A Clinician's Perspective on the Polyvagal Controversy
Psychology Today
by Annie Chen MA, LMFTFebruary 24, 2026
AI-Generated Deep Dive Summary
A long-standing controversy surrounding Stephen Porges’ polyvagal theory (PVT) has resurfaced in the trauma psychology community, sparking debate among neuroscientists and clinicians about its scientific validity and clinical utility. Recent criticism from a group of researchers, led by neurophysiologist Paul Grossman, challenges PVT’s core neuroanatomical claims, arguing they lack empirical support and questioning its status as a viable psychological theory. Porges has defended his theory, dismissing the critique as filled with straw man arguments and misrepresentations, while emphasizing the importance of rigorous scientific evaluation.
PVT, which posits that our nervous system states drive behavior and relationships, has been influential among clinicians for its insights into trauma, safety, and co-regulation. Many practitioners credit PVT with providing a framework to understand dysregulation and relational dynamics in clients. However, Grossman et al.’s critique highlights concerns about the theory’s scientific accuracy, raising questions about whether it should be taught as a definitive model. The debate underscores a broader tension between clinical intuition and experimental science, with critics emphasizing the need for more rigorous testing and clinicians defending PVT’s practical value.
Despite the criticism, many clinicians remain reluctant to abandon PVT, seeing its utility in guiding therapeutic interventions. For example, PVT has helped practitioners recognize that seemingly irrational behaviors in clients may stem from a lack of safety rather than irrationality itself. While the theory’s anatomical details are under scrutiny, its broader clinical insights continue to resonate with professionals who find it a useful lens for understanding and addressing dysregulation in their patients.
The controversy highlights the challenges of integrating complex scientific theories into clinical practice, where they must not only withstand empirical scrutiny but also provide meaningful guidance. As the debate evolves, clinicians will need to carefully evaluate whether PVT’s contributions outweigh its potential limitations, ensuring that their practices remain grounded in both clinical experience and robust scientific evidence. Ultimately, this discussion underscores the importance of maintaining a critical yet open-minded approach to psychological theories, balancing their theoretical rigor with their practical impact on patient care.
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Originally published on Psychology Today on 2/24/2026