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  • Writer's pictureDr Heather Dyson

Polyvagal Theory and Emotionally-Based School Avoidance

As adults, it can be difficult for us to understand why a child would not want to go to school. Objectively, schools are “safe places” where children are unlikely to come into any physical harm. However, difficult interpersonal dynamics, bullying, academic pressure, can all be felt as “dangerous” and responded to by our bodies in the same manner as which we would respond to a physical attack. Indeed, if we worked in an environment in which our colleagues called us names, harassed us, physically pushed or assaulted us, or created a hostile environment, we would (hopefully) be contacting HR and accessing support. However, for some children this support may or may not be accessible either because it’s not physically present within their institution or they may not emotionally/psychologically feel able to ready to access this help. Consequently, this may result in children feeling unable to attend school and refusing to attend.

Historically understood as “School refusal”, Emotionally-Based School Avoidance (EMSA) is a distressing phenomenon where some children experience overwhelming fear and anxiety about attending school. While there are various factors contributing to EMSA, the Polyvagal Theory (PVT) potentially offers a unique way to understand why our bodies respond to perceived threats within the school environments. In this blog we will considered PVT in relation to EMSA , gaining insights into why some children perceive school as dangerous and how their physiological responses can be viewed by observers as “avoidance behaviours”, perhaps it may be more useful to understand them as “protective behaviours”.

Understanding Polyvagal Theory PVT provides a framework for understanding the connection between our autonomic nervous system (ANS) and social behaviour. It explains how our body's physiological responses influence our emotional and cognitive states. The ANS consists of three distinct branches that regulate our physiological responses in different situations:

1. The Ventral Vagal Complex (VVC): The VVC is associated with feelings of safety, social engagement, and connection. When the VVC is active, it supports calmness, the ability to engage effectively with others, and emotional regulation. The VVC promotes a state of relaxation, allowing individuals to feel secure and connected within their social environment.

2. The Sympathetic Nervous System (SNS): The SNS is responsible for activating the "fight-or-flight" response when we perceive a threat. It mobilizes the body's resources to prepare for action, increasing heart rate, blood pressure, and alertness. The SNS is vital in situations where there is a real or perceived danger, enabling individuals to respond quickly and effectively to potential threats.

3. The Dorsal Vagal Complex (DVC): The DVC is associated with immobilization and disconnection. It becomes active when the perceived threat overwhelms the ability to fight or flee. In this state, the body shifts into a defensive mode, conserving energy and protecting itself by shutting down. The DVC response can manifest as feelings of withdrawal, dissociation, or even fainting.

The key thing for parents, teachers, and healthcare professionals to hold in mind, is that our autonomic nervous system (ANS) has developed over millions of years to ensure our survival. Our bodies and brains will prioritise our survival before anything else, hence, for example, why some of us jump when we have a spider land on our shoulders. Our rational brain understands that the spider cannot harm us, but our survival, flight-flight brain has a much stronger response, resulting in our bodies responding without conscious thought to ensure that we survive what it perceives as a deadly attack. Unfortunately for the human race, our neurological evolution has not kept pace with our cultural and societal evolution. Subsequently, we physiologically respond in the same manner (flight-fight) to physical, life-threatening, dangers (e.g. tigers) as to psychological or perceived dangers (e.g. high levels of homework, unemphatic teachers, school). When we start understanding that for these children, their bodies and brains are perceiving the school environment as dangerous, and therefore that they are responding in a perfectly logical and reasonable manner, then we can begin to see these behaviours as personally adaptive rather than pathological. I.e. If you were told that you had to go into a building that was filled with tigers that may or may not attack you, wouldn’t it be understandable that you would want to avoid going inside. (For a more in-depth exploration of PVT please follow this link:

Emotionally-Based School Avoidance and the Polyvagal Theory When we apply the lens of PVT to EBSA, we can better understand the underlying physiological responses that contribute to a child's desire to avoid going into an environment which is “perceived” as dangerous.

1. Hyperactive Sympathetic Nervous System: Children who perceive school as threatening may exhibit an overactive sympathetic response. This hyperarousal can manifest as physical symptoms such as increased heart rate, rapid breathing, sweating, and feelings of panic or dread. These bodily responses are the body's way of preparing for a potential threat, even if the danger is subjective.

2. Dorsal Vagal Shutdown: In some cases, EBSA may be linked to a shutdown response mediated by the DVC. When a child's nervous system perceives school as overwhelming and dangerous, the DVC may be activated. This can lead to a sense of immobilisation, dissociation, or even fainting. The child's body instinctively tries to protect itself by disconnecting from the perceived threat.

3. Disrupted Social Engagement System: The VVC, responsible for social engagement and connection, can be compromised in children who struggle with anxiety (and consequently avoid attending school). Their heightened state of anxiety or fear may hinder their ability to effectively engage with peers, teachers, and the learning environment. This disconnection can perpetuate a cycle of avoidance, making it increasingly challenging for the child to re-engage with the school setting.

Understanding these physiological responses is crucial for developing effective strategies to support students experiencing EBSA. By sthe role of the autonomic nervous system, educators, parents, and mental health professionals can tailor interventions that address the underlying physiological states and promote a sense of safety and connection.

Supporting Students Who are Struggling to Attend School

1. Foster a Supportive and Inclusive Environment: Create a school culture that promotes inclusivity, empathy, and emotional safety. Encourage positive relationships between students and teachers, implement anti-bullying measures, and provide resources for mental health support. By fostering a supportive environment, students will feel more comfortable and less threatened, reducing their reluctance to attend school.

2. Develop Individualised Plans: Work closely with students, parents, and mental health professionals to develop individualised plans that address their specific needs. This may involve gradually increasing their exposure to school, implementing accommodations or modifications to support their learning, and providing access to necessary resources and support services.

3. Build Strong Relationships: Develop positive and trusting relationships with students. Take the time to understand their concerns, fears, and challenges. Regularly check in with them, provide a listening ear, and offer guidance and reassurance. When students feel supported and understood, they are more likely to feel safe and connected within the school environment.

4. Teach Emotional Regulation Techniques: Provide students with tools and techniques to regulate their emotions and manage anxiety. Teach them deep breathing exercises, mindfulness practices, and strategies for self-soothing. By equipping students with these skills, they can better manage their physiological responses and reduce their anxiety levels (For more ideas on ways to manage anxiety, please follow this link:

5. Encourage Peer Support: Foster a sense of community among students by promoting peer support networks. Encourage students to form friendships, engage in group activities, and support one another. Peer support can help students feel more connected, reduce feelings of isolation, and provide a support system within the school environment.

6. Collaborate with Mental Health Professionals: Work in partnership with mental health professionals, such as school psychologists, or therapists, to develop comprehensive support plans for students experiencing school refusal. These professionals can provide valuable insights, therapeutic interventions, and additional resources to address the underlying causes of school refusal and support the student's well-being.

Remember, each student's needs and circumstances may vary, so it is essential to approach support strategies on an individual basis. By creating a supportive and inclusive environment, fostering strong relationships, teaching emotional regulation techniques, encouraging peer support, and collaborating with mental health professionals, we can effectively support students and help them overcome their school refusal challenges.

By delving into the intricacies of Polyvagal Theory, we can gain valuable insights into why some children perceive school as dangerous and develop effective strategies to support them. Recognising the impact of the autonomic nervous system on emotional and cognitive states allows educators, parents, and mental health professionals to tailor interventions for students experiencing emotionally-based school avoidance. By creating safe, inclusive environments and employing gradual exposure, regulation, and co-regulation techniques, we can help students overcome their fears, re-engage with school, and thrive academically, socially, and emotionally.

If your child is struggling to attend school and you would like more information on ways that you may be able to support your child, please feel free to contact me at

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