Do these sound like common traits your clients have? These may not be character traits but, instead, trauma responses.
Trauma is a mental injury, and our body may react to unconscious memories of significant negative events unknown even to us. Our body subconsciously protects us from future trauma.
How we respond to trauma has consequential implications on how we live our lives. Trauma responses ensure physical and emotional safety; however, these unintended reactions may interfere with our ability to flourish.
How can we teach our clients to identify these unintentional reactions and use them to their benefit? Read on to gain the tools to help us accomplish this feat.
Trauma responses are innate; they occur without our consciousness. A reaction to a perceived threat is called a trauma response. It is a survival instinct; it is reflexive and automatic.
Your body reacts to this perceived threat without your approval. Smells and sounds may remind your clients of the trauma they experienced and bring about memories that perhaps at one time were repressed. Despite the individual’s awareness, the unconscious self still remembers, and the body reacts.
A trauma response is how your nervous system has adapted following a significant situation and can manifest in various ways, whether there is an actual threat, or a threat is perceived.
Trauma responses cause a person to be hypervigilant, which may create an overwhelmed individual under normal circumstances. Contrarily, a person experiencing hypervigilance may also prove to be an effective person during crises.
Trauma responses get a bad rap; however, if clients can recognize them, they can prevent them from controlling their lives.
4 Typical Trauma Response Types
Originally, fight and flight were thought to be the only responses to stress, which focused on the autonomic nervous system (McCarty, 2016; Katz et al., 2021).
Freeze, as a trauma response type, was later developed after observing lab rats in stressful situations (Katz et al., 2021).
Today, the four most commonly known trauma response types include fight, flight, freeze, and fawn. Each of these actions is an adaptive, functional short-term survival counteraction.
Fight
As we know, the fight response involves combativeness toward the perpetrator. Example demonstrations of fight may include kicking, punching, or threatening the attacker (Katz et al., 2021). It may also include being verbally argumentative and yelling.
If an individual is quick to anger, they may be demonstrating a fight trauma response. This symptom of arousal may indicate self-criticism when someone feels internally threatened (Germer & Neff, 2015).
This reaction may include any attempt to stand up against a threat. It is a form of assertiveness. At a healthy level, it delineates healthy boundaries.
At a primal level, if an animal feels it is being attacked, it may choose to fight back if the threat is manageable. If the animal feels that it cannot successfully fight the threat, it may resort to our next trauma response.
Flight
Flight involves literally or metaphorically running from an actual or perceived danger. It is an act of nonconfrontation and avoidance of a threat. More importantly, it is a biologically determined sequence of responses to stress (Bracha, 2004). Flight is a disengagement from the stress-inducing stimulus. Paired with fight, it is the cornerstone of stress response research by Walter B. Cannon (McCarty, 2016).
Flight may include the habit of leaving the room or fleeing from the home following an argument. It may also include drug and alcohol abuse to avoid emotions.
Further, individuals demonstrating the flight response may be disconnected from their family, friends, or coworkers. Someone exhibiting the flight response may isolate themselves.
Over-sharing, over-explaining, and trauma dumping may indicate compartmentalization. If an individual shows compartmentalization, it may mean that they are unconsciously trying to distance themselves from the trauma, thus allowing them to speak of the event nonchalantly. Considering the purpose of divulging the information, this response could also be intended to gain attention (Shabahang et al., 2022), including sympathy or validation.
Hyper-independence occurs when an individual internalizes that dependence on others is unsafe. They avoid asking for help and instead build a wall. This could be a trauma response of flight, as the individual is avoiding an interaction or relationship.
Hypersexualization may also suggest a flight response. Someone who is hypersexual may be fleeing from other emotions. Likewise, this response may also represent the fawn response as an attempt to please others, which we will discuss later.
Freeze
This is an effective technique when fight or flight are not an option (d’Andrea et al., 2013). When the typical fight-or-flight responses are put on hold, this is considered the freeze response (Kozlowska et al., 2015).
This stress response involves the typical stop, look, and listen response and commands hypervigilance (Bracha, 2004). An individual may resort to this response when assessing a situation. Some suggest this response precedes the fight-or-flight, as the animal or victim is determining which response to employ.
As a primal example, during a bear encounter, physically attacking the bear may be unwise; likewise, running from the bear may not be helpful either. Feigning death may be your way out of this critical situation. This immobility eliminates auditory and visual clues that would otherwise provoke aggression (Baldwin, 2013).
Binge eating could be considered a freeze response (Rodriguez-Quiroga et al., 2021). Instead of facing the situation, a person who engages in binge eating consumes an unusually large amount of food in a relatively short amount of time. This type of eating disorder can be just as dangerous as bulimia and anorexia.
This stress response helps the individual to hide, and it shows that you are not a threat. Further, the person experiencing the freeze response is provided the opportunity to process the threat.
Fawn
This lesser-known and least-understood trauma response may be confused with being a character trait. Arguably, this may be the only response where one engages with the potential threat and attempts to change the other person’s behavior. The trauma response stems from our innate need for social connection and co-regulation.
In this response, a person may mirror the other individual’s gestures, facial expressions, or speech. They are hypervigilant about everyone’s happiness and safety in the room.
Physically speaking, individuals who consistently show fawning as their trauma response may also experience temporomandibular joint disorder, more commonly known as lockjaw, or pain in their jaw. They are overly agreeable and frequently sacrifice their boundaries.
For example, a man orders a well-done steak with a side salad from a notable restaurant. What he receives is a steak that is cooked medium rare with a side of French fries. That was not his order; however, he does not bring this oversight to the server’s attention for fear of disappointing someone, whether that be the wait staff or the chef.
People who frequently demonstrate the fawn response may be described as people pleasers, workaholics, over-explainers, and over-apologizers. During a traumatic event, a victim may experience Stockholm syndrome, which is when an individual attempts to appease one’s abuser or captor (Bailey et al., 2023).
Codependency can also be a fawn response (Walker, 2013). This is an unhealthy and dysfunctional relationship dynamic involving one person assuming the role of the “giver.” This response may also be referred to as the “friend” and “appease” response.
Besides the typical fight, flight, freeze, and fawn, there are a few more responses you may not be familiar with. Fright, flag, and faint are a few of the lesser-known trauma responses that are theorized by professionals of this field.
Fright
The fright response indicates tonic immobility. At first, the freeze response was theorized; however, it soon became apparent that this response could be differentiated from fright (Katz et al., 2021).
Similar to freeze and faint, the person experiencing fright will play dead, so to speak (Bracha, 2004). This is better understood when a predator has its prey in its grasp, and the prey goes limp and ceases its struggle to make itself less desirable for consumption.
Flag
This fifth element in Schauer and Elbert’s (2015) defense cascade model notes the beginning of the shutdown of the parasympathetic activation.
The defense cascade model offers a conceptual framework for a brief interview aimed at evaluating the underlying issues contributing to and resulting in the dissociative subtype of post-traumatic stress disorder (Schauer & Elbert, 2015). The flag response is characterized by numbness of emotion, cognitive failure, a drop in arousal, and surrender.
The individual’s attention may be elsewhere, and they may feel like they are observing themself, which is an example of disassociation. This is a built-in defense mechanism that increases pain tolerance or numbs emotional response.
The person who experienced the trauma may exhibit memory lapses as their brain attempts to protect its emotional wellbeing. For more fascinating information on this trauma response, you can watch this video by Tracey Marks.
How to deal with dissociation as a reaction to trauma
Faint
Also a biologically determined response to acute stress defense, faint is a lesser-known response (Bracha, 2004).
This may also be referred to as the “flop” response, also indicative of tonic immobility and is a preferable option when fight or flight is not possible. A common example of this phenomenon is when a person sees blood and literally faints from the sight of it.
Dealing With PTSD
Unlike the other disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, a diagnosis of post-traumatic stress disorder (PTSD) requires exposure to a particular type of event (American Psychiatric Association, 2013; Baldwin, 2013).
The symptoms that arise because of PTSD can be “severe and prolonged and interfere with social and/or occupational functioning” (Muldoon et al., 2019, p. 315).
In dealing with PTSD, the patient needs to reprocess the trauma in a safe environment. They require closure on how the trauma has affected them.
This unique disorder involves repeated experiences of traumatic stress that form a fear network that can separate contextual cues, including the time and location of the danger (Schauer & Elbert, 2015).
Clients who have been diagnosed with PTSD may benefit from the following techniques, as well as some of the later-mentioned trauma therapies:
Sensory grounding
To help them ground themself and bring awareness, encourage your client to try the following practice:
Name five things you can see, four things you can hear, three things you can touch, two things you can smell, and one thing you can taste.
They could also carry a grounding smell, such as a scented lotion, perfume, or cologne, or carry a grounding sensory object, such as a fidget or soft item. These grounding tools can be used discretely and have profound effects.
Cognitive grounding
Cognitive grounding is a process where clients must show themselves that they are safe. They could verbally review the following thoughts:
Remind yourself where the trauma occurred and how physically far you are from that location.
Remind yourself when the trauma occurred and how long ago that was.
Repeat inspiring quotes say coping statements such as:
I can handle this.
These feelings are temporary.
My present situation is different.
How do grounding exercises help with fears? - Dr. Tracey Marks
Healing Trauma: 7 Therapies
It comes as no surprise that trauma can have deleterious effects on physical and mental health. Trauma comes in different forms and varies from person to person. It is also important to remember that trauma can be passed down through generations.
Talk therapy is one of the most common trauma therapies; however, if verbalizing trauma seems more harmful than beneficial, there are other options.
Regardless, here is a non-exhaustive list of therapies that can address trauma.
Neurofeedback
With the goal of self-regulation and modification of brainwave patterns, neurofeedback is a therapeutic technique that uses electroencephalogram (EEG) to measure brainwave patterns. Clients receive immediate feedback about their brain activity.
Taken a step further, electroencephalographic neurofeedback is a cutting-edge treatment that reduces symptoms of PTSD by also modulating brain activity (Askovic et al., 2023). Neurofeedback using EEG involves regulating brain activity by adjusting the EEG frequency bands.
Typically, individuals exert control over their EEG patterns through visual or auditory feedback mechanisms. Neurofeedback techniques are advantageous because the patient doesn’t have to revisit painful memories that could be triggering.
Trauma-focused Cognitive-Behavioral Therapy
Trauma-focused Cognitive-Behavioral Therapy practices such as cognitive therapy, cognitive processing therapy, and prolonged exposure are effective in treating trauma (Murray et al., 2022).
In these therapies, the client talks about their trauma, and through the partnership with the therapist, they are tasked with making sense of the memories so they affect the client less.
Trauma-focused Cognitive-Behavioral Therapy is a type of talk therapy that has proven to be a beneficial intervention for trauma responses, including PTSD (Averill & Abdallah, 2022).
It can also be referred to as counseling, psychotherapy, or just therapy. It is a communication-based therapy where the therapist talks through the trauma with the client and creates a list of strategies to use.
Eye movement desensitization and reprocessing (EMDR)
EMDR therapy is a psychotherapy that is effective in treating not only PTSD, but other trauma-related psychological disorders (Mazzoni et al., 2022; Poli et al., 2023).
In using this therapy, the patient reduces the vividness and emotion of the traumatic memory by focusing on that traumatic memory while simultaneously experiencing bilateral stimulation such as eye movements, tapping, or tones.
Prolonged exposure
Prolonged exposure (PE) is an exposure-based form of Cognitive-Behavioral Therapy that has been shown to reduce PTSD and related psychopathology (Powers et al., 2010; van Minnen et al., 2012).
PE allows the client to work through fear extinction mechanisms using safe trauma-related stimuli, imaginal exposure, and processing of trauma memories without feared outcomes (van Minnen et al., 2012).
In this approach, the client confronts trauma-related memories, feelings, and situations that they have otherwise avoided or repressed.
Emotional freedom techniques (EFT) have been found to effectively treat psychological conditions (Fox, 2013). In this therapy, exposure to the trauma is paired with tapping specific acupuncture points.
EFT tapping is among the group therapies called energy psychology. It has been shown to improve conditions such as anxiety, depression, phobias, and PTSD, as well as physical ailments such as fibromyalgia, psoriasis, tension headaches, pain, traumatic brain injury, and seizure disorders (Nelms & Castel, 2016).
In this practice, unresolved emotional barriers are released, reducing the impact and intensity of past traumatic events. It involves tapping each of the five meridian points five to seven times while focusing on the negative emotion.
Somatic experiencing therapy
Somatic experiencing is a body-oriented therapeutic approach that focuses on the psychophysiological consequences of the event and can have positive effects on PTSD-related symptoms (Kuhfuß et al., 2021). In this intervention, clients focus on their body’s response to stress and restoring their nervous system back to a state of healthy balance.
The premise of this therapy is bottom-up processing, and the client brings awareness to their interoceptive, kinesthetic, and proprioceptive experiences (Brom et al., 2017).
To explore this therapy more, check out this video by therapist Emma McAdam.
Healing the nervous system from trauma: somatic experiencing
Internal Family Systems Therapy
Internal Family Systems (IFS) Therapy is a type of psychotherapy most notable for treating mood disorders, eating disorders, and personality disorders (Lester, 2017).
Working under the premise that the mind is made up of parts and not a single entity, this research-based approach addresses sub-personalities or families. IFS Therapy addresses these sub-personalities to focus on restoring harmony and balance, aligning them with the client’s core self.
17 Exercises To Reduce Stress & Burnout
Help your clients prevent burnout, handle stressors, and achieve a healthy, sustainable work-life balance with these 17 Stress & Burnout Prevention Exercises [PDF].
We discussed several therapies that address trauma, with EMDR being one of them. If you think this may be an effective technique for your patients, we suggest this EMDR Worksheet for your sessions.
Another trauma therapy we mentioned was the imaginal exposure process, and we’ve got a worksheet to help you with this technique. For additional information on somatic experiencing therapy, kindly refer to our article, Somatic Experiencing Therapy: 10 Best Exercises and Examples.
Our Growing Stronger With Trauma worksheet will assist your clients in identifying strengths they have gained from the traumatic event.
If your patients show the flight or freeze trauma response, you may wish to share the Conquering Avoidant Tendencies worksheet with them. By pinpointing the trigger, action steps, and coping mechanisms, your client can refrain from the propensity of the flight or freeze trauma responses.
Perhaps your client is hesitant to verbalize their trauma. Providing our worksheet, Healing From Trauma Through Writing, may help them overcome some effects of their trauma.
Understanding trauma responses enables us to help our clients identify their behavioral reactions to trauma and shut them down, allowing them to live more productive lives and truly flourish.
If a client recognizes their trauma response, they will be empowered to not only mitigate the behavior, but will also have more compassion toward themselves. They learn to observe the behavior, which provides clarity. They begin to understand that these sometimes-quirky behaviors are designed to protect them. Knowing this, clients can allow themselves more grace and kindness.
Trauma responses are a thermostat for potential danger. If an individual is sensitive to danger, they will have the advantage to survive. On the other hand, individuals sensitive to danger may also have difficulty leading a fulfilling life.
It is our duty to help our clients understand their trauma responses and get them to use them in a more positive and meaningful way.
What are the most common trauma responses you see in your clients, and what techniques do you suggest? Share in the comments below!
There are countless triggers to a trauma response; however, at the most basic level, a perceived threat or an unconscious memory of a traumatic event could elicit a trauma response. Unconscious memories may include a specific time of day, smell, taste, or anything or anyone who reminds the individual of the trauma.
Can trauma change your personality?
Trauma responses can be confused with personality traits. When your trauma responses are frequent, others may perceive this is your actual personality, when in reality they are your innate responses to a trauma experienced.
Is compassion fatigue a trauma response?
Yes, compassion fatigue can also be considered a trauma response to secondary trauma.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Askovic, M., Soh, N., Elhindi, J., & Harris, A. W. (2023). Neurofeedback for post-traumatic stress disorder: Systematic review and meta-analysis of clinical and neurophysiological outcomes. European Journal of Psychotraumatology, 14(2).
Averill, L. A., & Abdallah, C. G. (2022). Investigational drugs for assisting psychotherapy for posttraumatic stress disorder (PTSD): Emerging approaches and shifting paradigms in the era of psychedelic medicine. Expert Opinion on Investigational Drugs, 31(2), 133–137.
Bailey, R., Dugard, J., Smith, S. F., & Porges, S. W. (2023). Appeasement: Replacing Stockholm syndrome as a definition of a survival strategy. European Journal of Psychotraumatology, 14(1).
Baldwin, D. V. (2013). Primitive mechanisms of trauma response: An evolutionary perspective on trauma-related disorders. Neuroscience & Biobehavioral Reviews, 37(8), 1549–1566.
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d’Andrea, W., Pole, N., DePierro, J., Freed, S., & Wallace, D. B. (2013). Heterogeneity of defensive responses after exposure to trauma: Blunted autonomic reactivity in response to startling sounds. International Journal of Psychophysiology, 90(1), 80–89.
Fox, L. (2013). Is acupoint tapping an active ingredient or an inert placebo in emotional freedom techniques (EFT)? A randomized controlled dismantling study. Energy Psychology: Theory, Research and Treatment Journal, 5(2), 15–28.
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Katz, C., Tsur, N., Talmon, A., & Nicolet, R. (2021). Beyond fight, flight, and freeze: Towards a new conceptualization of peritraumatic responses to child sexual abuse based on retrospective accounts of adult survivors. Child Abuse & Neglect, 112.
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About the author
Tiffany Sauber Millacci, Ph.D., is an educator for both university students and elementary-aged students. She is a continuous learner who seeks facts through research and enjoys sharing her learning through her writing.
Over-sharing.
Originally, 
Unlike the other disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, a diagnosis of post-traumatic stress disorder (PTSD) requires exposure to a particular type of event (American Psychiatric Association, 2013; Baldwin, 2013).
