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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As a non-therapist I just want to share a hunch here and wonder what others think. It has to do with clingy mothers who love their children SOO oppressively much and expect the children to love them back the way they need to be loved. They end up trapping and confusing the children in the process. In light of the Emerging Defensive Responses my sense is that clingy mothers involuntarily confuse the DEFENSIVE state of Attach Cry for Help with the SAFETY state of love and attachment. I wonder what others think about that and whether there are any strategies out there for beginning to help children of clingy mothers. I’m thinking of a particular scenario where the mother is actually ill now, so she really and objectively needs special attention to keep her from relapse, which further narrows the options available to her teenage daughters. Also, I’d like to say thank you to the NICABM team for presenting the Emerging Defensive Responses so clearly. It was news to me and I’m really thankful.
From Daniel Chang Li, Registered Psychotherapist, Toronto
Hi, Dear Dr. Ruth Buczynski and other Leading-Edge Doctors:
Thank you for your very important series of workshops, neuroscience and neurobiologically-based, on how to understand trauma and trauma reactions, together with treatment suggestions. I especially agree with you: after fight-flight-freeze reactions, there should be other stages on: Attach/Cry for Help; Collapse/Submit; Please/Appease, as defense mechanisms.
I personally think your Collapse/Submit stage is the most important, and others may come under its umbrella.
For years, I have been talking with my colleagues, that I believe there should be a 4th stage or even more trauma reaction stages, after fight-flight-freeze reactions. I termed it as Disintegrate-Decompensate stage, roughly the same idea as your Collapse/Submit stage.
At this stage, the Window of Tolerance has been dramatically reduced, close to nil. Huge anxiety, severe depression, suicidal ideation or behavior, and very difficult relationships and inflexible handling, may appear.
As for stage of Attach/Cry for help – referring to looking for insecure attachment, I personally feel it could start even before fight-flight-freeze stages, sometimes.
Please/Appease is an interesting stage and reaction, esp. for children. A lot of traumatized children, abused or neglected, have to make adjustment in order to survive. However, their approach of adjustment is malleable, and it is intrinsically not a healthy change. Their malleability will eventually show up as dysfunctional, because the change falls in dysregulation.
Finally I want to say that I especially admire and enjoy your insights, wisdom, and respect your wish to help improve humanity….
The above is just my cent of thought, as a learner in this field….
I am a nurse practitioner in psychiatry, but I also have 3 fost-adopt kids who are now teens. This information is such a valuable resource as I tread the waters both with my patient population and my children. <3
(also, you may want to add a career selection option for "medical/psychiatric provider" so that PAs and NPs can select that rather than have to decide between "nursing" and "medicine." Just a thought. Thanks for all y'all are doing.
Thank you for a great session. I am taking away lots of information about the dorsal, sympathetic and ventral vagal systems and I will be mindful in recognising these in clients and myself. I will be using the strategies especially the experiential/somatic ones (so generously shared) in a new employment role where most clients have experience past trauma and are managing mental health complications and addictions.
I am sorry, I thought the video would be available this evening? It looks like I missed it this afternoon
Thank you for your session. I am still a counselling student and recognise the ‘please and appease’ survival strategy that of one of my clients, who has experienced trauma, uses. I now have a way forward in working with her. So much rich learning for me. Thank you.
Thank you for making it possible for us Europeans to receive this valuable knowledge, too – during the time we are awake 🙂
I will check in with my clients to see if I am attuned to them, if they feel they can disagree with me. I will avoid any leading questions. I will continue to invite clients to name their situation (risky, scary, dangerous) if interpersonal violence is involved. I will continue to check in with my racialized clients if my understanding of the systemic or direct discrimination they face aligns with their own.
lots to look at here. thank you!
I so appreciate this free series! So many useful insights.Wish I could afford the Gold package, but this new graduate practitioner has to get through an expensive licensing process first!
As a non-therapist, I learned to assist a friend to step back and think about dealing with someone who reaches to her for help and when she doesn’t respond EXACTLY as asked — then my friend gets attacked verbally and abusively.
I learned how fear can drive me to also use Please and Appease when I really wish to be honest.
Few things have helped me in my own ongoing process of trauma-outcome mitigation as understanding in greater detail the biological impact of my early environment on my nervous system.
This emerging focus on trauma is moving psychotherapeutics beyond what I found for years to be its deepest insufficiency—its propensity to pathologize behaviors recorded in the nervous system that are natural responses to real danger.
This pathologizing itself is retraumatizing in that it perpetuates the stigmas associated with trauma outcomes—depression and suicidal ideation (“mental illness”) addiction (character flaw, “disease”), self-destructive behaviors (lost cause), bonding instability (can’t maintain a relationship) and so forth. Those of us managing trauma outcomes must negotiate these marginalizing perceptions as well. It’s exhausting.
Thank you for creating such an accessible discussion on these more obvious outcomes of trauma and how to work with them, including the critical somatic aspects—something the yoga, mindfulness and massage therapy communities have been exploring for years, and that may be instrumental in the emerging natural movement/dance community. Martial arts can also be instrumental in retraining the body how to respond to danger—something I learned from personal experience, and later, from Marilyn Van Durber in her powerful memoir, “Miss America by Day.”
I bring these things up because most of us managing trauma outcomes have had to develop our program, practices and habits picked up from a variety of sources—including diet and physical fitness—because psychotherapeutics is only as good as the practitioner and is not available to everyone. Additionally, the impact of trauma and its outcomes is too prevalent for an army of even the best of the best practitioners. We desperately need to update public perception of trauma outcomes as well as the lexicon used for discussing them, and we need to make mitigation tools and practices available to everyone.
Thank you Deborah — I can fully relate! In some ways the need to address human response to trauma by professionals leads some to siimplify and not be able to navigate the truth of a client’s actual experience.
I’ve had to put together an alphabet of management tools and can use all of them in one day and not “get free” of the trauma response / grief associated / brain overload and so on!
wow. extremely well said. as an ill-trained practitioner who somehow always intuitively connected energetically and meaningfully with traumatized clients, especially those in crisis, I feel left out to dry as client myself, my only somewhat recent, very physically active reconnection to buried childhood trauma met with frustration, even anger, and ultimately (or frequently immediate) dismissal from both psych and medical practitioners because it does not fit with their specialties or preconceived notions of what should be. your clear-headed, insightful analysis of what those of us managing trauma outcomes (I love that!) face in our quest for mitigation and improvement—obviously coming from a depth of personal experience—gives me hope, if only that I’m not on this journey alone.
You mentioned a holocaust survivor, Crystal? during the collapse/submit section. Any addtional information? Who, and why mentioned? Thank you for this series.
Henry Krystal was a psychiatrist and a Holocaust Survivor.
Wow,
This information is incredibly helpful!
I am not a therapist, but notice some of these behaviors in family, friends, and even myself ! Ranging “from time to time” to “more consistent”. It would be so very helpful to offer strategies to those of us who are not in the therapeutic environment, but want to support healthy behaviors and changes in those we love, work with, and interface with in the course of daily life.
Thank you for this eye opening, hope and possibles window that you are opening!
As a retired educator having worked in the field of Special Education, I find your research and webinars very interesting and helpful so that I remain “current” with changing therapies and healthy engagement. Thank you for your advocacy to continue to share.
Of particular concern is the “please and appease” coping strategy. I have noticed this in a few present day childhood settings and I wonder how to address this, or respond, with a healthy approach, as an extended family member witnessing dysfunctional interaction?
I am so grateful to be able to watch the 3rd module of your master series, having missed the first two by sign in issues. I am non practicing retired physician and have PTSD and chronic depression. I learn a lot from your trauma series as I can relate to all the trauma responses and still living them ( unresolved) which is unfortunate of course.
I want to commend you in putting it together, and it surpasses in excellence in everyone I have done for recovery especially the part of differentiating it from resistant depression.
So Thank you to Ruth and all the esteemed experts. THANK YOU !!
I was able to notice behaviors of clients in two of the survival responses. One client I may have indeed mistaken to have borderline personality traits when in fact it may have been the attach/cry defense. Making the implicit explicit came to mind to verbalize more what’s going on with me if I sense misattunement between my client and myself. I plan to practice the ventral vagal intervention (saying no/yes from the different states) with a client who has presented with the collapse/submit response. I have especially enjoyed this session of the three sessions this far. Thank you for this training.
So many helpful ideas here! Recognising trauma responses as nervous system survival defences and states, not just habitual ways of responding and using your own nervous system response to recognise client states. Also the cautions relevant to each type of defensive response – things to watch out for. Helped be more aware of what may be going on with some of my clients coming for couples sessions.
I’m not a therapist but a client. I took away the idea that change takes time and brain takes convincing that there is another way. I will apply the concept of “ micro moments” and practice observing my nervous system with my spouse. Thank you!!!
As a coach, with a therapist, during this difficult time of the coronavirus, it was great to recognize myself and the please and appease behavior on my part. I might add that having a therapist during this time is a wonderful gift of self care, yes care to me from me!
Thanks Ruth and team for such a timely topic!
Warmly,
Kathy
So I am guessing that a person who has lived through trauma can react in all of these modes and some people or situations have tendency of one reaction more than others f.ex attach/cry for help or please and appease…
I’m intrigued by the countertransference that can be at play with the “please/appease” clients and therapists. I want to watch for this in myself, so that I’m not harming the client. Also, if I’m feeling pleased with myself, ask myself, what is leading to this with this client. Very helpful. Thanks!
I would sign up for the Gold Package in a second! But I am retired…
Still, as someone in recovery from a childhood w a narcissistic mother, many of these themes may help me help myself some, abd help 12-step sponsees. My husband may find this helpful too. He has a MSW, and is still discerning how he will invest his energies.
I am working with someone who moves from collapse to sympathise fight ; hates home self then reverts back to a collapsed shameful state. The information today has offered new thoughts about working with this cycle . First of all I can teach him what’s happening!
Very helpful. Describes so many people I work with. I would like more ideas about how to work with people in dorsal/collapse so they feel connected but not intruded upon….
One former client – need to review how I worked with please/appease.
Current client: been trying to delineate what I thought of as dissociated states: this nervous system language will be more helpful
The timing for this class was amazing for me. I was searching resources for this exact issue because I am currently working with a client who has attach/cry. I will take what I have learned to my session with her. This has made me feel much more regulated about the next session. Thank you for this amazing learning opportunity.
I’m a caregiver of someone with dementia. From the 2nd session, I learned the importance of breathing WITH someone to help ground/calm them. My client often gets very stressed out when I transfer her, and her breathing gets shallow and rapid. Before, I told her to breathe deep and I’d model it, sometimes I was more successful than at other times in getting her to breathe deeply to slow her breathing down and thus her blood pressure etc. Now I say, “breathe with me” and we do it together. What a difference!!
I have also noticed that she will reflect whatever mood someone else is in especially when that person is trying to mask it so as not to upset her. I have learned that it is important for me not to mask what I’m feeling. Rather, I tell her I’m feeling upset in a certain way about something that happened and it has nothing to do with her. When I do this, she no longer reflects my hidden emotions. I find too that by telling her I’m upset about whatever it is, it actually helps my own response to whatever it is so that I act/behave in a much healthier way. Instead of reacting, I start responding. Note, I also share with her when I’m feeling good about something!! Have to keep these things in balance.
I am a foster carer, in my third year of my counselling degree and a victim of childhood trauma. Your course has been valuable for many reasons. For my understanding of my clients on placement, the children I foster and my own personal development as I explored my please and appease that remains with me today. As I am in personal therapy and supervision I have found my please appease much less prominent of late.
Thank you for all you are doing. I have been a huge Bessel Van der Kolk fan since being recommended ‘The Body Keeps the Score’ about 5 years ago by my supervising Fostering Social Worker. I look forward to reading the work of your other esteemed speakers in the not too distant future. Your course reinforces the belief that I will never be bored in my future profession there will be plenty to learn and keep me busy.
Thank You
I am certified counselor and am studying trauma and dissociation from last year. I find this series pretty helpful. Especially the attach/cry, collapse and please/appease responses and drawing parallels to the parasympathetic and sympathetic systems. Thank you for the series plus the study guides and info graphics. Its wonderful to associate with NICABM. Hope to work with you sometime in future.