Yoga Therapy & Polyvagal Theory

HYPOTHESIS AND THEORY ARTICLE
Front. Hum. Neurosci., 27 February 2018 | https://doi.org/10.3389/fnhum.2018.00067
Yoga Therapy and Polyvagal

Theory: The Convergence of
Traditional Wisdom and
Contemporary Neuroscience
for Self-Regulation and
Resilience
Marlysa B. Sullivan , 1*
Matt Erb , 2
Laura Schmalzl , 3
Steffany
Moonaz , 4
Jessica Noggle Taylor and
5
Stephen W. Porges 6,7
 1
Integrative Health Sciences, Maryland University of Integrative Health, Laurel, MD, United
States
 2
The Center for Mind-Body Medicine, Washington, DC, United States
 3
College of Science and Integrative Health, Southern California University of Health
Sciences, Whittier, CA, United States
 4
Director of Clinical and Academic Research, Maryland University of Integrative Health,
Laurel, MD, United States
 5
Independent Researcher, Decatur, GA, United States
 6
Kinsey Institute, Indiana University, Bloomington, IN, United States
 7
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC,
United States
Yoga therapy is a newly emerging, self-regulating complementary and

integrative healthcare (CIH) practice. It is growing in its
professionalization, recognition and utilization with a demonstrated
commitment to setting practice standards, educational and
accreditation standards, and promoting research to support its efficacy
for various populations and conditions. However, heterogeneity of
practice, poor reporting standards, and lack of a broadly accepted
understanding of the neurophysiological mechanisms involved in yoga
therapy limits the structuring of testable hypotheses and clinical
applications. Current proposed frameworks of yoga-based practices
focus on the integration of bottom-up neurophysiological and top-
down neurocognitive mechanisms. In addition, it has been proposed
that phenomenology and first person ethical inquiry can provide a lens
through which yoga therapy is viewed as a process that contributes
towards eudaimonic well-being in the experience of pain, illness or
disability. In this article we build on these frameworks, and propose a
model of yoga therapy that converges with Polyvagal Theory (PVT).
PVT links the evolution of the autonomic nervous system to the
emergence of prosocial behaviors and posits that the neural platforms
supporting social behavior are involved in maintaining health, growth
and restoration. This explanatory model which connects
neurophysiological patterns of autonomic regulation and expression of
emotional and social behavior, is increasingly utilized as a framework
for understanding human behavior, stress and illness. Specifically, we
describe how PVT can be conceptualized as a neurophysiological
counterpart to the yogic concept of the gunas, or qualities of nature.
Similar to the neural platforms described in PVT, the gunas provide
the foundation from which behavioral, emotional and physical
attributes emerge. We describe how these two different yet analogous
frameworks—one based in neurophysiology and the other in an
ancient wisdom tradition—highlight yoga therapy’s promotion of
physical, mental and social wellbeing for self-regulation and resilience.
This parallel between the neural platforms of PVT and the gunas of
yoga is instrumental in creating a translational framework for yoga
therapy to align with its philosophical foundations. Consequently,
yoga therapy can operate as a distinct practice rather than fitting into
an outside model for its utilization in research and clinical contexts.
Introduction
Mind-body therapies, including yoga therapy, are proposed to benefit health
and well-being through an integration of top-down and bottom-up processes
facilitating bidirectional communication between the brain and body (Taylor
et al., 2010; Muehsam et al., 2017). Top-down processes, such as the
regulation of attention and setting of intention, have been shown to decrease
psychological stress as well as hypothalamic-pituitary axis (HPA) and
sympathetic nervous system (SNS) activity, and in turn modulate immune
function and inflammation (Taylor et al., 2010; Muehsam et al., 2017).
Bottom-up processes, promoted by breathing techniques and movement
practices, have been shown to influence the musculoskeletal, cardiovascular
and nervous system function and also affect HPA and SNS activity with
concomitant changes in immune function and emotional well-being (Taylor et
al., 2010; Muehsam et al., 2017).
The top-down and bottom-up processes employed in mind-body therapies

may regulate autonomic, neuroendocrine, emotional and behavioral activation
and support an individual’s response to challenges (Taylor et al., 2010). Self-
regulation, a conscious ability to maintain stability of the system by managing
or altering responses to threat or adversity, may reduce symptoms of diverse
conditions such as irritable bowel syndrome, neurodegenerative conditions,
chronic pain, depression and PTSD through the mitigation of allostatic load
with an accompanying shift in autonomic state (Taylor et al., 2010; Streeter et
al., 2012; Gard et al., 2014; Schmalzl et al., 2015; Muehsam et al., 2017). Gard
et al. (2014) have proposed such a model of top-down and bottom-up self-
regulatory mechanisms of yoga for psychological health.
Resilience may provide another benefit of mind-body therapies as it includes

the ability of an individual to “bounce back” and adapt in response to adversity
and/or stressful circumstances in a timely way such that psychophysiological
resources are conserved (Tugade and Fredrickson, 2004; Resnick et al.,
2011; Haase et al., 2016; Whitson et al., 2016). High resilience is correlated
with quicker cardiovascular recovery following subjective emotional
experiences (Tugade and Fredrickson, 2007), less perceived stress, greater
recovery from illness or trauma and better management of dementia and
chronic pain (Resnick et al., 2011). Compromised resilience is linked to
dysregulation of the autonomic nervous system through measures of vagal
regulation (respiratory sinus arrhythmia) (Dale et al., 2009). Yoga is
correlated with both improvement in measures of psychological resilience
(Dale et al., 2011) and improved vagal regulation (Sarang and Telles,
2006; Khattab et al., 2007; Telles et al., 2016; Tyagi and Cohen, 2016; Chu et
al., 2017).
This article explores the integration of top-down and bottom-up processes for
self-regulation and resilience through both Polyvagal Theory (PVT; Porges,
2011) and yoga therapy. PVT will be described in relation to contemporary
understandings of interoception as well as the biobehavioral theory of the
“preparatory set”, which will be defined later. This will help to lay out an
integrated systems view from which mind-body therapies facilitate the
emergence of physiological, emotional and behavioral characteristics for the
promotion of self-regulation and resilience.
We will examine the convergence of the neural platforms, described in PVT,

with the three gunas, a foundational concept of yogic philosophy that
describes the qualities of material nature. Both PVT and yoga provide
frameworks for understanding how underlying neural platforms (PVT)
and gunas (yoga) link the emergence and connectivity between physiological,
psychological and behavioral attributes. By affecting the neural platform,
or guna predominance, as well as one’s relationship to the continual shifting
of these neural platforms, or gunas, the individual learns skills for self-
regulation and resilience. Moreover these frameworks share characteristics
that parallel one another where the neural platform reflects
the guna predominance and the guna predominance reflects the neural
platform (see Figure 1).
FIGURE 1
Figure 1. The central eye represents the body, mind and environmental
context (BME) and the peripheral eye represents the context of an
observer/experiencer of that content. Within Prakriti, resilience is represented
by the capacity to recognize and shift states, as well as changing the
relationship to the fluctuations of the gunas (rajas/tamas/sattva) and neural
platforms (sympathetic nervous system (SNS)/dorsal vagal complex
(DVC)/ventral vagal complex (VVC)). Yoga aims to facilitate the emergence of
qualities such as eudaimonia by strengthening the experience of sattva and
VVC as well as developing facility in moving between gunas and neural
platforms and changing the relationship and response to the inherent
changing nature of the body, mind and environment reflected in gunas and
neural platforms.
This exploration is intended to be a comparative and translatory approach

aimed at enabling the complexity of the yoga tradition to be understood for its
benefits and application into modern healthcare contexts, while still rooted in
its own traditional wisdom and explanatory framework. A model through
which self-regulation and resilience occurs is described from a yoga
foundational framework which converges with current ideas in
neurophysiology and biobehavioral regulation (see Figure 1).
Polyvagal Theory (PVT)

PVT, and other emerging theories such as neurovisceral integration (Thayer
and Lane, 2000; Smith et al., 2017), help elucidate connections between the
systems of the body, the brain, and the processes of the mind offering
increased insight into complex patterns of integrated top-down and bottom-
up processes that are inherent to mind-body therapies. PVT delineates three
distinct neural platforms in response to perceived risk (i.e., safety, danger,
life-threat) in the environment that operate in a phylogenetically determined
hierarchy consistent with the Jacksonian principle of dissolution (Jackson,
1884; Porges, 2001, 2003). PVT introduces the concept of neuroception to
describe the subconscious detection of safety or danger in the environment
through bottom-up processes involving vagal afferents, sensory input related
to external challenges, and endocrine mechanisms that detect and evaluate
environmental risk prior to the conscious elaboration by higher brain centers
(Porges, 2003).
The three polyvagal neural platforms, as described below, are linked to the
behaviors of social communication, defensive strategy of mobilization and
defensive immobilization (Porges, 1995, 1998, 2001, 2003, 2007, 2009, 2011):
1. The ventral vagal complex (VVC) provides the neural structures that
mediate the “social engagement system”. When safety is detected in the
internal and external environment, the VVC provides a neural platform to
support prosocial behavior and social connection by linking the neural
regulation of visceral states supporting homeostasis and restoration to facial
expressivity and the receptive and expressive domains of communication
(e.g., prosodic vocalizations and enhanced ability to listen to voice). The
motor component of the VVC, which originates in the nucleus ambiguus
(NA), regulates and coordinates the muscles of the face and head with the
bronchi and heart. These connections help orient the person towards human
connection and engagement in prosocial interactions and provide more
flexible and adaptive responses to environmental challenges including social
interactions (Porges, 2011, 2017; Porges and Carter, 2017).
2. The SNS is frequently associated with fight/flight behaviors. Fight/flight
behaviors require activation of the SNS and are the initial and primary
defense strategies recruited by mammals. This defense strategy requires
increased metabolic output to support mobilization behaviors. Within PVT
the recruitment of SNS in defense follows the Jacksonian principle of
dissolution and reflects the adaptive reactions of a phylogenetically ordered
response hierarchically in which the VVC has failed to mitigate threat. When
the SNS circuit is recruited there are massive physiological changes
including an increase in muscle tone, shunting of blood from the periphery,
inhibition of gastrointestinal function, a dilation of the bronchi, increases in
heart rate and respiratory rate, and a release of catecholamines. This
mobilization of physiological resources sets the stage for responding to real
or assumed danger in the environment and towards the end-goals of safety
and survival. When the SNS becomes the dominant neural platform, the
VVC influence may be inhibited in favor of mobilizing resources for rapid
action. Whereas prosocial behaviors and social connection are associated
with the VVC, the SNS is associated with behaviors and emotions such as
fear or anger that help to orient to the environment for protection or safety.
3. The dorsal vagal complex (DVC) arises from the dorsal nucleus of the vagus
(DNX) and provides the primary vagal motor fibers to organs located below
the diaphragm. This circuit is designed to adaptably respond to immense
danger or terror and is the most primitive (i.e., evolutionarily oldest)
response to stress. Activation of the DVC in defense results in a passive
response characterized by decreased muscle tone, dramatic reduction of
cardiac output to reserve metabolic resources, alteration in bowel and
bladder function via reflexive defecation and urination to reduce metabolic
demands required by digestion and other bodily processes. This inhibition
of viscera reflects an attempt to reduce metabolic and oxygen demands to
the least amount necessary for survival. Behaviorally this is often referred to
as immobilization or shutdown associated with feigning death, behavioral
shutdown, collapse, or “freeze” responses, and may be experienced in
humans as a disembodied dissociative state that may include loss of
consciousness.
PVT posits that through these neural platforms particular physiological states,
psychological attributes, and social processes are connected, emerge, and are
made accessible to the individual (Porges, 1998, 2003, 2011, 2017; Porges and
Carter, 2017). The physiological state established by these neural platforms in
response to threat or safety (as determined via the integrated processes of
neuroception) allows for or limits the range of emotional and behavioral
characteristics that are accessible to the individual (Porges, 2003).
A core aspect of PVT is that patterns of physiological state, emotion and

behavior are particular to each neural platform (for a detailed review of the
neurophysiological, neuroanatomical, and evolutionary biological bases of
PVT see Porges, 1995, 1998, 2001, 2007, 2009, 2011). For example, the neural
platform of the VVC is proposed to connect visceral homeostasis with
emotional characteristics and prosocial behaviors that are incompatible with
the neurophysiological states, emotional characteristics or social behaviors
that manifest in the neural platforms of defensive strategies seen in SNS or
DVC activation. When the VVC is dominant, the vagal brake is implemented
and prosocial behaviors and emotional states such as connection and love
have increased potential to emerge. When the SNS is the primary defensive
strategy, the NA turns off the inhibitory action of the ventral vagal pathway to
the heart to enable sympathetic activation and behavioral and emotional
strategies of mobilization are supported. If the DVC immobility response is the
defensive strategy, the dorsal motor nucleus is activated as a protective
mechanism from pain or potential death and active response strategies are not
available (Porges, 1998, 2003, 2009, 2011; Porges et al., 2008; Porges and
Carter, 2017). It is important to note the VVC has other attributes that enable
blended states with the SNS (e.g., play) or with the DVC (e.g., intimacy).
However, in these examples of blended states, the VVC remains easily
accessible and functionally contains the subordinate circuits. When the VVC is
functionally withdrawn it promotes accessibility of the SNS as a defense
fight/flight system. Similarly, the SNS functionally inhibits access to the DVC
immobilization shutdown response. Thus, the profound shutdown reactions
that may lead to death becomes neurophysiologically accessible only when the
SNS is reflexively inhibited.
Vagal Activity, Interoception, Regulation and

Resilience
Vagal activity, via ventral vagal pathways, is suggested to be reflective of
regulation and resilience of the system where high cardiac vagal tone
correlates with more adaptive top-down and bottom-up processes such as:
attention regulation, affective processing and flexibility of physiological
systems to adapt and respond to the environment (Thayer and Lane,
2000; Porges, 2011; Streeter et al., 2012; Park and Thayer, 2014; Strigo and
Craig, 2016). Vagal control has also been shown to correlate with differential
activation in brain regions that regulate responses to threat appraisal,
interoception, emotion regulation, and the promotion of greater flexibility in
response to challenge (Streeter et al., 2012; Park and Thayer, 2014).
Conversely, low vagal regulation has been associated with maladaptive
bottom-up and top-down processing resulting in poor self-regulation, less
behavioral flexibility, depression, generalized anxiety disorder, and adverse
health outcomes including increased mortality in conditions such as lupus,
rheumatoid arthritis and trauma (Tsuji et al., 1994; Thayer and Lane,
2000; Park and Thayer, 2014; Muehsam et al., 2017).
The vagus nerve is comprised of 80% afferent fibers and serves as an

important conduit for interoceptive communication about the state of the
viscera and internal milieu to brain structures (Porges, 2004, 2011).
Interoception has been explored as essential to the bridging of top-down and
bottom-up processing and in the investigation of the relationships between
sensations, emotions, feelings and sympathovagal balance (Porges,
1993; Craig, 2015; Farb et al., 2015; Strigo and Craig, 2016). Support has been
found for the integration of interoceptive input, emotion and regulation of
sympathovagal balance in the insular and cingulate cortices, facilitating a
unified response of the individual to body, mind or environmental (BME)
phenomena (Craig, 2015; Strigo and Craig, 2016).
Self-regulation is proposed to be dependent on the accuracy with which we

interpret and respond to interoceptive information, with greater accuracy
leading to enhanced adaptability and self-regulation (Farb et al., 2015). As
such, interoception is considered to be important in pain, addiction, emotional
regulation, and healthy adaptive behaviors including social engagement
(Porges, 2011; Farb et al., 2015; Ceunen et al., 2016). In addition,
interoception has been proposed as key to resilience as the accurate
processing of internal bodily states promotes a quick restoration of
homeostatic balance (Haase et al., 2016).
It has been proposed that mind-body therapies are an effective tool for the
regulation of vagal function, with consequent fostering of adaptive functions
including the mitigation of adverse effects associated with social adversity
(Black et al., 2013; Cole, 2013; Bower et al., 2014), the reduction of allostatic
load, and the facilitation of self-regulatory skills and resilience of the ANS
across various patient populations and conditions (Streeter et al.,
2012; Schmalzl et al., 2015; Muehsam et al., 2017; Porges, 2017; Porges and
Carter, 2017).
Polyvagal Theory and Mind-Body Therapies for

Regulation and Resilience
Mind-body therapies emphasize the cultivation of somatic awareness,
including both interoception and proprioception, combined with the
mindfulness-based qualities of nonjudgment, non-reactivity, curiosity, or
acceptance in order to engage in a process of re-appraisal of stimuli (Mehling
et al., 2011; Farb et al., 2015). While being encouraged to cultivate awareness
of BME phenomena and stimuli, the individual is supported in a process of re-
interpretation or re-orientation to such stimuli so that insight may occur and
adaptability, regulation, and resilience may be fostered (Mehling et al.,
2011; Farb et al., 2015). This capacity to alter the relationship and reaction to
BME phenomena is thought to be essential for self-regulation and well-being
(Farb et al., 2015). It has been shown that patients utilizing mind-body
therapies for healing reported both a shift in their experience and response to
negative emotions and sensations as well as the development of self-regulatory
skills in dealing with pain, emotional regulation and re-appraisal of life
situations (Mehling et al., 2011).
PVT offers insight into how learning to recognize and shift the underlying
neural platform of any given psychophysiological state, may directly affect
physiology, emotion and behavior thus helping the individual cultivate
adaptive strategies for regulation and resilience to benefit physical, mental
and social health (Porges, 2011). As mind-body therapies affect the vagal
pathways they are suggested to form a means of “exercising” these neural
platforms to foster self-regulation and resilience of physiological function,
emotion regulation and prosocial behaviors (Gard et al., 2014; Schmalzl et al.,
2015; Porges, 2017; Porges and Carter, 2017).
Optimal neural regulation of the autonomic nervous system and the related
endocrine and immune systems is fostered through active engagement of the
VVC by utilizing specific movements or positions, breathing practices,
chanting or meditation which affects both top-down and bottom-up processes
(Cottingham et al., 1988a,b; Eckberg, 2003; Hayano and Yasuma,
2003; Porges, 2017; Porges and Carter, 2017). Resilience is proposed to be
fostered by both downregulating defensive states and supporting more
flexibility and adaptability in relationship to various phenomena of the BME
to promote physiological restoration as well as positive psychological and
social states (Porges, 2017; Porges and Carter, 2017). The individual can learn
to improve activation of the VVC with its homeostatic influence on the
organism, as well as increase the facility to move in and out of other neural
platforms such as the SNS or DVC when real or perceived stress is
encountered.
In sum, mind-body practices can teach the individual to make the VVC more
accessible, widen the threshold of tolerance to other neural platforms, change
the relationship and response to SNS and DVC neural platforms that occur as
natural fluctuations of the BME, and how to become more skilled at moving in
and out of these neural platforms (Porges, 2017; Porges and Carter, 2017).
Breathing maneuvers within yoga often facilitate similar shifts in autonomic
state with convergent psychological and health consequences (e.g., Brown and
Gerbarg, 2005a,b, 2012; Brown et al., 2013). These practices may also
contribute to our potential to experience connection beyond social
interactions or networks and to a more universal and unbounded sense of
oneness and connection (Porges, 2017).
Five Global States and Preparatory Sets

PVT further proposes that the three neural circuits of SNS, VVC and DVC are
not mutually exclusive nor antagonistic, rather these three circuits co-arise,
co-exist and co-mingle to create the array of complex human physiological,
emotional and behavioral states (Porges, 1998, 2011). Bernston elucidated co-
activation and complexity in SNS and PNS interactions in the doctrine of
autonomic space (Berntson et al., 1991). This complexity allows for response
to threat to start with a withdrawal of cardiac vagal tone before SNS activation
as well as greater flexibility and precision to adjust to circumstances.
The PVT defines five global states based on the neural platform(s) which are
predominant or active (Porges, 1998, 2011). The VVC, SNS and DVC circuits
as just described represent three of the global states, and the other two arise
from their co-activation.
When the VVC and SNS circuits co-arise there is a fourth state of safe
mobilization. The VVC enables the experience of safety and connection, while
the SNS supports the mobilization of the body’s resources for dexterity,
movement, and the quick or creative thinking needed for activities such as
dance, play, artistic expression, or writing. Mind-body practices such as the
postural practice of hatha yoga or tai chi are examples where the body can be
mobilized for action, but the mind and breath provide the stimulus for
calmness, safety and connection.
The fifth state arises from the co-activation of the VVC and DVC. These two
circuits working together facilitate the state of safe immobilization.
Immobilization without fear allows for the emergence of social bonds to be
formed through prosocial activities such as childbirth, conception and
nursing.
The concept of preparatory sets provides for a dynamic understanding of the

relationship between physical posture/muscle tone, visceral state/ANS,
affective state, arousal/attention and cognitive expectation (Payne and Crane-
Godreau, 2015). A change to any one of these components will result in shifts
throughout the preparatory set leading to an integrated reaction by the human
system in response to the needs of the environment or situation.
The five global states of the PVT reflect a complexity of interactions

throughout the preparatory set by way of the portal of the ANS resulting in
corresponding changes along somatomotor, affective and cognitive levels
(Payne and Crane-Godreau, 2015). In other words, by impacting the neural
platforms from which an individual is operating, there are concomitant effects
on muscle tone, visceral state, attention, affect and cognition.
Significant to this is the possibility that prolonged time in any PVT-defined

maladaptive threat state may contribute to disorders or conditions which
manifest with a combined disturbance of physiology, emotion and behavior
(Porges and Kolacz, in press). Porges and Kolacz (in press) have suggested the
plausibility of autonomic dysregulation as a causative factor in irritable bowel
syndrome and fibromyalgia both of which are characterized by altered
physiology including decreased cardiac vagal tone inferred from a lack of heart
rate variability (HRV), absence of obvious tissue pathology, and oftentimes
associated with a history of trauma (Kolacz and Porges, in press). This view is
consistent with the expanding body of research linked to the original CDC-
Kaiser Adverse Childhood Experiences Study demonstrating strong
correlation of stress and trauma history to various pathologies later in life
(Felitti et al., 1998).
An important insight that comes from an integrated understanding of PVT

and preparatory sets is the necessity to investigate mind-body therapies as
they were originally intended to be practiced, as integrative methodologies
affecting simultaneous components of the individual’s experience (Payne and
Crane-Godreau, 2015). Many mind-body therapies, including yoga, call for
simultaneous attention to the body, breathing, attentional and affective
regulation and cognition. Thereby representing a comprehensive methodology
and set of practices integrating both top-down and bottom-up processes in
response to BME phenomena. It is imperative to realize that when these mind-
body systems are reduced to investigate just one component, they are being
taken outside the original context of their cohesive practice, thereby likely
diminishing the intended combined effect.
Mind-body practices teach the individual to become aware of their

preparatory set, to effectively shift unhealthy patterns of response to BME
stimuli within their preparatory set, and learn healthier and more adaptive
preparatory set patterns in response to BME phenomena through various
techniques (Payne and Crane-Godreau, 2015). Tools for self-regulation and
the cultivation of resilience may occur as the individual learns the state of safe
mobilization such that activation of the system does not drive out positive
affective states or prosocial behavior and connection.
Yoga and Yoga Therapy

Payne and Crane-Godreau suggest yoga as one mind-body practice that can
shift the preparatory set (Payne and Crane-Godreau, 2015). Yoga consists of a
variety of practices which may serve to affect one or more components of the
preparatory set by influencing muscle tone/posture, ANS, attention, affect, or
cognition (Payne and Crane-Godreau, 2015). Yoga practices can be utilized to
affect the ANS and to both manipulate and change the relationship to these
shifting neural platforms described in PVT.
While much of modern yoga practice focuses primarily on physical postures

and movement sequences, the traditional roots are centered on a
philosophical path towards understanding the causes of suffering and its
alleviation (Stoler-Miller, 1998, 2004; Easwaran, 2007; Singleton,
2010; Miller, 2012; Mallinson and Singleton, 2017). To this point, recent work
by Mallinson and Singleton (2017) highlights the variable meaning of yoga
throughout the ancient texts. Historically the word yoga has been used to
describe both the method of prescribed sets of practices (yoga as
methodology) and the aim or goal of these practices (yoga as a state of
being; Mallinson and Singleton, 2017). Yoga as state of being includes the
definition as “union” which can mean union with one’s own essential nature or
a supreme Self (Mallinson and Singleton, 2017). Other definitions of yoga
include equanimity and “skill in action” (Mallinson and Singleton, 2017). Due
to the variable definitions of yoga and in an effort to be nonbiased to any one
perspective, we will utilize concepts common throughout yogic texts such as
the Upanishads (Easwaran, 2007), the Bhagavad Gita (Stoler-Miller, 2004),
Samkhya Karika (Miller, 2012) and the Yoga Sutras (Stoler-Miller, 1998). By
using concepts central to each of these texts, we will propose a framework that
traverses individual lineages and helps create a shared language and
understanding for yoga including relationship to current contexts.
Yoga therapy is an evolving practice in complementary and integrative

healthcare (CIH) with recent accreditation for schools and credentialing of
yoga therapists1. Yoga therapy is grounded in the ancient wisdom and
practices of yoga, integrated with scientific knowledge for application into
current healthcare contexts. There are a multiplicity of ways to define what
constitutes a yoga practice. As such, an obstacle to the professionalization of
yoga therapy has been reported as the heterogeneity of the practices and poor
research reporting (Jeter et al., 2015). An explanatory framework for yoga
therapy is therefore key to the understanding and utilization of yoga therapy
as a unique and distinct CIH profession.
Explanatory Framework for Yoga Therapy

Recent work has begun to define and establish an explanatory framework for
yoga therapy and to suggest theoretical frameworks outlining the mechanisms
underlying yoga-based practices from both neurophysiological and
psychological perspectives (Streeter et al., 2012; Gard et al., 2014; Schmalzl et
al., 2015; Sullivan et al., 2018). A recent explanatory model based on the
philosophical and ethical foundations of yoga explored yoga therapy as a
methodology for alleviating suffering by transforming an individual’s
relationship to BME phenomena and catalyzing the emergence of eudaimonic
wellbeing (Sullivan et al., 2018).
Eudaimonia represents a state of human flourishing or sense of well-being

that is non-transitory and is often connected to a sense of meaning, purpose,
or self-realization (Ostwald, 1962; Keyes and Simoes, 2012). Eudaimonic well-
being is linked to many health benefits such as: the mitigation of gene
expression changes in response to social adversity; reduction in perceived
loneliness; decreased inflammation; improved immune regulation; mental
flourishing; and decreased all-cause mortality independent of other variables
(Keyes and Simoes, 2012; Fredrickson et al., 2013; Cole et al., 2015). Yoga has
been correlated with both eudaimonia (Ivtzan and Papantoniou, 2014) and
related gene expression changes found in the mitigation of the response to
social adversity resulting in decreased inflammation and improved immune
regulation (Black et al., 2013; Bower et al., 2014). As such, it could be
hypothesized that yoga facilitates its many positive physiological, mental and
social health benefits through its capacity to facilitate eudaimonic well-being.
An explanatory framework of yoga therapy focused on its intention to promote
the emergence of eudaimonic well-being with its concomitant physiological
and mental health benefits is significant for both research and expanded
integration into modern healthcare contexts for a wide variety of patient
populations and conditions.
Yoga’s Philosophical
Foundation: Prakriti and Purusha
Yoga teaches that suffering arises from the individual’s relationship, reaction
to, and misidentification with the various phenomena of the BME (Stoler-
Miller, 1998, 2004; Miller, 2012). Yoga practices are intended to teach a
method of discrimination to facilitate a change in the relationship to BME
phenomena and ultimately in the experience of suffering itself (Stoler-Miller,
1998, 2004; Bawra, 2012; Miller, 2012). Through yoga, the individual learns
both the patterns of behavior and actions, which may perpetuate their
suffering as well as a path towards a shift in those patterns for the potential
alleviation of suffering.
This process of discernment to move from suffering to a change in

identification with such suffering and possibly its alleviation is taught through
inquiry into the difference between material nature, termed prakriti, and
spirit, termed purusha (Bawra, 2012; Miller, 2012). Purusha can be defined as
spirit, the indweller, the observer, the seer or “that which sees” and is said to
be the experiencer of material nature (Bawra, 2012; Miller, 2012). Prakriti is
the term given to all of material nature, or all that is seen, changes, and is
made manifest (Bawra, 2012; Miller, 2012; Mallinson and Singleton, 2017).
The clarity that arises from this discrimination and realization of the
difference between purusha and prakriti shifts the yoga practitioner’s
relationship to BME phenomena such that suffering is eased and the
experience of steadfast joy, or eudaimonia, may potentially emerge (Stoler-
Miller, 1998, 2004; Easwaran, 2007; Bawra, 2012; Miller, 2012).
The Gunas, Qualities of Material Nature

Prakriti is said to be comprised of three qualities. These three qualities,
named the gunas, are said to underlie and shape the characteristics of
everything that is of material nature including the BME (Bawra, 2012; Miller,
2012). The gunas enable and support a dynamism to the BME in which the
fluctuations and differing proportions of these qualities give everything in the
BME their unique and varied characteristics (Stoler-Miller, 2004; Bawra,
2012; Miller, 2012). As mentioned earlier, the root of suffering is said to arise
from the misidentification of Purusha with the various phenomena of the
BME, or Prakriti, and more specifically with the gunas (Stoler-Miller,
1998, 2004; Bawra, 2012; Miller, 2012). The knowledge and practices of yoga
are intended to assist the individual in the realization that they may be
“experiencing” the gunas vs. “being” the gunas. The apprehension and
discernment of these three gunas is key to the realization of the difference
between purusha and prakriti; thereby offering insight into the causes of
suffering as well as its alleviation.
The Samkhya Karika, a text representing a seminal philosophy found across

the yoga tradition, as well as the Bhagavad Gita and the Yoga Sutras of
Patanjali describes the gunas and their emergent physical, mental and
behavioral attributes as follows (Stoler-Miller, 1998, 2004; Bawra,
2012; Miller, 2012; Larson and Īśvarakrsna, 2014).
Sattva is the quality of pleasure, calmness and tranquility that serves the
function of illumination. Sattva is described as: lightness, clarity, harmony,
buoyance, illumination, lucidity, joy and understanding (Stoler-Miller,
2004; Bawra, 2012; Miller, 2012). The Bhagavad Gita highlights the
importance of cultivating sattva as it is the foundation from which wisdom,
discrimination and clear-seeing arises (Stoler-Miller, 2004).
While sattva forms the base for many positive attributes, maladaptive states
can also arise if one becomes overly attached to or dependent upon the quality
of joy, as is briefly described in the Bhagavad Gita. In contemporary
terminology words such as avoidance, unhealthy attachment, psychospiritual
crisis or indifference have been used to describe this attempt to hold on to or
maintain a static experience of sattva at the expense of allowing for the
natural unfolding of the movement of the gunas within all BME and life
experiences.
Rajas is the quality of energy, turbulence and pain that serves to activate. The
quality of rajas is given a spectrum of emergent attributes that comes from
this underlying capacity to mobilize and activate. On one end, rajas is said to
support movement, creativity, motivation and activity. However, rajas can
also underlie pain, anger, greed and agitation. The Bhagavad Gita explains
that because rajas obscures knowledge and clear seeing, it impedes the yogi’s
capacity to discern the difference
between prakriti and purusha. Rajas balanced with sattva and tamas creates
the motivation and creativity for inspiring change, movement and right action.
Conversely, its preponderance may increase anger, agitation, or anxiety
(Bawra, 2012; Miller, 2012).
Tamas is the quality of inertia, delusion and indifference that serves to

restrain or limit. Tamas is explained through a spectrum of emergent
attributes from this underlying capacity to restrain or limit.
Theoretically, tamas may provide the support for experiences such as stillness,
stability or groundedness. However, it may also foster dullness, inertia,
obscuration, delusion, heaviness, negligence or ignorance. Tamas balanced
with sattva and rajas may provide form and stability, whereas an over-
predominance of tamas may give rise to delusion, inertia or obscuration
(Bawra, 2012; Miller, 2012).
The Samkhya Karika offers the metaphor of a lamp to illustrate that all
three gunas work together. Just as the wick, oil and flame work together for
the purpose of illumination, the three gunas work together to reveal to the
individual the difference between purusha and prakriti (Bawra, 2012; Miller,
2012; Larson and Īśvarakrsna, 2014).
The three gunas are in constant movement and co-existence as they co-mingle

to create the various manifestations of BME phenomena (Bawra, 2012; Miller,
2012). The different proportions of sattva, rajas and tamas in each object of
material nature, including the subtle mental components of personality,
cognition, emotions and identity, give them their unique attributes (Stoler-
Miller, 2004; Bawra, 2012; Miller, 2012). The movement and shifting nature
of the gunas are intrinsic to life as they continually rise and fall, grow and
diminish. Suffering arises from either trying to stop the movement of
the gunas or from our relationship with each guna—not from the guna itself.
Each of these qualities can hold positive attributes in their capacity to
illuminate, activate, or restrain. However, our relationship to these qualities of
material nature, and any attempt to maintain one at the expense of the others,
may lead to imbalance, pain, or suffering.
Yoga teaches a methodology to nonjudgmentally and compassionately observe

and experience the movement of the gunas such that the relationship and
response to the changing phenomena of the BME is altered. The individual
learns how to welcome and explore the BME in a way that facilitates
eudaimonic well-being in the face of stressors or adversity.
Convergence of Polyvagal Theory with

the Gunas
Both PVT and the gunas provide a perspective to understand underlying
foundations from which physical, psychological and behavioral attributes
emerge. PVT provides insight into how underlying neural platforms are
activated in response to perceived threat or safety in the presence of BME
phenomena. Yoga suggests that physical, psychological and behavioral
attributes emerge from and are influenced by the underlying interplay of
the gunas.
Both frameworks discuss the co-existence and co-mingling of neural platforms

(PVT) or gunas (Yoga) and attempt to convey complexity amidst an inherent
tendency for reductionism within traditional academic disciplines. In PVT, the
co-existence of neural platforms gives way to the varied experiences of play
(safe mobilization) and intimacy (safe immobilization). In yoga, the co-
existence of the gunas creates the varied phenomena of BME and influences
the relationship and reaction to such stimuli. Both theories teach that it is
from the surfacing of the neural platform of PVT or the guna of yoga that BME
states are made manifest and established.
The gunas of yoga and neural platforms of PVT are also reflected in one
another in a convergent and analogous manner. This relationship between the
two models can be seen through the comparable descriptions of attributes.
When the ANS comes under the influence of one of the gunas a distinct neural
platform of the PVT may be activated supporting shared characteristics
between the two. Likewise, when a neural platform is activated it supports the
predominance of a guna and the shared characteristics between them emerge.
For example, when sattva reflects through the nervous system the
physiological, mental and behavioral characteristics of the VVC manifest, or
when the VVC is activated the attributes of sattva manifest, as will be
described in more detail below. This discussion explores the relationship
between the two models in how they relate and affect one another for the
emergence of physical, mental and behavioral attributes. Ultimately, this
relationship is meant to foster an understanding that yoga therapy may affect
both underlying neural platforms and gunas, resulting in improved self-
regulation and resilience for the well-being of the individual.
Comparative Look at Neural Platforms, Global

States and Gunas (Table 1)
Both PVT and yoga describe three primary and combinable neural platforms
or qualities from which specific physical, psychological and behavioral
attributes emerge.
1. Sattva and the VVC: similar emergent attributes are found in descriptions of

both sattva predominance and VVC activation. From sattva comes the
realization of the connection between all beings. Sattvic joy is similar to
eudaimonia with its more steadfast and everlasting quality and stems from
calmness, tranquility and understanding of the “Self” within Stoler-Miller
(2004). These attributes of connection, equanimity and eudaimonia are
proposed to be dependent on a neurophysiological foundation for their
emergence. Halifax proposed a model where qualities such as equanimity
and eudaimonia emerge only when the system is sufficiently primed and
includes an axis entitled “embodied/engaged” in which interoception is
essential (Halifax, 2012). The VVC neural platform provides support for
interoception, connection, equanimity and eudaimonia as it links awareness
of bodily sensations with self-regulatory capacity; the use of facial cues and
vocal prosody to communicate safety and connect to others; the tuning into
human vocalizations to connect with others; the inhibition of defensive
states to support equanimity, eudaimonia and connection through the
capacity to nonjudgmentally listen, observe, and be in relationship with
others (Porges, 2011, 2017). In sum through sattvic predominance and/or
VVC activation the promotion of interoceptivity, connection, equanimity
and eudaimonia may emerge. This state is well adapted for restoration,
relaxation and connection and can be maladaptive when the individual is
not able to adequately respond to the needs of the environment (including
threat) as described within the other neural platforms and guna states.
2. Rajas and the SNS: the attributes that emerge from rajas and the SNS are
shared in their spectrum from mobilization and activation to anger or fear.
The guna of rajas and the neural platform of SNS provide a common
foundation for activating and motivating forces. Similar to the state of safe
mobilization and play which come when the VVC and SNS synergistically
work together, when rajas co-arises with a balance of the
other gunas attributes such as creativity, motivation, optimal action and
change emerge. When rajas becomes predominant and is not balanced by
the other two gunas, similar to the SNS, it provides the base for mobilization
and movement in response to any demand for psychophysiological
resources. This includes a spectrum from eustress to real or perceived threat
in the environment with the emergence of behavioral attributes such as fear,
anger, or aggression. This continuum of mobilization includes the well-
adapted response to immediate threat, or may become maladaptive
contributing to excessive allostatic load.
3. Tamas and the DVC: the attributes that emerge from tamas and the DVC
provide a spectrum of experiences from stability and restraint to
immobilization. In the same way the VVC and DVC partner to create
internal conditions for the emergence of social bonding and
intimacy, tamas can co-arise with a balance of the other gunas to manifest
as stability and form. When tamas predominates, similar to the DVC neural
platform, it provides the base for the emergence of obscuration, dullness,
immobilization, inertia, or dissociation. This spectrum includes well-
adapted responses to extreme threat or may become maladaptive and
contribute to chronic disease states which has recently been proposed
(Kolacz and Porges, in press).
TABLE 1
Table 1. Characteristics and emergent properties of global states based on

comparative neural platforms of Polyvagal Theory (PVT) and Gunas of yoga.
The parallels between PVT and gunas are further elucidated through the idea
of the preparatory set. Five distinct preparatory sets stemming from PVT and
the gunas are proposed with their integrated patterns of muscle tone/posture,
autonomic state, affect, attention and expectation. As mentioned previously,
by altering the underlying autonomic state, there are concomitant changes
throughout the preparatory set. Analogously, an alteration in the
predominance of a guna from which an individual is operating may create
changes in the layers of the preparatory set from muscle tone/posture,
autonomic state, affect, attention and expectation. This is congruent with the
yoga therapy perspective, which utilizes an approach to evaluation and
intervention that acknowledges the influence of the gunas on the physical,
energetic, mental and behavioral aspects of the individual.
By including and emphasizing these underlying gunas and their effect on

physical, psychological and behavioral attributes, yoga therapy can retain its
integrated and comprehensive methodology based on its foundational
teachings. The outcome of this understanding is a movement away from
breaking apart the practices where asana (postures) are directed to
musculoskeletal imbalances, pranayama (breathing practices) are directed to
ANS state, and meditation or yama and niyama (intentional ethical principles)
are directed to attentional, affective and cognitive states. A more cohesive
approach can be implemented for both research and clinical applications
where the evaluation, assessment and direction of intervention is toward
affecting the underlying guna. The result would be an intervention consisting
of yama/niyama, asana, pranayama and meditation given toward influencing
the gunas and their correlated physical, mental and behavioral states. The
resultant change in gunas would have concurrent effects on all layers of the
preparatory set and on physical, psychological and behavioral well-being.
In sum, both PVT and gunas play a vital role in the understanding of how yoga
may help diverse conditions and patient populations by affecting the
underlying gunas and correlated neural platforms. Given the complexity of
living systems, this integrative yogic approach to the whole person, while still
necessarily reduced for explanatory purposes, has high potential for an effect
on the emergence of integrated physical, mental, social and spiritual attributes
and behaviors that facilitate well-being. These concepts will additionally
support the yoga therapist in developing evaluation, assessment and
intervention tools that are authentic to the foundations of yoga and the
provision of its practices in a cohesive and comprehensive format while
simultaneously assisting translation for researchers, the public and healthcare
contexts.
The Application of Yoga’s Model and Practices
for Self-Regulation and Resilience
Yoga practices, when provided as a comprehensive methodology, are proposed
to integrate autonomic, cognitive, affective and behavioral processes for
regulation across physical, psychological and behavioral domains. Through
both top-down and bottom-up practices, yoga may be effective at down-
regulating the system towards parasympathetic, ventral vagal dominance
(Streeter et al., 2012; Gard et al., 2014; Schmalzl et al., 2015). In addition, the
application of yoga practices for resilience of the system will be discussed as
they may support the individual’s capacity to work with shifting neural
platforms and gunas.
Research has supported yoga’s benefit for diverse conditions such as

depression, epilepsy, PTSD and chronic pain through its influence on the ANS
and other inter-related systemic mind-body mechanisms which contribute to
improved physical and mental regulation and decreased reactivity to stressful
stimuli (Streeter et al., 2012). Research has also corroborated yoga’s effect on
promoting vagal tone in diverse patient populations and its associated effects
in decreasing allostatic load and enhancing self-regulation (Sarang and Telles,
2006; Khattab et al., 2007; Taylor et al., 2010; Telles et al., 2016; Tyagi and
Cohen, 2016; Chu et al., 2017). In addition, yoga has demonstrated effect in
being more than just physical exercise as it also concurrently benefits
autonomic regulation, attention and affect (Mackenzie et al., 2014).
Furthermore, research has supported yoga’s relationship to greater body
awareness, compassion and eudaimonic well-being (Ivtzan and Papantoniou,
2014; Fiori et al., 2017). A program developed for adolescent depression
included the goals of autonomic regulation, the practice of attentional and
interoceptive awareness, and identification of intrinsic values to promote
prosocial behavior based on yoga’s cohesive and integrative methodology and
effect for regulation and resilience (Henje Blom et al., 2014).
Yoga is proposed to offer methods for regulation and resilience through the
integrated practice of yamas and niyamas (ethical/intentional
principles), asana (physical exercises), pranayama (breathing techniques)
and meditation (Streeter et al., 2012; Gard et al., 2014; Schmalzl et al., 2015).
Ethical intention setting (yama and niyama) informs and directs the meeting
of physical and mental sensations, such as from interoception or emotions, for
the promotion of positive physiological and affective states and prosocial
behavioral responses (Gard et al., 2014). The ethical principles provided by
yoga may help to guide the reaction, relationship and action of the individual
in response to phenomena of the BME. For example, by meeting stimuli of the
BME from a perspective of non-harming, non-attachment or contentment, the
individual alters the way they pay attention to such stimuli, potentially
facilitating an emergence of compassion, nonjudgment or acceptance (Gard et
al., 2014). Just as Aristotle taught that virtue ethics provided guideposts for
eudaimonia (Ostwald, 1962), the ethical principles of yoga elucidate a process
to meet BME phenomena to facilitate the emergence of such qualities as
eudaimonia. Asana, or physical postures may serve as a bottom-up regulatory
tool to help regulate and promote resilience by altering the state of the ANS
(Cottingham et al., 1988a,b; Schmalzl et al., 2015). Breathing techniques are
known to directly affect cardiac vagal tone and the initiation of the vagal brake
to move the system towards the VVC platform and provides another bottom-
up regulatory practice of yoga (Brown and Gerbarg, 2005a,b; Porges,
2017; Porges and Carter, 2017) Finally, the yoga tradition offers an array of
mind training practices for regulation, such as, focused attention and open
monitoring meditation (Gard et al., 2014; Pascoe and Bauer, 2015; Schmalzl et
al., 2015; Hofmann et al., 2016; Cramer et al., 2017).
Yoga Practices for Self-Regulation: Facilitating

VVC Neural Platform and Sattva Guna
As many of the beneficial characteristics for physical and mental health as well
as prosocial behavioral attributes are shared by sattva and VVC, it is proposed
that yoga practices may be utilized to strengthen one to affect the other. The
VVC neural platform may be activated or made more accessible through
practices that cultivate sattva and sattva may become more accessible or
predominant through practices that activate the VVC neural platform.
The Samkhya Karika emphasizes the importance of fostering the quality

of sattva through one’s habits, environment and behavior to realize the
difference between purusha and prakriti and for the alleviation of suffering
(Miller, 2012). This sattvic state is taught as being essential for the clarity
needed to gather insight into the individuals relationship to various
phenomena of the BME which may lead to healthy or unhealthy responses to
stressors or stimuli (Stoler-Miller, 2004; Bawra, 2012; Miller, 2012). Through
the clarity of sattva guna, the relationship to BME phenomena can be
explored and healthy relationships to both interoceptive and outer stimuli can
be cultivated.
Yoga therapy often first focuses on building a strong foundation of sattva

guna to strengthen discriminative wisdom, develop mental clarity and
increase systemic adaptability and resilience. Being established in sattva
guna enables the opportunity to build positive internal relationships with
interoceptive sensations, memories, emotions, thoughts and beliefs which may
in turn support positive relationships with others. These features of sattva
guna all benefit the self-regulatory capacity of the individual. From this sattva
guna base the individual may experience the fluctuations
of rajas and tamas and change their relationship and response to these
qualities of material nature, potentially facilitating resilience of the system.
The VVC is a neural platform that supports physiological restoration, mental

regulation and prosocial behavioral attributes. The VVC also provides a key
anchor to build the critical self-regulatory skills that lead to greater systemic
adaptability and resilience. Enhancing the individuals accessibility to VVC is
proposed as a method to “retune” the ANS in disorders with a combination of
diminished HRV as well as physical, mental and social health deterioration
such as IBS and fibromyalgia (Kolacz and Porges, in press; Porges and Kolacz,
in press).
Both VVC neural platform and sattva guna correlate with the emergence of

such qualities as connection, tranquility, equanimity and eudaimonia. We
propose that sattva guna shares neurophysiological features with VVC
mediated states during which cardiac vagal tone is increased and the
expanded integrated social engagement system is expressed. Both sattva and
the VVC may be related to states of self-restoration, interoceptivity and the
emergence of prosocial emotions and behaviors such as connection and
eudaimonia.
As noted previously, yoga therapy’s explanatory framework can be described

as the priming of the system for the emergence of eudaimonia with its
concomitant physiological and mental health benefits (Sullivan et al., 2018). It
is through the potential for eudaimonic well-being and shift in relationship to
BME phenomena that yoga therapy is proposed to help with diverse clinical
conditions and patient populations. Therefore, the reciprocal relationship
between the VVC and sattva, which facilitates the emergence of eudaimonic
well-being, is important to the yoga therapeutic process and application of
yoga practices.
Building the individual’s facility with accessing and promoting sattva

guna and the VVC neural platform is proposed to be a crucial and
foundational step in learning of self-regulatory skills and from which
resilience will emerge. Through self-regulation processes the nervous system
enables healthy and more adaptive physiological, psychological and behavioral
responses and provides opportunities for greater insight into the relationship
to BME phenomena to lessen and alleviate personal suffering. Healthy
adaptive physiological, psychological and prosocial states of eudaimonia,
connectedness and equanimity may emerge when sattva and the VVC
predominate. The practices of yama/niyama, asana, pranayama and
meditation may enhance the function of the specific vagal pathways that
optimize the neural platform of the VVC, and/or to strengthen the quality
of sattva guna (Tsuji et al., 1994; Sarang and Telles, 2006; Telles et al.,
2016; Tyagi and Cohen, 2016; Chu et al., 2017).
Yoga’s Practices to Cultivate Resilience

Promoting practices that increase sattva or activation of the VVC can create a
therapeutic container to safely challenge resilience-building. Within PVT,
these challenges would be conceptualized as neural exercises expanding the
capacity of the VVC to regulate state and to promote resilience. Yoga also
includes various practices that achieve similar effects in optimizing autonomic
control, providing greater physiological and psychological adaptability and
resilience through reducing emotional reactivity and lowering the
physiological set point of reactivity (Gard et al., 2014). In addition to
developing down-regulating capacity, we believe meeting the needs of the
environment requires the healthy navigation of VVC, SNS, DVC neural
platforms and their combinations.
From a yoga perspective, the importance of resilience is also reflected in the

model of the gunas. Just as the Bhagavad Gita elucidates the benefits
of sattva, it also provides the ultimate aim of transcending the gunas through
non-attachment, dis-identification and recognition of impermanence (Stoler-
Miller, 2004). It is emphasized that this fluctuation and movement between
clarity (sattva), activation (rajas) and restraint (tamas) is an intrinsic trait of
all material nature (prakriti).
Since all behaviors and neurophysiological functions are dependent on

movement of the gunas, the practice of yoga is not about staying in sattva, or
limiting the movement of the gunas. Rather, yoga teaches a methodology to
create a different relationship to the continual mixing and movement of these
qualities. This underlying objective is shared with the neural exercise model of
PVT. It is important to note that this state of discrimination
between Purusha and Prakriti, or the gunas, is not one of non-participation
or detachment from life. Instead, it is a state whereby the individual
experiences the movement of the gunas, but the “world does not flee from
him, nor does he flee from the world” (Stoler-Miller, 2004; p. 113). In other
words, through yoga the individual learns not to ignore the movement
inherent to BME phenomena, but to change the relationship with the
movement of such phenomena. The practice is not meant to subjectively
isolate oneself from the world, but provides a methodology and technology to
experience the world such that suffering is lessened. PVT provides a
neurophysiological explanation of the methods and techniques embedded in
yoga.
Understanding and discriminating between this movement of the gunas,

which make up the BME and that of “awareness”, or purusha, an individual is
able to experience deep equanimity, inexhaustible joy, and a sense of pure
calmness even when the movement of the gunas continue (Stoler-Miller,
2004). When one learns to nonjudgmentally observe and experience this
movement of the gunas an unwavering and profound capacity for equanimity
and eudaimonic joy emerges (Figure 1). The individual changes their
relationship with the fluctuations of the BME and learns to respond and
receive the changing phenomena of life differently.
The practices of yoga may serve in this development of resilience through the
idea of safe mobilization and safe immobilization. Just as in the state of safe
mobilization, there is activation of the SNS within a container of the VVC for
safe activation of the system. Similarly, within a foundational platform
of sattva the individual is able to utilize the rising of rajas for creativity,
motivation or change, rather than rajas becoming a negative force. By
developing an improved ability to recruit and engage the neural platform of
VVC or sattva, there is greater resilience when confronted with disturbances.
For example, the individual can learn techniques of ethical intentional setting,
attentional control, various other meditations, breath and movement to
cultivate sattva and maintain the neural platform regulated by the VVC. Then
the individual can assume challenging or activating postures or breath
techniques that mimic the activation of the system. Resilience is cultivated by
maintaining or building the facility to find calm mental or physiologic states
while activated. The individual is able to learn to move between guna states
and neural platforms and/or to experience the combined state
of sattva with rajas, or neurophysiologically promoting a neural platform that
integrates VVC with SNS.
By working with the qualities of rajas and tamas, while maintaining access

to sattva, the window to tolerance for sensation may be widened and
resilience facilitated. Through maintaining the neural platform of the VVC
while activating the system, as well as alternating between relaxing and
activating practices, the individual may foster both regulation and resilience of
the system. Thus, through the maintenance of the foundation of sattva, which
provides clarity and insight while experiencing activation, the individual may
find ways to change the relationship to BME thereby learning tools of self-
regulation that enhance resilience. The capacity to discern, alter reactivity,
and even to hold a positive attitude in the presence of activation offers an
important resource in promoting self-regulation, which may be utilized in
response to stressors in the BME including the experience of pain, illness or
disability and thereby also improving resilience both physiologically and
psychologically.
The yoga therapy process encourages a foundation of safety/VVC from which

rajas/SNS and tamas/DVC can be experienced with greater adaptability and
resilience with the broad relationship to BME phenomena (Figure 1).
Discussion
This article offers a theoretical model based on a convergent view of yoga and
PVT; two analogous explanatory systems for understanding the function and
interplay of underlying neural platforms (PVT) and gunas (yoga), and their
role in manifesting physiological, psychological and behavioral attributes. By
affecting the neural platform, or guna predominance and relationship to these
shifting neural platforms, or qualities, the preparatory set of the individual is
altered. The development of interoceptive awareness and sensitivity fosters
regulation and resilience to these shifting neural platforms and gunas in
response to phenomena of the BME. In addition, the gunas of yoga and the
neural platforms of PVT share characteristics that parallel one another where
the neural platform reflects the guna predominance and
the guna predominance reflects the neural platform.
Yoga is suggested to provide a form of neural exercise, and a methodology of

working with the gunas, for the regulation and resilience of the system.
Through altering and/or changing the conscious relationship to underlying
state of the gunas and neural platforms described by PVT, the preparatory set
is affected and physiological, psychological and behavioral processes are
reciprocally influenced (Payne and Crane-Godreau, 2015; Porges and Carter,
2017). Yoga practices may promote the accessibility of the VVC and the
relative balance of sattva to the other gunas to assist processes of
physiological restoration and positive psychological and behavioral states.
Yoga practices may also be seen as helping develop facility with moving in and
out of relative dominance of these theoretical neural platforms
and guna states such that resilience of the system is cultivated. As an
individual learns tools for self-regulation to explore and potentially alter the
relationship to BME phenomena, the relationship to suffering may be
improved (Figure 1).
While we do not wish to convey that the end-goal is cultivation of sattva, the
theoretical correlation to the neural platform of VVC may be seen as a
neurophysiological substrate or stepping stone towards the emergence of such
states as eudaimonia, connection, or tranquility. Similarly, we are not
suggesting that the other gunas and neural platforms are “bad” as these
energies and states are inseparable and adaptive in understanding the
complexity of human experience and behavior, and thus the potential
influence of a yoga therapy framework for well-being. The capacity to cultivate
eudaimonic well-being is significant to yoga therapy’s explanatory framework
in benefiting diverse patient populations and conditions for physical, mental
and behavioral health and well-being. The states of eudaimonia, calm, or
tranquility that may emerge from the cultivation of yoga practices influences
the preparatory set such that healthier relationship to BME conditions may be
learned and self-regulatory skills can be built.
From a strengthened foundation of the neural platform of VVC, and

the guna of sattva, the individual has the resources to move through states of
dominant rajas and tamas or SNS and DVC such that adaptability, flexibility
and resilience of the system is cultivated. The practices of yoga that engage
both top-down and bottom up processes may be utilized for the cultivation of
resilience by moving between neural platforms and gunas (Figure 1).
This model may be utilized in several ways. In one practice of this

model, sattva and the VVC serve as methods for self-regulation and the
practices of yoga build the tools to return to and strengthen these restorative
and calm states. This is a useful practice if an individual experiences
maladaptive or overwhelming states of rajas and SNS, or of tamas and DVC,
and can learn to utilize yoga therapy techniques to return to sattva or VVC for
clarity and calm. In another practice of this model, the individual learns to
change the relationship with and widen their threshold of tolerance to
both rajas and tamas, and SNS and DVC, thereby increasing the experience of
safe mobilization and safe immobilization. This means that the individual
learns how to find support in an underlying sattva or VVC state while other
platforms or qualities of rajas and SNS, or tamas and DVC, are activated. An
example is the utilization of postures or breath techniques that activate the
system, while simultaneously engaging in practices of intentions, meditations,
and breath techniques to facilitate the underlying sense of connection, calm or
tranquility.
The parallel between affecting the underlying neural platform or guna state is

significant in enabling yoga therapy to be practiced in a manner consistent
with its philosophical foundations while being translatable to current
neurophysiological thoughts. The ability to utilize the existing explanatory
framework provided by yoga and the gunas combined with the biobehavioral
model established by PVT enables the translation of yoga therapy into
healthcare and research without the need to adopt an outside
neurophysiological model and attempt to fit yoga into that model.
This work will contribute to yoga therapy being understood as a distinct

healthcare profession which benefits physiological, psychological and
behavioral well-being for diverse patient populations through the cultivation
of self-regulatory skills, resilience and eudaimonic well-being. This model
provides support for the creation of yoga therapy assessment tools to identify
underlying guna predominance. In addition it supports the yoga therapist in
evaluating, assessing and creating interventions aimed at working with
underlying guna predominance and identifiable and measureable neural
platforms towards these goals. Rather than creating protocols for allopathic
conditions, the yoga therapist influences these underlying guna states and
neural platforms to target the unique needs of each individual. Bridge building
efforts such as this work would support yoga therapists, who work with clients
in a manner that is simultaneously based on yoga foundational theory and
offers additional translatory language for research, the public, and integration
into healthcare.
Implications and Future Directions

The theoretical model put forth in this article points to several implications
and future directions.
It is suggested that yoga therapy research include the comprehensive system
of yoga in intervention protocols including: yama and niyama (ethical
intentional practices), asana (postures), pranayama (breathing practices) and
meditation.
In order to reflect the intention of yoga, the application and research of yoga
for diverse populations would benefit from being directed toward such ideas
as facilitating eudaimonic well-being. In addition, the targeting of yoga
therapy interventions to underlying guna states or neural platforms to
enhance self-regulation and resilience and its relationship to the cultivation of
eudaimonic well-being is proposed.
Several directions of future study are proposed:
a. Examining eudaimonic well-being, interoception, and indices of HRV (e.g.,

respiratory sinus arrhythmia) as underlying mechanisms through which
yoga therapy improves outcome measures such as: improved quality of life,
self-regulation, resilience and decreased pain, inflammation, perceived
loneliness, anxiety and depression in diverse patient populations and
conditions.
b. Exploring the relationship between indices of HRV, measures of
interoception, eudaimonic well-being and their connection to physical,
psychological and behavioral health and well-being both quantitatively and
qualitatively.
c. Testing the hypothesis of the convergence of neural platforms and gunas. It
would be of particular interest to investigate whether the physiological
states identified by PVT parallel the “states” and processes described in
yoga. For example: Is the VVC state, expressed as increased respiratory
sinus arrhythmia, decreased blood pressure and decreased catecholamines,
associated with subjective experiences such as calm, equanimity and
connection that practitioners describe as sattva? Is the SNS state, expressed
as decreased respiratory sinus arrhythmia, increased blood pressure and
increased catecholamines, associated with subjective experiences such as
anxiety, fear or worry that practitioners describe as rajas? Is the DVC state,
expressed as decreased activity, decreased heart rate and decreased blood
pressure, associated with subjective experiences such as a disconnect from
the world that practitioners describe as tamas?
d. Continued definition of the gunas and relationship to the neural platforms
and the utilization of their assessment, evaluation and targeted intervention
to facilitate regulation, resilience and physiological, psychological and
behavioral health and well-being in diverse client populations and
conditions.
Conclusion
Yoga therapy is proposed to facilitate eudaimonic well-being with its many
effects for physical, mental and behavioral health for diverse populations
through the building of self-regulatory skills and cultivating resilience of the
system (Figure 1). The attributes of the gunas of yoga and the neural platforms
of the PVT, while not the same, are reflected in one another. As such, working
with gunas and neural platforms that underlie physical, psychological and
behavioral attributes, provide a methodology for the application of yoga
practices for facilitating systemic regulation and resilience.
Yoga therapy builds a strong foundation in sattva and the neural platform of

the VVC for the emergence of connection, tranquility and eudaimonia with
resulting benefits to physiological, psychological and behavioral health and
well-being. In addition, resilience is facilitated through changing the
relationship to the natural fluctuations of the gunas of rajas and tamas, and
their counterpart neural platforms of SNS and DVC, such that the individual
learns to effectively “bounce back” to states of restoration and build resilience
(Figure 1).
It is when yoga is practiced and understood as a cohesive and comprehensive

system that the benefits for self-regulation and resilience may be realized. As
one learns new responses to potential BME stressors, he or she may
experience greater physiological, psychological and behavioral health and
well-being. The convergence of PVT and the gunas may help frame yoga
therapy as a method that supports self-regulation, resilience, and for lessening
allostatic load through building healthy relationships to BME phenomena.
When yoga therapy is applied through this perspective of shifting
underlying guna states and neural platforms, the integrated nature of the
practice can be understood as distinct from other CIH practices. It is hoped
that this helps inform both research and healthcare contexts interested in
integrating yoga interventions for various patient populations and conditions.
Author Contributions
All authors contributed to theoretical discussions as well as the writing of this
manuscript.
Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any
commercial or financial relationships that could be construed as a potential
conflict of interest.
Acknowledgments
We would like to thank Richard Miller, Neil Pearson, Erin Byron and Peter
Payne for fruitful discussions on the topics discussed in this article.
Footnotes
1. ^ www.IAYT.org
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HYPOTHESIS AND THEORY ARTICLE

Front. Hum. Neurosci., 27 February 2018 | https://doi.org/10.3389/fnhum.2018.00067

Yoga Therapy and Polyvagal

Yoga therapy is a newly emerging, self-regulating complementary and

The top-down and bottom-up processes employed in mind-body therapies

Resilience may provide another benefit of mind-body therapies as it includes

We will examine the convergence of the neural platforms, described in PVT,

This exploration is intended to be a comparative and translatory approach

Polyvagal Theory (PVT)

A core aspect of PVT is that patterns of physiological state, emotion and

Vagal Activity, Interoception, Regulation and

The vagus nerve is comprised of 80% afferent fibers and serves as an

Self-regulation is proposed to be dependent on the accuracy with which we

Polyvagal Theory and Mind-Body Therapies for

Five Global States and Preparatory Sets

The concept of preparatory sets provides for a dynamic understanding of the

The five global states of the PVT reflect a complexity of interactions

Significant to this is the possibility that prolonged time in any PVT-defined

An important insight that comes from an integrated understanding of PVT

Mind-body practices teach the individual to become aware of their

Yoga and Yoga Therapy

While much of modern yoga practice focuses primarily on physical postures

Yoga therapy is an evolving practice in complementary and integrative

Explanatory Framework for Yoga Therapy

Eudaimonia represents a state of human flourishing or sense of well-being

This process of discernment to move from suffering to a change in

The Gunas, Qualities of Material Nature

The Samkhya Karika, a text representing a seminal philosophy found across

Tamas is the quality of inertia, delusion and indifference that serves to

The three gunas are in constant movement and co-existence as they co-mingle

Yoga teaches a methodology to nonjudgmentally and compassionately observe

Convergence of Polyvagal Theory with

Both frameworks discuss the co-existence and co-mingling of neural platforms

Comparative Look at Neural Platforms, Global

1. Sattva and the VVC: similar emergent attributes are found in descriptions of

Table 1. Characteristics and emergent properties of global states based on

By including and emphasizing these underlying gunas and their effect on

Research has supported yoga’s benefit for diverse conditions such as

Yoga Practices for Self-Regulation: Facilitating

The Samkhya Karika emphasizes the importance of fostering the quality

Yoga therapy often first focuses on building a strong foundation of sattva

The VVC is a neural platform that supports physiological restoration, mental

Both VVC neural platform and sattva guna correlate with the emergence of

As noted previously, yoga therapy’s explanatory framework can be described

Building the individual’s facility with accessing and promoting sattva

Yoga’s Practices to Cultivate Resilience

From a yoga perspective, the importance of resilience is also reflected in the

Since all behaviors and neurophysiological functions are dependent on

Understanding and discriminating between this movement of the gunas,

By working with the qualities of rajas and tamas, while maintaining access

The yoga therapy process encourages a foundation of safety/VVC from which

Yoga is suggested to provide a form of neural exercise, and a methodology of

From a strengthened foundation of the neural platform of VVC, and

This model may be utilized in several ways. In one practice of this

The parallel between affecting the underlying neural platform or guna state is

This work will contribute to yoga therapy being understood as a distinct

Implications and Future Directions

Several directions of future study are proposed:

a. Examining eudaimonic well-being, interoception, and indices of HRV (e.g.,

Yoga therapy builds a strong foundation in sattva and the neural platform of