Why The Polyvagal Theory Is Untenable: An international expert evaluation of the polyvagal theory and commentary upon Porges, S.W. (2025). Polyvagal theory: current status, clinical applications, and future directions. Clin. Neuropsychiatry, 22(3), 169-184.
Level 5 - mechanism / opinion, no new human data
Expert consensus commentary and critical appraisal without primary empirical data
PubMed 41768017 · doi:10.36131/cnfioritieditore20260110
What was done
Thirty-nine international experts in vagus nerve physiology, evolutionary biology, and vertebrate social behavior were invited to critically appraise the core tenets of Polyvagal Theory (PVT) and a recent overview by its author. Thirty-eight accepted and co-authored the evaluation. The panel evaluated five specific elements: (1) whether respiratory sinus arrhythmia serves as a direct measure of central cardiac vagal drive, (2) the neuroanatomy and functions of the nucleus ambiguus and dorsal motor nucleus of the vagus, (3) assertions regarding vagus nerve evolution, (4) claims regarding the specificity of mammalian social behavior compared to nonmammalian vertebrates, and (5) interpretations of seminal physiological literature.
What was found
The abstract reports no quantitative measurements. All 38 participating co-authors agreed that the foundational neurophysiological and evolutionary claims underlying Polyvagal Theory are unsupported by past or current knowledge and inconsistent with the broader evidence base, rendering the theory untenable.
Why it matters
Polyvagal Theory is widely cited across clinical psychology and psychotherapy; this unified critique by domain specialists indicates its proposed physiological and evolutionary foundations lack empirical support.
Limits
This publication is an expert commentary and critical evaluation rather than an empirical trial or systematic review. The author panel was assembled by invitation rather than systematic selection, and the paper explicitly does not evaluate alternative models relating vagal function to psychological processes.
Cited by
- contradicts Mammals possess a dual vagal system consisting of an evolutionarily older dorsal vagal system regulating internal organs and a newer ventral vagal system linked to facial and vocal muscles.
- contradicts Although the nucleus from which the ventral vagus originates predates mammals, it did not possess cardioinhibitory fibers until mammals evolved.