Somatic · Polyvagal
Polyvagal Ladder
Ventral · sympathetic · dorsal — name the state, find the move
About this worksheet
The polyvagal ladder is Deb Dana's clinical translation of Stephen Porges's polyvagal theory: a three-rung map of the autonomic nervous system. At the top is ventral vagal — safe, social, connected. In the middle is sympathetic — mobilized, fight or flight. At the bottom is dorsal vagal — shutdown, collapse, dissociation. The ladder isn't pathology; it's the normal range of states everyone moves through. The clinical value is helping clients identify which rung they're on in the moment, what cues bring them up or down the ladder, and what regulation moves help. This worksheet has space for the client to describe each state in their own body (not generic descriptions), the cues that send them down, and the practices that climb them back up. Use it across trauma, anxiety, and burnout presentations. Most clients have never been given a map for what they feel; the worksheet itself is often the intervention.
When to use it
- Trauma, chronic stress, burnout, shutdown depression, freeze responses.
- Clients who can't name what they feel — the body-state map is more accessible than emotion vocabulary.
- Couples and family work to name relational dynamics (one partner up the ladder, one down).
- Compatible with most modalities — IFS, EMDR, SE, DBT, attachment work.
How to use it
- 1Draw the three rungs
Ventral (top, safe/social), sympathetic (middle, mobilized), dorsal (bottom, shutdown). Label each one.
- 2Describe each state in your body
Not textbook. The client's own body — what does ventral feel like for you? Where does sympathetic show up? What does dorsal collapse look like in your day?
- 3Name the cues that move you between rungs
Sounds, smells, people, places, internal thoughts. Cues down the ladder and cues up. The client becomes a researcher of their own system.
- 4Identify regulation practices for each direction
Sympathetic → ventral: orienting, slow exhales, co-regulation. Dorsal → sympathetic: small movement, cold water, naming. Anchor in ventral: gratitude, glimmers, safe relationships.
- 5Track the ladder over a week
Three check-ins per day, which rung. Most clients are surprised by their actual distribution — the data is the work.
Frequently asked questions
What is the polyvagal ladder?+
Deb Dana's clinical model based on Stephen Porges's polyvagal theory. It maps the autonomic nervous system as a three-rung ladder: ventral vagal (safe/social), sympathetic (mobilized), and dorsal vagal (shutdown).
Is polyvagal theory scientifically validated?+
Polyvagal theory is influential clinically and partially supported by autonomic research, though some specific neuroanatomical claims are debated. The clinical applications — state-mapping, co-regulation, ventral anchors — have strong observational support even where the underlying neurobiology is contested.
How is the polyvagal ladder different from window of tolerance?+
Window of tolerance is a two-band model (hyperarousal, optimal, hypoarousal). The polyvagal ladder maps the same territory with three discrete states and emphasizes the social/safety dimension of the top rung. They're complementary, not competing.
Can I use this with non-trauma clients?+
Yes. The ladder is useful for stress, burnout, anxiety, and even high-functioning clients learning to notice their nervous system. It's not trauma-specific.
Related worksheets
Worksheet — Polyvagal Ladder — provided by TherapistAssist for clinical use. Not a substitute for assessment or treatment.