Feeling Safe: A Comprehensive Systematic Literature Review of Psychiatric Disorders through the Lens of Polyvagal Theory

Abstract

Safety on a psychological level is progressively renowned as fundamental to mental health issues and
psychological well-being. The concept of feeling safe based on polyvagal theory, proposed by Stephen Porges
(2011), has emerged as a comprehensive structure for understanding the autonomic nervous system's role in
regulating social behavior, emotional processing, and physiological reactions. This review aims to explore the
application of polyvagal theory in the understanding of psychiatric disorders, with a focus on how autonomic
nervous system dysregulation influences emotional and behavioral manifestations, thereby contributing to the
development of effective therapeutic interventions aimed at enhancing feelings of safety and well-being in the
patients suffering from psychiatric disorders. The systematic literature review technique based on the PRISMA
model was used for this purpose. Sources were obtained through PubMed, APA PsycArticles, PLOS, Research
Gate, Google Scholar, and PubMed Central (PMC) database, using different keywords as the primary descriptor
and limiting the sources to English-language articles published in the last ten years from 2013 to 2023. The
review synthesized findings from various studies investigating the association between the polyvagal theory
and psychiatric disorders, including anxiety disorders, depression, psychotic disorders, post-traumatic stress
disorder (PTSD), borderline personality disorder, and childhood disorders including conduct disorder, attention
deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). The results exhibit that individual
suffering from these psychiatric disorders frequently displayed autonomic nervous system dysregulation, as
proposed by the polyvagal theory, which seems to be a shared feature in many psychiatric disorders. The
systematic review highlighted the significance of physiological aspects of mental health and indicates that
interventions focusing on autonomic regulation may hold the potential to assuage the basic symptoms relevant
to psychiatric disorders. Additional research work is defensible to clarify the primary mechanisms and improve
the implication of interventions which are based on polyvagal theory for better clinical outcomes.