complex ptsd

Guided Visualization Meditation to Build a Sense of Safety

by Abby Birk, LMFT

Recently, many of my clients (and I) have desperately needed to revisit our regulation skills. Skills that bring us back to a sense of calm, ease, relaxation or restoration in our bodies. In today's world, this state of being can be elusive between the go-go-go pace of life and the incessant call to be more and more productive. The need for intentional mindfulness and somatic regulation keeps increasing as we fall more and more into the trap of "I just don't have the time" day after day.

Below, I've written out the script I use to walk my clients through a visual meditation called Safe Place, to cultivate safety and security in the here and now. Many have their own version of this skill; here is the one I utilize in my sessions. My hope is to demystify these types of skills and make them accessible for practical, everyday use. As you continue, I recommend reading through (or listening to) the entire script at least once before trying it on your own with your eyes closed or gaze lowered.

Listen to the audio below:

Or read the script here (and maybe record it for yourself, or have a loved one record it for you!):

Find a comfortable seated, reclined, or supine position. Whatever position you choose, make sure you are not holding any tension to support this position, rather lean into and feel the support of your chair, floor, or object you are resting on, in, or against. It's best for grounding purposes (if you are in a position that allows it) to rest the soles of your feet on the floor. Let yourself get weighty and heavy as you allow your body to rest fully supported. You may place your hands wherever you'd like, on your thighs, in your lap, or on your heart and chest.

Now draw your attention to your breath. Do not seek to change anything yet, first observe with gentle curiosity the quality of your breath, the parts of the body that move or don't move as you breathe, the speed or sound of your current breath cycle...

As you observe, you might notice your breath starting to change anyways, that's okay. You can soon begin to intentionally lengthen your inhales and exhales. For this visualization meditation, we want to focus on elongated our exhales more than our inhales to better turn on our vagus nerve and calming parasympathetic nervous system.

Take a few rounds of deep breaths with longer exhales.

Minds wander, that's what they do. Label your thoughts as "thoughts" or "thinking" and return back to an aspect of your breath that can provide a bit more focus: the quality, speed, depth, length, feel, temperature, movement, etc.

Now you will select a safe place that you can imagine or think about for the rest of this exercise. It can be real or imagined. A place you've been to or never visited. It can obey the laws of physics or not. Whatever place you choose, you are in control here, you decide what is in the scene and what is not: if there's anyone with you, the weather, the way you feel here. You are completely safe and at ease in this landscape of your choosing. Take a minute to select a place or try a few different images to see which serves you today.

You will then explore your safe place through your 5 senses, starting with sight.

As you imagine looking around in your safe place, what can you see? How far can you see into the distance? What living things are around? What colors? What's the weather like? What buildings or people or nature fill up your space, if any? What surrounds you, what do you sit or stand or lay on? Once you've taken time observing, take some deep breaths simply enjoying the sensations that arise just by being in this place and looking around you.

When you're ready to move along, we'll continue our exploration through our sense of touch. What textures make up your safe place? Is there sand running through your fingers? Water? Are you surrounded by cozy blankets or laying on a fuzzy rug? Petting an animal? There are no wrong answers. Take stock of what you can feel on your skin, temperature, breeze, weather, etc. Take a few deep breaths once you're done observing with your sense of touch to enjoy the sensations that arise from the textures of your safe place.

Next, imagine closing your eyes in this place, identifying all that you can smell. If there are no naturally derived smells in your safe space landscape, you can invent some: maybe pulling in some of your favorite smells from different parts of your life like perfume/cologne, essential oils, warm drinks, nature, candles, etc. Take a few more deep breaths enjoying how the sense of smell in this place interacts with your body to create more safety and relaxation.

Now, you can continue imagining your eyes closed as you pay attention to the sounds that exist in this safe place. Further ground yourself into this landscape by singling out various sounds around you. Maybe you prefer your safe place to be silent, that is okay too! Whatever you find, just give yourself time to experience it fully and pay attention to how your body reactions to what it can hear in this space.

Lastly, we will engage with your sense of taste in this space. Like smell, you may have to manufacture a taste in your safe space if one is not naturally derived. You may pull from favorite foods, flavors, crisp, clean autumn air or the taste of the air after rainfall. Let yourself enjoy, with a few deep breaths, whatever flavors show up in your safe place.

Integrating all 5 senses in this imagined location allows for further grounding and experiencing of this beautiful internal resource. It allows your brain to fully simulate what it is like to exist in that safe, secure, relaxed state.

Take a few more breath cycles allowing yourself to simply exist in this safe place, remembering to see how your body feels. You will end the meditation with a body scan -- checking in slowly from head to toe (as if you were going through a scanner) for any sensations, feelings, emotions, etc. that arise. Then, you can wiggle your toes, eyelashes, and fingers: opening your eyes to fully come out of the meditation.

Remember, you are the author and originator of your own safe place, which means you have access to this space whenever you need it. Come to ground, regulate, relax, or restore yourself anytime you'd like! Visit when you need and just because you can, even allowing yourself a visit once daily or weekly. The more often we practice skills like these, the better utilized they will be when we actually NEED them in a difficult moment. Your safe place can change however you'd like or remain the same, time after time; don't forget, there are no rules, no "right" or "wrong" way to do this exercise. The important part to keep in mind is that YOU have full agency and autonomy over your safe place. View this guide as an invitation of cues to further ground you in your own experience -- which is all you, baby! Allow this guide to remind you of your own internal resources that you can avail yourself of anytime you'd like. Enjoy!

If you’d like to meet with a therapist to build a safe place together, or to further process stress in your life, Riverbank Therapy has therapists with openings, in person and virtual! Click here to schedule your free 20 minute consultation.

What is somatic therapy?

by Bobbi Smith, LICSWA

More and more, somatic therapy is being integrated into therapeutic techniques.  But what is somatic therapy?  And where does it come from?  In this blog entry I will attempt to give an overview of what somatic therapy means, and how to approach a therapist about integrating somatics if you are interested.  

 

As always, we start with context:  all the way back in the 1600’s (yes really) there was a French philosopher named Rene Descartes who was quite taken with examining the relationship between the human mind and body.  Since his work as a philosopher was pondering things, he began to think about the process of thinking itself, which he believed took place in the mind.  He theorized that the mind and body were separate organisms, and that the mind had dominion over the body.  This theory was known as Cartesian dualism, or sometimes mind-body dualism.  

Though there were always people that opposed Cartesian dualism, when what we now know as Western medicine began to form and institutionalize, it carried the legacy of Cartesian dualism with it.  Treatment of bodily ailments and treatment of mind ailments developed as distinct disciplines.  We don’t know if this is what Descartes intended, and can’t say for sure how he would react if he were alive to comment on it, but it unfolded this way anyway.

For generations, psychology has had the task of treating what western medicine firmly categorized as ailments that are located within the container of the mind, and therefore should be treated in that location, using the vehicle of thoughts to transfer a cure from the psychologist to the patient.  The most famous of these is “the talking cure” developed by Sigmund Freud.  In this approach, the psychologist would aggressively analyze the patients every word, which is 1. Deeply unethical and 2. Super annoying.

I’m getting to the somatic stuff, I promise.  

Let’s jump forward.  For decades now, some doctors, therapists and clients have questioned the utility of Cartesian dualism to truly address the complexity of mental and physical health conditions, and have been developing treatments that integrate both mind and body.  Soma means body.  Somatic therapy means incorporating some dimension of work with the body into treatment for ailments that used to be considered to be solely of the mind:  depression, anxiety, post traumatic stress disorder, and more.  

There are many traditions of what is called collectively somatic therapy- Sensorimotor Therapy, Somatic Attachment Therapy, Somatic Internal Family Systems, and more. There is no singular type that is agreed upon as the best approach.  Therapists that integrate somatic therapy into their practices are trained in and draw inspiration from traditions designed by many different healers, and that is a good thing.  Just like every other type of therapy, there is no one size fits all.  In addition, there are many, many traditional healing methods practiced across the world that include some type of body work, to which western somatic therapy traditions owe great honor.

 

The tradition I myself am mainly trained in is called Somatic Experiencing- I am not certified but simply studying it.  Somatic Experiencing was developed to treat PTSD, or what is now mostly called simply trauma.  The thesis behind Somatic Experiencing is that trauma can cause wear and tear on the autonomic nervous system, and so, trauma treatment should include the autonomic nervous system.  The autonomic nervous system is a component of the peripheral nervous system that regulates involuntary physiologic processes including heart rate, blood pressure, respiration, digestion, and sexual arousal. It contains three anatomically distinct divisions: sympathetic, parasympathetic, and enteric.  The autonomic nervous system lets us be relaxed, spontaneous, and socially engaged in a safe environment, or prepares us to fight, flee, or freeze in response to a threatening one.

 

Our human brains have evolved with add-ons to other species' brains, but we didn’t lose anything from them.  Basically, we have new apps but not a very different operating system.  As such, we have instincts to respond to harm or perceived harm in ways similar to other species.  Somatic Experiencing considers humans, aka homo sapiens, part of an evolutionary lineage that shares bodily features (such as an autonomic nervous system) and bodily instincts (such as fight, flight, or freeze) in common with other animal species that are evolutionarily older than us, and honors the innate intelligence of those similarities. In a threatening situation, animals either run to get away, fight off the threat, or if those don’t work, play dead (freeze) to appear unappetizing to a predator until it wanders away.

 

As animals, if an instinctual survival response sets off an alarm in our autonomic nervous system telling us to fight, flee, or freeze, it is important that that protective response is allowed to fully play out in service of its goal:  to get to safety.  If that response is prevented or constricted, the unresolved instinct can remain trapped in the nervous system as a chronic trauma response, or PTSD.  That can mean someone can feel trapped by the instinct to constantly fight, flee, or freeze, even if they aren’t in an unsafe situation anymore.  That is because even though our mind can cognitively register when a threatening situation is no longer happening, at the level of the organism (or body) there is no real proof of that, because all the nervous system knows is that it couldn’t do what it needed to in order to protect itself.  The nervous system doesn’t know time.

 

If that response were allowed to play out to its natural conclusion, our nervous system settles back into its baseline state, which is a proper flow in real time and proportional to what’s currently happening around us- not stuck in a chronic response.  We'll start in therapy by creating a safe container, building skills to cope with overwhelming emotions, thoughts, or body sensations. Then, when you're feeling ready, we may slowly approach your traumatic narrative, attending to body sensations along the way and supporting the discharge of trapped fight/flight/freeze energy.

 

One thing I love about Somatic Experiencing, and all types of somatic therapy, is that they acknowledge that human beings have evolved capacity for abstract thought, but otherwise are not fundamentally different from other animals per se.  Somatic therapy acknowledges the intelligence and healing instincts of other parts of our bodies besides just our minds.  Our bodies have instinctive reactions to what’s going on around us- and that means involving the body in therapy can have profound positive impacts on our sense of not only ourselves, but the world.  And who wouldn’t benefit from more wholeness and integration?

 

Most of our therapists at Riverbank incorporate somatic traditions into their treatment approaches. If you’d like to schedule a free 20 minute consultation with one of our therapists in-person in Seattle, or online for residents of Washington state, click here to fill out our contact form!

Embracing Your Villain Era

by Abby Birk, LMFT

My favorite trend gaining some notable notoriety amongst social media users is the call to embrace your "Villain Era". The "Villain Era" represents unleashing and embracing less acceptable parts of yourself that go against typical social messaging other or people pleasing. Full-heartedly supporting any movement to reclaim "socially unacceptable" parts of ourselves, I wrote this post so that you can make a plan for how to embrace your own parts that others have deemed villainous to their own oppressive agendas.

 

The movement calls into question exactly what we are villainizing. Selfishness? Clear expectations? Boundaries? These are all important ingredients for healthy relationships and wellbeing. Unfortunately, patriarchy, traditional gender norms, white supremacy, and racism have dictated what are favorable ways to act and be in society -- ways that perpetuate disempowerment of certain groups while perpetuating the power structures of other groups. This post serves to join the call to unleash your inner villain, all while questioning: is it really that villainous to take care of myself by setting boundaries??

 

This post is for those of you who find themselves falling into the trap of people pleasing and over-accommodating others at the expense of themselves. Allow yourself to explore what your villainous alter ego can offer and how you can use it to better your life with increased wellbeing.

 

People Pleasing & The Fawn Response

It's worth diving a bit into why we often revert to people pleasing as a way to navigate relationships and workplaces. People pleasing is a learned response to stress or activation that we often learn as children with our families of origin. We may learn to please as a survival mechanism to receive love, affection, connection -- striving to be "good children" and receive that all-coveted adult praise and attention.

 

As adults, we've learned that in stressful situations, we can "neutralize" the threat by befriending it or being pleasing to the threat (aka our boss, demanding co-worker, judgy friend, angry stranger, etc.). Many call this the "Fawn" response, an add-on to other well-known stress responses: Flight, Fight, & Freeze. At its core, it's not such a terrible strategy in the sense that it usually works to neutralize the threat and get us what we want in the end -- praise & attention vs. punishment & shame, and even survival vs. death or violence.

 

The catch with the Fawn response, is that if used chronically, it can cost us more than it's worth. Instead of addressing the stressor -- the toxic  boss, workplace, or friend, or relationship we need to leave--we learn to manage the stress by losing ourselves to please the stressor. This may work in the short-term, but in the long-term there can be increased levels of chronic stress, deteriorated mental health, increased anxiety, fatigue/exhaustion, or low sense of self-esteem and self-worth. When we consistently sacrifice our selves, our integrity, our internal knowing in order to simply survive, there are often negative consequences we must deal with, however unintended they might be.

 

How to Embrace Your Villain Era

If you are someone who struggles with people pleasing and "fawning" in the presence of others when stressed or activated, then the Villain Era is for you. While it might feel like an extreme departure from the way you're used to behaving in certain contexts, embracing attitudes and actions that larger society villainizes gives you a chance to play with some alternative behaviors that could open up possibilities for how to navigate some common situations.

 

Here are some signs that you are embracing your Villain Era:

  • Setting AND enforcing boundaries

  • Choosing yourself

  • Honoring your limitations

  • Prioritizing pleasure

  • Taking instead of giving

  • Walking away from what no longer serves you

  • Speaking up for yourself

  • Saying no

  • Not taking on more just to be a "team player"

 

You might find all or most of these daunting in the sense of ... okay, well how do I do that? Or you might know these things are important and are already working on how to show up differently in your relationships. Wherever you find yourself on the spectrum, it's important to know that no one is perfectly good at all these things all of the time.

And--you don't have to do all of these things all of the time. For example, there are situations where it does make sense to say yes and be accommodating! In order to discern what action or choice is going to best serve you in each moment, we need to practice what doesn't come naturally so that we have options. 

 

Remember, there's always room to grow and learn and unlearn. There are many ways to incorporate these actions in your life. Here are a few suggestions for the most common contexts we find ourselves in: workplace, intimate relationships, and family relationships. Most of these suggestions come from my work with clients and the most common challenging situations they face.

 

Embracing Your "Villain Era" at Work

For you "fawners" out there, the villainous trait to lean into at work is saying "no." There are a variety of reasons saying no to your boss or co-worker or client/customer feels wrong (or may not even be possible). It is important to examine the reasons why "no" may not feel appropriate (or be appropriate) for any given situation.

 

Is it that your boss has been un-supportive of you in the past, is it that your workplace culture favors productivity and results over wellness of their employees and sustainable workload? Does it feel impossible because maybe you haven't really tried it before? The answer may impact how you respond and navigate the situation.

 

Often, at work in America, if you aren't taking care of you, no one else is going to. So you need to be the one to take stock of your own limitations, your mental and emotional energy and place boundaries around what you can and simply cannot do, taking a realistic approach. Taking on more work from a coworker in order to be seen as a "team player" might sound like a good idea at the moment, or you might even notice that people treat you differently when you say yes all the time, you might be more likely to be chosen for a promotion -- these are all reasons why we say yes and keep saying yes. But there are important reasons to say no, too. Protecting your humanness by protecting your mental health sometimes trumps wanting your desk-mate to like you.

 

I don't mean to simplify this challenge. Saying no at work is HARD because the workplace system is built so that saying no is not easy and so that we DO NOT prioritize our own wellbeing. By saying no sometimes to more work that isn't yours, a late work night, weekend work calls, mobile phone notifications, you are saying yes to something else : YOU, your needs, your time, your relationships, your hobbies, your activities, your peace, your rest, your humanness.

 

If this is something you would like to practice, I suggest finding a space where you're alone, thinking of a situation where you would like to say no and practicing the word "NO" out loud followed by some type of gesture (pushing away from your body, palms facing out, shaking your head from side to side, stomping your foot, or balling up your hands into fists). Giving ourselves permission to say no sometimes just takes practice.

 

Embracing Your "Villain Era" in your Partnerships:

Embracing the villain in your intimate partnerships can look like being selfish and taking/receiving. Something to practice if you are often the caregiver or over-functioner in the relationship is to assert your own needs and receive care from your partner(s) instead of resorting to your usual giving tendency. Now most relationships are flexible on which partner is giving or receiving over a variety of situations. I am talking about people who have the tendency to give first, who have difficulty letting go and receiving care for themselves, their body, their needs...whether those be emotional, physical, romantic, sexual or otherwise.

Play around with being the needy one, the selfish one. Be the one to ask for something you want or need. Try taking what your partner is offering you, instead of politely declining. Try asking directly for what you need, and letting your partner provide it. Hopefully, these suggestions inspire some of your own ideas on how you would like to show up embracing your villain for the purpose of challenging the limits and stories you put on yourself to not need or enjoy other people taking care of you.

 

 

Embracing Your "Villain Era" in Family Relationships:

Embracing boundary setting AND enforcing can be a powerful way to embrace your inner villain in family relationships. Here's what I mean by setting AND enforcing boundaries.

First, you must identify where you would like a boundary with a family member and why. This helps your conviction when communicating the boundary and commitment to enforcing the boundary whenever you face push-back. For example, several of my clients struggle with questions, topics, or comments made by various family members over the phone or during time spent together. Many of my clients start to notice feeling anger, resentment, discomfort, hurt, or irritation in response to their family members. These are important emotional responses to listen to, for they might be telling you exactly where a boundary needs to be placed. Boundaries feel villainous sometimes because of how we've been raised, typically our family of origin dynamics and the roles we play or have played in our family. But just because it feels wrong or bad, doesn't mean it is wrong or bad. Boundaries are a necessary ingredient for healthy, happy, secure, and safe relationships.

 

As Prentis Hemphill's definition of boundaries remind us: "boundaries are the distance at which I can love you and me simultaneously." A lot of family members would verbally agree that that's exactly what they want with you, even if they're unhappy or uncomfortable with what that means or takes on their part.

 

Depending on the relational, structural, cultural, racial, or ethnic context of your family relationships, the factors influencing if, how, and where you enact boundaries may be extremely complex and take more time and consideration before setting or enforcing any type of boundary. If this is the case, it may be helpful to explore options relating to your specific situation with a therapist who shares identities with you or is culturally-competent enough to facilitate an exploration of ways for you to show up authentically and with care in your family system. Here is a lovely list of examples for verbal boundary setting related to changing topics or responding to questions you do not want to answer (credit: Amanda E. White: Therapy for Women @therapyforwomen):

  • "I'm not comfortable talking about that. Let's switch to a different topic."

  • "I understand why you're curious. It's just not something I want to discuss."

  • "I would prefer not to answer that."

  • "I'd prefer if you didn't bring that topic up again, unless I bring it up first."

  • "I've told you that I'm not comfortable answering this/talking about this, please don't bring it up again."

  • "It really negatively impacts me when you continue to ask me about this/talk about this after I've asked you not to."

  • "Asking that question puts a lot of pressure on me. I'm sure you didn't mean it that way, but I would prefer not to answer that."

 

Now comes the enforcement. Boundaries are just talk, unless we are prepared to DO something when they are violated or crossed. Enforcing a boundary is about what YOU will do if the boundary is not honored. This is an important and sometimes tricky step.

  • "I do not want to discuss this topic with you. So you can't bring it up or I'm going to yell at you..." is not usually the most constructive or helpful enforcement of a boundary.

  • "I do not want to discuss this topic with you and if you continue to bring it up, I will need to take some space from our conversation...." can be a better way to enact self-agency and enforce boundaries.

 

Remember, enforcing boundaries is not meant as a punishment but a natural consequence for not honoring a boundary. It is about what YOU will do IF/WHEN this boundary is crossed. With time and maybe some help from others, you will learn to fine tune this skill across the various relationships in your life so that you can create safety and security with others while honoring yourself.

 

I hope this post just whets your appetite for all the myriad ways there are to lean into this alter ego of sorts, the parts of yourself that you've learned to exile, the parts you're afraid to let run the show. Practicing flexibility with yourself and how you show up at work or in relationships can promote beneficial outcomes for your physical health, mental health, and overall wellbeing.

 

The Riverbank therapists would love to support you and any work you would like to do around this or other related topics such as boundaries, family of origin, intimate relationships, sense of self, self-worth, asserting needs, self care, etc. We have therapists in-person in Seattle and who provide virtual therapy across the state of Washington. Click here to book a free consultation with one of our therapists today!

 

Good luck to all of you embracing your "Villain Era" out there!

Your Nervous System and the Window of Tolerance

The nervous system is composed of the brain, spinal cord, and nerves that go throughout the body. The nervous system is the command center of the body, responsible for our thoughts, movements, and automatic processes such as breathing and digestion. Importantly, the nervous system is also responsible for our experience of emotion. Understanding your nervous system can help you become more aware of your emotions and how you can manage them without becoming overwhelmed.

Let’s start with a brief overview of the brain using this handy model created by Dr. Dan Siegel and based on the triune brain model by Paul McLean. It can be helpful to familiarize yourself with three major parts of the brain: (1) the brainstem (responsible for basic survival functions like breathing and heart rate); (2) the limbic system (the emotional center of the brain, responsible for our fight/flight/freeze response) and (3) the cortex (the “thinking and reasoning” part of our brain, responsible for managing big emotions, connecting with others, and helping us make thoughtful decisions).

hand model of the brain, triune brain

(Image from Kerra-Lee Wescombe, 2021)

When all three parts of the brain are working together, we feel safe and connected to others. This is the optimal zone of nervous system arousal, known as our window of tolerance, or our social engagement system.

 

 

                                                     



 

Window of Tolerance

Window of Tolerance, a term coined by Dr. Siegel, refers to the zone of nervous system arousal in which we are able to function and engage with other people most effectively. In this zone, our brain can process stimuli without becoming overwhelmed. This means the thinking part of our brain, the cortex, is online and helping us keep our nervous system (and emotions) regulated. This state is associated with our parasympathetic nervous system and is also known as the “rest and digest” state.

window of tolerance

(Image adapted from NICABM, 2019)

When we are within our window of tolerance and difficulties arise in our day, we are able to handle them without our nervous system becoming dysregulated. This means that we can manage our emotions without getting overwhelmed.

Within this zone, we feel safe and socially connected. We are grounded, open, curious, flexible, and able to take on challenges. We feel calm but not exhausted, energized but not anxious. When emotions like frustration or sadness take us closer to the edge of our window, our thinking brain is able to use strategies to keep our nervous system regulated so we can stay within our window. This diagram shows how our nervous system ebbs and flows when we are within our window and our brain is able to regulate our emotions:

window of tolerance

          (Image adapted from Levine, Ogden, Siegel)

 Sometimes, however, we can get thrown out of our window of tolerance when our limbic system sends our thinking brain offline. This happens when it senses danger and sends our nervous system into an automatic fight, flight, freeze, or collapse response. This state is associated with our sympathetic nervous system.

Fight/Flight/Freeze/Collapse

Our limbic system contains the part of our brain responsible for sensing threat and protecting us from danger. It can make split-second decisions to keep us safe, whereas our thinking brain wouldn’t be able to respond as efficiently to danger. Therefore, when our limbic system senses danger, it can turn our thinking brain offline and trigger our fight/flight/freeze/collapse response, moving us outside our window of tolerance in its attempt to keep us safe.

When we are in this state, our nervous system is over-activated, or hyperaroused. Our body is alert and ready to fight or flee danger—or it may freeze to avoid danger. Our breathing and heart rate quicken, our hearing becomes sharper, our skin sweats, our muscles tense, and our pupils dilate. Here we can feel anxious, panicked, angry, or out of control.

In the collapse response, on the other hand, our nervous system is under-activated, or hypoaroused. Our heart rate drops, our breathing slows (we may even hold our breath), and we feel immobilized. It can be easy to confuse the freeze and collapse responses, so it may be helpful to imagine you are playing a high stakes game of hide and seek. The seeker is right outside your hiding place. You are tense, alert, hyperaroused because you know they might find you: this is freeze. Suddenly, they lock eyes with you, and you’re defeated, hopelessness: this is collapse. In collapse, we can experience exhaustion, numbness, dissociation, depression, shame, and hopelessness.

window of tolerance, somatic therapy seattle

(Image from Mind My Peelings, 2019)

The fight/flight/freeze response evolved over ages to keep you safe and alive. It was very useful in our early hunting and gathering days when we encountered regular threats to our survival, like dangerous wild animals. And it is still useful when you are faced with real threats to your safety, like when you have to slam on your brakes to avoid hitting the car in front of you. In this case, you want to be dysregulated so you can respond effectively: You don't want to be in your window all the time.

However, our fight/flight/ freeze response is also frequently triggered by non-life-threatening occurrences, like a first date, a bad grade, a deadline, an argument, or a visit from your in-laws. While these are stressful events that can result in ebbs and flows in your nervous system and move you toward the edges of your window, sometimes our nervous system responds as if these events are life-threatening, sending us outside our window into fight/flight/freeze.

fight or flight response, trauma therapy seattle

Why do I react so strongly to stress?  Your window of tolerance can narrow and widen based on a number of factors, even throughout the day. If you have experienced trauma or you are going through a stressful time, your window can become very narrow. When your window is narrow, your nervous system is even more attuned to potential dangers, triggering your fight/flight/freeze response more often and for even smaller “threats.” This means your limbic system may sense danger when there is none. Unfortunately, by trying so hard to protect you, your limbic system is unintentionally sending your nervous system on a roller coaster ride that can keep you from experiencing safety and connection.

Expanding your window

How can you expand your window of tolerance? An important step in expanding your window is getting to know your nervous system a little better (you’re already doing this!) and starting to notice what it feels like both when you are within your window and when you are outside your window. You can start to notice what your body feels like when you are calm and connected—and what your body feels like when your emotions are dysregulated. You can start to take note of the types of triggers and situations that your limbic system labels as dangerous.

An equally important step is taking care of your body’s most basic needs like sleep, healthy food, and exercise. Even factors like feeling tired or hungry can narrow your window. Do you tend to snap at others more easily when you’re hungry for dinner? That’s because when your body is running low on something it needs for survival, your window can shrink. Anything that puts your body on high alert-–like physical or emotional pain, perfectionism, self-criticism, and disconnection-–can be a force that narrows your window.

Learning strategies for managing stress and finding ways to connect with other people are also ways to expand your window. Additionally, mindfulness and self-compassion are practices that can make your window bigger over time. Working with a mental health professional to process trauma and difficulties can also help you expand your window and get back to feeling safe and connected.

Coming back into your window

How can you come back into your window once you’ve gone outside? When your limbic system has sent your thinking brain offline and you are outside of your window of tolerance, there are many things you can do. As a general rule of thumb, if you are in fight/flight/freeze mode (hyperarousal), you may need to release energy and then sooth. If you are in collapse mode (hypoarousal), you may need to add energy to your system.

To release energy and then decrease arousal from fight/flight/freeze: First, you might try releasing the energy. Dance, go for a walk, run up and down the stairs, shake your body all around. Then, find something soothing. This might include: deep belly breathing (with exhales longer than inhales), laying on the ground, using a weighted blanket, drinking tea, listening to soothing music, making comforting food, stretching your body, giving yourself a hug, meditating, practicing yoga, or engaging in the 5-4-3-2-1 grounding exercise (find 5 things you see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste).

To increase arousal from collapse: Try out some physical activity like dancing, walking, or even just simply sitting up straight or standing and feeling your feet on the ground. You can also try listening to energizing music, rubbing your arms and legs, or stomping your feet on the ground.

Additional ways to regulate include taking a cold shower or dunking your face in ice water, journaling, doing something creative like drawing or playing an instrument, and increasing your emotional vocabulary (get out that emotion wheel and put a name to what you are feeling!).

Co-Regulation: All of the above tools are focused on what we call self-regulation (tools that you can use on your own). However, co-regulation (tools that are used with others) can be just as important for coming back into your window (as well as widening it). This might look like asking for a hug, petting your dog or your cat, or calling a friend. The people in our lives we feel safe with are one of our greatest resources when it comes to reducing stress, so reaching out for support is a great way to come back into your window of tolerance.

Therapy: If you’d like to explore these topics more specifically, and with a therapist trained to bring the nervous system into trauma therapy, we have therapists with openings for new clients in Seattle who are offering both in-person and virtual sessions. Click here to schedule a free 20-minute consultation now.

Sources:

https://kiddomag.com.au/education/a-handy-way-of-looking-at-childrens-behaviour/

https://www.goodtherapy.org/blog/psychpedia/window-of-tolerance

https://www.mindmypeelings.com/blog/window-of-tolerance

Disenfranchised Grief and Ambiguous Loss

by Eve Evens, LICSW

I was recently reading Ashley C Ford’s memoir, “Somebody’s Daughter” and came across a quote that has continued to stay with me.

"In the stillness of the nights that kept on coming at the end of every day, no matter how pleasant or productive the day had been, I wondered if something was wrong with me for ever loving my father in the first place. It made sense why everyone who knew the truth couldn't look me in the eyes when I asked. They didn't want me to feel ashamed, but they already felt ashamed for me. I saw it on their faces, pointed in my direction."

One of the main themes of her memoir is her experience of both disenfranchised grief and ambiguous loss surrounding her father’s 30-year incarceration. Besides the millions of people in the United States who have a loved one who is incarcerated, I started to think about all the other very common experiences that can cause both ambiguous loss and disenfranchised grief that do not often receive cultural recognition. So, I thought I would take a moment to talk about them here. Even if it doesn’t relate to you specifically, it may make you a better friend or support to someone else in your life who may be experiencing disenfranchised grief and/or ambiguous loss.

Just like society dictates rules for how to act, dress, speak and operate in the world, society also dictates rules around grief and these rules can be subtle or explicit. Disenfranchised grief takes these “grief rules” to another level by assigning who is entitled to grieve and, in turn, who receives support, acknowledgment, and validation in their grief. These societal expectations can feel excruciating when your relationship with someone significant is not acknowledged or the impact of their death or other type of loss is minimized.

Grief becomes disenfranchised when we don’t receive societal validation of our loss and subsequent grieving process. Society says you shouldn’t be grieving, so you feel like you can’t talk about it. You can’t find support. You feel alone. You think your feelings are wrong. There are four umbrella scenarios that could lead to one experiencing this kind of grief:

1) Society says the relationship isn’t important, so grief is not acknowledged

This often happens when your relationship to the deceased is one that society interprets as distant and not worthy of grief. Societal rules often dictate that we grieve “blood” relatives and as we get beyond that circle, we find less acknowledgement of the impact of a death/loss. Some disenfranchised losses that fall into this category may be:

  • Death of an ex-spouse

  • Death of a co-worker

  • Death of a pet

  • Death of an online friend (cyber loss)

  • Death of a same-sex partner

  • Miscarriage or stillbirth

  • Death of a step-child/step-parent

  • Death of a foster child/foster parent

  • Death of other non-blood relationships (friends, boyfriend/girlfriend in-laws, neighbors, etc)

2) The death is stigmatized by society.

Sometimes the cause of death may make it difficult for the griever to talk about the loss, due to stigma. These can involve guilt, shame, blame, and countless other feelings that can cause a griever to hide their grief, feeling the death is not worthy of the same grief based on societal rules. Again, just some examples are:

  • Death by suicide

  • Death by accidental drug overdose

  • Death by child abuse

  • Death to HIV/AIDS

  • Abortion

  • Death due to drunk driving

  • Death of a family member in prison

3) The relationship is stigmatized by society.

Though this can overlap with the two categories above, there are times that the relationship during life was a stigmatized relationship. This can lead to similar feelings after a death, with the griever feeling society will not acknowledge the impact of the loss, or they must continue to hide the relationship. This can include:

  • Death of partner from an extramarital affair

  • Death of a same-sex partner

  • Death of a gang member

  • Death of high-risk/stigmatized peer group (“drinking buddy”, drug abuser)

4) The loss itself isn’t recognized as a grief-worthy because it is not a death

These are often cases of losses that are grieved but are not necessarily a death. Again, this is far from an exhaustive list, but may include:

  • Dementia

  • TBI (traumatic brain injury)

  • Mental illness

  • Infertility

  • Substance Abuse

  • Loss of function

  • Adoption (e.g. an adoptee is told that they should just be “grateful” that they have a family or is cautioned not to be vocal about feelings of loss of their birth family because it may make their adoptive family “feel bad”)

  • Religious conversion (to or away from a religion)

  • Incarceration

  • Disability/Loss of ability (Diagnosed later in life or from birth/childhood)

Similar to disenfranchised grief, “Ambiguous loss” is a term used to describe losses that are related to presence and absence.  There are two types of ambiguous loss; when someone is physically absent but remains psychologically present such as with a missing person, immigration, or adoption; or when a loved one is physically present but psychologically absent, for example with chronic mental illness, addiction, or brain injury. Ambiguous loss differs from traditional loss because you are unable to attain closure. It is uncertain by nature, making it incredibly difficult to understand and to move forward or live with the uncertainty.

While every experience of disenfranchised grief and ambiguous loss is unique, there a few general coping strategies that I believe can be beneficial no matter where we are in our grief/loss. This list is again by no means exhaustive but should serve more as a place to begin or jumping off point to explore other ideas.

1. Acknowledge your love for that person was true and significant and your loss is no less valid. Love is love. Loss is loss. Your love was real and valid; your grief is real and valid.

2. Remind yourself that you are worthy of time and space to grieve, be it the death of a friend, co-worker, four-legged family members, or any other loss. You may even want to write it on a card in your wallet, put it in a note in your phone, or put that message wherever you can easily access it. When someone says something dumb (oh and they will!) that makes you feel you are not worthy of your grief experience, pull that message out, read it over.

3. Remind yourself that you are not alone. It is easy to fall in to isolation when you are finding no acknowledgement or support of your grief. What can be helpful is seeking the experience of others who have experienced similar losses. With the growth of the internet and support group for those experiencing grief/loss, you may be able to find others who have experienced a similar loss, and some of the same challenges of a loss that is not given cultural recognition.  More groups are popping up for survivors of suicide, overdose deaths, stillbirths, transracial adoptees etc.

4. Create your own ritual. There are many times that, due to the nature of these losses, that you are not able to take part in a funeral or closure ritual in the way you would have wanted. Maybe because of the nature of the relationship, you were not welcome at the funeral, or you felt awkward, so you didn’t attend at all. Maybe there was no funeral to go to or memorial to visit, such as with adoptees or the loved ones of incarcerated individuals.

Consider if it would be helpful to create your own ritual now. This doesn’t have to be elaborate; it could be as simple as writing a letter or visiting a meaningful place.

5. Assess your support system. Though you may be feeling that none of your family or friends are supportive, be sure to really think carefully about this before you write everyone off. If all your “usual suspects” are not supportive, think of people a little further outside your circle. Sometimes you find empathetic people in surprising places! This may be just the time to reach out to a distant friend who also lost a child to overdose, suffered a miscarriage, etc.

6. Seek personal ways to explore grief and express your emotions. Consider journaling, art, photography, and other personal expression. Though you may not have the external support you want, you can still find ways to explore your grief and emotions on your own.

7. Be a support to others experiencing disenfranchised grief and ambiguous loss. This is something you may not be ready for right away, but down the road, it can be healing to be a support to others. Remember that, just because you have a similar loss, this does not mean your experience will be identical. But you can acknowledge and validate their right to grieve, no matter how similar or dissimilar their experience is to your own.

I know some of you may be thinking “That’s all well and good, but what’s the point when I have so little impact on changing society’s view of grief and loss”. It’s true. We cannot change society’s grief/loss rules overnight. But society’s rules, norms, and expectations DO evolve over time and we as those who have experienced disenfranchised grief and ambiguous loss play a very real part in that.

We can speak up about these losses and how deeply they impact us. We can support others and give them the permission they need to grieve, no matter what. We can help others understand when their words are hurtful and minimize another’s grief. We can start sharing our experiences with our friends, family, and community, if and when we feel strong enough, because those are the things they will remember and cling to if they have the misfortune to suffer a similar loss. We can stand up for the fact that we are all worthy of having our grief and loss humanized, no matter what shape it comes in.



If you’re experiencing any type of grief right now, we have therapists who can provide you with support. Going to therapy is perfectly normal when you’re grieving. Click here to book a consultation now.