How to Work with Emerging Defense Responses to Trauma (Beyond the Fight/Flight/Freeze Model)
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with Pat Ogden, PhD;
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with Pat Ogden, PhD; Stephen Porges, PhD; Bessel van der Kolk, MD; Janina Fisher, PhD; Kathy Steele, MN, CS; Deb Dana, LCSW; Ruth Lanius, MD, PhD; Thema Bryant-Davis, PhD; Ruth Buczynski, PhD
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I find this training helpful in multiple ways. It helped me to understand the responses of a family member diagnosed with major mental illness. It helped me to understand my own trauma responses. It helps me understand the responses of some of my clients while working in the prison system.
In the next sessions with my cry for help client I will engage my boundary muscles and hold to finishing on time by preparing 10 min earlier. I will revisit our last session where her very willful 14 year old part was in sympathetic overdrive, pause in that cycle, engage in ventral vagal attunement response, see if it is possible to get playful. Then examine how the three nervous systems say no to reveal more choices. Look for an opportunity to share when my nervous system reacts to her desperate cry to be experiencing faster results from our therapy in order to honor the principal of co regulation. At some point this will come to naming how her cry has unintended consequences that drive others away.
I am a LCMHC who was kidnapped in my home for 6 months by someone I met on a dating site in 2017. He lied re: his identity and quickly imposed himself in my life. After years of abuse that escalated to attempting to murder me, living with constant threats of killing me etc. he is in jail with 1 million $ bond. Living the experience taught me a great deal about trauma obviously. I spent years in please and appease, what I called containment of his emotional state for my safety. I experienced helplessness, there seemed no resolution short of disaster. When I finally realized my choice was to die rather than continue life that way I began to be more assertive, triggering more and escalating abuse. The most notable and frightening experience was how confused and unable to think I was for 2 weeks after he acted on his threats and arrest. It was like I had a stroke. I was numb and am told that I kept repeating “ he tried to kill me”.
Bodily sensation returned in about 24-48 hours, I numbed myself to endure the sexual assault focused on what I needed to do to survive. I was literally unable to pay bills, cook, for a month. Going back in the house to live was extremely difficult. It is now for sale. How a person can only focus on survival was astounding to me. Trying to eat and drink. Since it happened while I was in deep sleep, sleeping remains difficult. Feeling this experience is quite different from understanding it for someone. It is devastating. I was glad to hear about please and appease. It is difficult to understand why I couldn’t stop it. The shame and embarrassment have been strong. I haven’t decided if I will work again. But to me the feelings have been difficult to control with logic and rational thinking. Thank you for contributing to my understanding of my survival techniques.
So many valuable takeaways in today’s instruction. One thing I will implement is to intentionally activate my ventral NS when implementing boundaries when responding to clients’ “cry for help”. Thank you!
As an 81-year-old survivor of multiple traumas I have found this series invaluable! It gives me so much hope for my own traumatic healing, but also my grandchildren and now great grandchildren! Unfortunately, living on Social Security these past many years, I am unable to purchase the Gold Package, but I would like contact information for therapists in my area of Northwest Arkansas who regularly attend these sessions on helping people with trauma. I certainly don’t need a therapist who gets triggered by my trauma so that I pick up their stress and trauma to add to my own sometimes overwhelming experience! Thank you for this outstanding series.
Laura Beth Morrow
also known as:
Rev. Allorrah Be, CAHt.
Mobile Minister
Circles of Light Ministries
West Fork, Arkansas
(479) 466-6784
Allorrah.Arkansas@gmail.com
oh yes! a list of affordable therapists who attend these kinds of things would be wonderful! I hope you get a follow up answer, I’ve had dreadful luck with therapists and have had to do much of my own “blind” healing.
I am amazed at how well organized the presentation is. it crosses multiple links to understanding the complications of the work along with such helpful straggles of using feedback, language focused questions, and openness to not getting it ourselves to bring the client into the room and conversation. thank you. I really love NICABM and will purchase modules again.
An excellent resource to utilize in my psychotherapy practice. An immense thank you for sharing this series!
This was so helpful, thank you Ruth and Co.! The breakdown in the differences of please/appease, collapse/submit and attach/cry for help was enlightening. I somehow managed to clump all of these into freeze. Understanding the nuances and complexities as well as proper responses (to myself first) is really life changing. Your work is always cutting edge. Thank you for your hard work and for sharing what you find that helps us all. All the best.
Thank you so much. I am in sympathetic n s high alert for last 8 months. I will request therapist to work directly with cry attachment dorsal collapse and please appease strategies
the please appease part has helped me with practical steps like asking client: when did this part appear? can you remember the situation?
I like the polyvagal approach to addressing these responses. Especially with adolescents. Thank you for sharing your work with us. Florence- Kenya
I really love the in-depth analysis and new content. It’s long overdue in the therapeutic world at a level which should be taught in ANY psychological vehicle in training to newcomers to this field and seasoned professionals. My only gripe is that I missed all of Wednesday’s sessions on flight or flight which is present in most of my clients in one way or another as I work with anxiety a lot. Its the one I really wanted to watch!
I really appreciate the trainings I’ve watched through NICABM. This is really important work and I honestly find more social workers better trained in trauma than psychologists. So watching this is refreshing. You guys help put words to how I naturally work with clients. Pathologizing is not helpful. Understanding the usefulness a behavior served at one time is… and how it’s not helpful anymore. I spend so much time normalizing the ways my clients react to situations in order to develop a sense of compassion for themselves. I get frustrated with the medical model and the DSM when it comes to mental “illness”. I appreciate the sense of humanity and caring these trainings bring. Thank you!
Wonderful presentation! This presentation is opening up a whole new arena for me so that I can become more aware, and use my own body reactions as a bellwether to more closely attune to what is going on in my client’s inner world.
Module 3 – Very helpful and practical training – thank you.
Key learnings for me were the reminders and demonstrations of how to anchor in ventral vagal energy/ engage the boundary muscles while maintaining warmth for Attach Cry Response,
Reducing stigma in labelling of trauma responses as “treatment resistant depression” vs understanding the learned helplessness response. Regarding the 4 ways that collapse/submit may present I wonder if this psychoeducational teaching for clients could also be linked to Motivational Interviewing style intervention – highlighting the ways in which the response impacts on work, relationships, daily living etc / then looking at the ways in which the response may be perceived as helpful etc.
The languaging ideas to name the presence of the Please/Appease in the therapeutic relationship, and also recognition of needing to be cogniscent of when as practitioners we can miss this is happening/because it feels good to get praise/feel we are helpful etc(!) also very helpful. Thank you for these valuable teachings.
I would like it if you could do a quick recap of the ideas presented at the end. I like to listen attentively and then take notes.
So much new learning in these fields! Book and online recommendations would be helpful too.
It’s an eye-opener to realize that ‘Please and appease’ is a survival response. The impressive social skill can so easily mask the underlying fear and dread of a therapist’s ( parent’s ) disapproval. If the client ‘seduces’ the the therapist, then nobody wins. I wish more was presented on how to counter the clients behavior. Deb seems to have the a helpful strategy for getting the client to recognize their self-censoring ways by ‘getting on the same page’ and letting the client ‘be real.’ Because the patient so idealizes the therapist, it was interesting for therapist to reveal their own insecurities or imperfections. This allows the ‘child’ to feel ‘safe’ with parent-therapist.
In direct response, the information provided has helped enormously, in adding, modifying, adapting and for me personally confirming my knowledge and experience base. Really great to hear so many affirming expressions of dynamic interpersonal relationships, in particular ‘a human doing is a human being…who are we when we are ‘being’. My the thanks again for all of the people who made this possible. Power On !!.
regards
Duncan
I was immediately drawn to thinking about a patient who flatly denies over and over of any trauma/ dangers experienced in life but her dissociations, collapse , helplessness, and tendency to give me only “news and views” sessions ( please / appease) inexorably leads me back to wonder about history of unexplored dangers in her life. Something possibly about me feels dangerous because she is so push pull ( ambivalent) toward me. She was literally fired by her last therapist who expressed anger that she “couldn’t do therapy”in a phone call I made to explore what had happened. She obviously activated the therapist’s sympathetic fight reaction. I will see how this paradigm fits. Thank you.
In the past, DID was difficult to diagnose and treat. Clients were resistant and many clinicians were not trained to recognize or treat it. The motivation to be in treatment needs to come from the client. The current psychotherapy tools and knowledge for dealing with DID clients are new and specialized. The clients’ responsibility and willingness to participate in the clinical process is key. That is a good take-away from today’s session. The session also indicates how essential it is that therapists be adequately trained to be effective. Clients need to be willing to engage with the process of DID treatment, which is highly specialized.
In the past, in my experience as a non-clinical pastoral counselor, it was often reported that DID clients resisted clinical treatment or were released or “fired.” They shifted to pastoral care, but that was problematic. They often have child or inner parts that try to shift the responsibility onto the professional care provider. Or their child parts constantly test boundaries.
A client’s amnesia and reluctance to recognize a dx of DID might be why previous therapists are not able to be effective. The therapist was wise to dismiss the client. In my experience in the past, I observed severe DID clients have extreme difficulty in recovering.
The information and insights provided here give therapists tools for recognizing clients’ nervous system responses that are newer methods that did not exist ten or twenty years ago.
I had experiences as a pastoral counselor, but not as a clinician, with clients who had been unable to effectively work with the methods of clinical psychologists.
They also did have their own support systems. I witnessed the damage their DID system inflicted on some therapists. After years of my fruitless support of them, they revealed they had been dismissed or “fired” by previous clinicians. That was when I was able to release them completely.
There are many ways clients manage to be unable to be helped by the limitations of methods of specific therapists or methods. it is challenging for us not to personalize this. But DID clients can be harmful. It is really up to the clients how motivated they are to do the work, and sometimes “synchronicity” that they find the right person with the right knowledge.
I understand how the things explained in this video apply to client-patient relationships, but are there resources for clients to use this knowledge in the real world, not just experience it in a therapeutic setting. I.e. how to move from dorsal vagal to ventral vagal IN a situation, so that collapse/defensive responses aren’t the only ones available?
Hi Elizabeth, that’s a good point. In my training (the Human Givens approach) we learn how to ‘rehearse success’ during guided imagery at the end of each session (that is, whatever success would look like for the client). So, in this case, once you have taught the client some strategies of how to respond differently (in a ventral-vagal way) during the session, you find out from them what might be the next time they would need to use this new response, and then, after getting them nice and relaxed, you help them to visualise and evoke how they will act in the way they would like to. Usually, this would be two-fold – firstly imagine they are watching themselves in a ‘video of the future’ and then, going back to the beginning and getting them to imagine actually doing it. This is just one option and I’m sure that there are others, but if is very effective.
Learning about the attach/cry for help response was quite helpful as it helps me to understand the dynamic happening with a particular client. I now have strategies to help her! Thank You.
I have a question from last week’s presentation. One of the speakers indicated that one of the signs of dissociation (or DID) is when drugs and supplements have a paradoxal effect. Why is this?
Thank you! The class is fascinating.
SSRI’s can be very activating to anxious people, who are exquisitely sensitive to any perturbation and interpret it as dangerous. Only St John’s Wort is a supplement SSRI-ish enough to do this I would think.
after falling into the please and appease pattern in order to maintain a relationship with family members, i was able to say, “meeting your needs at this particular point in time is jeopardizing my own needs “. however, the repercussions to mutual cooperation and understanding remain to be seen.
This is a practice changing seminar. Thank you for offering it for free. I see so much more in my clients behavior that is evidence of their poly vagal system needing regulation. Learning to read poly vagal or somatic signals has been made easy here. Watching Janine, Pat and Deb to name a just few has given me more confidence helping clients learn to regulate. It has also given me insight to my own survival strategies growing up in an unsafe household.
I have been receiving these invites for ages and finally tuned in! So glad I did! though I am retired from practice, I am a survivor who is about to start therapy again after a long absence. All of this makes so much sense in my own healing or lack thereof. You have given me a new language to engage with my therapist! I also am a novelist whose two main characters are both survivors and the mother is a therapist! Lots of material to digest! thank-you and I will be back!! Renée B.
Speaking nervous system to nervous system – really helpful.
Thank you
Need explicitly to explain three states for client who when scared/anxious/indecisive/“depressed” retreats into darkness on screen and long silences. Also experiment with not just letting client write when stuck in silence (a way to share feelings in writing when speech was inaccessible) but maybe will try suggestion to lift self into physical spine-lengthening and pushing back.
The topic today “How to Work with Emerging Defense Responses to Trauma (Beyond the Fight/Flight/Freeze Model)” helped me understand more about stress and trauma using the lens of neuroscience and mindfulness. Using this perspective, I conduct stress management programs in schools and the community, which has worked well. The polyvagal theory, the importance of the awareness of neuroception and mindfulness-based interventions are very important in my area of community work. Thank you NICABM for the opportunity.
I am recovering from my own complex trauma experience of being unheard scapegoated child with a predominantly fight response .where being unmeshed was dangerous and disloyal
I am.developing my own compassion for my pain and more important any appreciation of my own resilience in healing journeys .
your sessions have been very valuable ..much gratitude for all of you
I’m going to use the information in my personal life to better understand family People Pleasers, and to try to figure out why they bother me so much.
I find these lectures so helpful regarding the connection of mind, body and spirit. I think it is important for my practice to help integrate what my clients are feeling physically which can help them look at what they feel emotionally especially when they are shut down. Thank you all for sharing your wisdom. This seminar has and is helpful in looking at the entire soul of a person versus just only one aspect. I hope this makes sense. Thank you again.
thank you, excellent info!!
I found the reference to W. E. B. Dubois’ double consciousness immediately applicable, especially helping people identify how they may act, speak, or self-censor as part of a please and appease survival strategy. Related questions I found helpful include “where did you learn that?”, and “how can we help you tune in now to your needs and views, and how can we develop alternate ways to respond?” I especially appreciate bringing in W. E. B. Dubois and these questions, as it helps in recognizing that sometimes there may be structures, systems, and societal processes that go beyond and are bigger than the individual, but that the individual can develop alternative ways to navigate within these systemic or structural realities that may be more true to themselves.
Yes, thank you for mentioning the marginalized groups ‘erasing’ the self in order to accommodate the expectations of the majority group. Just like a ‘please-appease’ child, these folks long to be ‘whatever we want them to be.’ As a child I learned to ‘think and see’ through my mother’s head in order to avoid her rages. Self-abnegation, it’s no way to live..
I can see how empowering psycho-education can be to understand the polyvagal theory and the adaptive and protective nature of trauma responses- at the time of the trauma. And how the after affects in chronic can be so maladaptive and disempowering. The languaging from these experts and examples of what they say and do with patients are so helpful. I love the idea of using my boundary muscles. For me, to stay in ventral vagal state and social connection with warmth and inner strength, I use a technique where i drop back into my back-body, centring in my wombspace and spine and feel my energy within myself. I also ground that energy and resource from the earth below and ‘source’ above, so I am not just limited to my personal energy. I love how these sessions help me to realise the patterns I have used throughout my own life in various situations and how I might re-program my habitual responses with new options and choices that are more empowering. Very powerful to hear about the please and appease from the perspective of a “Black person” in a “White dominant environment”, hacing to be attuned to two cultures running at once…I also really appreciate the therapists describing what to do in the moment when these responses are triggered in a session- regarding pausing, naming what is happening and then trying something differently, starting over. Especially when we recognise it has been missed. I feel like this is very empowering as a relatively inexperienced therapist. Thank you for this great webinar and program!
I am a neurodevelopmentalist working in reentry and complex trauma. For many with criminal justice in their histories, please/appease is the top layer of many responses, due to judicial oversight. Working backwards from this layer is particularly important as they return to citizenship.
Thank you
I am a bit of a lone tracker but I always learn more to keep on going
With best wishes 🌺💖🌺😘☕️☕️
I would like to pay attention to, be aware of the nervous system state in me and also in my clients and by investigating and sharing my own state have them be in touch with theirs. Thank you for the excellent segment!
Although reasonably familiar with Polyvagal supported Traumatherapy, new to me was:
– the saying `yes´ and `no´ from each of the 3 states nervous system states (my own and the client’s way of doing this)
– being open to and recognizing the desperation in the (for me sometimes excessive) `cry for help´ response which previously often seemed to me manipulative and invasive.
– activating boundary muscles in my own body to help me deal with the attach/cry response so I can continue to speak with a warm voice while maintaining a contactful boundary.
– appreciating the differentiation between the collapse response & depression, I tended to equate them.
This is so helpful! Thank you!
Working with my clients, I can put a framework on the way they have learned to cope so as to survive, and how this is directed by the brain (heroic), so the client is actually heroic in their adapting to difficult life environments.
It gives me direction with an Attach/Cry client, one being working on developing boundary muscles.
Collapse/Submit, from learned helplessness, going towards learning to say no, and yes!
Please and Appease, clients can disagree with us. If express they don’t want to let us down, we can ask how our own behavior/presence in session leads the client to feel that way?
My biggest takeaway today is that first discovering how the client learned any of these survival responses, then playing with going in and out of the three different states helps clients become self aware, self compassionate, and helps them learn self-regulation that starts to transform the ways they respond in their close relationships outside of therapy.I noticed that I can relate to all these trauma responses, and wonder if there is a spectrum of trauma responses for many people who have lived in addicted, abusive, abandoning family systems throughout their childhoods? For me, what is most striking about this course is the teaching of non-verbal ways of working with people and teaching them self-regulation skills that are likely to manifest in healthier relationships with their loved ones.
I thank you for your dedication and the advices you gave, I am working with light to support people’s energy system.
But how you present it, your kind words, is really helpful!
I wish that I could present Light to you, to support many of our traumatised friends
Love and Light
Leona
This has provided a lot of material for self-reflection (reconising the Please/Appease in myself!) and ideas I want to explore further in relation to working with the nervous systems. I wish I could afford your training package, but sadly I cant, however I am so grateful for your free webinars they are so helpful….thank.
This was a really interesting session and I look forward to learning more in the coming weeks.
Thank you for offering this free training. In these times I am super grateful for this resource.
Lots of ways I’ll use it — wondering if please- appease is the psychological version of “freeze”. If you can’t flee or fight, you cry desperately for help. If no help, you freeze. In this stage your sympathetic system is still highly engaged, but you are immobile. In the physically functioning human, what becomes “frozen” or inhibited are one’s OWN needs, wishes, impulses etc.— one’s authentic self goes into “freeze”.
I know please and appease as “fawn”. I know for myself I have had a tendency to freeze in fear then pretending to be okay and speaking with a normal calming appeasing humor-filled voice, (possibly being extra complementary, certainly super attuned to the person I fear, possibly extra warm and affectionate…. that’s how I survived). This is a kind of special combination they talk about at the end of the video I think. My nervous system tends to be frozen in that hyper-vigilance, plus the fawning which I feel may well have began in utero of a mother with unpredictable uncontrollable fits of rage. Working to transform and heal.
Dual-consciousness is very common in several communities.
Great training, thank you. I like that we, as therapists, can check in with ourselves and our clients regarding the state of our nervous system and how it is responding to them. I also like the idea of letting a client know that we can disappoint or trigger them, and that’s okay, and that they have permission to disagree with us. So much good information.
Thank you! This session brought at least two patients to mind, for me to more deeply understand how to work with their early childhood traumas of not being safe in their inner or exterior worlds. Very very helpful. So important to distinguish the differences in Cry for Help, Please/Appease and Dorsal Shut Down. Very grateful ……
Tina Chase, LMFT (CA)
Excellent presentation. It tied into my experience with trauma clients and personality disorder clients. My main comment is that, although the speakers wanted to differentiate from borderline PD, BPD is also often rooted in trauma, and the various treatment methods that have been developed can be integrated into your approach. Also interesting – submit can look like dependent PD, but can have different roots.
Agree totally. Abstaining from using BPD helps me stay empathic
try différent strategies with my patients, thank you
I am inspired to become more attuned to my own nervous system responses both in and out of therapy sessions,both for my own well-being and also as a “tuning” fork for me to use to co-regulate with my clients in that phase of therapy. Thank you!