Strategies to Treat Patients Trapped in the Freeze Response
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with Bessel van der Kolk, MD;
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with Bessel van der Kolk, MD; Stephen Porges, PhD; Ruth Lanius, MD, PhD; Pat Ogden, PhD; Thema Bryant-Davis, PhD; Bethany Brand, PhD; Deb Dana, LCSW; Janina Fisher, PhD; Kathy Steele, MN, CS; Ruth Buczynski, PhD
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I will try to help clients celebrate the skill they have to freeze rather than add to their negativity of their experiences of freezing. I really like that idea . It’s logical but not something I thought about before. Thank you for bringing it to my attention.
Thank you for offering these sessions. I am using this information in my work in leadership and organizational development; creating healthy workplaces.
Hi Ruth
I’m very happy to participated of this master program. I work since 1978 how a Junguian Psychotherapist with children and adults in my own office. My approach envolves always psique and body. My master degree was in Psychosomatic and my teses was with sheltered children and resilience. Today we have an ONG that works with prevention of violence ( particularly domestic violence). I am watching the videos when my time allows. I learn a lot with Peter Levine and I’m a practitioner of SE. The neurobiology of trauma changes my clinical view and the work with my clients. I thing that we learn to work with respect and compassion against the pain of our patients. A lot of gratitude for this opportunity. My English is not so good, sorry about this. Neusa Sauaia
This was a truly EXCELLENT session! Very well curated, with pragmatic tips that felt immediately accessible to apply! I have been watching a lot of sessions in Free Conferences over the past few months and I have to say this was one of the most valuable so far. The Study Guide, the pace of the presentation, the quality of video editing of the different people–it was all very very well done! Thank you so much!
Thank you so very much for this free presentation on the freeze response. I cannot wait to experience the rest of the modules in this series!
Feeling grateful to have more tools in my arsenal to help people I cross on my path. I do not have clients but as a future ships captain this is invaluable knowledge to ensure the health and safety of crew and passenger. It can be a highly stressful environment.
I have witnessed people freezing at heights when climbing the rigging. I feel more prepared for the future to help them come back into their body and continue holding the fear that keeps them safely holding on and releasing the extra tension that stops them progressing.
Thank you for the work you’ve done to bring this to so many people. You should be very proud of yourselves! Looking forward to the next sessions!
Thank you for the opportunity to use this information in my volunteer opportunities with children. As a retired pediatrician, I know some of these children have been traumatized and a concrete approach as that described in this presentation will allow me to reach more of them and provide a safe learning environment.B
Excellent presentation, so well planned and presented. What a privilege to be privy to this knowledge. Thank you so much!
As a Gold Member, I can say that I am definitely glad I have access to the series to watch over to internalize the material. I was able to reflect on current client and how the techniques would be useful in the here & Now….Thank you
I really enjoyed learning from others and sharing their experiences in practice. I often use the body movement approach and the grounding techniques to engage clients experiencing freeze response and I love it when Dr. Ruth noted that oftentimes freeze response has been mistaken for the unwillingness of the patient in therapy.
Thank you so much fir this great webinar especially as it’s free which is very appreciated. I’ve watched this over 2 days and missed bits in both broadcast. The key thing I missed both times was the beginning…. presumably how to recognise the frreze response. Can anyone please tell me how I can recognise it especially at a more subtle level that I may not recognise ordinarily as the freeze response?! Thsnk you.
Always great to hear very recent/current developments in the treatment of trauma.
One thing that you didn’t mention about being careful to go slowly when helping a client come out of the freeze response is that moving too quickly can sometimes trigger a rapid switch to either the fight or flight response. This sudden switch-up can be dangerous (fight) or end your work with the client if they flee.
I’ve done this on both sides: when I was in therapy, it took years longer than necessary because I was either too ashamed to admit I’d over-reacted or I assumed the therapist really didn’t care what I was experiencing so why go back? As a therapist, I’ve gotten excited at the prospect of helping someone and pushed a little too hard (in spite of my personal experiences) and lost the client’s trust. It took me a long time to recognize what I was doing.
Excellent presentation, very clear and we’ll organized, thank you.
EXCELLENT. It’s wonderful to hear new things of the past 3 years! I thought that your previous trainings were great and up-to-the-minute, but there were many new & practical teachings in your training today. Thank you!
Would you consider helping therapists in Ukraine who do not have the money to pay for the sessions? This would help them tremendously. Please contact me. Marika Paquin OTReg.(Ont.) Occupational Therapist, Psychotherapist
Great! Didactics and content! Thank you
Thank you for sharing this knowledge in a systematic way with examples and repetition. Helps me to organise myself in nowadays interventions. Look forward to see the next chapter, next week!
That was terrific! I really appreciate the way you developed a coherent teaching
narrative by introducing themes and having the experts speak to them. Looks
like lots of listening, thinking and editing went into this production. The only thing is that I am
not sure you spoke of how clients can address their freeze states in between sessions.
Maybe just having them apply what you did in session? I might have missed this!
Thank you for your work!
This needs to be shared with Police Departments.
I love these webinars because are great reminders of forgotten learnings and an opportunity to reaffirm or to correct or to start implementing new insights and knowledge to my practice.
I thought this was excellent. Very much needed, professional informative clear communication. Thank you.
I gained an overview of the freeze response, how to detect it, what to avoid doing and what to do for the client. I’m a counselling student and this is very helpful. Thanks!!
I hope this will be addressed more in future sessions:
I totally understand how helpful it is to have a therapist or other helping professional present who can help someone through a freeze response. But I’m still not clear on how someone experiencing the freeze response can help themselves — even if they’ve learned some of these techniques/tools from their therapist — considering that being frozen incapacites the cognitive “executive function” to either (a) remember these tools (like deep breathing), or (b) be able to apply them when they are so dysregulated?
How can someone in a freeze response without a therapist handy, or someone else who can help co-regulate them when they’re frozen actually apply any of these techniques when they’re frozen?
How can someone who is frozen even recognize that they are frozen when a therapist isn’t there to help?
Hi Bambi,
We are rebroadcasting the first module today (10/15) at 11am and 2pm Eastern Time. Please contact us at respond@nicabm.com for further help.
Hope this helps.
I found this fascinating! As a lay person, I have often noticed that “rabbit in the headlights” response in other people (children, adults) where they are definitely incapable of taking in anything that’s said or happening around them. So glad to know what it is now and to understand what’s going on, even if I don’t know what triggered them. But it’s a lesson in observation, and then stopping “business as usual” and realizing it’s not the time to carry on as usual with that person.
My question is…then what? In a therapeutic setting, or as professional, this would be hugely helpful. But in inter-personal relationships, then what? If it notice this in someone I’m talking to, what do I do? What is the appropriate response in inter-personal relationships (say, with a partner, an adult sibling, a co-worker, a neighbour) when I notice these freeze responses? I can see regulating my voice so it’s quiet, slow and calm. I can see offering the suggestion to pause and just breathe deeply. But other than that, what’s appropriate for someone in purely inter-personal relationships, whether neither person is a therapist or a helping professional?
As a 3rd year student, I am so grateful to be able to access this wonderful program free of charge – thank you all very much!
My chosen dissertation topic is on Trauma (focusing on dissociation), making this information invaluable. I also look forward to applying this new found knowledge when working with my clients. Can’t wait for next weeks module!
I guess this workshop coming in during the Pandemic is like a ray of hope even for those therapist who do not necessarily work with Trauma client or are trauma informed trained therapist. having the knowledge of freeze and how clients responds how we may / may not respond is a way of making online sessions a lot more easier and a safe space as well since it helps therapist look for Signs that may now indicate freeze and not necessarily avoidance ( due to anxiety). Having permission and including it mindfully in our session can help us slow down with clients. Just very curious about if Freeze response may differ with the issue being Trauma triggered .. or anxiety/ depression triggered.. or would they all be same . The Pictorial guide is so immensely helpful especially for therapist who rely so much on visuals. thank you so much.. This workshop is definitely adding so much space for me to give a ground and center my intentions with my knowledge while I work with my clients.
Thank you. I will apply the tools in my practice with clients. I already use several of them, but it is good to be reninded 🙂
I am really enjoying all the information and training from nicabm however as an O.T with over 30 years experience in CAMHS I am puzzled that there is no mention of Sensory Integration in terms of theory or treatment as O.T’s have been doing this since the 1960s and know all about the benefits of proprioceptive input, gravity blankets, sensory processing and the neuroscience (Jean Ayers) etc ……
I’ll use these to increase my mindfulness and attention to others in all situations as friends and family become more traumatized or retraumatized over world events and in activist groups/training. (Retired from nursing/mental health counseling.) I also related them to my own personal experience in trauma therapy several years ago and realized what a gifted therapist I had. I am very grateful for free access to this program as I have read many of the presenter’s books but am not able to finance extra courses now.
The impression I got, Debra Carriere, wasn’t that “talk therapy falls short” in general, or in all cases, but that it’s a matter of discernment, what technique or approach works best in different situations. Different strokes for different folks, and at different times. This comment was made specific to the freeze response. How can someone in freeze, who may have lost the power of speech and cognition, benefit from talk therapy? Later, yes, of course, they can. But isn’t it helpful to have as many therapies, approaches and techniques in one’s tool-kit as possible, each with their own strengths to contribute at different times, as needed?
As with any tools, you don’t use the same tool for every task. We choose the tool that’s most suited to the task at hand.
I don’t think the comment was meant as a criticism or rejection of talk therapies, but as an acknowledgment that other tools are needed in certain situations. Both/and…about expanding options and resources not just for the patients/clients, but for therapists and other helping professionals.
Move slowly and patiently. Allow time for the client to catch up. Moving too fast can exacerbate their triggered reaction and possibly increase fears and defenselessness.
This was very thoughtfully put together with clear, concise and organised information. I appreciated hearing the perspectives and methods from so many different practitioners. Thank you!
Well delivered and profoundly useful…
In a cognitive society, exploring somatic response may be a breakthrough for so many “stuck” patients!!!
What an excellent start to a 5 segment program that looks inspiring and pragmatically effective! Megwetch. (That is thanks in the Ojibwe language)
I am not a practitioner, but a person devoted to healing from childhood trauma. I liked Pat’s 4 step plan, particularly pinpointing the time right before a freeze (response), when the body is still able to move (I had never heard it explained like that) and asking myself what I might have wanted to do. RUN!!!!!!!! And as she said, it gave me pleasure to do that. Thank you.
Wow!!! Thank you this was a wonderful Webinar which I found very helpful and insightful!!! Many thanks, Karen Delves-Hay
I am so glad I watched the program today as I missed most of it yesterday. I was most informative. I almost did not attend this morning. I will be sure to watch the rest of the series. Thank you. Lani Westervelt LMFT in Lockeford CA
What a wonderfully informative session! Now I can help not only my clients, but my traumatized daughter as well. I love the variety of therapists. Wish I didn’t have to wait a full week for the dissociative session!
Thank you so very much for making these free videos available to us.
Soooo helpful. Thank you.
Thank you so much for making this available. A lot of food for thought. Looking forward to the next 4 weeks!
Excellent!
Thank you.
Good morning, Dr. Buscynski,
With all good intention to view the entire webinar yesterday, I missed the first 4 or 5 minutes (due to a technical problem on your end) and the final 10 minutes (with a with a tree removal) issue on my end. But the quality and clarity of the discussion in-between was superb. If possible I will catch the missing portions today. I was really glad to hear you advance the notions that this material is not only useful, but really applicable to folk whose engagement with other is not a medical practice. It confirms that you value feedback from “students” and that you strive to help us understand the broader applications of the disciplines within which the psycho-social being is addressed. I had previously written to say that, as a spiritual counselor, I was concerned to understand therapies used with TBI/PTSD patients so that I could responsibly avoid interfering with the medical aspects of this therapy. While some of my peers find my position odd, most counselees are appreciative.
On a second visit one of them TBI expressed his gratitude that I had taken time to investigate about the neurological and physical aspects of some of the therapy he is undergoing. His family has trouble relating to some of the therapeutic activity, but he feels comfortable (natural was his word) when I recognize a practice that his physical and/or neurological therapists utilize and can affirm it as how God has designed our bodies/brains to work for our protection and healing. Two personal/professional comments regarding the benefits I receive and I’ll get on with my morning routine. First, I am working with a local city jail chaplain to become a volunteer in her chaplaincy program — when and if the jail she serves opens up to volunteers again in a post-COVID-19 future. Something I recognized in conversation with her is how brain and trauma information covered in Dr. Bessell van der Kolk’s “The Body Keeps the Score” seems to have far reaching, unrecognized application to most, if not all incarcerated persons. The reading I have been doing on the history of the development of the penitentiary system seems to ignore the significant life history of most incarcerated persons. The history of jail and prison chaplaincy and volunteer ministry (at least the Christian involvement) appears to have the same shortfall. Should I be accepted for a D. Min. program that begins next year, I plan to focus my 4-5 year studies on combining the two healing disciplines, religious/spiritual and neuro-psycho/physical in the restorative “treatment” of incarcerated persons. Second, I want to thank you for the “free” access you are providing for these NICABM events. My retirement budget would not accommodate paying for them and all the services that I provide to the church and to individual counselees are without remuneration. Your gracious, on-line support is accepted as God’s providence for me and for those I serve. I thank you and pray for your success. Carol E. Bayma, M.Div. Candidate for Ministry (PCUSA)
It was very interesting, I have not had a case of “freeze”; it’s always important to be ready for new type of clients. I took note and wrote the names of the presenter. Thanks for giving us the opportunity to see a for free a day. Im very grateful. The COVID19’s times are very dark time. I don’t work since February, when I got it. Thanks God a very good friend treated me well and I responded positive, despite being a diabetic person.
Well, Ruth God Bless You!
Aida L Redondo
Some very useful tips thank you. It’s good to know not to look them in the eye and be slow to get them to move. Also useful to know that a client who freezes might still be able to nod and shake their head or move their eyes. Important to know not to use empathy in these circumstances. Looking forward to the next one.
This session today was excellent. I thought of four clients at four different age-levels, all of whom experienced major trauma and have physical symptoms that are probably related to, or made worse by, the trauma. One is a man in his 60’s who had a close family member die suddenly in his arms. He was close to suicidal when I first interviewed him and too frozen to discuss what had happened. He just wanted to share positive memories of their life. I acknowledged the positive memories and indicated that the traumatic part was something that they had also shared…it was their trauma story and his decision if, when, how, and to whom it would be shared. He relaxed and came back for more sessions, letting me know about his progress in simply getting up, getting cleaned up, getting meals for himself, and wanting to come back to meet with me more often. I think that it is so important to proceed slowly when there is major trauma involved.
This person had never owned a pet, but asked about a therapy dog we have on the premises. I shared information about emotional support dogs, service dogs, and therapy dogs. The next day, I received a message from him about pursuing the dog option. The rest of the story is one of my favorites. He himself chose discussion about the wished-for dog as a metaphor for what he might need to recover. When he demonstrated signs of freezing, I was able to help him transition to his thoughts about what kind of dog, how the dog might help, etc. His breathing and physical demeanor would change immediately as he spoke about this…
He spent weeks searching for the right dog on-line and decided on one with a disabling condition. He said, “We are both broken and can help each other.” With the help of a trainer, this dog actually did get to the point of a being a service-dog-in-training, one that is now welcome at his doctor’s office, in the restaurants he likes to go to, etc. Through the dog, he has developed an entire new support system involving neighbors and other dog owners he never knew. The trainer is helping him train the dog to apply the deep pressure you discussed today, something that the dog began to do naturally without even being fully trained, The dog helps him with hyperventilation and has already intervened when he is triggered by the sound of an ambulance or other reminders of how his family member died. His physical symptoms are becoming less severe. If the covid pandemic hadn’t occurred, he probably would have had the dog in my office with him. He always has the dog with him when we have sessions on telehealth.
The second client situation involved a girl referred after she froze on the witness stand at a preliminary hearing when she was cross-examined by the defense attorney for the man who hurt her. I was being asked to help her with the post-trauma symptoms, not just associated with the crime itself, but also from the nature of the cross-examination. (This cross-examination was so inappropriate that it left many of those who witnessed it outraged and somewhat traumatized.). Again, the therapy dog metaphor was used…She loved the metaphorical story about how a specific type of dog had been bred, in part, to keep the children warm in Siberia and in other Arctic-like places. Her mother discussed actually saving-up to purchase this type of dog at some point after the actual jury trial took place. She had several months of therapy to process the traumatic components of both the crime-victimization experience and the traumatic cross-examination. That stuffed Samoyed puppy was with her constantly during therapy and at home in-between sessions. She used it herself to provide deep pressure intuitively as she processed trauma and planned for the upcoming trial. I used the dog metaphor as well, to help her when she began to freeze up. That stuffed dog took a real beating as it helped her develop a sense of agency in practicing how to set boundaries with the defense attorney if he tried the same line of questioning at the trial. It helped her develop her “power words.” Because she wasn’t allowed to have the stuffed dog with her in the courtroom, I asked her if she would like to have a big, powerful police dog either in the court room or right outside of the courtroom while she testified. She agreed and was able to see the police dog ahead of time. The strategy worked well. We had given her permission to focus visually on the police dog, and to hold a small object to focus on and use if she began to freeze. Her trauma-processing isn’t over yet, but I was told that she did very well in testifying and was very effective in both setting boundaries with the defense attorney and in responding to the cross examination in a way that had a powerful impact on the jury.
Thank you for today’s session. It was very helpful. I haven’t taken the early-bird bonus yet but wish that I had more information about those five example sessions you mentioned today. Are they observational or do we, as providers, actually participate?
Hi Meg,
Thank you for your kind feedback, it means a lot. Our courses are primarily observational, but the Gold Package comes with video and audio files, transcripts, study guides, Critical Insights and Focus on Application sessions for a more immersive experience.
Hope this helps!
Thank you for this important content. I am grateful it is free.
For therapists and lay persons who are attending, Hans Selye’s model, mentioned in the welcoming comments by Dr. Buczinski, is mentioned in the Appendix A of Adult Children of Alcoholics along with R. D. Laing’s concept of ontological security (ACA Big Red Book, pp. 621-32). Many other early pioneers in family generated PTSD (now called C-PTSD) – where caregivers harmed their children – where the “mother” was not “good enough”(Winnicott) – where violence was learned and tolerated as “normal” – have helped heal and shape the consciousness of Adult Children. The “recovery” from the 14 Laundry List (Tony A.) traits is not just about healing me, it is about me choosing not to continue the dysfunction. For me, this has taken the shape of learning to love my inner child(ren) who found incredibly adaptive ways to survive madness I was born into and to understand there is no shame in human vulnerability.
I have been helped by each of the presenters here. I have read each of your major books – they are on my bookshelf. I have watched your videos on you-tube. I have an unofficial PhD from no-where university from no-city USA, after quitting a graduate program in 1997 because I saw that it would leave me hundreds of thousands in debt.
I am fortunate to have the gift of intellect, but this has not been what has healed me. Being able to experience myself in safety while in the presence of others in an ACA room, gave me this nervous system co-regulation before their was a professional name for it. For anyone unable to afford $100 – $300+ sessions with professionals, or for professionals who are willing to consider it a helpful supplemental support for their clients/patients, the ACA program is amazingly healing. The Laundry List trait workbook upends the victim-perpetrator-rescuer triangle loop. ACA addresses healing at the level of Body, Mind and Spirit. ACA has freed me from toxic shame, self-abandonment, and learned helplessness. Professional therapy has also helped (IFS for a year). I so much wanted to try Ogden’s Sensorimotor – but all the therapists in my area were full to capacity. I am grateful to ACA, to the internet, to Google, You-tube, Vimeo, libraries, and each of the therapists who made presentations here. Your work and research has been truly beneficial to me, and I think, to humanity. But ACA gives me the support I need – a loving family – people with boundaries, self respect, and integrity. It is a great combo. Thank you.
There are some wonderful insights from this session.
Many ideas were very important refreshers/reminders for me or expanded my understanding. One example is the idea of two nervous systems communicating. Here it was expressed as a dys-regulated nervous system being able to be brought into a sense of safety by a regulated nervous system when the right pacing and tone is found for that person.
Unfortunately, with two dys-regulated nervous systems, the outcome can be explosive, leading to DV for example.
Also, there was the implied reference made to the possibility that practitioners could panic when a client has a powerful freeze response.
This is an important point to bear in mind and prevent through being prepared; otherwise there would be two dysregulated nervous systems, even if briefly, and this would be very unhelpful for both, especially the client with less resilience. It also made me consider how teacher-student and police-citizen relations can spiral down or ramp up explosively very quickly where trauma is involved.
Other ideas presented were new to me (eg. using a pulse oximeter to gauge O2 levels when doing breath work, because levels are lower in people who’ve experienced deep trauma ) or were not new but offered explanatory background (eg. weighted blankets and deep pressure acts on the spinal dorsal meniscus which improves sensory integration and spatial orientation). If this is not correct, please correct me.
Thank you.
I meant to also say that there are very useful suggestions here to help with the teacher-student or police-citizen situations; also medical practitioners-clients. There really is room for this sort of professional development in all these fields.
Thank you Ruth for such wonderful facilitation! I appreciated how you summarised on a regular basis. The pace is not too fast allowing for excellent note taking. The embodiment of unfreezing from trauma (survival) reaction is an empowering process!
Being a patient at times myself suffering complex trauma and ptsd I can assure you talking does “fall short” as effective support lol I really liked how that was put!
Love, love, loved all the learning. So appreciate all the practical tips of ways to help people when they are in freeze, but are safe now and need to be supported to get back into their window of tolerance. BUT, I kept ‘shutting down’ while watching it. Almost falling asleep. I wondered if in a weird way I was going into freeze as I learned more about freeze! Did anyone else experience that?
As a survivor of abuse, and here to better understand what I have been through, I am stunned with the information so far. I have repeatedly “frozen” in sessions, not understanding what it was or why I did it. Feeling so ashamed for my actions/in actions I never went back for help to that therapist, also ashamed of how I treated the therapist. Right now I find myself trying to breathe and listen to my body so that I can take in what I have just heard.
My deepest thanks to each of you being so tender and compassionate about your willingness to help those in need.