🧠 The Bottom-Up, Top-Down, and Outside-In Model: A Powerful Approach to Nervous System Regulation
- Ute Lorch
- Jul 23
- 3 min read
In the fast-evolving field of neuroscience and mental wellbeing, Dr. Sarah McKay—a respected neuroscientist and science communicator—offers a refreshingly practical and holistic framework for understanding how we can influence our own nervous system health and emotional regulation.
She calls it the Bottom-Up, Top-Down, and Outside-In model.
This model bridges the gap between science and lived experience, giving us insight into how brain-body regulation happens not just from our thoughts, but also from our actions, environments, and sensations.
Let’s break it down—and explore how applying it can support vagus nerve tone, emotional resilience, and long-term wellbeing.
🔄 1. Bottom-Up: Body to Brain
Bottom-up regulation refers to how sensory input and physical states from the body affect the brain. This includes signals from muscles, organs, breathing patterns, posture, and movement. One of the key pathways here is the vagus nerve—the superhighway connecting the body to the brainstem and influencing everything from digestion to heart rate to emotional calm.
Bottom-up practices include:
Deep breathing (especially slow, diaphragmatic breathing)
Cold exposure (splashing the face or cold showers)
Gentle movement (like yoga, walking, or somatic shaking)
Interoception (tuning into bodily sensations without judgment)
These activities can stimulate the vagus nerve, increasing vagal tone, which is linked with improved mood, better heart rate variability (HRV), and greater emotional flexibility.
🧠 2. Top-Down: Brain to Body
Top-down regulation refers to how our thoughts, beliefs, focus, and interpretations influence the body’s physiological state. The brain doesn’t just respond to signals—it interprets and gives meaning to them. This process plays a crucial role in stress perception, emotional reactivity, and how we make sense of pain or threat.
Top-down practices include:
Mindfulness meditation
Cognitive reframing
Self-compassion and gratitude
Visualisation and mental rehearsal
Research shows that these mental practices change patterns of neural activity, calming the amygdala (our threat detector) and strengthening the prefrontal cortex—enhancing self-regulation and decreasing sympathetic nervous system activation (fight/flight).
🌿 3. Outside-In: Environment to Brain and Body
The outside-in component focuses on the impact of our environment and relationships on our nervous system. Humans are deeply social beings, wired for connection, safety, and co-regulation. Our nervous system doesn't operate in isolation—it continuously responds to light, sound, nature, touch, and social cues.
Outside-in strategies include:
Spending time in nature
Healthy, safe relationships
Touch and physical closeness
Music, rhythm, and safe soundscapes
Light exposure (especially natural morning light)
These external inputs provide powerful cues of safety or danger to our nervous system. A well-designed sensory and social environment can down-regulate the stress response and facilitate healing, especially for those recovering from chronic stress, burnout, or trauma.
💡 Why This Model Matters for Vagus Nerve Health
The vagus nerve is the main communication channel between the body and brain in the parasympathetic (rest-and-digest) system. When vagal tone is high, the body and brain are better equipped to:
Regulate emotions
Recover from stress
Sleep deeply
Digest properly
Connect socially
By working through all three lenses—bottom-up, top-down, and outside-in—we can actively stimulate the vagus nerve and teach our nervous system to feel safe, flexible, and resilient.
✅ Practical Application
To support your nervous system daily:
Start your morning with a short breathing practice (bottom-up)
Pause mid-day to reflect and reframe stressful thoughts (top-down)
Design your environment to feel calm and connected—add music, plants, or get into the sunshine (outside-in)
Connect with safe people or even animals—co-regulation is real!
🧘♀️ The Takeaway
Dr. Sarah McKay’s model offers a powerful, integrated way to support brain and body health—not just by thinking differently, but by living differently.
Understanding that we can regulate from multiple directions—bottom-up, top-down, and outside-in—empowers us to take consistent, compassionate steps toward greater wellbeing.
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