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.
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?).
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
What’s Happening in the Nervous System of Patients Who “Please and Appease” (or Fawn) in Response to Trauma? With Stephen Porges, PhD
[Infographic] – How the Nervous System Responds to Trauma
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