We know fight, flight, and freeze . . .
. . . but recently the experts have identified several more defense responses to trauma, including “attach/cry-for-help.”
This response is potentially the least understood, and it can be challenging to work with.
And according to Kathy Steele, MN, CS, there’s a common mistake that practitioners make when their patient is stuck in this response.
Have a listen.
In the Advanced Master Program on the Treatment of Trauma, we dive into the attach/cry-for-help defense response, including several specific behavior patterns that can help you recognize it as well as concrete strategies for working with it.
Plus we’ll walk you through a couple other emerging defense responses to trauma. This program has some of the experts’ newest thinking on trauma treatment, so be sure to check it out.
Now we’d like to hear from you. Have you seen the “attach/cry-for-help” defense response with your clients? What have you found most helpful for working with it? Please leave a comment below and let us know.
If you found this helpful, here are a few more resources you might be interested in:
Is Your Patient “Feeling” Unworthy? What May Be the Underlying Cause, with Janina Fisher, PhD
[Infographic] – Four Key Ways Collapse/Submit Can Present in a Client
As a patient, how you handle this is really important. Recently, I fired my therapist after two and a half years because we got caught in this cycle and it didn’t go well. I have no family or friends to lean on, I just have my kid’s but I try to not to rely on them for support since they are just kids. She treated me like a friend and it felt like we made great progress for a long time. I function so much better than I did when I started. But we were definitely in this weird pattern like you described sometimes, especially any time my parents visit from out of state. But I’m an adult and I do try to curb my intense desire to be needy. Like, I live in society and I know when I’m being weird. I could see I was dysregulated and we would deal with why I was acting that way. We had conversations about how I had to tell myself she isn’t my mom. Well one time I guess I latched onto her in a way she didn’t like. I remember crying alot during session and being over the top clingy like a toddler. My dad had just called and lectured me. We never dealt with my issues with my dad yet. Those ones are burried deep. She said ‘you were treating me like the ideal other’ then she yanked all attatchment away harshly. She was stern, cold, and dissaproving with me. I felt emotionally punished like my mom would do. We never got our groove back. She may have tried, but it all felt fake aftet that. She said that when she had shown me compassion in the past when I was sad, it was her job to show me how to do it. Not that she actually felt compassion for me. It was like hiring an actor to pretend they like me. This was really painful from my perspective because before that I thought that on a human level she did like me, not as an intersting case or something. I think I’m more insecure about trying to make friends now than before.
As a person with a chronic pain affliction now going on 20 years, an affliction that can present with many more symptoms than just chronic body pains, I realize how much I have had to cobble together from a “Do It Yourself” model of care. This is because the science and practice of chronic pain care is still sorely lacking in our healthcare system. I wuickly surmised from this short video about “Attach/Cry” that I have been through this phase myself. Thankfully I now recognize it, if in the rear view mirror. I came upon this when I googled “chronic pain is the brains cry for help.” The thought and search term occurred to me as I watched a report on suicide prevention in teens. Thank you to all professionals who struggle to understand and treat chronic pain. And thank you to those courageous doctors who still prescribe opioids with careful monitoring. For some of us they truly are a life saving medicine.
This is huuuuuuugely enlightening.
Can you speak a bit about how the activation of that cry-rage-shame cycle sometimes results in rage towards the therapist/other attachment figure, and how the therapist/attachment figure should react to THAT?
Also, how can someone who is NOT a therapist, but who is experiencing this with a friend/family member/etc. effectively deal with this kind of behavior when they encounter it in a loved one?
within the session is a whole different thing though
very helpful to meet their attachment needs ( therapeutically) within session to help heal the attachment wounds. If they are negated, side stepped or not directly addressed it can cause re-traumatization
Thank you I’d like to receive this in my inbox
The client is desperate for attachment because trauma has destroyed or severely damaged their own connection to THEMSELF. I have found that a combination of body-centered therapy such as Reichian work, even though it is old-fashioned, or techniques I learned from “At the Speed of Life” by Gay and Kathlyn Hendriks help get rage, grief and fear out of the body. The client then begins to develop a better connection to their own inner self rather than needing an external connection constantly. Dialectical Behavioral Training and when needed CBT can help with condemning thoughts. Slowly, the client begins to have a more positive and compassionate experience of THEMSELF and their parts. Self-compassion therapy is also effective with this as well. Just putting up “good therapeutic boundaries” is just going to trigger more abandonment. And talking about it does not make the energetic triggers in the person’s body and field go away. People can spend DECADES talking and talking and talking to a therapist and get NO WHERE. 45 minutes a week is not enough to undo the damage done to a person who is cutting or suicidal. But the body-centered approach can be done themselves when needed. This makes me question the foundations of Behavioral Medicine.
As someone who has struggled for most of my adult life with pain from traumatic injuries and having become disabled for work by it becoming “neural centralized” and “emotion driven” now for over 15 years, I believe you have a valid and very valuable insight.Many people have no idea that they are struggling with a trauma induced affliction. Those of us who do struggle to unravel it and get to the underlying energy that keeps it going don’t yet have a full toolbox to fix it. Talk therapy seems to provide a way to unearth things but that creates fresh and strong emotions which are rocket fuel for chronic pain symptom intensification. Once we begin to unearth and expose all that trauma we need to know what to do with it.
Well said !!!!
Hi! Im a client myself and recognise this attach/cry for help pattern in me. How does it differ from needing constant reassurance?
In my case, the only one who always replies to my emails is my psychiatrist and Im so grateful to him. I feel like I can trully trust him, and its probably the closest to a secure attachment I’ve ever had.
On the other hand, every time I message my therapist and she doesnt reply to me I feel rejected and ashamed. So I dont know how this applies in this case?
This is interesting to hear that other people struggle with this. I’m a client, and I might have the opposite problem: I have a hard time calling on people for help, and often “forget” that my therapist exists between sessions, and is available for help, even though I “know” that she is. Therefore, I often go right into freeze if fight or flight don’t work. I wonder if that feels more familiar to me. Potentially that’s a consequence of being attached to an emotionally unavailable and unresponsive spouse in my past marriage, which probably solidified some of my childhood wounds.
Interesting! I understand that the more we therapists (care takers) try to meet the needs of your client in a desperate attachment cry state, the more we fall into a vicious circle. If the client is in a desperately attachment cry situation, and she/he is not conscious of the international conflicts, focusing on the outside world, we may take risk to end up with a vicious cycle of Need/Shame/Rage pattern with attachment care. So, the best way is to let the client to turn his/her consciousness to the inner conflict.
In case that a therapist/care taker is feeling “I have not done enough Care”, the therapist/care taker may fall into a trap of being ashamed of himself/herself, doing more efforts. This more attachment care would activate the vicious cycle of Need/Shame/Rage pattern.
Question: So, how could we work on the clients who are always thirsty and needy for helps? How could we let them work on their internal conflicts without letting them in a rage/attacking mode?
Thank you.
i relate so much with what you said, every time i reach out for someone in a dessperate way to attach i end up rageos or shameful, but i dont’t know what to do different, it is clearly related with structural dissociation and a lack of internal guidance. what do you think it can be done?
I would love to learn more about how to work with this trauma response, attach/cry with a highly verbal adult client. I find myself naturally able to work with children in movement with this pattern but struggle more with the verbal focused needs of this client. Is there anything you might recommend reading?
Janina Fisher’s “Healing the Fragmented Selves of Trauma Survivors” and in particular the Internal Dialogue process is extremely helpful with this sort of situation.
Great!! Many psychoanalysts who should understand we have to deal with inner conflict and not try to attend to one side or the other would benefit with this embodied explanation!
Thank you
Lúcia Azevedo
This is amazing, and a true fact.
I have a client with attachment issues and decades of struggling with an eating disorder who is currently caught in this cycle; she is frequently asking me to call her between sessions as she’s experiencing having a horrible day, has a new perspective on her situation etc. This has given me a better understanding of what’s going on here
Thank you for identifying something rarely (if at all) talked about which I’ve experienced as the most painful pattern. It’s difficult when you are conscious you are in it but unknowing how to exit yourself so shame takes over and the “helper” gets triggered in their “not good enough” and goes into their own fight/flight. I recently came across a piece of insight which feels linked to the root of this. Looking beyond the typically talked about abandonment wounds. It was referred as functional freeze. When your caregivers as a child, did not have the capacity to handle their own emotional regulation when you hurt yourself, thus the child registers “when I feel hurt I must focus on the other person (including their well-being) to survive and feel safe”. Huge breakthrough.
Thank you for this insight
Wow, thank you so much for sharing this. As a client experiencing this now you have just given me a ‘eureka’ moment. I couldn’t work out why I was suddenly withdrawing from my therapist, feeling angry and feeling desperate for her to rescue me when up to that point we were going along perfectly well. I realise now it was because I noticed her looking worn out and emotional and I immediately switched to caretaker role and things escalated from there. She did absolutely nothing wrong but I interpreted her looking worn out and emotional as the first steps to her not being available to me. This is what I’ve been hypervigilant to my whole life and you dear anonymous teacher from CA have put all the pieces together for me. From the bottom of my healing heart I thank you.
Thankyou Ruth for sharing that. Very helpful.
I was a fire victim 10 years go and have been also a student of student of counseling.This cry for help attachment, makes total sense to me! I actually experience this at one point and never understood it.Thank you!
Thank you. I just used your idea to ask myself what I’m escaping from when the neediness for my therapist attacked me. Maybe there is hope after all.
I love Kathy Steele’s beautifully concise explanation of getting sucked into an unhealthy but well meaning response to client’s attachment pain. I usually handle this in a 2 fold manner – 1) make sure that client has a robust and well practiced list (actually written out for some folks) of healthy emotional regulation practices/tools and 2) helping client identify their inner conflict through parts work (Eg “So a part of you knows that I care about you and another part of you is fearful that it’s all an act and someday I will find a reason to leave – just like your dad did”) and from here encourage client to have self compassion for the fearful/needy part when it gets triggered. And we work on the triggers in a variety of ways (I personally use EMDR and Flash Technique as my go to).
Can you please explain ‘Flash Technique’?
Thanks for this, Susan. Really interesting!
So how do you do that without reinforcing their feeling of abandonment and desperate aloneness? You’re saying therapists should not be giving more attachment, but that has to be done such that it does not mimic the original wounding of rejection, etc. What is your method that addresses that? Thanks.
I’m so grateful to finally hear an expert talk about my particular dissociative pattern of Attachment/Cry For Help Response. I’ve had more than 20 years of therapy with various therapists yet I’ve never had a therapist who could help me with this pattern which is so frustrating. I’ve given up on therapy because I always get too attached to the therapist and it’s not helpful. I’m doing my best to work consistently on grounding and calming practices. I’m wondering what else I can do to help myself with this particular pattern?
There is no such thing as getting ‘too attached’
Clinging to an unquenchable Thirst, some times also called Obsession or hooked like a drug ( Thrishna in Buddhist philosophy) is mistaken for a Healthy Bonding that comes from Interdependence of true unselfish love. Setting healthy boundaries is the most Important part of a genuine Therapeutic Relationship. through which comes Autonomy and sense of a coherent self.
Letting go of the Therapy ,the Therapist and leaving the ‘Sick Role ‘ is the toughest part of terminating the relationship, differently this time by being able to say ‘Good bye’finally with feelings.
Love This! Thank You for sharing!
Thank you so much¡¡
Provide consistent connection that is focused on self – responsibility, self-empowerment and profound acceptance of human need.
I am so grateful for the work you are sharing. It is exhilarating to see the growth of NICABM! I have received amazing insights from your programs for my work as an RN assessment coordinator and holistic life coach. Along with this Advanced master Program for the Treatment of Trauma, I have purchased several excellent NICABM courses in the last few years. They have provided a terrific and gratifying method of acquiring CEUs. I cannot thank you enough for empowering me as a provider. Rooting for you always!
Lately, I have been under more stress than ever. I am also older than I have ever been ? It is a month that is the anniversary of my younger sister s untimely death, and the death of my mother who had bpd. I have been waking up with sciatica on my right side. I keep having a thought bubble come up, that the physical pain is not purely physical. I have been using stretching, and trying to bring to my mind, the things that are going well, are good in my life.
In the last session, they mentioned how we can dissociate because of pain. That leaves the pain– whether emotional or physical- still in the body. While we need to look for the good and be positive, we also need to allow ourselves to grieve/feel the pain, both with love and compassion, for that hurting part of ourselves.
This has been made especially clear to me this week, as I am currently finishing Tara’s Meditation and Relationship NICAM course.
I also have suffered great loss- my husband and daughter within a year of each other. I’m sorry for your losses!
I am sorry for your losses, too. In my experience, a systemic approach of tapping might help with such a strong pain of body and soul related to the loss of loved ones. Ronald Hindmarsh in Germany developed a form of tapping of acupoints of Chinese medicine in combination with a mind-set that while tapping those points with the fingertips:
1. first of all THANKING the pain for showing up, for containing the unbearable. Then it usually shows up more intense and more specifically (continue tapping, the turning point will come)
2. show absolute wonder: such an incredible pain, this is really too much, no human should have to experience this …
3. invite all the persons related to the pain to show up (visualization) and tap together to transform this incredible pain …
4. if necessary: include all situations with similar pain …
5. supplicate all those related to the pain to look benevolently upon us, if we are the first (in the family / workplace …) to live without that pain, in good health, emotional freedom, with new love …
It sounds too simple to be successful, but actually the tapping of those acupoints that free up blocked emotions, physical sensations and parts of the brain can work very effectively in sessions but also as a self-help tool. I use several EFT-based tapping procedures like positive tapping, Trauma Buster Technique (for single trauma, by Rehana Webster) with my clients, but the systemic approach with the heartfelt THANKS for the negative emotion, physical sensation or dissociation is great and the following: nobody should have to suffer like this … really makes a difference and keeps the right brain parts active and effective in self-compassion and often new insights into what makes it difficult or what can help right now emerge. I wish you powerful tools to alliviate the pain!
This is so helpful and I will forward it to a niece who has suffered intolerable pelvic pain since her only sibling brother dropped dead of no known cause 2 years ago.
I have encouraged her to engage with somatic psychotherapy which she is doing. As a Dr. of Natural Medicine, she may research your suggestions to find relief. She has had so many ‘medical tests, scans, interventions’ with no real results. The answer is to find ways to release the deeply held pain through working with the body where it is trapped.
I’m sorry for your losses. My mother likely had bpd as well. While working on a book about my family, specifically a section about my father ignoring my mother’s abuse of me, I went for a walk and the right side of my body went out on me and I fell. Right – yang/ left – yin. It made sense once I stopped to listen to my body and its messages. Now if pain or weakness appears on the right, I look at my stuff around men and if on the left, women, beginning with my parents. Now I’m pain free for the first time in years. Hope this is helpful.