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How to Help a Client Come Back from Freezing in a Session

27 Comments

Working through trauma can trigger many perceived threats for our clients.

They might start to breath rapidly and find it hard to hold still, or perhaps they start to freeze up during the session.

So what are some practical ways to calm the nervous system and keep a client grounded – especially when they begin to freeze?

Bethany Brand, PhD will walk you through 5 strategies in the video below. Have a listen.

 

 

 

Click here for full transcript
Dr.Brand: Noticing that breathing getting very rapid, the person sounding agitated, looking tense, maybe they’re making fists, looking like it’s hard to hold still, then you point that out and you say, “Do you notice that? Could we just take a minute and let’s stop talking about what we were discussing and instead just take a minute. Look around the room and describe it.” This is where clinicians often know the skill, describe three things in full detail. As they begin to describe what it is they see in your office, I often add because they’re feeling at some level threat I’ll say, “What are three things that you like to look at in my office?” They go to those things that becomes their anchor again. With my client, I’ll say, “Look at the cat figurine, can you describe that one,” or whatever. One of my patients loves the plants in my office, “Look at the crazy hair plant, can you describe that?” We’re connecting back to our relationship and the present moment. As they’re doing that, their sympathetic nervous system is starting to calm down because they’re able to start breathing better, more normally. If I’m not seeing their breathing get regulated, then I may also point that out after they’ve described some items in the office in detail. I might say, “It’s looking like your breathing is still fast, do you notice that? How about we work on breathing together.” Just letting our breath out slowly, that exhalation is really important to activating the parasympathetic nervous system. I’ll keep checking back in with them from time to time, “Are you feeling more present now? Are you back here in the office with me?” For clients who are okay with the technique of just asking where are you from 0 to 10, it’s a very cognitive technique but I’m trying to help them learn to tell where along the level of dissociation are they. I might ask how grounded do they feel right now if 10 is very grounded, that’s what we’re looking to be, somewhere in that upper range. When they can tell me they’re there, then we go on back to, if we can, whatever we were talking about. If I’m noticing that they’re starting to look more frozen, so they’re breathing often begins to slow down, well, the breathing may continue rapidly, but they’re frozen. I may just point it out, that it looks like you’re starting to get a little bit still and your breathing is rapid, do you notice that, could we work on grounding. When they’re starting to go into the beginning state where there’s both hyper arousal or sympathetic nervous system and parasympathetic activated at the same time, so the rapid breathing plus a frozen state, I want them to recognize that if they can. Then because they’re frozen, that can be very frightening to people who’ve been traumatized. Not being able to move can be terrifying. I’m going to try and help them get to the point where they can move. I’ll say, “It’s looking like you’re frozen or holding very still. Would it be okay just to move just a little bit? Maybe you could push your feet into the floor.” I’m watching for that tension. If i see there’s the beginning of a movement, I’ll just keep going with that, but if I see no indication of movement, then it probably means that they’re more frozen, or into that tonic immobility state and maybe going into collapse. Although with collapse, you begin to see exactly what the name says. You often begin to see the person pulling inward, getting small, something like that. Going back to the tonic immobility, I’m trying to get a little muscle movement. If I don’t see any indication their feet are pressing into the floor, I might say it looks like I’m not noticing that. I wonder if you might move in a way that’s so small nobody could see it. The reason why that can be helpful for some people is because they learn to hold very still as a survival mechanism. They didn’t want people to notice them, they wanted to be small and hidden as best they could, and take up little space often. If you add that little statement that nobody could see them, they might be a little bit less afraid. I might suggest maybe you could just move a toe or a little pinky finger, something like that. If you see any movement, then you keep encouraging them to increase that, “That’s great, see if you can keep moving that even more. Wonderful, you’re starting to get yourself unfrozen, that’s terrific.” I might just repeat from time to time, “You’re here with me, and who I am because you’re working on orienting. You’re with me in my office. It’s may 2020.” I’m just repeating all these kind of grounding orienting techniques while I’m encouraging movement.

It can be very challenging when a client freezes in a session – that’s why it’s critical to have a full toolkit of strategies to help them mobilize and feel grounded again.

Now we’d like to hear from you. What have you found most helpful when working with a client who freezes up during a session? Let us know in the comments below.

If you found this helpful, here are a few more resources you might be interested in:

[Infographic] How to Differentiate Between the Freeze and Shutdown Trauma Responses

Working with the Freeze Response in the Treatment of Trauma with Stephen Porges, PhD

When a Client Is Stuck in the Freeze Response, with Peter Levine, PhD

 

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Related Posts: Healing Trauma, Nervous System, Trauma, Trauma Therapy

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27 Comments

  1. Rose Ann Vita, Psychotherapy, CA says

    Thank you. So simple, yet so profound.

    Reply
  2. K Hay, Clergy, Shawnee, KS, USA says

    Excellent, practical, beneficial!!!

    Reply
  3. Robyn Bowie, Counseling, GB says

    Like this a lot! It’s important to distinguish between entering into hyperarousal and entering into freeze, and using different strategies accordingly. I love the idea of the hidden movement— this idea had never occurred to me before but it makes good empathic sense. I think it also accommodates the shame that accompanies trauma for so many of us. Being allowed to keep something private, keep it to yourself, yet not abandoning the client in their distress— what a good idea.
    This description sounds like powerful empathy and superb pacing. I think I can learn something important from it.

    Reply
  4. Deborah Wiggins-Hay, Other, GB says

    Does the freeze necessarily always have the fast breathing? What Are your thoughts about when it is Accompanied with the held breath, or slower or interrupted breathing? Thank you.

    Reply
  5. Patricia Lane, AU says

    Thank you – this is very useful

    Reply
  6. Bridget Burgess, Counseling, AU says

    Very helpful…thank you

    Reply
  7. Judith Rivera Rosso, Another Field, IT says

    Beautiful! Thank you!

    Reply
  8. Beatruz Fontana, Other, CA says

    Extraordinary simple content and way to deliver it! Thanks!

    Usually we hear about dealing with fight or flight, but very seldom about the frozen state

    I also wonder how this might be a parallel to a state of “being stuck” on a daily basis during longer periods of time (weeks, months or even years)?

    Reply
    • Beatriz Font, Other, CA says

      Beatriz

      Reply
      • S Beck, Teacher, USA says

        Aha! Yes, it seems that may be a direct correlation.

        Reply
  9. Lo, Social Work, Norman, OK, USA says

    The freezing response is interesting in that the patient is seemingly trying as the video emphasizes to become invisible. I would like them to remember a time when they liked a certain amount of attention, then feel into that more and more stressing relaxation all the while and grounding!

    Reply
  10. Shelley Stockwell-Nicholas, Rancho Palos Verdes, CA, USA says

    What you describe as “frozen” may also mean that they are entering a natural trance state which can be fully passive and that is terrific because now you can dialogue with their Higher Self.
    Shelley Stockwell-Nicholas, PhD

    Reply
    • S Beck, Teacher, Mpls, MN, USA says

      I understand frozen as appearing inactive (passive), yet in reality is very actively defensive, not the least bit passive.

      Reply
      • Anonymous says

        I don’t think in all cases it is a defensive response, although it can look that way, I think it may be a way of opening up to the therapist in the only safe way that is known at that time for that part of the traumatized self.

        Reply
    • Anonymous says

      I agree with your statement, however, the “Higher Self” may be a dissociated younger self coming forth and testing the waters.

      Reply
  11. susan, Psychotherapy, CHEEKTOWAGA, NY, USA says

    wonderful “environmental” awareness tips. Breathing awareness often is my go to. Particularity with the telehealth system the initial tips offered are very helpful

    Reply
  12. Nancy Allen, Another Field, USA says

    Very helpful. Yesterday my puppy, who has been triggering my childhood trauma and freeze with her aggressive play biting, punctured my arthritic hand. It was incredibly painful. I was shocked at my response. I freaked and froze. Inside I was jittering, close to a breakdown! The naming and describing three things, even to myself, would have led me out of it. I will remember this tool. Thank you.

    Reply
  13. Ginger S, Psychology, Coraopolis , PA, USA says

    These are techniques that I’ve used for a long time; but I must say your presentation was absolutely beautifully done. Bravo

    Reply
  14. Brenda M, Social Work, CA says

    What a fabulous teacher you are! Would love to do training with you! Never mind have you as my Therapist. I knew everything you said however how to use it as you walked us through was amazing and unforgettable. Thank You! And my future clients thank you.

    Reply
  15. Judy Lipson, Counseling, West Bloomfield , MI, USA says

    Dr. Brand, I thank you so much for your descriptions and your gentle techniques. This is the first time I’ve ever seen anyone talk so clearly about the frozen state. Can’t thank you enough.

    Reply
  16. Lynn Ber, Social Work, Keene , NH, USA says

    Excellent grounding strategies.

    Reply
  17. Esther Brandon, Coach, Boston, MA, USA says

    Your approaches are so clearly integrated with the somatic touchstones. Thank you from my experience breathing is not always neutral, Ivan be triggering…. mindfully noticing sounds or simply noticing your fingers, eac finger can be grounding for some people. Thank you, Esther

    Reply
  18. Louisa Aspden, Counseling, GB says

    This is really useful and practical. thank you

    Reply
  19. Philip Allen, Psychotherapy, GB says

    Very helpful indeed. Much thanks

    Reply
  20. Luisa Giordano, Counseling, GB says

    So helpful
    Thank you

    Reply
  21. Gertrude van Voorden, Health Education, NL says

    Knowing my Frozen lasted up to 3 hrs in the past her remarks would make me feel terribly nervous, unloved, unaccepted. What works is a safe place, outside the office, alone, a chair, where i can just let the Frozen melt in its own pace. My dentist, one of my worst traumatriggers, has put a picture of his 5 dogs, heads only, put up at the ceiling. It connects me to his dogs, his love for them as well as to my own 3 dogs. I am an extreme empath, which according to Peter Levine happens to patients with prenatal trauma a lot. Connecting to personal emotional states of a therapist, knowing f. i. she is a mother who was pregnant and birthed children works.

    Reply
  22. Joanne Hurst, Other, GB says

    Bethany Brand .. your expression is ….. spacious .. you moved me to almost tears by the end …… that sensation one gets when one …… deeply witnesses .. how somebody else is in tune with ….. deep lifelong terror. …… I use the word terror as that it what I have been consumed by ….. a long time.
    .. to be honest am .. so unresolved, so wearily pre-frightened, flooded with terror taking over my body as normal .. when someone even mentions breath work.
    I just ….. go. Like, having ones whole body dispersed at a molecular level, the energy is all, the energy at dispersal is total, instant, heart pounding, skin weird, inside flesh taking over any brain like rational anything.
    All gone.
    This is survival, and its obvs. not just in the therapy room, but in the every day …… very scary.
    I drank for many years just try and .. be normal.
    The way you talk in this video, it is …..very noticeablethat you notice .. that is what stops me in my tracks and …… allows .. for the fact that this stuff is real.
    Thank You.

    Reply

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