Listening for Safety: A Qualitative Exploration of Clinicians’ Embodied Practices Through the Lens of Polyvagal Theory

Abstract

The following dissertation explores how mental health clinicians intentionally support clients’ nervous systems in fostering emotional safety through embodied presence, attunement, and coregulation. It aims to extricate and illuminate specific embodied practices that clinicians utilize to cultivate a physiological sense of safety within the therapeutic encounter as well as identify and explore a thematic analysis therein. The following three interrelated themes emerged from the analysis: (a) safety as an embodied, coregulated relational process, (b) attunement as a dynamic, rupture and repair process, and (c) respect for client autonomy. The findings suggest that the promotion of safety in psychotherapy is best understood by utilizing a process model. The study further extends existing conceptualizations of therapeutic presence by illustrating moment-to-moment behaviors through which therapists facilitate coregulation and support clients’ capacity for emotional engagement. Implications include recommendations for clinical training, supervision, and trauma-informed practice that emphasize the development of embodied presence alongside theoretical knowledge and technical skill.