The Threat Response

The Threat Response, The Window of Optimal Arousal, and the Traffic Light

This section covers information which is well known by us as clinicians but often not by our patients. We all have different ways to educate our patients on topics. The following is my way of going about it. It seems to be well understood by the people I see. I hope this may help you in your psychoeducation of your patients.

When I work with patients, I tell them I want them to understand the basics of neuro-regulation beyond the fight/flight and freeze response most of them are familiar with. I have a diagram of a traffic light schematic with the green light, yellow light, and red light marked. We talk about we have a limited repertoire of threat responses and that we have the same responses as all mammals. I do refer to it as the mammalian threat response as some of my examples are animal examples.

The first thing we look at is the green light. I refer to it as the state we are in when we feel safe. Safe, both from external threat as well as interpersonal threat. I talk about this as the green light as green means “go”, “everything is a -ok”. I do mention that in this state we have a capacity for connection and the ability to interact with others freely. I tell them that when we are in this state, we have the capacity to feel alive, and can have creativity and joy. This is the preferred baseline state, the default from where we have the most resiliency.

I then indicate that many people do not have this as a baseline state, that because of trauma and other issues, many are in the default of the yellow light, yellow being “caution”. This is the realm of sympathetic nervous system activation. We discuss that when fully “on” we have the flight/flight response but most of the time the baseline is a lower level of arousal. I say we know we tend to live in the yellow light zone if we deal with chronic anxiety, or chronic irritability or anger. This is the baseline realm for the majority of our patients. I indicate they have the capacity to be in the green light sense of safety zone and then explain why it seems so difficult at times.

I then go to the example of the cheetah and the gazelle. I do this as I want the patients to realize that it is not their fault they are anxious or irritable or want to isolate. What I want them to know that when the sympathetic nervous system remains activated, biologically they are not supposed to be interacting with anyone. So, the neurobiology is telling them to stay away the daily tasks of life push them to have to function as if they are in the green light zone. But they are not. To force through the biological drive to flee so they can go to school, go to work, take care of their children etc. takes a huge, massive degree of energy. The result is they are chronically exhausted, often unable to do anything after school or work is over. Many times, they get diagnosed as having chronic fatigue syndrome. When patients learn this, it often brings about a great deal of relief. Not only that but they start giving themselves credit for all the things they have been able to push through to do when their neurobiology as saying loudly, “No! Don’t! “. It gives them the sense that they really do have a lot of resilience and the tendency towards self-blame diminishes.

We then turn to the red light. Red light means “stop”. The red-light state is the state of the immobility, the collapse, what they have heard of as they freeze state. I continue to use the cheetah and gazelle example. I tell them that when fleeing fails, the cheetah catches up with the gazelle, the cheetah does not grab the gazelle to the ground. The gazelle falls to the ground automatically as soon as the claws touch. This immobility, collapse response is the last-ditch effort to stay alive. It is an automatic response, not a choice the gazelle makes. It is “playing” dead in a way. Many predators to not tend to eat dead animals. In addition, hyenas often hang around to snatch the gazelle away. When the cheetah has to deal with the hyena, the gazelle can then get up and run away. So, most of the time the collapse response doesn’t keep the gazelle from being eaten, but sometimes it does. The next thing for them to realize is what happens when the gazelle begins to be eaten? We know from human examples by human beings who begin to be dragged off or start to be eaten by lions. They report feeling nothing, no pain. They also describe that time seems to change, and things feel surreal. What is happening? They are dissociating.

Now coming back to our patients, I tell them that we as humans tend not to fall to the ground like the gazelle. When we are in the red-light zone the human experience is “I want to (do something) but I can’t”. “I have no energy” or “I feel nothing.” Also, there is no sense of a future, thoughts tend to be depressed, and there are often thoughts of death and suicidal ideation. And for many there is dissociation. When patients learn this, they understand why they can’t seem to do anything and again self-blame goes down.

So, what is it that males some patients have a baseline of red light instead of yellow? There are genetic factors, unsolvable life problems, syndromal depression, and others. However, for many patients this zone has been a default for many years. Why? Childhood trauma. A child growing up in an unsafe home has no green light experience. When the trauma is early, the child cannot flee or fight. The only option is red light, shutdown dissociation. Because of the early onset this response is so ingrained so even minor anxiety as an adult can result in automatic dissociation.

Dr. Dan Siegel’s concept of the window of tolerance or the window of optimal arousal is another way to communicate the same neurobiology. It is a different schematic with safety, regulation in the middle, sympathetic nervous system over the window, and immobility/shutdown below the window. Some patients can grasp the concept easier this way, some by the traffic light analogy so I use both.

One final thing. Many patients have learned the phrase “fight/flight, freeze, and fawn” The only problem is that fawn is a complex, learned safety behavior not an autonomic nervous system response. The reason I want the patients to know the difference is that they cannot consciously change the built-in brain stem patterns but they can reduce and discontinue the fawn behavior they don’t like through cognitive-behavioral therapy and good boundary setting. In addition, many women and men who use the fawn behavior a lot can be in active abuse situations, and at risk of being harmed if they don’t fawn. So, when someone brings it up or has any questions about it, I need do a good risk assessment as sometimes the intervention recommended is to get to some other safe place.