In the previous blog series, we learned all about mindfulness.  In particular, we learned that applied mindfulness involves a three-step sequence: Awareness, Acceptance, Action. First we need to become more aware of what’s happening in the moment.  Then we need to become more accepting of what’s happening in the moment. And then, once we are both more aware and more accepting, we are in a much better position to finally take action:  In other words, to deal with the situation.

 

When we experience trauma, however, we are not using the part of the brain that guides us through awareness, acceptance, and action.  We are using a different part of the brain which is more concerned about our immediate survival. We are using the part of the brain that causes us to alter awareness, activate judgments—and jump straight to action as soon as possible.  But there are only three main options for action with this part of the brain: Fight, flight, or freeze.

 

The fight response means we become hostile or belligerent (whether physically, emotionally, or verbally).  

The flight response means we either physically leave or emotionally avoid a situation.  

And the freeze response means we just shut down altogether.  An extreme example of the freeze response is fainting.        

 

So what happens when you are in a situation in which it is not safe to fight back and it’s also not possible to escape?  That’s precisely why many trauma survivors learn to freeze—and then escape in their own minds. This is a process that psychologists call dissociation.  Dissociation is a combination of the freeze and flight response; this happens when you mentally freeze and then mentally escape, even if your body is still fully functioning and fully present in the situation.

All of these responses to danger or crisis are extremely helpful when we are experiencing a traumatic situation.  Awareness is altered because you need to focus only on survival. Judgments are activated because you need to make quick snappy decisions about life-and-death matters.  And you certainly do not have the luxury of consulting with a panel of experts on the best course of action. That’s why your brain limits your choices to the three options most likely to help you survive: fight, flight, freeze (which, as we saw, includes dissociation).

 

But here’s the problem…

 

When we have been traumatized enough, we learn to execute these responses to everything in life—even if we are not in immediate danger or crisis! In other words, our brains over-learn these responses.  Do you see the problem with that?

Let’s assume your coworker responds to you in a tone that you did not expect.  Now let’s assume your awareness is altered (you only notice her stressed tone, not her baggy eyes from not sleeping last night)…and then your judgments are activated instead of acceptance (“I can’t believe I have to work with scum that give me no respect)…and then you jump straight to fight, flight, to freeze.  I will let your own imagination take over from there. But here’s my point: Are you off to a good start at work? Did your trauma response just make things better—or a whole lot worse?

 

Remember that DBT is all about restoring balance?  DBT has entire set of skills called Distress Tolerance which are designed to provide temporary “quick fixes” to help us quickly restore balance in the moment, when we are triggered.  In other words, the purpose of these skills is to give us alternatives to replace our instinctive fight/flight/freeze reactions, and to get us back into our Balanced Mind as soon as possible.  

 

One of my favorite definitions of Distress Tolerance is “how to survive the moment without making it worse.”  In short, Distress Tolerance is all about healthier and more effective ways of coping—as opposed to unhealthy or ineffective coping, in which you hurt yourself, hurt someone else, or somehow make the problem worse than it already was. Another definition of Distress Tolerance that I really like is “turning unbearable pain into bearable pain.” Notice that Distress Tolerance does not take away pain—but it does help you deal with painful situations in ways that do not cause the pain to become even worse.

   

Ultimately, Distress Tolerance skills will help you with both acceptance and action.  That’s why the first Distress Tolerance skill you will learn is called Extreme Acceptance.  As you will see, Extreme Acceptance is a special kind of acceptance that we need to apply to both trauma and its consequences. However, after you learn about Extreme Acceptance, you will next learn a series of coping skills that will help you take action; in other words, learn how to react in more effective ways.

Notice that effective coping involves both acceptance and action. This is another one of the great balancing acts of DBT!

For practical exercises to learn more about your

fight, flight, freeze response, please refer to my new workbook: 

DBT Skills Workbook for PTSD: Practical Exercises for Overcoming Trauma

and Post-Traumatic Stress Disorder

Coming soon in 2019!