Stanley Rosenberg is a body therapist whose 2017 book Accessing the Healing Power of the Vagus Nerve introduced a set of exercises based on Stephen Porges’s polyvagal theory. Rosenberg’s exercises — particularly the “Basic Exercise” — became widely practised in therapeutic and wellness communities. This article examines what the exercises are, what they claim to do, and how they stand up against the current evidence for vagal modulation.

The Basic Exercise

Rosenberg’s signature technique is the Basic Exercise, designed to shift the autonomic nervous system from a dorsal vagal (shutdown/freeze) or sympathetic (fight-or-flight) state into a ventral vagal (social engagement) state — the three-state hierarchy described in polyvagal theory.

The exercise involves lying supine (face up) with fingers interlaced behind the head, then turning the eyes to one side (without moving the head) and holding the gaze for 30-60 seconds until a spontaneous sigh, swallow, or yawn occurs. These autonomic signs are interpreted as the nervous system shifting into a ventral vagal state. The eyes are then moved to the other side and the process is repeated.

Rosenberg’s rationale involves several anatomical claims: that the suboccipital muscles at the base of the skull can become chronically tight and compress the vagus nerve or its associated structures as they exit the skull through the jugular foramen, that the eye movements activate the suboccipital muscles (which are innervated by the suboccipital nerve from C1) and release tension in this area, and that this release alleviates vagal compression and restores ventral vagal function.

Evaluating the Claims

Several aspects of Rosenberg’s anatomical rationale are problematic when examined against current neuroanatomy.

Vagal compression at the skull base. The vagus nerve exits the skull through the jugular foramen — a bony opening in the skull base, not a muscular passage. The suboccipital muscles (rectus capitis posterior major and minor, obliquus capitis superior and inferior) attach to the atlas (C1), axis (C2), and occiput, but they do not directly overlay the jugular foramen and cannot compress structures within it. Vagal compression at the jugular foramen does occur in certain pathologies (glomus jugulare tumours, jugular vein stenosis, Eagle syndrome), but these are structural lesions, not muscular tension problems amenable to exercise.

Eye movements and suboccipital release. Eye movements do have connections to the suboccipital muscles — the rectus capitis posterior muscles have been shown to have connections to the spinal dura through myodural bridges. However, the claim that lateral gaze specifically releases suboccipital tension in a way that affects vagal function is not supported by published research. The autonomic signs Rosenberg describes (sighing, swallowing, yawning) are general signs of parasympathetic activation that can occur with any relaxation technique, including simply lying supine with hands behind the head in a comfortable position.

Polyvagal theory framework. Rosenberg’s exercises are built on the polyvagal theory’s distinction between ventral vagal (social engagement), sympathetic (fight-or-flight), and dorsal vagal (shutdown) states. While polyvagal theory has been influential in therapeutic communities, its core neuroanatomical claims have been challenged by several researchers. The primary critique is that the sharp phylogenetic distinction between unmyelinated dorsal vagal and myelinated ventral vagal systems, as described by Porges, does not align cleanly with comparative neuroanatomy across vertebrate species. This does not mean the clinical observations behind polyvagal theory are wrong — there clearly are different autonomic states — but the specific neuroanatomical mechanism Porges proposes remains debated.

What May Actually Be Happening

People do report benefits from Rosenberg’s exercises, and dismissing these experiences would be unhelpful. Several mechanisms that do not require Rosenberg’s specific anatomical claims could explain the effects. Lying supine with hands behind the head is a physically relaxing posture that naturally reduces sympathetic tone and increases parasympathetic activity. The sustained lateral gaze requires focused attention, which can function as a form of mindfulness — redirecting attention away from anxious thoughts and toward a neutral physical stimulus. The instruction to wait for a sigh, swallow, or yawn creates expectation and attention to autonomic signs, which may itself facilitate relaxation (a form of biofeedback without instrumentation). Cervical muscle stretching — the position does stretch the posterior cervical muscles — may reduce muscle tension that contributes to headaches, neck pain, and general discomfort, producing secondary improvements in wellbeing.

These mechanisms are all consistent with general parasympathetic activation through relaxation, body awareness, and gentle stretching — they do not require the specific vagal compression/release mechanism that Rosenberg proposes.

Rosenberg’s Exercises in Context

Compared to vagal modulation techniques with stronger evidence bases — resonance frequency breathing, cold water face immersion, HRV biofeedback, aerobic exercise — Rosenberg’s exercises have no published randomised controlled trials demonstrating their specific effects on vagal tone, HRV, or clinical outcomes. This does not mean they are ineffective, but it means that their mechanism and efficacy are unproven.

For someone looking to build a vagal health programme, evidence-based techniques should form the foundation. Rosenberg’s exercises may serve as a useful relaxation and body awareness practice alongside these core techniques, particularly for people who find them helpful — the absence of evidence is not evidence of absence, and a technique that someone practises consistently because they enjoy it is more effective than an evidence-based technique they abandon.

However, it is worth being honest about the evidence: the specific claims about vagal compression, suboccipital release, and ventral vagal activation through eye movements are not supported by published neuroanatomy or clinical trials. The benefits people report are likely genuine but may operate through more general relaxation and body awareness mechanisms rather than the specific vagal pathway Rosenberg describes.

Building an effective vagal health programme means understanding what works and why. My Vagus Nerve & Me covers the full range of vagal techniques — from well-established to emerging — with honest assessments of the evidence behind each. Get My Vagus Nerve & Me eBook and make informed choices about your vagal training.

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