The window of tolerance is such an important concept when we’re working with trauma and dysregulation.
For clients who have experienced trauma, that window often becomes quite narrow.
They may space out and dissociate, or get too angry or anxious to focus. Or, they might fluctuate between hyper- and hypo-arousal. When they’re too far outside the window, it makes it difficult to continue the work of healing.
So what are some ways to help clients expand their window of tolerance and come back into it?
Ruth Lanius, MD, PhD and Bessel van der Kolk, MD offer some of their insights in the video below. Take a look – it’s under 5 minutes.
Click here for full transcript
Ruth and Bessel, together with Stephen Porges, PhD and Pat Ogden, PhD focus on: How to Help Clients Tolerate Dysregulation and Come Back From Hypoarousal as part of the Treating Trauma Master Series.
Now we’d like to hear from you. What have you found effective in helping clients learn to self-regulate? Please leave a comment below.
Take them on a natural walk
yoga
I have noticed that supporting clients in developing self-compassion as a path back into the “window of tolerance”. So when the client has fallen out of the window, into hypo or hyper arousal states, there is a “recovery” needed to find the way back into the inner calm state that exists inside the window. Self Compassion offers the recovery, the self regulating tool to accept, forgive, reassure, normalize the experience they have had, and reintegrate back into a wider space of self trust that they can manage what comes their way in life.
This is very true, I self realized acceptance and commitment with self compassion regards to emotions and thoughts made me see the window of tolerance better and stronger as a patient.
I find people with DID have parts that only come forward during the times of being out of the “window of tolerance” both hyper and hypo. It seems much more beneficial for them to express themselves where they are-rather than doing a technique that causes them to go back into hiding. In other words some dissociated parts are only found in the “outskirts” of the clients window of tolerance.
Wow, you really hit the nail on the head there I think. I have been diagnosed with DID and I couldn’t agree more as that is really my experience. I have parts that I feel actually contain some of the those responses. With my therapist I have discovered there is a part that uses the hyper aroused state of another part to actually drive this part’s own hypo aroused state. This enables me to have no knowledge between parts of what the trauma is that is causing one part to enter a hyper aroused state, but that hyper aroused state actually triggers other states in other parts so that I go into a hypo state without having any idea at times what the trigger was or the trauma that caused it… but my therapist will by talking to the part that was hyper aroused and feeding it back to me… as a university lecturer myself I am very curious at times with how complex the human brain is, especially in response to complex trauma.. very good article and interesting comments
I use tapping in the Emotional Freedom Technique (EFT) sense of the word. I also include the eye movement part of the EFT process, which is also very powerful to help self-regulate clients and put their minds into a relaxed and more receptive state. It may take a few rounds of tapping depending on the client’s initial state.
As a Clinical Hypnotherapist, helping the person to get into a calm state of mind and body is key. From there, good work begins by use of cutting edge protocols.
Linda Kelowna, BC
Hypnosis For Life
I use Emotional Freedom Techniques and Matrix Reimprinting and find that if I use Emotional Freedom Techniques at a point well before any arousal they stay regulated.
I have found the presence of my dog very helpful for my clients struggling with a narrow window of tolerance. My dog isn’t a trained therapy dog but he’s a very gentle and calm animal. When my clients start to become dysregulated they watch him sleeping peacefully and this helps them calm their breathing. It’s like their breathing starts to match my dog’s breathing and they are able to keep going in therapy, rather than freezing up or shutting down.
Well, just to throw this in; before the client comes, as a therapist I want to make sure I am centered, and breathing well and have erased the time before so that I can take in the whole of the person coming to me. I believe they can feel I am present and therefore respectful and caring of them and then we can address the issues. I want to regulate myself.
I think you are touching a very important element here, Selma. We need to model the sensation we would like our clients to feel. I do all the exercises with them and have one part of my consciousness constantly on their body and the reactions they show.
I agree completely. I am in recovery from Narcissistic Abuse. I receive the weekly offerings of NICABM and there have been some real nuggets of helpful information. Also, after listening to Sounds True Brain Health Summit, I intend to begin Neurofeedback. But to date, what has been most beneficial is working with Quantum healing processes that ERASE memory from the various Quantum fields that influence us. Examples: Eileen McKusick is getting her PHD using tuning forks to restore coherence in the human biofield – Shift Network highlights her work this month. I benefitted from her Brain/Vagus Nerve/Adrenal Reset sessions. The LIFE biofeedback machine is used to diagnose and treat people in Europe. In N. Am. the LIFE machine is considered by FDA to be a “relaxation device”. Too bad. I believe therapists incorporating this modality in their treatment would wonder how they ever did therapy without it. And then there is the rapidly growing field of shamanic psychotherapy. Abby Wynn and Linda Star Wolf are two of the many therapists who combine both disciplines. And then there are the intuitive/empaths. I have greatly benefitted from Melanie Tonia Evans, NARP program (almost 100,000 people subscribe to her channel which deals exclusively with recovering from narcissistic abuse). I have also worked extensively with Spiritual Acceleration which has been THE SINGLE BEST resource in my recovery. Just recently Shift Network offered the Ancestral Healing Summit which included talks re: transgenerational/epigenetic commentary by Dan Siegal along with conversations from Indigenous Grandmothers and shamans. Won’t it be something when we finally come to realize that the most marginalized people in our culture – the indigenous peoples – have all along held the wisdom for true healing of trauma.
Dear CG,
I find your comment very interesting, have you tried what is suggested by therapists in this course, to reset the physical memory of the pain you lived through in the past?
I enjoyed reading the ideas you contributed, thank you!
Tamara from Spain
Love the term, “Live within their ribcage.” Can see how that statement will get them focused in that main dysregulated area. Eye contact and body movement is often a way to see that dysregulation.
Beach balls were very helpful with young people, but now my ball is deflated, much like they probably feel. As my office is no longer conducive to bouncing a ball, I wonder if using my drums might me helpful until I expand the office.
Breathing accurately is most helpful to open up the parasympathetic nervous system and clients understand it, especially if it is shallow at first. Terms like this are so affective in imagery. Literally see that window of tolerance as I often sit in the SNS. That helps me, personally, to not get angry or recoil in avoidance. Thanks for the phrase, both of your reminders and suggestions. You both do such good work in passing on ideas to aide clinicians. It is much appreciated to also calm our own bodies.
We always start with HRV and breathing exercises and then tapping techniques. We then follow up with guided relaxation meditations to develop theta cross over to access deep material and then integrate with more tapping techniques to stimulate memory reconsolidation. We are neurofeedback practitioners and deal primarily with people in a more “normal” range of emotional self-regulation in order to develop optimal brain function.
I’m not a therapist, I’m a trauma survivor. I watch these videos because I self educate to help myself where most therapy has not been sufficient. There are very few therapists who really understand and many mean well but miss the mark. Having someone truly get it alone is calming – to not feel alone in a vast ocean of solitude in excruciating pain. Trying to communicate with another person – be it a therapist, friend, or partner – who doesn’t understand and gives suggestions that doesn’t work feels almost worst than just accepting feeling alone in the first place. We wouldn’t expect someone undergoing a surgical procedure anesthetize not to scream. And yet we somehow think someone can be in excruciating psychological, emotional, and spiritual pain and think their way out of it. Pain is pain. I appreciate these videos because they at least address the physical component. If I can picture someone accepting me and understanding I’m in severe pain and wanting to address the pain rather than just tell me to handle it with logical techniques, I start to feel a bit of relief. It’s hard to see the wisdom of a person who is screaming (metaphorically or not) when we can’t see the cause of their pain. But sometimes the clients themselves have a lot of wisdom if the therapist will hear it. They may not have the answers for what to do about it, but they often get treated like a dysfunctional mess instead of someone having a logical reaction to pain. At least that’s how I’ve felt most of the time in therapy. I’m trying to find someone who takes my insurance who is truly trauma informed. In the meantime, I read and I watch these videos. Please excuse my lengthy comment. However perhaps at least someone will find it useful to hear from an educated person on the survivor’s side instead of on the therapist’s side. Or at the least, thank you for making these publicly available.
See the comment above from cg that I intended to post here as a reply,
I understand completely, as I’m a trauma survivor myself. I subscribe bcuz I want to become a trauma counselor. I feel that having experienced it makes it a lot easier to understand. Though I see a lot of psychologists, medical drs and therapists on here who have an excellent understanding. The bigger problem is insurance covering the cost or allowing so little amounts of sessions in order to overcome things that took years to imbed in our nervous and lymbic system. The one thing thats been helping me the most is diffusing Trauma life, release and joy essential oil blends by Young living essential oils. I try to diffuse one in the morning and one in the evening. Another good one is Sara. Trauma life is my favorite and ever since I started diffusing it at night when I’m relaxing and then as I’m going to sleep I sleep deeply and my nervous system has calmed down to where I’m calm almost every day unless something unexpected triggers me. Hope this helps!
hi I so get u , compassion is key to emotional pain.i have read up learnt practiced all sorts of therpy and still suffer physical / emotional pain . therapists often advise so i am finding tapping the best. online Garry is tops and Gwynneth is amazing.I borrow benefits and i tap with a friend and get clarity, can cry and feel relief. I love my teddy and use it to self sooth. we survivors are strong and will heal the next generation, believe in your healing powers and remember G d believes in you. Zippy
I have used a stuffed animal for them to hold on to tight to their chest. I work mostly with alcoholic women who have big abandonment issues and some with sexual abuse by family members. The stuffed animal allows them to feel a sensual contact to something that will not hurt them and doing the deep breathing exercises also helps.
I work with children and find blowing bubbles is a great calming activity which helps the client regulate.
I got an additional illness following a rare illness, l cannot let it in, despite therapy! it threw me own the edge of my tolerance!
I work with Feldenkrais and Postural Integration. When clients are frozen I work on unfreezing using voice, breath and movement. Like Stephen Porges I also observe breathing and posture. When I see clients breathing so slightly that their rib cage hardly moves I know I have to work with them to release that. It’s like they took in a deep breath when they experienced trauma and they’ve never released it. It’s stuck inside and kept there by freezing, locking down on it like the lid of a pressure cooker. Release comes through deep tissue work, fascia release etc. and the clients use of sound – screaming, sobbing, howling, wailing or voice – shouting, swearing, pleading or physical movement – biting, kicking, shouting, shaking, gagging and so on. I think psychotherapy together with body work can be very freeing for clients who have experienced trauma, especially those that are almost outside their bodies with terror and cannot find a way back through talking alone.
This sounds really interesting. Do you have a website?
I’m wowed by how good and wise this training is and how well put together; also how generous it is – a great deal of work must have gone into it. Some is familiar, some new; all of it is helpful. At the moment am still assimilating it but it’s very good to feel hopeful that the effects of trauma are not irreversible.
On self-regulation I have found that colouring-in can be soothing. The movement, selection of colour, feel of pencil in hand and sensation of the paper on skin help to provide strong focus on what’s happening here and now.
Me, too. I work with colors and a silhouette… It’s a 4 step map for registering the different stated of emoticonal dysregulation on a body based intervention.
Which sheets do u use?
My young children loves their crayola crayons. For my clients, I would prefer to find something more therapeutically for prof. use. Can you share about what is “a silhouette”, for coloring? and the 4 step map?
Thank you.
Wouldn’t it be pretty wild if one’s regulation and emotions were all rooted in the balanced or imbalanced microbiome…. from natural birth vs. c-section, over-use of anti-biotics in the meat industry, toxic waste, plastics, sprays, etc., causing a GUT IMBALANCE and because the gut is in communication with the Brain through the vagus nerve, all sorts of MENTAL PROBLEMS (Alzheimer’s, Autism, Depression, protruded cases of PTS, Parkinson’s, Compulsions) and disregulated emotions (Greed, Rage, Jealousy, Lack of motivation), have arrived on the scene. What was once thought of as Mental problems are actually imbalances in the Microbiome.
Two things occur to me – it seems like accessing Self, as in IFS, is a way of regulation. Dick Schwartz and Loch Kelly held an online course last spring called ‘Accessing Self’ giving methods/meditations on how to do this. When I access Self, I find myself moved out of either hypo or hyper arousal (I have severe developmental trauma I am still working on).
The other thing I am wondering about is that I know I have heard Dick comment on how IFS avoids the whole window of tolerance issue by the nature of the IFS approach, but I can’t recall how/what/why. Anyone else know?
IFS?
Internal Family Systems.
Check into Accelerated Recovery Therapy. It explains the bypass of the the cerebral cortex to go directly to the midbrain. I have had some excellent success with individuals who have had recent trauma using this type of therapy.
Using Emotion Focus Therapy would help too.
I find that psycho-education relating to the window of tolerance can be an eye-opener. Folk with a strong visual imagination will ‘see’ it and notice how it can go up and down/in and out – like bag-pipes, perhaps.
I realise that the experience of the window can be flooded by ‘explanation’ and I am not too sure if I know how I discriminate those who ‘get’ it, from those I will hold back the information from. I am cautious and valued this short video as pointing to ways of relating differently to the experiences!
I have found body work and deep breathing with mindfulness as well as visualisations very helpful to expand my clients window of tolerance. It helps them move from chaos or rigidity to a safe place where trust and connection is possible
Do you use a particular example of visualization with your clients? Thanks.
I am a physical therapist and I use ball throwing as well to help someone get into their body and feel safe to express. I also have my clients stand on a balance board while having a conversation about something they like. It helps them get into their core muscles and be able to express truth.
I recently tried the newest iteration of Thr Flash technique with a client who couldn’t tolerate thinking of the traumatic event without shutting down. This method was “more helpful than anything else we tried”.
The “SeeSaw” breathing lessons from the Feldenkrais Method of Somatic Re-education, not only expand the lungs but can lead to the development of new neurological pathways that over-ride pathways created during trauma. All the Feldenkrais lessons release habitual muscle-tension holding patterns.
Body scan or loving kindness meditation. Grounding exercises.
In my practice (Tom Robertson Therapy) I usually have the clients adopt a positive physiology – looking forward, not down, smile on their face (even if they don’t mean it) shoulders back and of course, deep breathing! In addition I use Emotional Freedom Technique (tapping) too. I find tapping is very powerful in most cases.
However, I do like the beach ball imagery described in the video and may incorporate it into the procecedure.
Thank you for your video. The description of what the window of tolerance is was well explained. I am a therapist and am disappointed at the lack of more practical ways that really help clients increase or return into their window that were offered.
I work at Dandelion Time in the UK. We utilise movement in the body to help families rebuild relationships and rhythmic sensory experiences to help them self regulate. We work largely outside in the natural world and we work systemically. Our work is experiential and I have found that kneading dough, using the shave horse in green wood work, digging in the garden, stroking a guinea pig, felting wool or simply walking offer opportunities for self regulation.
Thank you. Succinct grasp of the whole person dynamics with flexible options to ‘unwind’, expand and balance tolerance levels.
Thank you very much for this video! I found it very interesting! Working through conscious breathing, centering the attention in the body, in stillness or movement are two powerful keys to help clients learn to self regulate.
I teach clients slow micro-movement meditation whilst sitting. It takes 1-2 minutes. The shift before and after is very tangible enabling them to relax before moving into hypnosis.
Could you please elaborate on what micro-meditation is. It sounds interesting! Thank you.
I would like to know too!
As a healing practitioner and educator, I have designed an entire trauma-informed program for individuals and groups that includes nearly 50 different actionable techniques for emotion regulation, stress reduction, and, thus, building a bigger window of tolerance.
Based on Hanna Somatics, EFT (Tapping), Qi Gong, acupoints, breathwork, sound, and rhythm, I designed the Mindful Motion program (www.SomaticRelease.net) to bring people into their bodies in easy and comfortable ways so that the work of healing from trauma is accessible. Using Porges’ concept of the Social Engagement System, which allows us to use particular parts of our body to allow us to connect to ourselves and others, Mindful Motion is a mindfulness-through-movement program that has been shown to reduce the symptoms of PTSD, anxiety, and depression.
I have included all of the science behind how and why these evidence-based techniques work. I gathered my information from the writings of many experts: Eugene Gendlin, Bessel van der Kolk, Peter Levine, Daniel Siegel, Stephen Porges, Suzanne Scurlock-Durana, Candace Pert, Thomas Hanna, Tom Myers, Moshe Feldenkrais, Bruce Perry, and many others.
Thank you for bringing this information forward, NICABM!
Very interested in your work, but the website is down. Do you have a new one?