Blog
Types of trauma and responses to trauma: ‘Fixing’ as ‘the fifth f … a new thought
These days, talking about the responses to trauma triggers is household language. With public figures like Gabor Mate also becoming household names, there’s a much greater understanding and literacy about our tenderness and vulnerability as human beings. There is much more awareness of the range of experience; from people who are constitutionally highly sensitive, and whose nervous systems and psychology are acutely affected by stimulus that others with ‘thicker skins’ may not even notice; to the effects of learned patterns of behaviour and defended-ness, such as being hyper-vigilant, which is something that can happen whether people are generally highly sensitive or not.
Nowadays, terms such as trauma, Polyvagal, trigger, PTSD, CPSTD, fight, flight, and freeze, and sympathetic (or parasympathetic) activation, are just some words that are part of common, everyday parlance. This is an important development, in that there is now more general awareness, sensitivity, compassion and support for people who grapple with the effects trauma. In workplaces and schools etc there are more ways peoples’ experiences are understood, and eg some employers realise that it’s to the advantage of the business as well and employees to help people thrive by providing resources to help people manage their symptoms, by time off, or by being able to be honest about how they are impacted by these conditions. (Resources / resourcing is another one of those terms now being recognised and widely-used).
In Somatic Experiencing there is an understanding of what Peter Levine calls HGIA – high global intensity activation - which is a general sensitivity to stimulus, usually associated with developmental trauma, characterised by chronic and sometimes also acute low level anxiety. Gabor Mate’s work highlights that for many people, especially those who are on various spectrums of being neuro-divergent, including ADD, ADHD, autism and Aspergers (to name a few diagnoses), a state of generally feeling awful is the baseline. And that having to ‘mask’ is an experience common to many people, even over and above the level of ‘normal masking’ which is learned early on as a way of fitting in – to family, to school, to society.
Fortunately, psychosomatic therapies like Somatic Experiencing have brough new levels of trauma awareness to working with people psycho-therapeutically, by attending to the nervous system and the body generally as a core part of therapy. Even psychologists working mainly with approaches like CBT now often claim to be ‘trauma aware’, and at least pay lip-service to working with the nervous system, even if many so-called trauma-aware or trauma-informed practices are not and just use the label.
Another part of household language these days is ‘the f’s’ of trauma – fight, flight, and freeze. Nowadays more people are referring to the 4 f’s, fight, flight, fawn and freeze. So, for example, both therapists, society and courts (hopefully) understand that if someone is attacked, including sexually, going into fawn or even freeze is an instinctual response. It doesn’t mean that someone didn’t fight back.
Those with a more in-depth understanding of the range of responses available in the case of aggression or attach would also include ‘social engagement’ as the first response, even before fight. So, for example, if a mugger threatens you on the street and you can talk them out of taking your wallet, rather than running away, or freezing, you have used social engagement as the first line of defence, without needing to engage the others.
We also see, in doing trauma therapy, that a piece of therapeutic work is complete when the client returns to a state of social engagement, for example you may smile or even joke with your therapist at the end of a session, after working with states of the other ‘fs’, as a sign that nervous system regulation has happened. So it’s important to understand that social engagement is as important a response to work with as the f’s. This is one reason why doing verbal repair pieces of work are part of trauma healing, ie getting to speak what wasn’t able to be spoken.
If you’d like to understand in more depth about the stages and complexities of the ‘4 f’s’ I highly recommend Pete Walker’s brilliant book Complex PTSD from surviving to thriving. Walker details the various ways the 4 fs can manifest. To name just two examples, repetitive OCD behaviours can actually be a form of a thwarted flight response, and social anxiety and isolation can be manifestations of freeze. (Walker talks about this and more in fascinating detail). Knowing this is invaluable in terms of how best to treat these adaptive behavious. (Walker’s book is also an excellent resource for learning about the superego – which he calls the inner critic, and how best to deal with it).
I’d like to introduce another consideration into this discussion: something I’m calling ‘the fifth f’ which is fixing. I haven’t seen this named in the literature, but I believe that ‘fixing’ is also a common, indeed almost universal response to trauma. As anyone with trauma, or who works with people with trauma knows, it’s very common for people dealing with trauma to be constantly looking for ways to resolve and deal with the symptoms. That is, to fix themselves. (Some people also think of or describe themselves as ‘broken’). This can look like trying many types of different psychotherapists, modalities like EMDR, breathwork, other forms of ‘trauma release’, multiple bodyworkers, courses, groups, workshops, medical and nutritional approaches … the list goes on. This is natural, and part of the innate desire to seek healing or wholeness. And of course, by persevering, people can find relief and healing, so this move to fix isn’t a bad thing. But it may be useful to also consider it in a trauma-informed way. Often ‘fixing’ as a trauma-response can be counter-productive at worst or frustrating and upsetting at best, as we can be doing so much we don’t know what is working and what isn’t.
Consistent with key SE principles of slowing things down, of titrating, and of taking enough time to integrate, it can be useful to recognise that, just like being caught up in perpetual anger and blame (a stuck fight response), of always seeking escape (flight), of incessant people-pleasing (fawn) and in dis-association (freeze), over-seeking of help and therapy, and using multiple modalities at once, could be a response to being stuck in fix. This may seem like a subtle distinction at first, but it has profound implications for healing trauma effectively.
There is a whole other piece to be written here on the therapeutic value (indeed necessity) of self-acceptance and compassion, and also about how learning to be with discomfort and uncertainly are crucial aspects of therapy. Indeed, Levine has even defined trauma in a very interestiung way. He says that trauma is happening whenever we are not present.
Being stuck in ‘fixing’, just like being stuck in the other of the ‘f’s’ is simply perpetuating trauma.
What are the implicatioins of this possibility for self-help? That an orientation to ‘fixing’ is actually a trauma response. As with the other 4 f’s, it is important to access this response as a way to heal trauma. However, if fixing is being acted out unconsciously, a compulsion to keep fixing can be as much a symptom of PTSD/ CPTSD as a solution.
One we recognise this, then it’s possible to consider a healing approach that is actually therapeutic, and works out how to institute healthy and appropriate ‘fixing’ strategies and approaches. This is something that will be individual for each person, and can be discussed with your therapist, so that therapy is as effective and efficient as possible.
Therefore it is useful to work with your therapist/s to develop a strategy or plan that recognises and takes account of how to utilise the ‘fix’ response as a productive part of therapy, rather than something that is re-traumatising and counterproductive.