jodi: Yes. You’ve said so many amazing things
that I want to unpack. But I really want to land
on that last point, especially now we’re being
overwhelmed with fear messaging, which makes
us feel unsafe, and we’re not allowed to connect
so we’re being taken out of our ability to self-
regulate, which turns off our immune system, as
well.
Dr. Porges: I wrote a paper this past month
for Psychiatry Journal, which talked about the
paradoxical challenge to our nervous system
of the pandemic. Number one, we’re under
threat. The virus is a threat. And we have to
acknowledge it. But what could happen when
our bodies are under threat? We’ve retracted our
social engagement system with this ventral vagal
circuit so that we’re more hypervigilant and more
concerned about what’s going on around us and
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our physiology is now more likely to be reactive to
those that we interact with, whether it’s on social
media or over the phone.
So through the history of humanity, the history
of the evolution of being a human, when humans
were threatened, how did they mitigate their
threat responses? They mitigated it through social
interaction, through being hugged, through being
with a trusted individual. But we have what we’re
calling a “social distancing” going on. And the
social distancing creates a problem because it
takes away from us the toolkit that humanity had
always used to regulate threat. So it’s problematic.
In some of my discussions, I’m learning that
people shouldn’t use the word social distancing,
they should use the word physical distancing so
they respect social communication. So even when
they’re physically distancing they should wave
at people, and smile, and have an interaction,
instead what we often see, and I’m going to pick
it up right in front of me because I have one right
with me, you’ll see I do have a mask.
Jodi: Yeah, you can’t see facial expressions.
Dr. Porges: I’m not going to put it on, but I have
a mask. And often when people walk by, they
drop their heads, they gaze avert. And so when
you gaze avert to a person, it’s a trigger to their
nervous system, through neuroception, it’s a
trigger of being dismissed or being rejected. And
our bodies interpret these reactions with our own
personal narrative. And we start to feel less, or
poor about ourselves, or we may get angry at the
person who does it.
But we have to understand that our bodies are
reacting to these cues. We have to really respect
the fact that the virus is a true threat. And we
have to understand that we have to maintain a
type of social communication. And what I’ve been
really saying, since I now spend so much time on

Zoom or Skype, and what I decided to do, was to
treat the moments a little bit differently because
we have been so trained with two-dimensional
screens not to think of them as people or
moments of interaction.
So if you and I were at a Starbucks, we’d be
looking at each other, we’d be talking, and we’d
have a different level of connection. So I said,
“Well, I have mine, here, too [Shows cup of coffee].”
So I made a decision. I decided I’d start wearing
my reading glasses during webinars so that I
could see people’s faces more clearly and I would
make an effort to look more directly at them.
The problem with my—I have a 27-inch screen—
so I’m looking up when I want to look down at
you. So the camera’s really not in the best place,
but I’m really, I would say, I’m retraining myself to
do what I would naturally do. And that is to look
at people’s faces, to pick up the cues in their face,
to listen to their voice, and to, basically, be more
present with them in a video chatting format.
The problem is that over the years, we, basically,
have bailed out whenever someone goes on a
two-dimensional screen, we’ll pick up our phone,
we’ll do something else, and we would take that
moment of feeling that we’re present with that
person. So I’m really saying that the way of dealing
with this, during this crisis, since it’s going to be
with us for a while, is that we have to, in a sense,
take moments, like the moment that we have
together now, and, basically, say this is a moment
of being present with you.
Jodi: Yeah, and you said two things that I think are
fascinating. One thing that you said is the vagus
nerve is assessing all the senses, so sight, sound,
smell, everything as a threat. And that’s also how
you engage it, and put it in the place of safety.
Dr. Porges: Let me clarify. The vagus is really
connected to our visceral organs. Now, it also has
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23
impact in terms of taste and gustatory types of
signals, but it is related to other things. So like,
if we lost our vagal control, bodies would be in a
more mobilized state, more defensive, and our
pupils would dilate, and now we would be light
sensitive. So there’s going to be interactions.
And the muscles that are going to our middle ear,
our middle ear muscles, they will become loose
so that we can pick up low-frequency predators.
So the senses are changing, but they’re not
changing, necessarily, directly through the vagus,
but indirectly through the vagus. So the vagus is
affecting, basically, a greater area of regulation in
the brain stem than it affects our global state.
Jodi: Is it a domino effect that the vagus gets more
alert so it triggers these other things to try on?
Dr. Porges: Well, yeah, you could think of it as a
domino effect. But if you thought of it as a neural
platform, that you need specific neural platforms
to be focused, to be able to listen, to pick up cues,
in tune, let’s say, our smells, you’ll want to be in a
state where you’re not hypervigilant and turning
around to enjoy an odor, your body gets triggered
to different neural states, and they are great for
different classes of behaviors.
Sometimes the class of behaviors are defense
oriented so that we can take care of ourselves.
But we pay a price for that. And that is when we
take care of ourselves, in terms of physical threat,
we lose the capacity to engage and feel connected
with another.
Jodi: Yes, and that is the pathway back like what
you were saying. That’s a great tip. By the way,
everyone who’s listening, that when you’re on
these conference calls, imagine we’re both looking
at you, and smiling right now so you are engaging.
What are some of the other things that you
have found, in your research, that really helps

people engage their safety mechanism and their
parasympathetic state?
Dr. Porges: Yes. Well, let me just bring it back
a bit. We’ve been doing research about what’s
happening during COVID-19. And the underlying
hypothesis was that people who have trauma
histories will be dealing with the pandemic, it
will be more difficult in terms of depression, and
PTSD symptoms, and worry. And we’ve been also
using, in a sense, a polyvagal metaphor. And that
is physiological state is that intervening variable
meaning subjective measures of our autonomic
nervous system.
Now interestingly, that, in general, people with
trauma will have more defensive autonomic state,
but if you co-vary out autonomic state from the
trauma history, virtually all the variances are gone.
And so the real issue is what is your physiological
state? So what is your--
Jodi: Is that like your vagal tone, your resilience?
Dr. Porges: Yeah, the physiological state is saying,
“Is my autonomic state responding defensively or
is it well regulated and enables me to feel calm?”
So we have some questions about salivation in the
mouth, palpitations, irritable bowel symptoms.
So you start getting a map. And we have an index
of what that means, but, in a sense, the reaction
to the COVID virus is really dependent upon that
subjective physiological state.
And we’ve done other research before the
pandemic like asking questions about trauma
histories and sexual function. And interestingly,
again, trauma histories don’t lead to sexual
dysfunction, trauma histories lead to autonomic
state dysregulation that leads to sexual
dysfunction, or lack of pleasure in sex, and even
purpose in life follows the same thing.
So the gateway is really your physiological state. If
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your physiological state is more dysregulated, and
more reactive, more defensive, meaning less vagal
regulation in the pro-social and positive way, then
purpose in life, depressive symptoms, anxiety,
worry about the pandemic, all of these things
start going together.
Jodi: So it’s the foundational piece that
determines if you’re going…It’s like The Three Little
Pigs, “Is the big bad wolf going to blow your house
down or not?” if your vagal…
Dr. Porges: Right, if you have a good autonomic
vagal regulatory system, your house is made of
bricks.
Jodi: Yes, yes, I love it. That is the main point I
really want people to land on that you do not have
control of anything outside of you, but you have
control of your state. And I’m very excited for you
to share some things with us.
Dr. Porges: Well, this is the interesting question.
Before we emphasize you have control of
your state, sometimes your state acts more
reflexively. So we don’t want to get people to
feel that…Like there are already people who
have been victimized, let’s say rape, and their
body immobilized, and now they’re carrying the
shame that they couldn’t run and fight when their
body went into an adaptive, defensive state of
immobilization. So we want to understand this as
reflexes, in part. But we also have an awareness
of our response. And we also have some tools
that we can bring in to help enhance that
resilience, greater regulation.
Jodi: Thank you, that was a very important point.
You should never go to blame, shame, or guilt.
Yes. And it can always be unraveled. It’s like you
can turn the Titanic. It takes time, but you can do
it.
Dr. Porges: Right. We have to be very careful
 25
about the causality model. We know that our body
is that intervening variable, but the causality of
it…So if I’m an anxious person and physiologically
defensive, what is my responsibility? And this is
really what your question is. My responsibility is
can I learn to downregulate the physiological state
that supports anxiety and defense? And what are
the tools that are available to me?
So we talked initially about coregulation. But
some people project so much anxiety, so much
defensiveness, that no one wants to go near
them, no one wants to give them a hug. Although,
the person who is in that physiological state of
defensiveness, their dream is to be loved and
to be hugged, but the cues they’re presenting to
another is, “I’m not going near that, it’s too, too
dangerous.”
So what do we as enlightened, civilized people
do? Well, we have a knowledge of things like
breathing. Breathing is a powerful regulator of
vagal activity. Why? Because when we exhale,
we actually are enabling the vagus, that neural
mammalian vagus, to slow our heart so it’s going
right to the heart’s pacemaker. So deep, slow
exhalations are increased vagal activity, while long
inhalations will turn off that vagal activity. So if we
wanted to get ourselves worked up, we huff and
puff.
Go back to your three little pigs and a wolf,
metaphor. We huff and we puff. And that turns
of the vagus. But if we take a deep breath and
exhale slowly, then the vagus comes on. So
chanting is also exhaling slowing, but also talking
can be exhaling slowly if we enhance or increase
the duration of our phrases so when I get off from
this webinar, I’ll feel really relaxed because I’m
getting long phrases.
Jodi: Amazing. This is very helpful. Can you talk
a little bit more, especially if someone…So many
people that I know had some kind of trauma in
The Parasympathetic Summit
their life. And if they’re listening, and maybe they
were raped, or felt like they were victimized in
some space, how do people, like what’s a good
first step? How can they start to unpack that
trauma and build resilience?
Dr. Porges: Well, the first part is often our
reactions to the trauma or our functionally
disembodiment adaptive responses, “It didn’t
happen to me. It happened, but I’m not there.”
So people start losing or becoming numb. They
become numb to others, numb to themselves.
So part of the real strategy is to have a deep
respect and to honor your own body’s reaction. So
often when people have been in these situations,
they’re both ashamed of it, and they also carry an
implicit blame, and they can’t get rid of it. So the
part is to be developing and honoring of one’s
own physiological reactions and saying, “My body
did wonderful things for me. I might have been
raped, but I’m alive. Why am I alive? Because I
didn’t fight back. And if I had fought back, I could
have been killed.
So we start seeing this gratitude of our own
reactions and we start learning that our body
can help protect us. The problem is the rest of
the society has to be enlightened and informed
about how the body actually works because when
another person hears these stories, they said,
“Why don’t you fight?” And the judicial system is
now slowly being informed that lack of fighting
doesn’t mean consent. And that’s part of what
people have to start learning that bodies react
and our body has its own computer where it’s
making judgments. And these judgments are
there to keep us alive.
So when you see people who tend to be
combative or oppositional, think again about
the intentionality, and start looking at them with
a different light, and saying, “Why are they so
scared, or why is their body so scared, and can
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we give their body, not their entire intellectual
world, but their body cues of safety? Can we
slow up how we talk to them? Can we give them
a little distance? Can we reduce the cues of
threat, as opposed to increasing cues of threat by
being demanding of people who don’t have the
resilience to self-regulate?
Jodi: And that’s interesting what you were saying.
I do talk to my dog in a baby voice. And that
definitely helps. I wonder if it’s the resonance of
your own calming energy that influences their
energy?
Dr. Porges: Well, you see, vocalizations or
acoustic energy is energy. Our presence is an
energy, it’s both our vocal, it’s our movements. So
it’s just a different metaphor. So we are always
trying to get into resonance or at least we should
be trying to get into resonance with another. But
the underlying cue there is, does the other person
feel safe with us? So you’re not going to get a
resonance, even with a puppy, unless the puppy
feels safe with you. And so you understand the
titration of your behaviors. You can’t approach too
rapidly. You have to assure the puppy that you are
there to take care of them and not hurt them.
Jodi: Yes, yes. And I know you’re looking into
some acoustic devices that can help build vagus
resilience. Can you speak to that a bit?
Dr. Porges: Yeah. So several years ago, I
developed the intervention that’s called the Safe
and Sound Protocol. And initially, it was to deal
with kids who had auditory hypersensitivities like
individuals on spectrum, the autism spectrum,
and it was using, basically, a computer-altered
vocal music that emphasized the intonation of
modulation.
Now, as I said earlier that this is really a trigger to
our nervous system to calm down. But what does
that mean neurophysiologically? It means, put the
The Parasympathetic Summit
vagus back on. Let the vagal brake calm us down.
So I conducted research. And we showed that
it increases the vagal regulations of the heart,
it reduced auditory hypersensitivities. And now
the work that we’re conducting is that it’s also
reducing tactile hypersensitivities and visual
hypersensitivity, and even increasing when people
have trauma or are autistic, they don’t like to vary
their foods, they want something that they’re
familiar with. And so we’re actually looking at
selective eating. And what we’re seeing is they’re
becoming more diverse in their food choices.
This system is available. You can go to my
webpage and you can click on Safe and Sound
Protocol and we’ll send you to the company that
is distributing it. But we’re also modifying some
of the algorithms so it can be used as an acoustic
vagal nerve stimulator. And this will be available
shortly.
And we’re doing clinical trials. Right now, we have
clinical trials set up with Ehlers-Danlos syndrome,
which is the hypermobility syndrome, but those
people also have gut problems and anxiety. And
we’re seeing if it can modulate their pain. And
we’re doing a study with Parkinson individuals to
see if we can increase the neural regulation of the
facial muscles.
So the whole idea of this acoustic vagal nerve
stimulator is a lot of disorders, whether we’re
talking about autism or Ehlers-Danlos or
even Parkinson’s, we don’t know whether the
clinical feature’s like a flat face, and all that, and
Parkinson’s is really flat, is really part of the
disorder, or is it part of the body’s response to
having the disorder?
Jodi: Oh, my, gosh, yeah.
Dr. Porges: So we have to think differently about
this. And some of these symptoms may be

treatable, whether it’s through an implantable or
contact vagal nerve stimulator, which are on ear
or by listening to acoustic music that’s designed
to trigger the vagal feedback. So this is part of
what we have to start learning and not think of
comorbidities as being life-long deficits.
Jodi: So I wanted to delve deeper because you
mentioned autism and some sensory seeking
sensory avoiding behavior. I’ve heard you say that
a lot of the behaviors that autistic kids experience
is really just trying to self-regulate. Can you speak
to that a little bit?
Dr. Porges: Well, I would say that many of the
special populations that we could talk about
who have aberrant-type behaviors, whether
it’s autism or even addiction, are really valiant
attempts of the individual to try to regulate their
state. So they’re really, in a sense, with autistic
kids, they’re trying to be good kids, but their
body is highly mobilized, and they have to move
around and ritualize certain behaviors. So we start
seeing the unfolding of some behaviors because
their physiological state is providing this neural
platform for behaviors that are anti-social.
Jodi: Can you elaborate on that for addiction?
Dr. Porges: With addiction, think about what an
individual is doing, they’re trying to regulate their
physiological state through either behavior or
through a drug. And what’s the optimal way of
regulating your behavior? Through coregulation,
through interacting with another. So even when
we mobilize and make face-to-face contact, we
either call that dancing or we call that team
sports, which we often call people who are
dancing.
We see a team sport or basketball, and they’re
dancing together because they’re moving,
but their cues are keeping their behaviors of
movement not to hurt each other, so which
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27
is really remarkable. So play for mammals is
mobilization with social communication, usually
face-to-face. And if you don’t have face-to-face,
with vocalizations.
Jodi: Interesting. And can you also…I’m curious,
you’re using a sound device. You talked about
the ear. Can you speak to why the ear is a good
platform for accessing the vagus nerve?
Dr. Porges: Well, the ear is an amazing platform
for accessing the vagus because there are sensory
pathways that go to the external ear. But there
are also pathways that go to the trigeminal, out
from the ear, that goes through the trigeminal
and facial nerve. And an afferent goes to an area
of the brain stem that regulates the vagus. So it
doesn’t really matter that much whether you’re
really on the vagal afferent or on the trigeminal or
facial afferent. And even think about the notion
where people will massage or suck on something,
that’s also an inefficient, but an attempt to
stimulate that vagal calming mechanism.
Jodi: So the pacifier, the reason the Binky works is
because they’re activating the vagus nerve. Wow!
Dr. Porges: Yeah, well, also, think about when
people do this. [Rubbing forehead with hand]. The
trigeminal nerve, the afference of the trigeminal
are just below the surface. And when we do this,
it goes back into the brain stem. And it’s the area
that regulates the vagus going to our heart and
calms us down. And when we do this to our dog
[Rubbing neck with hands] or to ourselves at 4
o’clock in the afternoon to calm ourselves down,
it’s affecting, also, blood pressure receptors, which
are going to the vagus and calming us down.
So a lot of the behaviors that we do, it’s ritualized
behaviors that we think we’re doing to calm
ourselves down, are actually neural exercises.
Jodi: That is amazing. Is there anything else that

you want to share that we haven’t spoken to yet?
Dr. Porges: No, I think, we’re in a point in time
in which a better understanding of our neural
physiology starts to map into practices that
people for hundreds of years have known worked
or they were intuitive to others, but they actually
have a neural anatomical and neural physiological
substrate.
So when people talk about yoga, or they talk
about breath, they talk about chanting, or they
talk about even ingestive behaviors, or listening
to music, that makes people feel safer and
more comfortable, there’s a neural physiology
underneath. And it’s not, in a sense, woo-woo, it’s
actually, one can think of it, and one can think of
compassion as a neural biological intervention.
Jodi: Well, I loved everything you have said.
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28
You’ve shared so many tools that are going to
be so helpful during this time period. Thank you
so much. Could you just repeat your website for
people that might want to write it down?
Dr. Porges: Sure, the website is StephenPorges,
one word, .com.
Jodi: Wonderful! Thank you.
Dr. Porges: That’s with the S-T-E-P-H-E-N.
Jodi: Wonderful! Thank you so much.
Dr. Porges: You’re quite welcome.
Jodi: This was amazing.
Dr. Porges: Enjoyed being here. Thank you.
 29

Practical Overview: Your

Parasympathetic State
Jodi Cohen, NTP

Jodi: Hi, I’m Jodi Cohen, your host, and I wanted
to give you an overview on how parasympathetic
can activate your body’s ability to heal. So just
to introduce myself, I founded an essential oil
company called Vibrant Blue Oils that really
focuses on balancing different regions of the
brain and organ systems in the body with the
specific focus on activating the parasympathetic
branch of the nervous system because I really
think that that is the critical component to health
that most people are missing.
was killed in a car accident on August 27, 2018.
And when that happened, my world, obviously,
turned upside down. And I was given limited
options. And none of them quite fit. And what
did fit was what I’m going to share with you today
about this idea that between the stimulus and
the response, there’s a space. And in that space
is our power to choose our response. And in
our response lies our growth and our freedom.
And that comes from Viktor Frankl, who was a
holocaust survivor.

All the people that are doing everything right.
You’re eating the perfect diet. You’re exercising.
You’re meditating. You’re sleeping. And yet, you
feel like you’re just treading water and not really
swimming to shore. Often, it’s just a minor tweak,
a gear shift from the sympathetic fight or flight
branch of the nervous system that limits your
ability to heal into the parasympathetic branch.
And I’m so excited to share all of these amazing
colleagues, and speakers, and let you really dive
deeply into understanding the parasympathetic
branch of the nervous system. I have written two
books. I have a bestselling book that’s currently
available on Amazon, Healing with Essential Oils.
And my second book, Essential Oils to Boost Your
Brain and Heal Your Body is going to be published
by Random House and is available March 16, 2021.
So I’m going to lead with my, “Why?” This is my
son, Max. He was born on March 8, 2006 and he
And not that my situation is any way comparable
to the holocaust, but when you have really
challenging external circumstances, even like
what’s going on in the external world right now
with the virus where certain social opportunities,
and jobs, and other things are really shut down,
and you have no control over that situation, it can
make you feel very powerless, but you do have
control over your own response and your ability
to activate the parasympathetic branch of your
nervous system really accelerates your ability to
feel like you’re in control, to be able to calmly and
clearly ascertain different options, and to move
forward in a way that is the best for you, both
mentally, physically, and emotionally.
So let’s dive in. My hope with this presentation is
to give you an overview of the parasympathetic
branch of the autonomic nervous system and also
a little bit of a coming attraction on what some of
the speakers are going to dive in to more deeply.

The Parasympathetic Summit


So for those of you that don’t know, your
autonomic nervous system connects your
brain, your spinal cord, and your organs. And it
regulates all of your unconscious body functions
like digestion, respiration, your heart rate. And
it has three branches, which we’re going to dive
in to more. Your sympathetic branch, which is
your fight or flight branch. Your parasympathetic
branch, which allows you to rest, digest, and heal.
And then your enteric nervous system, which is
part of your gut, which also connects.
So the way I think of it, just like that previous
image showed, it’s your nervous system, and
especially your vagus nerve, is a highway between
your brain and the rest of your body. And,
ideally, it’s a two-lane highway. And messages
are communicated from the brain to the body,
and then from the body up to the brain. But just
like a highway, there can be congestion, there
can be an accident, there can be something that
compromises the ability of signals to clearly pass
from the brain to the body. And that’s when
problems arise.
And we’re going to get into that a bit more. But
that highway is really your vagus nerve. It’s cranial
nerve #10. It wanders from the brain through
almost all, well, all of the digestive organs and
almost all of the organs. It innervates your liver,
your lungs, your spleen, your kidneys, your gut.
And it provides bilateral, which means two-way
communication between the gut and the brain
[inaudible] organs.
And by bilateral what we really mean is 20% of the
vagus nerve fibers are sending messages from
the brain down to the body and that 80% of the
body is sending messages up to the brain. Eighty
percent of the messages are from the body to the
brain. And those are important because the brain
is constantly monitoring my blood sugar levels,
heart rate, respiration rate, oxygen rate. And it
really needs accurate information that’s incoming
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in order to send out the most appropriate signals.
So if the messages are not as clear and accurate
as possible, that’s when problems start to
develop.
So the vagus nerve also touches on the heart,
the brain, the liver, the gut. It’s involved in
inflammation. It helps with the mouth and blood
vessels. We’re going to dive more into that. I just
wanted to give you an overview here. And this is
a graphic that I created for my company that I like
because what it shows is how these two systems
work together. And sometimes, for purposes of
marketing, I try to simplify it to make it slightly less
complicated. So I talk about it as shifting gears or
when one branch turns off, the other turns on.
Obviously, they’re both still active at the same
time, but one is more dominant. It’s an ebb
and a flow and both cannot be dominant at
the same time. So when the parasympathetic
branch is dominant, and sometimes I call that the
parasympathetic state, you’re able to digest your
food so all of your blood flow is routed towards
your organ of digestion, you’re able to detoxify,
your pupil, the black part of your eye, gets small,
and you can focus, and have a conversation where
you can hear things.
And then the sympathetic branch is activated
when there is a sense of danger. So you’re
designed to really keep yourself safe and stay
safe. So if you anticipate danger, you have three
options, right, you can fight back. If it’s a predator
like a lion or a burglar, you can flee. Run away
from it. Or if you don’t think you can fight back or
flee, you can freeze. Play dead. Sometimes that
works. For victims of physical abuse, sometimes
they play dead. And that releases the pain
numbing chemicals so you don’t feel things as
much.
But why this is important is that so many of us
are in that stress state because of actual stress

in our life or anticipatory stress, things that we’re
thinking and worrying about or some kind of
physical stress, either from a car accident with a
traumatic brain injury, or a post-traumatic stress
disorder, or some kind of overload of where our
ability to detoxify is compromised so we have
a chronic toxic burden in our body. All of those
things can keep us in the sympathetic gear, the
sympathetic state.
And so, no matter what we’re doing, it’s almost
like if you have a boat full of water and you’re
trying to bale the water out of the boat, but you’re
not patching up the hole, you’re only going to hve
limited success.
So my goal is to help you understand why your
success might be limited and what you can do
to have maximum success. This is just another
graphic that I use that explains the difference
between the sympathetic flight-or-fight state
of the nervous system and the rest and digest
parasympathetic state.
And the things I really want to point out is that
when you’re in the sympathetic state, you have to
flee, so blood flow is routed to the limbs. You have
to have energy so your heart beats really fast
so more blood with nutrients and oxygen flows
through your body. You have to have oxygen for
energy so your respiratory rate increases.
And all of the things that are non-essential to
your survival—so connecting with your partner,
digesting your food, detoxifying, turning on
your immune system, long-term ability to anti-
inflame—those are all put on the back burner
because they’re not critical to immediate survival,
which is fine for a short-term survival surge, but
not ideal ongoing.
So the interesting thing is that your vagus nerve
serves as the on-off switch. Again, not literally, but
it helps the body shift gears between, “I am in the
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flight-or-fight sympathetic state and I’m shifting
into the rest and digest parasympathetic state.”
And it’s the parasympathetic state, as I mentioned,
that really controls your unconscious actions so
your digestion, your immunity, your respiration,
your cardiovascular health, your brain health,
your ability to detoxify and anti-inflame.
So we’re going to get into this a little bit later, but
there are some key things that compromise your
vagus nerve’s ability to function. And those are
toxic thoughts, or stress, and those emotional
stress patterns that serve as anticipatory stress.
And your body can’t really differentiate between
the car that’s about to hit you, and the fear that
you’re going to get fired, or that your relationship
is going to end, or that there’s going to be some
financial doomsday in the future. Physical toxins
can also cause problems, infections, and viruses.
And then any kind of physical or emotional
trauma.
Let’s talk about the vagus nerve. The vagus nerve
is right where you might have had trauma. And
so any trauma in that area can impact the vagus
nerve. And then diving a little bit more into the
sympathetic flight-or-fight response, it is your first
line of defense.
And so, as we mentioned, there’s a whole
chemical cascade that’s triggered when your body
thinks it’s going to die. There are hormones like
adrenal that are released to make your heart beat
faster. Your blood pressure and respiratory rates
increase so you have more oxygen. Your pupils
dilate so you can see more clearly.
There’s actually an interesting tell. If you’re trying
to have a conversation with somebody and you
notice that their pupils are dilated, meaning the
black part is large, they’re not really going to be
able to hear you because their body is so hyper
focused on that next one move, they can’t really

see all of the options. In fact, when my son was
little, one of my friends used to say, “Connect
before you correct.”
So we would be at the playground. He would
maybe throw sand at another kid in the sandbox.
And it never worked if you disciplined them on the
spot. You had to scoop him up. Walk over to the
swing. Say, “Calm down, connect.” Say, “Hey, can
you hear some feedback. You can’t really do that.
Let’s stay out of the sandbox for the rest of the
day. And, you know, if you do that again, we can’t
come back to the park,” that kind of thing. But
they can hear you when their pupils are small and
they’re more calmed down.
So again, we’re designed to toggle between these
two states. There’s a danger, we respond. We’re
safe. We recover. We go back into sympathetic.
I’m sorry, parasympathetic rest and digest. But
the problem is that stress isn’t really acute and
short term like that. Like our body’s designed to
navigate. It’s more chronic and prolonged.
And this is an estimate. But 20% of the time,
we can be responding to external stressors or
internal stressors and 80% of the time, especially
while we’re sleeping, we should really be in that
parasympathetic rest, digest, and heal state.
And the challenge is that override of sympathetic,
also known as sympathetic dominance, disrupts
this natural balance. And it can impact things
like blood pressure, heart rate, digestion, and
constipation’s often linked to sympathetic
overdrive. So when you’re able to help your body
shift into that parasympathetic state, there are so
many health issues that can just be resolved.
So I made slightly an extensive list: autoimmunity,
brain fog and memory disorders, any kind of
anxiety, any kind of inflammation like arthritis,
even [inaudible] like anorexia and bulimia,
autism and ADD, chronic infections, blood sugar
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32
issues like insulin resistance, heart health issues,
digestive issues, especially including, constipation,
detoxification issues, fatigue and energy
issues, food sensitivities, leaky gut, nerve pain,
fibromyalgia, heart disease, migraines, tinnitus—I
should add vertigo to this list, multiple sclerosis,
mood disorder, cancer, digestive issues like IBS
and SIBO, and obesity.
So let’s really dive in and let’s talk about the ideal
digestive cascade and how your parasympathetic
nervous system activates that. So again, when
you’re in danger, digesting your food is not a
priority. So in order to really digest your food,
you need to be in that parasympathetic rest and
digest state. And then the digestive cascade is the
vagus nerve triggers the parasympathetic state
and also the mouth is releasing saliva.
So you know we have digestive enzymes that are
released by the pancreas, but digestion really
starts in the mouth. And it’s a mechanical and
a chemical process. So your teeth are making
the food particles smaller and the saliva and the
digestive enzymes are chemically helping you
digest the food.
And then here’s an interesting thing. After you
swallow the food, it goes to your stomach where
there’s supposed to be a sufficient amount of
hydrochloric acid also called stomach acid. And
people think they have acid reflux and they have
too much acid, it’s actually the opposite that’s
true.
If you think about taking a bath, right, you don’t
necessarily get in the bathtub until the water is
the right temperature. Similarly, the food doesn’t
necessarily drop into the stomach until the
stomach is acidic enough to break it down so it
hangs out further up and you can experience it as
reflux or heartburn so there is often that there is
not that vagus nerve that’s signaling the stomach
to release the hydrochloric acid. So that’s often

something that can be remedied by activating the
parasympathetic state or stimulating the vagus
nerve.
Vagus nerve stimulation also triggers your
gallbladder to release bile. Bile does two things.
It helps to emulsify and break down fat. So if
you’re eating a high-fat diet like a Keto diet or a
Paleo diet, you really want to make sure that your
gallbladder is helping break down and assimilate
those fats so that it doesn’t sit there and rancidify
and make you feel worse.
Your pancreas releases digestive enzymes to help
you break down fat, protein, and carbohydrates.
And then the small intestine is really interesting.
The gut-brain access, the vagus nerve connection
between the gut and the brain, the gut is our
second brain.
And I’m so grateful we have amazing speakers like
Kiran Krishnan, Dr. Natasha Campbell McBride
who are going into extensive detail on what’s
happening here, and how this works, and the big
connection between the vagus nerve, and the gut,
and the brain.
But just the coming attraction preview synapse
what’s happening is that the nutrients are being
absorbed and assimilated. And if the vagus
nerve isn’t really signaling that, it’s hard for these
nutrients to be absorbed, it doesn’t work as well
as it possibly could.
And similarly, there’s what’s known as a motility
wave, a housekeeping wave. And the vagus nerve
moves the food through the process so that it
actually doesn’t stop and cause constipation, and
food lingers, and then it causes small bacteria
overgrowth or other gut problems, it actually
allows you to eliminate things so that they leave
your body. So that’s a really important aspect of
what the healthy parasympathetic state is doing
for digestion.
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And it’s an interesting point is that how you eat is
as important as what you eat. So when my kids
were little, I used to cook these nutrient-dense
tofu noodles. And then we’d wolf them down
before soccer practice because we were late. So
I often wondered did I negate the benefit of the
food because we were eating in such a rushed,
hurried state.
So before meals, this is one reason that people
take a moment, and sit, and calm down, and don’t
eat in front of the television, or the computer,
or the phone, and really maybe say a prayer,
really allow themselves to drop into that state
where they can digest, absorb, and assimilate the
nutrients.
And again, the parasympathetic state, it’s a
two-way communication. So if you’re not in the
parasympathetic state, it’s really hard for the
brain to know, “Oh, gosh, I’m full. I don’t need to
eat anymore.” So like weight issues can really play
into this. And, also, a lot of the digestive disorders
that we see like IBS, SIBO, acid reflux, eating
disorders, they all have a basis in being able to
shift into that healing parasympathetic state.
So the parasympathetic state for immunity, there
are these things called opportunistic pathogens
that Kiran Krishnan really gets into. But the
idea is this. When your body is in stress, in the
sympathetic state, there are certain chemicals,
stress hormones, that you release like cortisol and
adrenaline.
And you have these pathogens that are laying
dormant in your body, but the minute they sense
opportunity, “Oh, we sense a stress chemical.
She’s under stress. She’s vulnerable,” they start to
multiply and take over.
So stress really does weaken your immune
system, not just because it deprioritizes it
for survival, but also because it signals these
 34
opportunistic pathogens. And that’s when the
virus and the disease start to spread. And you
can have chronic, undiagnosed infections that are
taking a toll on your immune system. And making
you weaker becomes this crazy, vicious cycle.
So when you see things like H. pylori, candida,
fungal infections, periodontal infections,
because remember we talked about how the
parasympathetic state triggers saliva in mouth, or
any kind of even chronic sinus, respiratory, gut,
or urinary infection, just consider, “Gosh, am I in
the parasympathetic state? Is that something that
could help shift me out of this repetitive issue?
Parasympathetic for respiration, it’s your vagus
nerve that tells your lungs when it’s time to
breathe. And it communicates with the diaphragm
to produce deep breaths. And I’m very grateful,
some of our speakers like Jennifer speaks about
this and how she really gives, and Elisa Song,
some really great deep breathing exercises that
can help you get into the parasympathetic state.
So the vagus nerve does not control the adrenal
glands, but they are affected. We’re not just that
old song, “The arm bones connected to, you know,
the hip bone, or whatever, you know, the shoulder
bone.” It’s not like these organs live in isolation. So
when we’re in that survival state, we are triggering
our adrenal glands to release stress hormones.
And it’s a little bit like whipping of the horse
or deficit spending. If we keep demanding the
release of these hormones, at a certain point,
we’ve run on empty. And then we have issues of
low energy and fatigue. So this is just a little bit of
detail about some of the stress hormones that are
released by the adrenal glands which correlate to
being in that fight-or-flight state. So when you’re
able to calm that fight-or-flight response, you’re
able to stop whipping the horse and allow the
adrenal glands to recover.
The Parasympathetic Summit
So I want to talk a little bit about the amygdala
hijack, which David Perlmutter does such an
amazing job covering in his talk and also in this
new book, Brain Wash. So the amygdala is part
of that fight-or-flight safety response. It’s actually
the part of your brain that’s gathering all of the
inflammation from all of your senses to determine
if you’re safe and if things are a threat. So I’ll give
you an example of how it works.
You’re walking in the woods. You think you see
a snake. You automatically jump back. You don’t
even need to think about it. And then what’s
supposed to happen is your amygdala double
checks with your executive function, your pre-
frontal cortex, which is on your forehead. And
your pre-frontal cortex accesses the situation
and says, “Oh, you know what? That’s just a stick.
You’re good. You’re fine.” So you calm down, and
you don’t worry, and you keep hiking.
But what can happen, especially when you’re
in that chronic sympathetic overdrive where
you think everything is an emergency is your
amygdala can start to get hijacked. And it can start
to respond to every stick as if it’s a snake. And
what that turns on is this sickness response where
you’re constantly always in an emergency. So pain
is heightened. Fatigue is heightened. You’re really
in this locked down place.
And one of the keys to unraveling that vicious
cycle, and Niki Gratrix talks a lot about this, about
how constant trauma, constant fear, especially
in childhood, can really lock us into this place
where we never feel safe and our sympathetic
nervous system is in chronic overdrive so you
need to unravel that a little bit so that you can
shift into the parasympathetic state. And then
your amygdala is not constantly overreacting and
you’re not constantly in a state of stress or fatigue
or pain or multichemical sensitivity.
So your body has rhythms. You have your sleep/

wake cycle, which is known as your circadian
rhythm, and then the rhythm of your survival,
parasympathetic state, and your rest, digest,
and heal, parasympathetic state. And the
parasympathetic state ties in with your circadian
rhythms and your ability to sleep.
So when you’re not able to relax, it’s super hard to
sleep. And if your sleep rhythms are thrown off,
that can cause other problems. So aligning your
ability to get into the parasympathetic state of the
nervous system will really open up your ability to
sleep more soundly and have better sleep, and
reset your circadian rhythm.
So the parasympathetic state and heart health—
when you’re in the rest, digest, and heal state,
your vagus nerve releases the neurotransmitter
acetylcholine, which allows your heart rate to slow
down. So remember, when the tiger is chasing
you, your heart rate needs to speed up so that
you have more blood and more energy to run
really fast. And then you escape the danger. And
it allows your heart rate to slow down and calm
down.
And this ability to be responsive to speed up when
you need to and recover when you need to, you
contract that with your heart rate variability. And
they have devices like the O-ring or other things
that you can do where you’re able to track how
quickly does your heart rate recover.
And it’s important to know it’s not variability,
it’s not consistency, it’s not that you have this
constant heart rate, it’s that it can drop, and you
can recover. It can go high, and you can recover.
It’s all about homeostasis and returning yourself
to balance and having your vagus nerve healthy
and in a healthy place, it’s called vagal tone.
Vagal health is measured by vagal tone. Then
you can more readily adapt your heart rate. And
that allows you to keep your heart healthy. And
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remember your heart pumps blood. And blood
carries nutrients and oxygen. So all of those
things function better.
The vagus nerve also helps with anxiety and
depression. One of the things that I keep reading
is that amygdala’s highjacked when it’s overactive,
that’s anxiety. You’re worried about everything.
And the check in point for the amygdala is your
frontal lobe. And when your frontal lobe isn’t
functioning as actively as it could, that’s when
you’re depressed.
So just helping to calm down the overactive
amygdala, and maybe activate the prefrontal
cortex, because remember when you’re not
feeling safe and everything’s a danger, you can
only focus on that one thing, you can’t really have
options, which is what your prefrontal cortex
does, so the more you can get yourself into that
parasympathetic rest, digest, and heal state, the
more options become available.
It’s also interesting when we talk about vagus
nerve stimulation, but there is a device, it’s like
a pacemaker, they implant it in two places right
behind the ear lobe because it’s where the vagus
nerve is most accessible, and then in the chest.
And it stimulates the vagus nerve. And FDA
has approved it for depression and epilepsy.
So there is a lot of scientific evidence that just
calming the body can really, sorry, activating the
parasympathetic state can help with your mood.
Your vagus nerve also innervates your gut, which
we talked about and any kind of compromised
communication blocks the release of the
inhibitory neurotransmitter GABA, which helps
inhibit those anxious thoughts.
So parasympathetic for inflation, we talked about
how the vagus nerve releases acetylcholine. And
acetylcholine is known as your anti-inflammatory
neurotransmitter. And in the sympathetic state,

when things are on, it gets slightly complicated
because when you’re in fight or flight, it, initially,
calms inflammation because if you twist your
ankle and it swells up, you might not be able to
escape. But what happens is over time, it’s almost
like the dam breaks and you just can’t control the
inflammation. And so it starts to run a little bit
wild.
Blood sugar. We have some great speakers. Dr.
Rita is talking about blood sugar. And basically,
when you’re in that fight-or-flight state, you need
more energy, you need faster. So you raise your
blood sugar. And then when you’re able to get in
the parasympathetic state, it balances out.
But for anyone who’s been really struggling with
blood sugar issues for a long time, and you’re
eating the perfect diet, you’re taking all the perfect
supplements, it’s important to think about the
parasympathetic state because it’s like trying to
drive a really good car on a road that hasn’t been
paved or through the jungle, you need to lay
that foundation in order for everything to flow
properly.
Oh, we, also, have Dr. Anna Cabeca talking about
hormones and how important the vagus nerve,
which releases all of these stress hormones, is
to really setting you up for hormonal success.
Hormones often relate to how much is being
thrown in to the system. Like how much cortisol
are you putting out? And what the precursor for
cortisol is, also, a precursor for progesterone. And
so if it’s all being used for your stress response,
then you’re going to run out of steam at a certain
point.
Similarly, old hormones need to be eliminated
from the body. And those hormones are
detoxified through the bile that gets dumped
into the small intestine and supposed to leave
the body. But if the bile isn’t flowing, as it should
be, and those hormones, those old hormones
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aren’t eliminated, then they get recirculated. And
so there is another imbalance. So there is a lot of
correlation between being in the parasympathetic
state and optimal hormonal health.
Autism. I’m really excited, Dr. Robert Melillo, and
Elisa Song touches on it a little bit, and then my
friend, Tara Hunkin. There is a huge correlation
between children on the spectrum who are really
stuck in that left-brain overdrive vagus nerve
sympathetic state overdrive. And anything you
can do to help them get into that parasympathetic
state allows them to feel calmer, allows them to
have that social connection to make eye contact,
and to really be present. So I’m excited to delve
into that.
Pain relief. We have a couple of speakers like Kirk
Gair is talking about pain is really a signal from
your brain to your body. So if you can help calm
the signal, he uses lasers. You can use essential
oils. You can use breathing. All of these things
can really help you manage through pain, even
chronic pain.
Dr. Stephen Porges is talking a bit about the
parasympathetic state for connections and how
the vagus nerve innervates your mouth. And
so laughing and smiling, eye contact, these all
help us to connect and feel safe, which is such a
critically important aspect, especially right now. So
learning more about that can really help you feel
calmer and safer.
And then memory—I don’t know how many of
you, you walk into the pantry and you’re like, “Wait
a minute, what did I come here for? Oh, right,
paper towels,”—it can be strengthened because
your vagus triggers the release of norepinephrine,
which helps to strengthen your memory storage,
and especially if something is emotionally
arousing. So we’re going to help you alleviate
your fatigue, minimize your pain, improve your
digestion, strengthen your memory.

And I saved this for last because it correlates
with some toxicity that can impede the vagus
nerve function, but you really need to be in the
parasympathetic state in order to detoxify. The
process is the waste, the metabolic waste, or
whatever pathogens leave the cell, they go into
the lymph, and they travel through the blood to
the liver, to the gallbladder, to the gut, and then
ideally to the toilet.
But at any stage in that game, it can back up,
and be congested, and flow back into the blood,
and then get pushed out through your skin, and
present as rashes or other issues or try to be
pushed out through your kidneys, and suddenly
you have low back pain. All of these things are
expedited if the parasympathetic state is opening
the door so that all of a sudden gallbladder can
flow.
And if gallbladder is congested, then your body’s
like a hydraulic system, everything else backs up.
And I’m really grateful, Dr. Christine Schaffner, Dr.
Daniel Pompa, we have a lot of great speakers on
parasympathetic and detoxification.
One of the key things that I’m really excited to
share research on, Dr. Marc Ruggiero and Dr.
Dietrich Klinghardt have discovered what they
call vagus nerve toxicity. And it’s this idea that
the vagus nerve starts with the brain stem, wraps
around both sides of the neck, and is in really
close proximity to your trigeminal nerve where all
of your toxins are draining.
And if you think about what is in your neck,
which is why I show this picture, you have your
structure, your bones, you also have your vascular
system, you have your lymphatic system, and you
have your vagus nerve.
And think about if you’ve ever been on an airplane
with someone next to you who took up more than
their seat. They’re crowding over into your seat.
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Your neck is not huge. And you have all these
things going on in there.
So if your lymph is really congested because it’s
trying to drain toxins and things are stuck, that’s
going to spill over and congest into your vagus
nerve. And Dr. Ruggiero shares his amazing
research and presentation on this. But this is one
of the challenges. This is one of the big things that
can impede optimal vagus nerve function and the
parasympathetic state.
And a Tufts neurologist, Dr. Michael VanElzakker,
talked about this. He called it, “the vagus nerve
infection hypothesis.” And he correlated this with
chronic fatigue syndrome and fibromyalgia. And
his point is that nerve-loving viruses, because the
nerves are very receptive to viruses or infections
in or around the vagus nerve, can trigger a very
difficult to detect immune response that produces
the fatigue and other sickness response.
So sickness response, when you’re sick, you want
to get well. So you have a fever because the heat
helps to move through the virus. You swell up.
You’re slightly immobilized. You’re fatigued. All of
these things so that you stay still so you can heal.
And then ideally, the infection passes and you get
better.
But what if that’s your day-to-day life? What if
you’re constantly so exhausted you can barely get
out of bed and so in pain that everything hurts?
That often happens when there’s this minor
infection that you can barely detect. Often, it’s
Epstein-Barr or some kind of herpes virus.
And your vagus nerve serves as your immune
system’s conduit to the brain so it’s constantly
signaling the brain that there is an infection that’s
present that is causing these problems. And so if
you can help to heal vagus nerve toxicity, vagus
nerve infection, often you get to the underlying root
cause of this problem. And the problem goes away.
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One of the other problems, when there are toxins
in the nerve, especially in the neck channel, it
blocks the signaling of the downstream organs,
and keeps you stuck in that anxious overwhelmed
fight or flight. A lot of chronically ill people always
feel a little anxious and overwhelmed. And Dr.
Dietrich Klinghardt found that it presents in 90%
of his chronically ill patients. They’re seeing these
symptom clusters, these comorbid things that
are always present so he always tests for this and
finds it to be present.
So this is just a little more complicated. It shows
how viruses, bacteria, and toxins, and metals
can travel upstream through the nerves because
nerves are super receptive to toxins. And it
impacts a lot of functions: the eye, the inner ear,
your ability to smell, sometimes you lose your
ability to smell, your blood supply to the brain, it
keeps you stuck in that fight-or-flight sympathetic
state, which turns off digestion, immune function.
So basically, this one thing is causing all of your
symptoms and also impeding the other aspects of
your body that could help overcome and heal.
And these are some of the symptoms that
it presents as similar to what I presented to
you with the parasympathetic state. [Chart for
Symptoms of Vagus Nerve Toxicity].
So here’s what’s really interesting. There is a
doctor name Kevin Tracey who started playing
with stimulating the vagus nerve with pulses of
electricity with what I was talking about with vagus
nerve stimulation. And it was originally designed
for epilepsy and seizures, but they found all these
other really powerful benefits. This idea of vagus
nerve stimulation improves your parasympathetic
tone.
So your ability to drop in to the parasympathetic
state, it’s a little bit like you’re training for a
marathon. You might start with two miles and you
gradually work up to 26. And every time you work
The Parasympathetic Summit
up, like when you’re suddenly running 13 miles in
a week, then when you have to do two miles, it’s
nothing because you train the tone of your body,
you can train the tone of your vagus nerve to
help you have more resilience and respond more
quickly.
And that’s really the goal of this Summit is to help
everyone be aware of this muscle that they didn’t
even know they had and then learn how they can
stimulate it. So I’m going to share some tools. A lot
of the practitioners that we speak to are sharing
more tools.
But I find that right behind the earlobe on the
mastoid bone, this is a really accessible point. It’s
a really popular acupuncture point. You can see
it here. This is where they insert the device. But
I like to apply a stimulatory oil. Mine’s clove and
lime. Lots of things work. But just right behind the
earlobe to activate the parasympathetic state.
And just in case you don’t know, essential oils are
basically the concentrated essences of herbs and
plants. And herbs and plants are super correlated
with humans. Dr. Terry Wahls is actually writing
the foreword for my book. And she’s a speaker on
the topic.
And she talks about how we all need plant
diversity in our diet to turn on these secondary
metabolites and digestion known as flavonoids,
but they serve a lot of good. But the main point
is that it’s almost like we’re built from the same
building blocks as plants. So you can use plants to
help us return to balance.
And the other great things about plants, especially
clove, clove has been used through our history
and dentistry because it’s antibacterial, antiviral,
antifungal, and it really helps to kill infection. So
if the infection and the bottleneck is right here,
and you’re able to topically apply something right
there that has such small molecules that it gets
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absorbed into the skin, and can then help detoxify

the infection, toxicity, whatever you want to call
it, that really goes a long way to clearing the
bottleneck and letting you heal.

So some of the other tools that I like include yoga,

deep breathing. I don’t like gagging myself, but
you can try it using a tongue depressor, gargling,
or singing is great, laughter is great, freezing
water activates the vagus nerve.

So thank you so much for taking the time out

of your day to spend with me and to participate
in this summit. And we hope that it brings you
tremendous value and learning and that you have
a new tool to help you pause so that you can get
into the parasympathetic state and feel healthy.
Thank you.

The Parasympathetic Summit