Regulating Hyperarousal 2 (Flight Response)

PTSD makes regulating emotions extra hard (more). That is why we will look at ways to deal with different emotions.

But first there is one thing we need to take care of and that is hyperarousal (flight/fight response)

People differ in their tendencies, some going into fight more regularly, others don’t feel that at all and actually get scared of their own aggression when it comes up and they automatically turn to flight.

Hyperarousal (flight) is not fear, but the impulse for action might be similar, that is, run or hide. We cannot manage hyperarousal, which is a physical arousal level, with the psychological tools we use to manage emotions. Our emotions usually make sense, they can be analyzed and we can find a need that drives them. Hyperarousal is a mindless instinctual state that causes undifferentiated attempts of escape.

.

We might enter hyperarousal in harmless every-day situations and literally run from them. That can cause disruptions during work, when in public or during a T session. When we don’t see a way to get out of the situation we might go for hiding instead, which can lead directly into dissociation or at least draw unwanted attention. Other people notice our stressed attempts of hiding/avoiding harm and they cannot comprehend what we are doing because they don’t perceive a threat.

Hyperarousal means that there is a lot of energy buzzing through our body, ready to be used for flight/fight. While the fight-response often comes with nervous energy in the arms (for attacking), the flight-response might show as a restless energy in the legs (for running away). It might be helpful to focus on skills that use the legs to lower arousal levels. That could be:

• an actual running motion while sitting or standing

• jump squats

• calf raises

• standing kicks like in martial arts

• pushing against a resistance

• stomping feet hard on the ground

.

.

For me personally there is rarely an impulse to run and the energy is not as focussed. I am a hider.

I get good results using bi-lateral stimulation. Examples for that are

• taking turns tapping on my left/right knee

• clapping games

• tapping myself with a butterfly hug

• using bi-lateral sounds on my headphones (can be found on youtube)

• or even eye-movement like in EMDR (please don’t try without instructions from your T. Especially in people with DID this kind of bi-lateral stimulation can lower dissociative barriers and that might increase the difficulty of the situation)

When I struggle to get out of mild hyperarousal I use EFT/tapping. I have seen all kinds of opinions about it, from “wicked pseudo-science” to “trauma studies show positive effect”, I do not even believe in the energetic concepts it is based on, but it still helps me.

.

When we are in flight instead of fight mode it is usually easier to receive co-regulation from the people around us. Relational regulation is one of the strongest tools we have to calm down. It can be offered by more regulated people around us or we can tap into a memory of a safe person. Recent science shows that talking to someone calms our nervous system.

So does safe touch, even as small as holding someones hand. If you do it mindfully, you can hold your own hand and still feel a difference.

This is especially useful if you have DID and there are parts of you inside who are in hyperarousal while the front person is not. It is incredibly tricky to calm these parts if they are not connected to the outside world (More). Their mind might not be in a state to reason about safety and grounding but they might be oriented enough to connect with the body. Invite dysregulated parts to send their awareness into one of your hands and then gently hold it with the other one, offering support, warmth, stability and strength. It can create a sense of not being left alone or left behind in trauma time, a comforting presence in the dark.

.

Breathing exercises help our nervous system to calm down quickly. That could include breathing in sync with someone else, humming or singing.

You can also use music for regulation. Put on a song that is matching your current arousal state. Then pick the next song to be a little more calm. You can mindfully listen your way down into your window of tolerance, if you prepare a playlist for these occasions.

Nature is like medicine. Just looking at trees, flowers, grass and natural water sources can dissolve our stress. Going for a walk would be great, but if there is no park around, google images for things like “beautiful lake”, “mountain sunset” or “hidden beach”. Pick a picture you like and a spot in the picture where you would like to be. Then imagine being there, breathing in the fresh air, taking in the environment.

.

The division between flight and fight we are making here is an artificial one. It just describes tendencies but it is normal to go from one to the other within seconds. They are like different sides of the same coin, that is hyperarousal. More on fight

When you calmed down enough you can go on with more stabilizing work like discrimination and a reality check or move to identifying emotions and regulating them. Always make sure to stay within your window of tolerance. If the interventions above are not strong enough you can find more intense DBT skills over here.