Like many of the emerging defense responses to trauma, the collapse/submit response can be difficult to recognize.
So to give you a clearer idea of what this trauma response can look like, we created this free infographic that highlights four key ways it might present in a client.
To put this infographic together, we gathered insights from several leaders in the field of trauma: Ruth Lanius, MD, PhD; Pat Ogden, PhD; and Deb Dana, LCSW.
Take a look.
Click the image to enlarge
Adapted from Ruth Lanius, MD, PhD, Pat Ogden, PhD, and Deb Dana, LCSW.
The collapse/submit trauma response is often considered “the defense response of last resort.” It’s how the nervous system often handles chronic, inescapable trauma.
In a moment of trauma, the defense response can lessen the client’s experience of pain. But after the trauma has passed, these adaptations interfere with a healthy life.
Here are four key ways collapse/submit might show up in your client:
1.Compliance / Obedience
Your client might be simply going through the motions of life on autopilot. They may feel detached from bodily experiences, and their feelings no longer guide their actions. For example, a client who experiences domestic violence may no longer be aware of fear, which keeps the person in the situation.
2.Treatment-Resistant Depression
Experiencing ongoing, inescapable traumatic stress can lead to treatment-resistant depression. The defining feature of this kind of depression is learned helplessness. When your client presents with this symptom, it’s important to consider the client’s history (for example, did they experience chronic, inescapable stress?).
3.Interpersonal Conflict
A patient in collapse/submit might have difficulty engaging with others and/or setting boundaries.
4.Social Avoidance / Desire to Isolate
Collapse/submit can make it difficult for a patient to engage in basic daily activities, like making meals or personal hygiene. They may withdraw socially.
Being able to recognize the many ways that collapse/submit can manifest in your client is crucial for providing effective treatment.
(If you’re sharing this infographic, please attribute it to NICABM. We put a lot of work into creating these resources for you. Thanks!)
If you’d like to print a copy, you can use one of these links:
In the Advanced Master Program on the Treatment of Trauma, we take a look at how to work with the collapse/submit response at the level of the nervous system.
Beyond that, the experts get into the attach/cry-for-help and please & appease (or fawn) responses, along with how to detect and work with them.
You’ll hear from top experts in the field of trauma treatment, like Bessel van der Kolk, MD; Peter Levine, PhD; Pat Ogden, PhD; Stephen Porges, PhD; Ruth Lanius, MD, PhD; and Deb Dana, LCSW. Take a look here.
Now we’d like to hear your takeaways from this infographic. What have you found helps clients who are stuck in the collapse/submit defense response? Please let us know by leaving a comment below.
If you found this helpful, here are a few more resources you might be interested in:
Is Your Patient “Feeling” Unworthy? What May Be the Underlying Cause, with Janina Fisher, PhD
[Infographic] – How the Nervous System Responds to Trauma
It gives you no clues as to what intervention would work
One of the best info to read and share with my client.
You are truly awesome and not alone. Myself and those who are with me see you and rejoice that we are not alone either. Coming to understand that the imprint was a lie helped me. I still cannot feel or belief that others love me BUT I do feel and believe that I love me. That changes everything. Be with peace.
A’
Phenomenal effort for a very difficult , multilayered psychological state. Done a super job of teasing it out, visually and clarity of text
Hello everyone. I’m looking for someone who has this incredible knowledge and skill to help me work through so much trauma (of literally every type you can image). Any recommendations for therapists in Victoria, BC would be appreciated.
Sincerely,
Kathie Cross
Thank you.
Really good thank you
What a RELIEF to see that someone else gets this..well stated!!!
Excellent resources!!!! Thank you for sharing!!!
Thank you for this infographic. The pictures can definitely create a visceral response if one has experienced any of these feelings/sensations. It helps one feel understood and seen.
Items like these are helpful for working with my clients and for my own trauma recovery journey.
I myself was caught in compliance/depression/isolation after a series of extremely traumatic events over some years. I try to get acupressure sessions two or three times a year, I did an art therapy class on zoom, I hire a house cleaner for 1 1/2 hours every two weeks, I adopted some chickens to take care of, and once I started to come out of it a bit, I resumed an old “art project” (refurbishing an old boat). The acupressure allows me to feel “normal” for about a day, which is a good reminder. (Plus it moves me to take a bath or shower first.) The art therapy stretched my brain and improved my confidence a little . Before the house cleaner comes I usually do the dishes and after she’s gone the result makes me feel briefly that I could actually DO this and sometimes I even do the dishes the next day as well. That’s usually good for at least a day, and the house is slightly less unsanitary. (Does nothing for the personal hygiene issue though.) The chickens were a huge leap and having living beings to be responsible for was a mood booster. It made me adhere to a routine, and they actually sparked some feel-good emotion, especially when I got some chicks too and they lived inside the front of my down vest for the first couple of weeks (it was winter.) Killing them (as meat birds) makes me sad but capable and self sufficient. (Progress, as I was numb for so long.) As for the boat, it makes me feel capable and confident when I get something to fit right, but the issue now is to keep at it. I’d like to learn to value the time I spend on it more highly. Because it’s hair brained and crazy, I don’t honour it as a healing agent the way I could. Old women around me paint flowers…. I say “I paint boats” but my boats are basically a solitary pursuit and garners little to no attention or interest. They’re too big to take to the art centre. Not that I think I want recognition, but I do realize it isolates me from just about everybody and that’s probably not a good thing.
Thank you Rosalind. You ve reassured me that the ideas I’m working on with a client are good. And you ve given me some new inspiration. May you go from strength to strength. And keep sharing. Theres lots out there also struggling like you.
Anne
Thank you for sharing these helpful resources.
Hi,
Yes bringing awareness to body posture in a session….facilitating more open posture supports clients in collapse…..thank you for the graphic,
Melanie (Psychotherapist and Play therapist)
This infographic is very helpful. I can think of several clients I could help using this tool. Thanks!
Many thanks for the info graphics. The visual image combined with a distilled text is potent, a good reminder to re-centre especially when, paradoxically, the pull of strong energy is capable of seducing us away from what matters.
Thanks for the effort taken to create these aids.
I found this very informative, helpful and thought provoking. I will certainly be using it to inform my assessments of my clients.