Sunday, November 29, 2009

Three reaction to stress & suicide


Solutions to problems or high stress. It is generally acknowledged that the more a person is placed under stress the more they will revert to their childhood solutions to problems and the more they will regress, as it is known. This means they move from the Parent and Adult ego state into the Child ego state as is shown in the diagram 1 below.



Diagram 1



This illustration shows that as one is placed under more and more stress, the more they will revert to their early ways of thinking, feeling and behaving. The more childlike they will become in their thinking and behavior and the more obvious their early decisions become in how they behave. They move from their grownup Adult and Parent ego states into the Child ego state part of self. This is supported by research in neuro-psychology as is shown by Johnston (2009). When people are placed under stress they are less able to access the pre-frontal cortex of the brain which is associated with the more developed functions like problem solving, decision making and stress management. Instead people will tend to access the more primitive part of the brain in the amygdala.



When this happens the early decisions about how they should think and feel become more pronounced. These early decisions influence the current decision making much more than if the Parent and Adult ego states were fully operational. As a result one finds such people making decisions that may seem quite out of character for them Decisions can be made which seem odd and even bizarre based on the facts at the time because it is the early child like thinking that is dominating in the personality.


Generally there are regarded to be three main responses to high stress. In 1915 an American physiologist called Walter Cannon described the fight or flight response. This is a fundamental response to a threat or perceived attack where the person will either fight the attacker or flee from them. Since that time another response has been added and that is the freeze response where the person does not either attack back or flee they just freeze and end up doing nothing. This freeze response is seen as the ‘playing dead’ reaction. In the animal kingdom sometimes an animal will play dead so that its attacker thinks it is dead, becomes bored and then moves away. A good example of this is the mouse who is caught by a cat. It plays dead in the hope that the cat will tire of it all and become distracted onto something else.


Everyone has used all three at some time but we all will have one basic response that we use when there is a very high threat or very high level of stress. It is our last bastion when all other options have been tried. Our most basic response to stress of course will be the one that we decided upon as a young child and which fits most with our basic temperament. Our temperament will effect our decision making to varying degrees and thus will effect wether we choose fight, flight or freeze as our primary solution to problems and stress.


Fight, flight or freeze?


Below are some behavioral examples of how a person may respond to threat in each of the three ways.


Fight - this person may physically hit out (as can be the case in domestic violence), verbally hit out, fight for their rights, put in a complaint or sue somebody. In childhood this is the child who will hit out, shout in their defense, maybe break property or try and hurt the other person in some way. The primary response is to fight up against the adversary either overtly or covertly. When under great stress this person will tend to hit out at others physically or verbally. In childhood the child may voice disapproval at mother and father or seek to angrily get change in some way in the home. If mother and father are fighting the child may actually seek to intervene in some way between them.


Flight - This solution may include things like using alcohol, drugs or prescription medication. All these are a way of getting away from the problem as a means to solving it. The person who quits their job and simply goes elsewhere. Here one chooses to geographically relocate or to move away from the problem thus solving it in their mind. In childhood the youngster may display running away from home behavior or the child may go and hide under their bed as a response to stress in the home. Unlike the fighter this child does not seek to change the conditions in the home or express their disapproval instead they move away from the problem and wait for it to subside. They want to ‘slide under the radar’.


Freeze - In earlier times this person would have been diagnosed as having a nervous breakdown. In essence the person collapses in on self and goes into a state of incapacitation. They simply fall to the ground or crawl into bed and go into the fetal position. These days people go on stress leave from work, they may seek hospitalization, some can have panic attacks and agoraphobia which are both incapacitating conditions that can keep them home bound. In childhood the child just stands there and simply does not know how to respond. In the extreme they can loose bowel or bladder control. Whereas fight is primarily an angry response, freeze is mainly an anxiety response.



Suicide primarily is a flight response. One solves the problem by getting away from it and suicide does indeed do that. Interestingly enough in the histories of suicidal individuals it is not uncommon to hear of them report running away from home behavior which of course is the flight response as well. Most often if a child says they are going to run away from home, when asked where they are going to run to they has no answer. In essence the child is running away to oblivion.


Suicidal individuals are in a state of considerable distress and often confronted with some very difficult problem whether that be a recent event that has occurred or just an increasing state of malaise, melancholy and distress that has evolved over time. Thus they will act in more child like ways as mentioned before. When taking a client's history they reports flight as a main way of dealing with stress then this is another point to note when making a suicide risk assessment.


All people fight suicidal urges to some degree. If they did not then it would not be long before their did indeed die. If however the person has a primary flight response then they will be more willing to give up on the fight and take the flight solution of suicide. If the person has a strong fight response then you know they will be less likely to give up and make a serious suicide attempt. The no suicide contract can be particularly useful for this type of indidivual. They can use it as part of their fight response.



Counselling generally speaking is a fight response. Client's wish to identify the problem, find the cause of the problem and then change it rather than simply moving away from the problem. However this is not always the case. Some people will use counselling to identify the problem and then seek ways of getting away from it. Depending on what the problem is, either approach can be useful.


For instance if the client has a primary fight response and has a problematic relationship with mother they will tend to try and alter that relationship by changing self or by negotiation. Those with the flight response will not try so much to alter the relationship but will tend to take the solution of simply never seeing mother again. Some people come to counselling to get permission to do precisely that. To get approval from the counsellor and make a decision to terminate the relationship with mother. Obviously as a therapist it is conducive to work out which of these responses the client is essentially looking for.


Those with the flight response are much more likely to seek a purely medication approach to their problems of emotional distress. For instance the medication approach to depression is a example of a flight response. If it is found to be successful then that person would have little interest in seeking a counselling approach as well. On the other hand one not uncommonly meets clients who say they don't like taking medication as it does not solve the problem and they will seek to find the cause of the problem and try and remediate that.


Sometimes the fight response can be the problem in the itself. If the person has a toxic relationship with their mother that brings them great angst they can seek to change it. The problem with changing relationships is it usually requires both parties change. If mother refuses to then there is not much you can do about that. The person with the fight response will tend to continue to try to change the relationship (mother).


Sometimes it is very hard to accept

that things can not be changed



Some things you cannot change and the person with the fight response will have trouble identifying those times and will get stuck trying to change the unchangeable. The therapeutic goal in these circumstances is for the person to give up their fight which some can find very hard to do.


Graffiti

27 comments:

  1. OY, I could have really gone forever without seeing that photo of the jumper who landed on the car.

    ReplyDelete
  2. Life is life and death is death isn't it April?

    Cheers

    Graffiti

    ReplyDelete
  3. You are right Roses,
    Only half the time

    Graffiti

    ReplyDelete
  4. Now Roses,
    You know I am not a cheeky chops like you are

    Tony

    ReplyDelete
  5. Remember Mr Graffiti sir that it is you that i aspire to be like. If i'm as good as you say then all the credit goes to you.

    Smile... it's very good for you

    ReplyDelete
  6. Hello Roses,
    Yes I like a smile or two myself.

    Sometimes I am not too sure what to do with you Roses and your aspirations. I like your aspiration and yet I am not too sure what to do with it, if anything

    Graffiti

    ReplyDelete
  7. Good post. I can sure see clinical relevance in this.

    ReplyDelete
  8. Oh! I don't think my aspirations contain anything for you do - except to be yourself and do the best that you can. That's pretty much all i have too.

    I like the way you think you are. And i like the things you aspire to do. Its nice.

    There are no expectations for you to fill. Not from me anyway.

    Its almost christmas - the challenge is to not get caught up in the consumerism of it all. I personally hope my hubby and i make it through another festive season. Things change and i guess that's that.

    Hold on to your hat... Santa's on his way!

    ReplyDelete
  9. Hello Roses,

    It was not so much what do I do with them but how do I respond.

    but WTF! good on you for having such aspirations Roses and I am glad that I am part of them.

    For me christmas is a good time of year and I don't usually get caught up in the hype
    All the best

    Tony

    ReplyDelete
  10. Hello Sara,
    Glad you liked the post

    Consider it my christmas present to you

    Tony

    ReplyDelete
  11. OH and BTW Roses,
    are you a fighter, flighter or freezer?

    OH! Not too sure if I would want to be a "Freezer"!

    Tony

    ReplyDelete
  12. I don’t really know how to answer that question because I can’t tell which one is my main one anymore. I’m not the kind of person who will hit out at anyone but if it were necessary it could happen. Fight, flight or freeze – doesn’t that all depend on which emotions the weight of the main stressors are activating?

    It appears to me that if anger, frustration, annoyance, fear are carrying the weight, then I will probably fight but not so much in a verbal or physical way as such. That’s when I enjoy facing something and challenging it. It could be something that I can’t seem to grasp or someone who is behaving in a challenging way, a puzzle or a game of golf (*rolls eyes*- stupid game!) I do enjoy the challenge.

    When it’s something that I can’t do anything about or seems hopeless, then I dodge, ignore, go around it and keep going on where ever I can.

    Around 6 years ago I fell in a heap for around 3-4 years and failed to function in the most basic ways. I cried all the time, couldn’t think – as though I was in a dream state all the time and at night I, couldn’t for the life of me go to sleep. I would ache like I’d never believed anyone could – basically stopped I guess. Since then, when ever stressors weigh too much, I go to bed and sleep – amazingly for days at a time. I can’t fathom why. Those times are getting less now and instead of a week in bed it’s just a day or an afternoon or something like that and it’s not often – maybe a couple of times this year. Just recently I did spend quite some time in bed – I wasn’t ill, just couldn’t function; so angry and yet our hands were tied. That was when I withdrew from my studies and rested. Maybe I’m learning to read the signs.

    Is that what you mean? I think I’m getting my ‘fight’ reaction back again... gradually. But it’s different this time... somehow.

    Happy day to you...

    ReplyDelete
  13. Hello Roses,

    It does sound like you had a very bad time 6 years ago and it is great to hear that you think you are coming out of it Roses.

    Some of what you describe is a freeze reaction like the going to bed stuff. However from the little I know of you, you do seem to have a fighter quality inside you. However that is based on only the contact we have had over the internet.

    Instead of looking at present day examples it may be more instructive to examine the childhood to see if you can identify a pattern of the three possible responses to stress, in particular this will be shown in the life script decisions you made in the first decade of life.

    Graffiti

    ReplyDelete
  14. Considering how long a childhood actually lasts, it seems i don't remember a lot of it. I think i was always in a dream - they still treat me so. Its nice though - they don't much of me.

    I don't think that i should have been born a human being because i just don't understand things the way others do. Does that even make any sense? Probably not - but it's all good.

    I used to be ultra shy, but i think i learned that everyone is scared so that made things much easier to process some how. I learned to pretend just like everyone else does. It works - but it's a distant and lonely thing to do.

    It - the pretend process - lacks intimacy and i need that.

    ReplyDelete
  15. You make some good points Roses like the pretend process lacks intimacy.

    If I was interviewing you I might ask that as a child where you bullied by your peers. People with the fight response are rarely bullied to any significant degree. They don't accept the bullying and fight back so they are hard work for bullies.

    Whereas the person who freezes and plays dead is far more likely to be the recipient of bullying as they don't do anything and just take it in the hope that it finally stops.

    It does sound Roses that you could have made significant repression of your childhood and so we would have to do repressed memories therapy

    Tony

    ReplyDelete
  16. I remember 2 incidents of being bullied. Both were in primary school (probably 10-12 years of age) and both were only one off incidences. The girls soon became friends. I didn't fight back - i've never found a need to fight back. Strange - both times it happened on a bus - i think i just let them be the boss of the bus and not long after that we were friends. Maybe i'm just not important enough to bother with.

    Everyone seems so nice - mostly.

    Who ever got to me first was the group or gang i'd hang out with that day or that week. Like it matters who one hangs out with at school!

    You have to know Tony, even at that young age, it did seem weird for someone to fight to be 'boss of the bus'. I mean... seriously?

    As i said, i just never understood things the way others seemed to. We humans are a very weird (unique?) species!

    Happy weekend - your theraputic prescription sounds very big and intense. Is it as big and intense as it sounds?

    ReplyDelete
  17. Hello Roses,

    glad you were only bullied twice at school so that wouldn't count. that means you may be a bit of a fight person.

    And yes the therapeutic prescription is big and intense. With repressed memories therapy you find out all sorts of things you had forgotten, some good and some not so good.

    And if the therapist is good enough he can even add a few of his own in as well. Serious.

    Tony

    ReplyDelete
  18. Is that a bit like what Mrs Loftus or people who took Mrs Loftus' stuff and used it - is that what you're talking about?

    Cause that stuff is scary!

    ReplyDelete
  19. I don't know who Mrs Loftus is Roses?
    Tony

    ReplyDelete
  20. Isn't she the lady who found - well, something to do with bring out sexual abuse from the past? They would have a therapy session and then all of a sudden the person remembers being abused when they were a child and then it would go to court and Mrs Loftus would give professional evidence against the accused and the accused would go to goal (jail). But someone found out that innocent people were going to jail and things began to go badly for Mrs Loftus. I think that was her name. Pretty sure that was her name.

    ReplyDelete
  21. No! It was the other way around and that's what got her into trouble! She explained that situations and things could be put into a persons memory and that person would believe that stuff to be the real thing that happened when it wasn't. Sorry - it's been over a year or so since i read it.

    They did the 'lost in the mall' thing where they convinced some people that when they were little they got lost in the mall. They convinced these people that certain things about the (non-existant) situation that eventually became a real (feeling) memory for them.

    People didn't like what she was finding out and when she did testify her stuff, some of the people who were guilty of 'stuff' were getting off the hook. That's when she started getting into trouble. Well that's what the text book said. I think.

    http://en.wikipedia.org/wiki/Elizabeth_Loftus

    ReplyDelete
  22. I remember feeling so angry when i was reading the book... what was it called again... It was something like "Openning Skinners Box"? It was about Psych people - like, famous psych people, and she was one of them. I was so angry while reading hers simply because she had a lot of good ideas and great things to say and she got fairly pummuled for saying it. Just made me angry, that's all.

    ReplyDelete
  23. Hello Roses,
    I had never heard of her before but now I know who she is thanks to you! Maybe that is your christmas gift to me this year!

    Yes it is a very thorny issue and area about repressed memories especially when the law gets involved. I might write a post about it.

    So Roses, I could use some therapy techniques to get you in a highly regressed state and then implant some repressed memories which you believe to be true.

    So what memories do you want Roses? Do you want me to implant the memory of the time when you climbed Mt Everest. That would be a good memory to have.

    Graffiti

    ReplyDelete
  24. Mt Everest?!? Umm, no thanks but thanks anyway. They say frost bite hurts and as you know, i'm not all that good with pain.

    That wasn't a christmas present - least not a very good one. I wonder what i'd get you for christmas? What would you like for christmas?

    Let me think...

    ReplyDelete
  25. Come on Roses, be adventuresome.
    I think it is a good present!
    Tony

    ReplyDelete