Stanley Rosenberg’s 2017 book Accessing the Healing Power of the Vagus Nerve introduced a set of simple physical exercises designed to shift the autonomic nervous system from a defensive state into what he calls “social engagement.” Rooted in Stephen Porges’s polyvagal theory and Rosenberg’s own decades of craniosacral therapy practice, these exercises have become some of the most widely shared vagus nerve techniques online. Here is what the exercises involve, how they are supposed to work, and what the current evidence says.
Who Is Stanley Rosenberg
Rosenberg is a body therapist who trained in Rolfing and craniosacral therapy before specialising in autonomic nervous system regulation. He practised for over 30 years at the Rosenberg Clinic in Copenhagen, working primarily with chronic pain, emotional trauma, and autonomic dysfunction. His book, published by North Atlantic Books, applies Porges’s polyvagal framework to a set of self-help exercises that anyone can perform without a therapist.
His central premise is that many chronic health problems — anxiety, depression, digestive issues, social difficulties, chronic pain — stem from the autonomic nervous system being stuck in a defensive mode (sympathetic fight-or-flight or dorsal vagal shutdown). His exercises aim to re-engage the ventral vagal complex, which Porges associates with calm social engagement, by mechanically activating the cranial nerves that feed into the ventral vagal system.
The Polyvagal Foundation
Rosenberg’s work relies heavily on Porges’s polyvagal theory, which proposes that the vagus nerve has two functionally distinct branches: the ventral vagal complex (myelinated fibres originating in the nucleus ambiguus, associated with social engagement, calm alertness, and regulated heart rate) and the dorsal vagal complex (unmyelinated fibres from the dorsal motor nucleus, associated with immobilisation, shutdown, and energy conservation).
This framework is not without scientific controversy. Physiologist Paul Grossman and others have challenged several of polyvagal theory’s core claims, particularly the sharp phylogenetic division between myelinated and unmyelinated vagal fibres and the assertion that the dorsal vagus is exclusively responsible for freeze and shutdown responses. However, the practical exercises Rosenberg developed do not depend on every aspect of polyvagal theory being correct. Many of them target well-established cranial nerve pathways regardless of the theoretical framework used to explain them.
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The Basic Exercise: Step by Step
Rosenberg’s signature technique is called simply “the Basic Exercise.” It is designed to activate the ventral vagal complex through eye movements that engage the suboccipital muscles and, by extension, the spinal accessory nerve (CN XI) and the vagus nerve (CN X), which share a common origin in the nucleus ambiguus.
The exercise proceeds as follows. Lie on your back and interlace your fingers behind your head, cradling the base of your skull (the occiput) in your palms. Without turning your head, look to the right with your eyes only, as far as comfortable. Hold this eye position for 30 to 60 seconds while continuing to breathe normally. Wait for an autonomic shift — typically a spontaneous sigh, yawn, or swallow. When the shift occurs, return your eyes to centre and repeat the process looking to the left.
The proposed mechanism is that lateral eye movement engages the suboccipital muscles (which are innervated by C1 and have connections to the spinal accessory nerve), and this mechanical engagement creates a reflex activation of the ventral vagal complex. The sigh, yawn, or swallow is interpreted as a parasympathetic shift — a sign that the autonomic nervous system has moved out of a defensive state.
Half-Salamander and Full Salamander
Rosenberg builds on the Basic Exercise with progressively more involved movements. The half-salamander exercise involves tilting the head laterally (ear toward shoulder) while keeping the eyes looking in the opposite direction. This creates a stretch through the sternocleidomastoid and scalene muscles on one side while engaging the suboccipital muscles, targeting the spinal accessory nerve from a different angle.
The full salamander exercise adds trunk rotation: from a hands-and-knees position, the head tilts to one side while the spine curves laterally, creating a C-shaped bend through the entire torso. This is meant to engage the full chain from cranial nerve innervation through the spinal accessory nerve and into the trunk musculature, producing a broader autonomic shift.
Both exercises follow the same principle of holding the position for 30-60 seconds and waiting for an autonomic sign (sigh, yawn, swallow, stomach gurgling) before switching sides. Rosenberg recommends performing them in sequence — Basic Exercise first, then half-salamander, then full salamander — as a daily practice.
Other Techniques From the Book
Beyond the salamander series, Rosenberg’s book covers several additional approaches. He recommends specific self-massage techniques targeting the sternocleidomastoid (SCM) muscle, because the spinal accessory nerve passes through or alongside it. Gentle kneading of the SCM, from its attachment at the mastoid process behind the ear down to the clavicle, is intended to release tension that may be compressing or irritating the accessory nerve.
He also discusses the neuroception exercises, designed to help individuals recognise their autonomic state — whether they are in ventral vagal (social engagement), sympathetic (fight-or-flight), or dorsal vagal (shutdown). Body awareness practices, facial expression work, and gentle vocalisations complement the physical exercises. These draw on the polyvagal concept that facial muscles, middle ear muscles, and laryngeal muscles are all innervated by the ventral vagal complex and can be used as both indicators and levers of autonomic state.
What the Evidence Says
No randomised controlled trials have specifically tested Rosenberg’s exercise protocol against a control condition. The evidence supporting these exercises is largely mechanistic (the cranial nerve pathways he targets are real and well-documented), anecdotal (many practitioners and patients report benefit), and indirect (other vagal stimulation approaches using similar pathways have clinical evidence).
The mechanistic rationale has some support. The connection between the spinal accessory nerve and the vagus nerve through the nucleus ambiguus is anatomically established. Suboccipital muscle engagement does influence cervical autonomic pathways. And slow eye movements have been shown to reduce sympathetic arousal in eye movement desensitisation and reprocessing (EMDR) research, though the mechanisms differ.
The practical limitation is that Rosenberg’s specific claim — that his exercises reliably shift the autonomic nervous system from a dorsal vagal state to a ventral vagal state — has not been formally tested. Without controlled studies measuring HRV, cortisol, or other autonomic markers before and after the exercises compared to a sham condition, the specific efficacy of his protocol remains unvalidated. This does not mean the exercises do not work — it means we do not yet have rigorous data showing that they work for the reasons he proposes.
Integrating Rosenberg’s Approach
Rosenberg’s exercises are gentle, require no equipment, and carry essentially no risk. For individuals dealing with chronic stress, anxiety, or trauma-related autonomic dysregulation, they offer a structured entry point into body-based nervous system work. Many trauma therapists incorporate elements of his protocol alongside established approaches like somatic experiencing and sensorimotor psychotherapy.
The exercises are most likely to be useful as part of a broader vagal tone practice rather than as a standalone treatment. Combining Rosenberg’s mechanical techniques with validated vagal stimulation methods — slow diaphragmatic breathing at approximately 6 breaths per minute, cold water face immersion, sustained humming or chanting, and regular aerobic exercise — creates a multi-pathway approach that targets the vagus nerve through several distinct mechanisms simultaneously.
For those interested in Rosenberg’s full system, his book Accessing the Healing Power of the Vagus Nerve (North Atlantic Books, 2017) provides detailed instructions with photographs. It remains one of the more accessible practical guides to vagal exercises, even if its theoretical framework should be held with appropriate scientific caution.
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