Stanley Rosenberg’s 2017 book “Accessing the Healing Power of the Vagus Nerve” introduced a set of exercises designed to improve vagal function through gentle movements of the head, neck, and eyes. Rosenberg, a body therapist trained in craniosacral therapy and based in Denmark, built his approach on Stephen Porges’ polyvagal theory — specifically the idea that the ventral vagal complex and its associated “social engagement system” can be activated through targeted physical maneuvers. The book has sold widely and the exercises circulate across wellness platforms, often as downloadable PDFs. Here is what the exercises actually involve and what the evidence supports.
The Basic Exercise
Rosenberg’s signature technique is called simply the Basic Exercise. Lie on your back and interlace your fingers behind the base of your skull (the occiput). Without turning your head, move your eyes to the right and hold that gaze for 30 to 60 seconds. Rosenberg instructs you to wait for an autonomic shift — a sigh, yawn, or swallow — which he interprets as the ventral vagal complex re-engaging. Then look to the left and repeat.
The claimed mechanism is that this eye movement, combined with the hand position supporting the occiput, engages the suboccipital muscles and upper cervical region, influencing cranial nerves that connect to the social engagement system (CN V, VII, IX, X, XI). Rosenberg describes this as “resetting” the autonomic nervous system from a dorsal vagal or sympathetic state to a ventral vagal state.
Half-Salamander and Full Salamander
The Half-Salamander progresses from the Basic Exercise. In the same supine position, tilt your head to one side — ear toward shoulder — while keeping your eyes looking in the opposite direction. Hold until an autonomic shift signal appears. The Full Salamander moves to hands and knees: tilt the head to one side while extending the arm on the same side, creating a lateral flexion through the whole body. Both exercises aim to mobilize the cervical spine and engage the accessory nerve (CN XI), which Rosenberg connects to the social engagement system through its innervation of the sternocleidomastoid and trapezius muscles.
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What the Evidence Actually Shows
No published randomized controlled trial has tested Rosenberg’s specific exercises against a control group with HRV or other autonomic outcome measures. The evidence base consists of clinical observation, case reports, and anecdotal patient feedback. This does not mean the exercises are ineffective — it means they are unvalidated in the formal sense that a breathing protocol with 15 published RCTs is validated.
The autonomic shift signals Rosenberg describes — yawning, sighing, swallowing — are real parasympathetic markers. People do report experiencing them during the exercises. What is unclear is whether these signals indicate a vagal mechanism specific to Rosenberg’s technique or a general relaxation response that occurs whenever someone lies still in a quiet room for 60 seconds while paying attention to their body.
The polyvagal framework underlying the exercises is itself contested. Grossman’s 2023 and 2026 critiques demonstrated that the ventral/dorsal vagal distinction, as Porges described it, is not experimentally validated in the specific neuroanatomical terms the theory uses. The “social engagement system” is a useful clinical concept, but its connection to CN XI and the suboccipital muscles is theoretical rather than demonstrated.
What Probably Works and Why
Setting aside the polyvagal explanation, the exercises involve several components with independent evidence:
Gentle cervical mobilization. Slow, controlled movements of the neck reduce muscular tension in the suboccipital and cervical paraspinal muscles. Chronic tension in these muscles is associated with headaches, jaw dysfunction, and sympathetic arousal. Manual therapy targeting this region has established evidence for reducing neck pain and associated symptoms.
Supine rest with body awareness. Lying still while attending to internal sensations is a form of interoceptive practice. Body scan meditation and progressive relaxation use the same mechanism — shifting attention from external concerns to somatic experience — and have strong evidence for parasympathetic activation.
Slow, deliberate movement. Any gentle, intentional movement performed mindfully tends to reduce sympathetic arousal. The specificity of Rosenberg’s positions may matter less than the general principle of slow, attentive bodily engagement.
The exercises are safe for most people. Individuals with cervical instability, recent neck injury, or vertebrobasilar insufficiency should consult a healthcare provider before performing sustained cervical rotation or lateral flexion.
The Book in Context
“Accessing the Healing Power of the Vagus Nerve” is one of several consumer books built on polyvagal theory, alongside Deb Dana’s “Anchored” (2021) and Navaz Habib’s “Activate Your Vagus Nerve” (2019). Rosenberg’s contribution is the specific exercise sequences — concrete, reproducible physical maneuvers rather than general lifestyle advice. For people who prefer structured body-based practices over breathing exercises or meditation, Rosenberg’s approach provides a clear protocol. The exercises take five to ten minutes and require no equipment.
The honest summary: people report benefit, the exercises are low-risk, the theoretical framework is contested, and formal validation is absent. If the exercises help you feel calmer and more present, the lack of an RCT does not invalidate your experience. If they do nothing, the lack of an RCT also means there is no strong reason to persist.
Looking for a grounded guide to the vagus nerve that covers both established science and practical techniques? Get My Vagus Nerve & Me eBook for a clear overview of what works, what is emerging, and what remains unproven.
