April 1, 2020

How to Cough without Shame: Polyvagal & Trauma-informed Breathing.

It occurred to me this morning that part of preparing to dance with a respiratory virus involves examining our willingness to exhale.

I have dealt with a nonproductive, barking cough since infancy. Over the last 20 years or so, I have recognized how fear contributes to my inability to use my cough for what coughs are designed to do—clear the lungs.

Over the years, I have learned to risk the vulnerable feeling of making noise that draws attention to myself. I have learned to let go.

When we cough, our bodies blow whatever cover we have created to hide our true selves. For most of my life when I would cough, there would be such a desperate internal message of Do Not Cough that of course I would cough again, and again. Over my 63 years of living, I began to recognize my barky cough as my body’s way of screaming, Hey I am Here.

I am a counselor and dance/movement therapist. In 2013, I started becoming an expert in scientist Stephen Porges’ polyvagal theory and many of my articles on polyvagal theory have been published on Elephant Journal since then. (I have also done a sh*t-ton, as my daughter might say, of my own personal therapy.)

Letting Go

One exercise I did to help myself tolerate being seen authentically (so I might stop bark-coughing and start lung-clearing coughing) was to fist my left hand and use my right hand to slowly open each finger that hungered to hold on. With each move, my left hand resisted the pull of the right. I felt a rush of compassion for my infant grasping. Slowly, the pull of the right on the left helped me sense my strong, grown-up capability.

As the world deals with COVID-19, I invite each person to prepare to be able to cough productively should they dance with the virus within their bodies. From my experience, we do this by honoring the fear that keeps us holding onto things it may have become safe to let go of. It might help to think both personally and globally.

I have thought that perhaps our dance with COVID-19 could help us let go of some old communal defensive patterns, shifting into new, more life-sustaining ones.

One major shift I hope we will make is a return to sustainable business practices. The idea that constant financial growth is a sign of health is like thinking a constant inhale is a sign of health. I invite us to look for how our economy can healthily exhale and then prepare for economies that inhale and exhale.

I invite us to prepare for inhalation and exhalation in each person within each community, so we do not get the misguided idea that some people should be the Inhalers and others the Exhalers. We all need to inhale and exhale—with productive coughing when our lungs need clearing.


As I have learned about nervous system science, I have recognized how I survived much of the first 30 years of my life in shutdown. Shutdown is a state provided by the parasympathetic nervous system for waiting out danger. Shutdown creates a stupefied, robotic kind of functioning. It is probably stupification that got huge groups of people to forget that exhales are a necessary part of breathing for all people.

In my 30 years of trauma training and trauma facilitating—mine and my clients’—I have experienced how we wake up from shutdown with bursts of fight/flight response. When we do not understand this fight/flight wake-up from shutdown, the fight/flight response can scare us so much that we do not risk waking up.

When my cough would draw attention to myself, I did not excuse myself into some private space where I could welcome my cough as the means to clear my lungs of mucus. I shamed myself, creating the bouncing back and forth between freak-out and freeze—bursts of fight/flight response shamed into shutdown, triggering more fight/flight response and more shame, etc. This kind of coughing scratched my throat, which made me want to cough more.

Wake-up as Exhale

As I learned to move through the vulnerable wake-up, I learned to cough productively—and privately. I learned to recognize my fear of “blowing my cover.” I learned to honor the family patterns that sent me into shutdown and tolerate the truth—I deserve to take up the space my body takes up.

I deserve to exhale. Exhale creates the space for the next inhale.


Dee Wagner, LPC, BC-DMT has developed a polyvagal-informed and dance/movement-therapy-informed partner practice called Chi for Two® to help us better understand, do and enjoy the nuanced energetic dance of relationship.

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