Born with a heart condition: the clinical implications of polyvagal theory

Since antiquity our hearts have been linked to our feelings in our collective conscious yet, modern medicine has relegated this organ to a functional pump. However, a wide range of psychosocial vulnerabilities including anxiety, depression, developmental delay, poorer QoL, infant feeding & oral motor difficulties are associated with being born with a heart condition (Kovacs et al, 2009). To date, these difficulties have been accounted for by secondary factors with recognition & management limited (Morton, 2015; 2014; 2012; 2011). Here, I propose Porges' (2011) Poly Vagal Theory (PVT) offers a more holistic account of this condition (Morton, in Press). PVT provides a comprehensive understanding of our nervous system, senses, emotions, social self & behaviours. Porges proposes the nervous system employs a phylogenetic hierarchy of strategies to self regulate & respond to threat, adapting to our environment when we are safe (enabling the 'Social Engagement System') & unsafe (enabling defensive mechanisms), with homeostatic variability shaped during our early years. Since the heart is central to our nervous system congenital cardiac anomalies may compromise our response to stress, emotional regulation & the Social Engagement System. This has implications across the lifespan providing strategies to optimise normal development of social & defensive behaviours & inform therapeutic interventions, explored here drawing on psychological theories & personal/advocacy experience. Morton, L. (in Press) Born with a heart condition: The Clinical Implications of PVT in Clinical application of PVT around the world (working title) Ed: Porges, S & Dana, D. Norton Professional Books: New York.