Podcast - Dr Carrie Rigoni on Kulturing Kuriosity with Kirsty Wirth
This blog post is a transcript of the podcast interview between Kirsty Wirth and Carrie Rigoni. It was created for those of you who prefer to read rather than listen (please forgive any grammar mistakes, it may have come across differently verbally vs in written form).
“This is the Kulturing Kuriosity podcast.
Hello there everyone, how are you going? Welcome to episode 30 and what an awesome episode this is! I'm interviewing Dr Carrie Rigoni who is a chiropractor who specialises in the vagus nerve. Now the vagus nerve is something that is of great interest to me, I'm fascinated by it and I love learning more about it and I think it's very misunderstood, a lot of people don’t know about its importance with regards to recovering from a health crisis, from a traumatic experience, from a brain injury to support your immune system to support your stress resilience, the list goes on. The vagus nerve is so important and we need to understand what it's about and how to optimise it. That’s where Dr Carrie comes in, she is just a wealth of knowledge in this area and it’s a real passion of hers to get the message out there about how important the vagus nerve is and she has a real passion for working with mums and babies. She wants to set up the next generation and to help them with their thriving bodies and beautiful brain health and of course that immune system response.
So, Dr Carrie Rigoni works out of her practice in Perth in Western Australia but she has a lot of great information as well on her website and also, she shares a lot through her blog posts. So grab a cuppa, sit back and listen to Dr Carrie Rigoni and her wealth of knowledge with regards to the vagus nerve and what you can do to optimize your vagus nerve.
Hi Dr Carrie, thanks so much for joining me today.”
Thank you so much for having me.
“I am so interested to dive into this whole space that is something that you are really passionate about which is the vagus nerve. So, for me, the vagus nerve is something I knew about and then I had quite a significant head injury a couple of years ago and really had to utilise and understand and really get to know how important the vagus nerve so I'm so stoked that you are coming on the podcast because it's something that not many people know about and I think it's really important that we get that information out there so how did you become interested in the vagus nerve, where did this come from?”
For me, it's been a long journey coming to find the vagus nerve. When I was in my 20s I was diagnosed with chronic fatigued syndrome and I spent a lot of my 20s kind of hunting for any possible reason that I could be feeling so terrible and how I could make myself feel better, you know, I didn’t buy into the label, I just wanted to have a quality of life and it wasn’t until my 30s that I discovered the power of the vagus nerve and how it literally connects everything in your body and when I started focusing on improving my vagal tone or how well my vagus nerve could function my health just skyrocketed and now I can say I am completely free of chronic fatigue which is just amazing, so it's been a life changing journey for me.
“That is so fantastic, I love hearing stories like of hope like that, you get curious and you apply your learning and it really supports you. So, what is the vagus nerve? Let's dive into that because not everyone would have heard about the vagus nerve.”
The vagus nerve is the biggest nerve in the body, it runs from our brain stem, through our neck, through our torso, digestive system all the way down to pelvic floor and it has a number of really important functions. Number 1 it functions to control a lot of our automatic processes that we just don’t even think about like our heart rate, our breathing, our digestion, how well we absorb our food etc. but what a big part about the vagus nerve does is that it actually has these little senses all through our body that tells the brain what's going on in our body and how safe we might feel in our bodies so the vagus nerve has the ability to either keep us in a chronic state of stress if we feel unsafe or bring us back into a parasympathetic state which is where we rest and digest and that’s where our body usually gets some healing. A lot of people come to my practice and say ‘oh you know I've got some digestion stuff and I've heard that the vagus nerve can be linked, maybe its irritable bowel or constipation’ etc. but when we start talking about it many people don’t realise the power it has in our whole stress response and how that can manifest through the rest of the body in terms of chronic stress and headaches or insomnia, the list is actually quite long with how it can influence the body.
“That’s what I find really interesting, how much it does influence for someone and how wide reaching it can be so your experience with chronic fatigue, it might be someone with a trauma in their lives, it might be someone that’s really struggling with constipation. So, what are some of the ones that you see that people are struggling with and when they have their vagal tone improved and you treat as a chiropractor their vagal tone?”
As a chiropractor part of my process in my clinic what I start with at the initial consult is a heart rate variability challenge just to see where their vagus nerve is kind of sitting at the moment. I do 2 challenges with them which is 1 sitting in a general state as the ordinary would and another one doing a particular breathing exercise. The first one kind of tells me how their vagus nerve is day to day and the second one tells me if we stimulated the vagus nerve is it ready, willing and able to work better. So, it kind of gives me a really big picture to begin with and then as we go through the process what I do in my practice is I don’t jump straight directly into the vagus nerve, what I do is I check the body for anything that could have a negative impact on the vagus nerve, so I kind of remove all barriers to the vagus nerve working and then we double back and work on the vagus nerve. I find that a lot of people, once we have doubled back and checked the vagus nerve again its already working better itself and it's not such a fight so to speak so say you have some listeners who know about the vagus nerve and they are doing all the things like gargling and having cold showers and trying everything they can to stimulate their vagus nerve and they are not getting anywhere then it's likely that there is some kind of barrier in between where they are and where the need to be, where they want to be that’s inhibiting the vagus nerve and that’s kind of the realm I work in.
“Awesome, so what are some examples of those barriers?”
So, a really big one is just a general level of stress from the body or cortisol so that can be emotional, physical or chemical so for a number of people that can be a gut imbalance. We work through how their body and their brain can function with gravity. A lot of people with low vagal tone also have poor balance and this can put the nervous system into a state of chronic stress. They are probably the two biggest things. The other thing that can have a strong influence on the vagus nerve is actually the jaw and how the jaw sits on the face and how that influences the nerves that connect to the jaw into the mid brain, those nerves actually integrate with the vagus nerve and can have a direct influence on the vagus nerve.
“It's so fascinating when you look at the jaw structure and it can be such a telltale sign especially for children and how they develop and how they need to be supported. Once you have moved past those barriers and you're starting to see improvements already do you re check that heart rate variability, is that something that you just keep coming back too to check how things are going?”
Yes, absolutely, so it gives me a guide as to how well they are progressing because some people's nervous system just needs a little bit of a tweak and they are like ‘yes I feel amazing,’ other people I am like certain that is how they are going to respond and are just a much slower responder so a HRV assessment gives me a really objective measure to be like well this is what we are dealing with now, it has improved but you're not feeling that within your body yet, let's make a plan around improving that so you actually do feel and see some changes within your body.
“Yeah, and it's such a great objective measure that you can also do at home so you don’t need to see a practitioner, you need to see a practitioner to have your treatment plan and make sure that you are getting all of the information that you need but you know I wear an aura ring every day and it gives me feedback on my HRV every day and how I'm going and my stress response and so forth so it’s a really cool little trick to see how your body is tracking and functioning and for me when I'm tracking if I see any changes I'm like ok I got to make some changes here or I've got to get back to improving my vagal tone so I really love it! When you have some solid data, it just cuts out all the noise of ‘is it this’, ‘is it that’.”
I found that even in the last maybe 4 years of my practice people have learnt a lot about vagal nerve and heart rate variability and I think that is because of these products that are on the market that they can just have at home and I encourage people that have got one, like you say it's that data, seeing it and thinking my vagus nerve is actually struggling, maybe today I won't go and do a HiiT workout I'm going to go for a nice walk or I'm going to add in some meditation, you can actually tailor your day around how you wake up. The big thing with checking that data is I always say check it at the same time every day so maybe do it the moment you wake up so that it’s a consistent time of day for that data to be more accurate.
“You hit the nail on the head there, for me particularly why I first started tracking that data was because I'm not very good at stopping myself, I come from a background of sport and just trashing yourself so I actually needed a third party in my life which was my aura ring to actually say calm your farm, like you've barely slept or stuffs going on or this is just not the day to be going out on 2-hour mountain bike ride or so forth and it been great, that third party has made a significant change in being able to make great choices about the best way to you know either do sport or sleep or rest you know whatever those decisions are, I just can't believe it so for people who find it really hard to stop and slow down which is most people with vagus nerve tone issues I highly recommend getting a third party in your life, it such a game changer!”
I'm the same, I'm a constant doing type of person and when our vagus nerve kicks in and it's really strong it just feels like there is calm in the body for one you know, we don’t have to go so fast and hustle and do all the things so it’s a really lovely feeling when you can reach it as well.
“Yeah, and then take note of that and sit with that feeling because a lot of people, maybe for you Carrie having that so early on in your 20s, a lot of other people don’t actually know what that feels like, it so foreign to their everyday or what they deem their normal that having a balance of heart rate variability and having a wonderful strong vagal tone is so far from it it’s a new thing to pack and understand and we almost have to document it and sit with it for a while and think this is actually my goal standard of where I want to sit in my life on an everyday basis, it's quite the revelation right?”
One thing we need to remember when we are shifting from that chronic state of fight or flight or just chronic stress is that if we have been like that all our lives, our nervous system always prefers familiarity so it's even harder, the longer you have been in chronic stress the harder it is to shift into that para synthetic high vagal tone and when you get there your nervous system is likely to go ‘this is new, I don’t like this, I feel really uncomfortable, I'm going to do something to get myself back’ so what I find on that when I'm doing a HRV assessment on these people is that, we do some breath work and they can kind of get into an ok state but it lasts about 30 seconds and then it bottoms out and my question is always if you're sitting on the couch trying to relax after about 30 seconds do you feel that itch, do you need to like reach for your phone to scroll or do something and 9 times out of 10 they say ‘yes, how did you know’, because I can see it bottom out on the HRV and I'm like cause your nervous system wants to stay in that state so you kind of gently need to nudge your nervus system into this coherence state. It can feel really crap to start with and really uncomfortable so if you're starting this process, I would suggest you just start with 30 seconds or move to a minute, then a minute and a half you know, be really kind to your nervous system because if you push it too hard and you push it too far into a state of unfamiliar then you are going to create a bigger stress response than if you just slowly nudge it.
“Absolutely, and a lot of people who get into that state, do you find they get really tired and really fatigued because the body is finally slowing down and recovering and repairing and the immune system is finally switching on?”
Yeah exactly, there is an eye exercise that I do with my patients. I ask them to give themselves an hour afterwards with nothing to do because often at times they will need to go and have a nap, that is how powerful it is. It just shifts their nervous system immediately into that para synthetic and they just can't keep their eyes open.
“It is true and so if you're that person that says ‘when I stop, I'm so tired’, its often on a Sunday or people go on holidays and they are like I just so exhausted all the time when I stop so it's better that I keep going so if you're saying that kind of stuff you are the person we are talking too, or its much better for me to keep going and that classic you stop and you get sick, so you want to talk about that cause I think that’s and important thing a lot of people say ‘oh every time I go on holiday I get sick’ or ‘when I stop I get sick’ but it’s the body and the immune system finally cleaning up the debris from the body.”
When we are in a constant state of chronic stress we can't digest our food properly, we can't manage our blood sugar properly, we can detoxify properly, our immune system drops so your absolutely right the first few times you shift into it for a longer period of time such as a holiday your body has to go to work, it's like finally I can do some work now and kind of cleanse the body and sort of recalibrate so to speak.
“It's so powerful, i see it a lot when you go camping and there is no other external input, there's no WIFI or phones, a lot of the times there are no sugars or things that stimulate the body and sometimes it takes a while for you to get over that line, like its normally about 3 days, I see it in my son particularly because his body is often elevated and then it's like a 3 day effect, I did so much research on that 3-day effect and the body finally kicks in, it's just amazing to watch, the whole system just drops and it's like thank goodness I'm here.”
Yeah, I say to my husband all the time people should not be going away just for a long weekend, its good in theory but it's that 3-day effect, go away for a long weekend and they are still that hustle and they don’t get the full effect, it should always be about 7 to 10 days so they have those first few days to really drop in and then have time to stay in it.
“Kind of likening it to catching a wave, like you literally have to drop into that space and have that sort of envelope and then come out the other side, it's so joyful, it’s a nice visual it’s a nice analogy.
So, let's talk about trauma, and how that affects the vagus nerve and how you can be stuck after a trauma and yes you can have a lot of support around, but the body can get stuck in that state so I think it's really nice to talk about that.”
Yes, its very true, and often a lot of people are talking about childhood trauma now in particular with the vagus nerve as it can happen at such an age where we are not familiar with what's happening, we haven't really got the self-regulatory capacity to really comprehend what's going on. The thing with the vagus nerve is it determines if we feel safe or not and if we don’t feel safe it will keep us in a state of fight or flight or even the dorsal vagal response which is like the freeze type response and it's not so much the trauma itself it's how our body responds to it that keeps us in that state and that’s why trauma is so subjective, you know this whole oh I had this happen and im fine so what are you worrying about is so subjective and this is why I work a lot with babies and kids in my practice is because my big goal is to have them have as high a vagal tone as possible so that they in their scope can manage their self-regulation whatever is thrown their way you know the vagus nerve improves stress resilience and so I'm really passionate about working with that from kids from the get go, I don’t think I'll cure childhood trauma because I think even when we are trying to avoid it t still happens. The vagus nerve will store that trauma and get stuck in a particular state, I do believe that’s a big part of what happened to me with my chronic fatigue but it took me a long time to recognize that chronic fatigue could be a complete dorsal vagal response.
“That dorsal response, I lot of people have this picture of someone with chronic fatigue you're literally laying on the couch, sleeping long hours and that is that freeze response, the body has just gone ad shutdown saying I can't even cope so it's very very interesting when it gets to that level, to shutting down, it's had enough.”
Trying to get on with your life when you are in a dorsal vagal response feels like, this is how I describe it, like when you get a really bad flu and your muscles ache and it just hurts to lift your arm, like gravity feels heavy, it's like that constantly because my nervous system was saying hey no, lay down and play dead, be safe and I'm trying to push through and take all these supplements to give me energy to get on with my life, I was fighting my nervous system to just have any experience of life and it wasn’t until I shifted that back into sympathetic fight or flight then shifted back into a vagal response.
“You can't fight against it you just can't this is built deep in our bodies so it doesn’t matter how many supplements you take or how much your willpower is or how much you want to get going you got to fix the issues, it's like driving a car with 3 wheel's it doesn’t actually work!”
When it comes to adults the trauma play's a much bigger role than when I'm working with babies and kids. unfortunately, I don’t do the HRV on them because I just don’t feel its accurate with the product, I've got but they get a bigger response really quickly because their vagus never is still just hanging out and as long as they are in a secure attachment relationship with their caregiver, their babies are feeling safe in that moment and when we get their vagus nerve working well, they just shift, they sleep better, they are happier, all of the things that the vagus nerve has a big impact in. Then we reach adulthood and we have all these stored traumas and if we haven't processed then and we haven't even recognized that we are storing them in our body that's when it can become really hard to, even just changing the vagus from a physiological point of view because if you are still getting triggered from that trauma constantly then it's kind of like one step forward, two steps back.
“It's so important that if a child is born with some sort of trauma the best thing that you can support is that vagus nerve so it doesn’t get stuck, you know 50 years later. Do you think that children or little babies that have had any birth trauma or working with mums and bubs who have had emergency C sections, you know something has happened. How early on would you prefer to work with mum and bub?”
I see babies from around 3 days old onwards, I do some home visits here in Perth for the 4th trimester so mums don’t have to leave their homes to get the support that they need. The big thing with babies and their vagus nerve, if there is a big trauma in the birth then yeah, that plays a big role. There is a lot of research around how much cortisol is in the mum's body while she is pregnant and how those manifests in the vagus nerve and in the newborn so I actually prefer to start working with woman either in pre conception or during pregnancy to get their vagus nerve working as well as possible to allow their baby to marinate in a really positive environment you know not too much cortisol, not too much stress and then work on the baby when they arrive on the other side.
“It's such an easier way to fix it than mop it up when you are 35 or 40 or older, it's such a nice way and unfortunately there are complications for woman in birth or for children and to get on top of it quickly and to get that child feeling like the world is safe, I popped out here and its ok and I'm going to be fine, it just sets them up for a completely different life style.”
Yeah, 100%.
“I read a little bit about once they have had that trauma or stress at birth it's just set in their overdrive, that’s their set point. What's you're understanding on that? Have you seen many of your patients really get out of that set point?”
I think that the earlier you start the quicker you can change that set point for sure. It would have to have been quite a significant trauma for that set point to be really set in stone.
“The moral of this story is I think and I'm sure you agree, that all babies should have care a couple of days after they are born to get their alignment back in, even if it's just the most beautiful amazing birth ever because it's such an important thing right!?”
Absolutely, my two kids had I guess from the outside the perfect medication free, intervention free homebirth and they still needed quite a bit of care especially with their cervicale's in their neck and shoulder so I think that sometimes we get too worried about how the birth actually happened. I've seen C Section babies who have had no need for any realignment and I've seen home birthed babies who have needed a lot so we place a lot of pressure on ourselves as mums as to how we birth and if it went to our plan or not but really, it's just about the whole entire process, the pregnancy and the birth and the postpartum.
“Oh, I love that and that yeah you can make those changes are there are so many amazing resources now to be able to make those changes and just support bubs as they progress. There are some pretty cool ways to stimulate the vagus nerve and to create that vagal tone, so could you just talk about vagal tone, what does that actually mean? And then what are some ways that you can start to support your vagal tone and your vagus nerve?”
Vagal tone just kind of means how well is your vagus nerve working. The job of the vagus nerve is not to prevent the stress response completely, the stress response keeps us safe, for example say you are driving around and you see a shadow and it looks like something is falling to hit your car, you want your body to get into a stress response to check our what's actually happening. Then you notice of its actually not a tree it's just a bird flying overhead and I fine then the vagus nerve kicks in to bring you straight back out of that stress response. So, the higher your vagal tone the quicker you can recalibrate yourself out of that stress response but into a state of coherence or calm. Popel with low vagal tone would tend to stay in that stress response for a while, you may have seen a shadow or a bird and think it was a tree falling, kind of gasped, swerved your car feeling very very anxious and it kind of ruins your day...that probably means you have low vagal tone and you just can't recalibrate that easily. So, my favorite ways to simulate the vagal nerve, my most favorite way is actually horizontal eye movement. The way that a recommend you do this is by sitting back with your hand behind your head and you just kind of lift your chin a little bit and then what you do is move both your eyes across one side, it doesn’t really matter what side, if you feel more drawn to one side over the other you can start there and don’t go too far that you're really pushing your eyes to the side but you just go far enough that they are looking sideways and you just have a fixed gaze on something and what you do is you hold that eye position until you feel a shift in your body so that might be a yawn, a sigh, you might fee that your body finally relaxes and then you swap to the other side and you wait for that same sign. So, if you have really low vagal tone you might need to hold that eye position for what feels like forever to get a response. When you start to recalibrate, when your vagus nerve goes, I know what you are doing here, I love this, let's do this then you should be able to hit it within 10 to 20 minutes.
“My favourite time to do this is actually when I'm brushing my teeth, it is just my trigger like this is the time that I do my eye movements, well the reason I started doing it was because I needed the dots on the mirror because my eyes were so disorganized and then the dots on the mirror from side to side it was just a game changer and now it's just a bit of a practice that I do because that’s what I started doing. What are some other ways that people can stimulate their vagus nerve?”
Another one I love is just to cold water on the face. A lot of people get hung up on cold showers and while they are amazing, if that’s too much of a step for you, the way you can start is freezing cold water just on your face, this just shifts the nerves that are associated with the jaw and allows the vagus nerve to kick in a little bit quicker so, it’s a quick and easy one to do without having to like fully strip off and jump in a cold shower or take an ice bath or whatever. The other ones that I really love particularly for mums and kids is signing, humming, gargling, you know having lots of fun and a big part of the vagus nerve is social engagement and eye contact and wanting to connect with other people and our kids they crave that, particularly in a tec society where we are looking at screens so often and just making time to do that so stopping and making eye contact with our kids and singing songs together or even if you're not with you kid like put the music up loud and sing in the car, just bring that joy back.
“When I first started learning about the vagus nerve, I was like one of those suggestions is to join a choir!! I love signing but it was interesting when I am really stressed out and tired traditionally singing seemed so far from where I wanted to be even though I love it so I found that an interesting suggestion. I love hearing my kids sing, I don’t know about you, it just brings me a sense of calmness and joy because you know they must be feeling in a beautiful state to be sitting there singing and humming and not stressed out.
Do you have any other great tips or suggestions for people who feel like this is definitely something they need to dive into and explore further? What would your top 3 tips be?”
My first would be just always start noticing how you feel in your body, you will intuitively know if you're in a constant fight or flight or feeling restless.
Tip 2 would be to, say you are trying to sit and have a moment of calm, notice when you feel like you need to do something like how your body is feeling and what your mind is doing and rather than doing the thing that your body wants you to do just try and sit with it and just slow your breathing a little bit. See if you can start to kick out of that stress response and just sit with that calm for a bit longer. So, for most people these days that would be reaching for your phone and scrolling mindlessly, leave the phone, maybe try some humming or horizontal eye movement or just sit and feel how your body is feeling. Awareness is the first step, if you can be aware of how your body is feeling that’s when you can learn to shift it.
And then, don’t be so hard on yourself, it is so so hard to change a nervous system that is deep rooted in the stress response, so if you feel like it's been since your childhood then don’t expect to go to an hour-long meditation class and feel comfortable like you can drop into meditation straight away and come out feeling amazing. Don’t set giant goals, set little goals that you can reach every day and eventually you will get there if that’s your final goal but you can't jump straight in, the nervous system will feel worse rather than better.