1
00:00:00,000 --> 00:00:04,029
You know the Polyvagal Theory's
primary states already, safety,

2
00:00:04,600 --> 00:00:06,920
flight-fight, and shutdown.

3
00:00:07,340 --> 00:00:10,370
But what happens if they mix?

4
00:00:11,540 --> 00:00:15,269
In this episode, we move
into the mixed states.

5
00:00:15,659 --> 00:00:18,680
What happens when two
states are firing at once?

6
00:00:19,379 --> 00:00:21,360
And we start with freeze.

7
00:00:22,019 --> 00:00:23,939
Why freeze is not the same as shutdown.

8
00:00:24,189 --> 00:00:29,220
What panic and phobias and rage have
in common, and the difference between

9
00:00:29,320 --> 00:00:32,909
coping with freeze in the moment
and actually thawing it over time.

10
00:00:33,459 --> 00:00:38,980
And we will return to Courtney as
her story takes a difficult turn.

11
00:00:40,270 --> 00:00:41,379
I'm Justin Sunseri.

12
00:00:41,500 --> 00:00:41,850
Hi.

13
00:00:41,959 --> 00:00:46,910
I'm a therapist, a self-regulation
coach, and Polyvagal Institute

14
00:00:47,090 --> 00:00:48,930
Editorial Board member.

15
00:00:49,529 --> 00:00:52,050
Welcome to Stuck Not Broken.

16
00:00:52,119 --> 00:00:56,869
This is Book One: Trauma
and the Polyvagal Paradigm.

17
00:00:56,869 --> 00:01:00,719
This is a, uh, audiobook that I
am reading to you all through,

18
00:01:00,899 --> 00:01:02,959
uh, season two of the podcast.

19
00:01:03,559 --> 00:01:07,789
So obviously, a quick note here before
we continue, this is an audiobook,

20
00:01:08,699 --> 00:01:10,799
and it's meant to be heard in order.

21
00:01:11,269 --> 00:01:14,659
Each episode builds on the ones before it.

22
00:01:15,389 --> 00:01:18,990
So if you're just finding the show
now, I am so happy you're here.

23
00:01:18,990 --> 00:01:19,429
Welcome.

24
00:01:19,709 --> 00:01:22,719
But also go back and start
from the beginning, please.

25
00:01:23,080 --> 00:01:26,280
It'll make a lot more sense that way,
especially if you're new to this stuff.

26
00:01:26,930 --> 00:01:30,889
And if you do wanna support the show
or you'd rather read the book, this

27
00:01:30,930 --> 00:01:35,749
book and the next two are available
now in both digital and softcover.

28
00:01:36,229 --> 00:01:40,069
I'll put a link in the description
and thank you ahead of time if you

29
00:01:40,070 --> 00:01:42,940
choose to support the show financially.

30
00:01:42,949 --> 00:01:43,959
I appreciate it.

31
00:01:44,383 --> 00:01:46,923
The mixed s- The mixed states.

32
00:01:48,273 --> 00:01:53,263
So far, we've only covered the primary
states of the autonomic nervous system.

33
00:01:53,913 --> 00:01:57,453
There are more states, but
these are the mixed states.

34
00:01:58,173 --> 00:02:04,083
When two or all primary states are active
simultaneously, they create a mixed state.

35
00:02:04,693 --> 00:02:08,063
If you mix two primary colors,
you get a secondary color, right?

36
00:02:08,643 --> 00:02:11,703
Red paint mixed with blue
paint makes purple paint.

37
00:02:12,403 --> 00:02:15,143
Two primaries create a mixed result.

38
00:02:15,453 --> 00:02:21,346
Same with polyvagal primary states
and mixed states   The mixed states,

39
00:02:21,546 --> 00:02:24,236
uh, math breaks down like this.

40
00:02:24,456 --> 00:02:28,006
Freeze is flight or fight plus shutdown.

41
00:02:28,716 --> 00:02:31,806
Play and motivation are
safety plus flight-fight.

42
00:02:32,296 --> 00:02:37,816
Stillness and intimacy are safety
plus shutdown, and appease is safety

43
00:02:37,826 --> 00:02:42,196
plus fight-fight plus shutdown, and
fawn is flight or fight plus shutdown.

44
00:02:43,746 --> 00:02:46,386
We'll talk about each one of
these more in future episodes, so

45
00:02:46,386 --> 00:02:47,156
you don't have to memorize that.

46
00:02:47,166 --> 00:02:48,346
We're gonna start with freeze, though.

47
00:02:49,546 --> 00:02:52,646
Freeze is not shutdown.

48
00:02:53,786 --> 00:02:59,046
You've probably noticed by now
that I refer to the third polyvagal

49
00:02:59,056 --> 00:03:02,266
rung as shutdown and not freeze.

50
00:03:03,066 --> 00:03:07,486
Typically, the word freeze is used,
and it was also my default word.

51
00:03:08,136 --> 00:03:14,326
That is, until I chatted with Dr. Porges,
and he clarified that freeze and shutdown

52
00:03:14,326 --> 00:03:19,176
are  distinct autonomic phenomena,
though they are closely connected.

53
00:03:20,306 --> 00:03:24,696
He says, "There is this whole ambiguity
because people use the word freeze

54
00:03:25,316 --> 00:03:27,046
when they really mean shutting down.

55
00:03:27,606 --> 00:03:30,866
The mouse in the jaws
of a cat is not frozen.

56
00:03:31,106 --> 00:03:31,906
It's just limp.

57
00:03:32,626 --> 00:03:37,466
The limp loss of muscle tone
is a dorsal vagal response." He

58
00:03:37,466 --> 00:03:40,866
said that in my interview with
him way back in episode fifteen.

59
00:03:42,166 --> 00:03:46,256
Shutdown and freeze are both
immobile, yes, though shutdown is a

60
00:03:46,336 --> 00:03:48,946
limp collapse and freeze is tense.

61
00:03:49,616 --> 00:03:54,566
Freeze combines sympathetic
flight-fight plus dorsal vagal

62
00:03:54,586 --> 00:03:57,856
shutdown, mobility plus immobility.

63
00:03:58,426 --> 00:04:02,706
Freeze involves an intense and rapid
buildup of energy to run or fight,

64
00:04:03,156 --> 00:04:09,226
while also the body immobilizes, whether
that's due to force or perception.

65
00:04:10,387 --> 00:04:12,307
Sexual assault is an obvious example.

66
00:04:12,507 --> 00:04:15,967
There's an impulse to mobilize, but
the individual is unable to use it.

67
00:04:16,547 --> 00:04:18,997
They potentially enter
a freeze mixed state.

68
00:04:19,607 --> 00:04:23,527
Their body is immobile while
sympathetically charged.

69
00:04:24,597 --> 00:04:29,707
People can also enter the freeze state
in everyday scenarios, like being put to

70
00:04:29,707 --> 00:04:32,437
sleep while highly anxious before surgery.

71
00:04:33,167 --> 00:04:36,647
When someone goes under in this
state, they come out of their

72
00:04:36,687 --> 00:04:38,957
anesthesia with a sympathetic charge.

73
00:04:39,557 --> 00:04:42,167
They wake up in a fit,
screaming or flailing.

74
00:04:43,017 --> 00:04:48,377
This terrifying waking scenario is
something that medical staff have told me

75
00:04:48,377 --> 00:04:51,077
that they often witness in surgical rooms

76
00:04:52,333 --> 00:04:58,493
Panic might be the most common experience
of freeze, uh, day-to-day experience.

77
00:04:59,283 --> 00:05:02,343
Think about the last time
you had a pa- a panic attack.

78
00:05:02,923 --> 00:05:06,813
Your heart rate was probably
increased, breathing was shallow and

79
00:05:06,813 --> 00:05:09,693
pressured, but you were also immobile.

80
00:05:10,233 --> 00:05:13,622
Your sympathetic state
was active but frozen.

81
00:05:14,424 --> 00:05:18,374
Phobias might be the result of a
freeze response within individuals.

82
00:05:18,654 --> 00:05:23,104
Certain stimuli, like spiders, activate
the sympathetic and dorsal vagal

83
00:05:23,494 --> 00:05:28,044
systems, or they trigger a freeze
activation that's already there.

84
00:05:28,594 --> 00:05:33,664
For me in particular, driving over bridges
can induce this response, or it has.

85
00:05:33,664 --> 00:05:36,804
I've gotten… It's gotten a lot
better, but it has, um, especially

86
00:05:36,804 --> 00:05:38,164
if I can't see the ground.

87
00:05:38,784 --> 00:05:40,874
Rationally, I know I'm safe.

88
00:05:40,904 --> 00:05:45,054
My car is reliable, I'm a
capable driver, and the bridge

89
00:05:45,054 --> 00:05:47,304
is structurally sound, isn't it?

90
00:05:48,214 --> 00:05:52,174
However, when I cross over those
bridges, my heart rate goes way

91
00:05:52,174 --> 00:05:55,434
up, breathing becomes shallow
and rapid, and my muscles tense.

92
00:05:56,114 --> 00:06:00,064
Despite my efforts to stay grounded,
I feel disconnected from reality.

93
00:06:00,774 --> 00:06:05,884
My mind conjures a catastrophic scenario
where my car stalls on the bridge,

94
00:06:05,914 --> 00:06:09,154
causing a pileup as cars ram into me.

95
00:06:10,104 --> 00:06:12,034
Like I said, it's gotten better,
but it used to be pretty bad.

96
00:06:13,034 --> 00:06:17,954
After talking out loud, narrating
everything happening, and forcing

97
00:06:17,954 --> 00:06:22,964
myself to maintain regular breathing,
I overcome the acute freeze

98
00:06:22,964 --> 00:06:24,844
response, and I regain control.

99
00:06:25,514 --> 00:06:29,464
Once I reach solid ground, the
freeze immediately subsides.

100
00:06:30,014 --> 00:06:33,284
Freeze is the combination of
sympathetic flight-fight plus shutdown.

101
00:06:33,824 --> 00:06:39,374
But the sympathetic system has two
distinct possibilities, flight or fight.

102
00:06:40,464 --> 00:06:46,154
What happens when one is in a dominant
flight sympathetic plus shutdown?

103
00:06:46,444 --> 00:06:49,604
And what about a dominant
fight plus shutdown?

104
00:06:50,844 --> 00:06:54,464
When flight mixes with
shutdown, it results in a

105
00:06:54,474 --> 00:06:56,954
frozen panic, like the phobias.

106
00:06:57,724 --> 00:07:01,644
Panic is specifically the
immobilized impulse to flee.

107
00:07:02,007 --> 00:07:06,267
But when fight mixes with shutdown,
it results in explosive rage.

108
00:07:06,277 --> 00:07:10,447
At least the release of the
fight activation from a fight

109
00:07:10,447 --> 00:07:14,557
freeze can be rage when the
immobilization piece of it comes off.

110
00:07:14,567 --> 00:07:19,357
Otherwise, panic and rage can live really
frozen in the system for quite a while.

111
00:07:21,207 --> 00:07:23,417
Coming out of freeze in the moment.

112
00:07:24,807 --> 00:07:28,497
There is not a singular coping
skill that works for everyone in the

113
00:07:28,497 --> 00:07:34,277
intense moments of panic and rage,
fear, and overwhelm, sorry to say.

114
00:07:34,967 --> 00:07:37,007
Sensory stimulation is helpful for some.

115
00:07:37,317 --> 00:07:40,727
It may help if a loved one
firmly grasps your hand.

116
00:07:41,237 --> 00:07:44,757
Saying things out loud can be helpful,
like narrating what's happening or

117
00:07:44,757 --> 00:07:45,997
counting things in the environment.

118
00:07:45,997 --> 00:07:46,607
Yeah, maybe.

119
00:07:47,697 --> 00:07:51,597
But really, anything to get your
body a bit more grounded into the

120
00:07:51,597 --> 00:07:54,187
present moment or to get you more
grounded into your body as well.

121
00:07:54,777 --> 00:07:58,057
Anything to get the safety pathways
a little bit more active can

122
00:07:58,057 --> 00:08:00,767
help the freeze intensity reduce.

123
00:08:01,797 --> 00:08:06,757
So those ideas and many, many
other options, they're fairly

124
00:08:06,777 --> 00:08:10,887
typical coping skills or grounding
techniques to help reduce the

125
00:08:10,887 --> 00:08:14,777
intensity of a momentary freeze.

126
00:08:15,607 --> 00:08:18,417
They don't exactly help the
individual to feel more safe.

127
00:08:19,007 --> 00:08:22,207
It's more like they reduce the freeze
activation, which is something.

128
00:08:23,107 --> 00:08:26,727
Coping with freeze through these
techniques is different than anchoring

129
00:08:26,727 --> 00:08:30,837
to safety and actually balancing it
out and actually relieving the freeze.

130
00:08:31,847 --> 00:08:35,217
Yeah, I know it seems impossible,
but if you build the strength of

131
00:08:35,217 --> 00:08:39,917
your safety state enough, you can
eventually notice when there's a

132
00:08:40,067 --> 00:08:44,777
tolerable amount of panic in the system
before it becomes a full-on panic.

133
00:08:45,617 --> 00:08:48,287
You might notice it as anxiety or worry.

134
00:08:49,117 --> 00:08:54,337
The feeling is still there, but it hasn't
yet built into a crescendo of panic.

135
00:08:54,967 --> 00:09:00,037
Likewise, you could eventually notice
lower levels of anger or irritation

136
00:09:00,097 --> 00:09:05,797
before it's a full-on rage, or mild
stress before it becomes overwhelm.

137
00:09:06,433 --> 00:09:10,493
When you notice the lower level of
emotions building into a freeze,

138
00:09:10,613 --> 00:09:14,283
you can use mindful safety anchoring
or coping skills more effectively.

139
00:09:15,123 --> 00:09:18,843
Balance out the mild freeze with
safety activation if you can.

140
00:09:19,473 --> 00:09:23,903
When you do, the immobilization
of freeze can peel away, allowing

141
00:09:23,903 --> 00:09:25,483
the mobility of flight-fight.

142
00:09:26,203 --> 00:09:29,973
Then mindfully use the flight-fight
activation through movement,

143
00:09:30,103 --> 00:09:33,793
like walking outside or tensing
and releasing your muscles.

144
00:09:34,533 --> 00:09:37,393
It can also help to listen to
and allow your body to breathe

145
00:09:37,393 --> 00:09:38,903
as it naturally needs to.

146
00:09:39,163 --> 00:09:42,263
Or maybe you could even
purposefully extend your exhale.

147
00:09:42,263 --> 00:09:47,293
That can help settle into safety a little
bit more and then try a small movement.

148
00:09:47,870 --> 00:09:50,760
This probably seems
impossible or intimidating.

149
00:09:51,560 --> 00:09:55,600
If you practice safety outside the
context of a freeze, using those

150
00:09:55,600 --> 00:09:57,670
same skills is more accessible.

151
00:09:57,940 --> 00:10:02,760
Likewise, practice noticing mild
flight-fight activation before it

152
00:10:02,760 --> 00:10:05,570
becomes anxiety or anger that's too much.

153
00:10:06,310 --> 00:10:08,930
When you notice it, use a safety
practice to balance it out.

154
00:10:09,620 --> 00:10:14,360
Over time, your ability to notice
mild freeze activation early on will

155
00:10:14,390 --> 00:10:19,930
increase, and you can use coping or safety
anchoring techniques way more effectively.

156
00:10:20,920 --> 00:10:25,140
Freeze activation will also
reduce and be more tolerable.

157
00:10:25,860 --> 00:10:28,220
Eventually, it might
not be an issue at all.

158
00:10:30,892 --> 00:10:33,452
Coming out of freeze through thawing.

159
00:10:35,124 --> 00:10:41,264
But a freeze state can be ongoing,
not just one panic attack, but a

160
00:10:41,264 --> 00:10:45,774
state that someone can potentially
exist in for years and years.

161
00:10:46,674 --> 00:10:50,214
Don't confront the
long-lasting freeze directly.

162
00:10:50,844 --> 00:10:54,934
Instead, one should
gradually thaw the freeze.

163
00:10:55,694 --> 00:11:00,484
Ideally, the stuck sympathetic energy
is felt in small pieces at a time.

164
00:11:00,914 --> 00:11:03,994
Uh, this is something called
titration, and there's much more

165
00:11:03,994 --> 00:11:06,034
on this process in book three.

166
00:11:07,064 --> 00:11:12,934
However, therapists and other helping
professionals sadly often ignore

167
00:11:13,224 --> 00:11:18,194
one essential aspect of thawing a
freeze in their trauma work, building

168
00:11:18,194 --> 00:11:20,274
the client's safety state strength.

169
00:11:21,164 --> 00:11:22,634
More on that in book two.

170
00:11:23,554 --> 00:11:26,584
This neglect results in re-traumatization.

171
00:11:27,374 --> 00:11:30,914
If your safety state is not strong
enough, you may end up re-traumatizing

172
00:11:30,914 --> 00:11:35,604
yourself by attempting to heal your
freeze before you're ready for it.

173
00:11:36,614 --> 00:11:42,154
It will be self-defeating and reinforce
any fears you have about getting unstuck.

174
00:11:43,624 --> 00:11:49,474
I know you want to discharge your
freeze energy to heal the trauma and,

175
00:11:49,474 --> 00:11:52,774
and move on with life, like right now.

176
00:11:53,684 --> 00:11:58,874
But do not rush this process because
it could result in re-traumatization.

177
00:12:00,014 --> 00:12:05,654
Therapies that focus on trauma
narratives like EMDR and trauma-focused

178
00:12:05,664 --> 00:12:13,464
CBT may inadvertently reinforce
trauma because of this exact reason.

179
00:12:16,294 --> 00:12:17,004
Titration.

180
00:12:18,134 --> 00:12:21,634
Releasing a bit of trauma at a
time becomes an option once you

181
00:12:21,634 --> 00:12:24,124
anchor deeply enough into safety.

182
00:12:24,784 --> 00:12:28,984
Part of titration is another process
called pendulation, which is shifting

183
00:12:29,054 --> 00:12:32,474
from safety to defense and then
back to safety, back and forth.

184
00:12:33,194 --> 00:12:37,404
Pendulation repeats until the defensive
state softens enough to be tolerable

185
00:12:37,804 --> 00:12:40,194
or even discharges from the body.

186
00:12:40,204 --> 00:12:44,444
And again, much more on this process
and how to get there in book three.

187
00:12:44,464 --> 00:12:45,954
It is not as easy as it sounds.

188
00:12:48,627 --> 00:12:49,187
Courtney.

189
00:12:50,147 --> 00:12:53,287
Let's check in on Courtney once more
now that you know the difference

190
00:12:53,287 --> 00:12:58,917
between shutdown and freeze,
limp versus tense immobilization.

191
00:12:59,937 --> 00:13:01,597
A quick recap, though, first.

192
00:13:02,277 --> 00:13:05,637
She's in the back house at
her aunt's with her friends.

193
00:13:06,397 --> 00:13:10,087
A man came back there and tried to
get into a room with Courtney alone.

194
00:13:10,927 --> 00:13:16,567
Her friends got him to back off,
but he again tried to stop Courtney

195
00:13:16,637 --> 00:13:20,507
from leaving, uh, the front door
to, you know, the front house.

196
00:13:21,527 --> 00:13:26,117
The aunt and others came to the back
house in response to the yelling from

197
00:13:26,167 --> 00:13:31,167
Courtney and her friends, and Courtney's
uncles stepped in and the man backed off.

198
00:13:32,297 --> 00:13:38,447
He laughs it off and marches to the front
house, finally leaving the girls alone.

199
00:13:39,957 --> 00:13:44,747
Courtney and her friends explain what
happened to the aunt and the others that

200
00:13:44,747 --> 00:13:47,007
have gathered around the back house.

201
00:13:48,247 --> 00:13:52,797
They explain how he was acting
weird, trying to be alone with

202
00:13:52,807 --> 00:13:55,097
Courtney, and grabbing at her.

203
00:13:56,157 --> 00:14:00,467
They tell them everything, using
their voices loudly and forcefully.

204
00:14:01,307 --> 00:14:06,827
They demand action be taken,
that the uncles beat his ass.

205
00:14:08,537 --> 00:14:11,637
Her aunt says, "We heard you yelling.

206
00:14:12,577 --> 00:14:18,587
Then we checked the security cameras
and saw everything before coming down

207
00:14:18,587 --> 00:14:25,027
here." The aunt looks Courtney up
and down and says, "He wouldn't act

208
00:14:25,037 --> 00:14:27,977
that way if you didn't lead him on."

209
00:14:30,211 --> 00:14:32,251
Courtney is stunned.

210
00:14:33,411 --> 00:14:36,761
Her eyes go wide, and she stands still.

211
00:14:37,781 --> 00:14:40,511
"Lead him on?" She checks herself.

212
00:14:42,081 --> 00:14:44,321
"I'm wearing a T-shirt, Auntie.

213
00:14:45,381 --> 00:14:46,751
We were just watching TV."

214
00:14:48,825 --> 00:14:52,455
The aunt says, "I've seen you and
your friends back here before.

215
00:14:53,115 --> 00:14:57,045
I've seen you talking to the men and tying
up your shirts and showing your skin.

216
00:15:00,355 --> 00:15:04,235
Courtney feels the energy leave her body.

217
00:15:05,355 --> 00:15:09,945
She goes numb, and her
shoulders slump down in defeat

218
00:15:12,473 --> 00:15:19,053
The ant continues, "Don't be coming
around here no more. You and your

219
00:15:19,143 --> 00:15:21,903
little friends can go somewhere else."

220
00:15:26,027 --> 00:15:30,767
Courtney hangs her head
and walks slowly off.

221
00:15:32,267 --> 00:15:37,257
Her friends put their arms around her,
yelling back at the aunt about what

222
00:15:37,257 --> 00:15:43,147
really happened, how wrong this was,
and how they did not deserve this.

223
00:15:46,073 --> 00:15:50,443
So now that you know the difference
between freeze and shutdown,

224
00:15:51,733 --> 00:15:54,013
what do you notice in the story?

225
00:15:54,240 --> 00:15:57,560
Before this section, Courtney
clearly went from her safety

226
00:15:57,560 --> 00:16:00,260
state to flight and then fight.

227
00:16:01,810 --> 00:16:06,060
After the man leaves, Courtney and her
friends are still in their fight state.

228
00:16:07,190 --> 00:16:11,210
They successfully got the
attention of others, but their

229
00:16:11,350 --> 00:16:12,880
fight activation persisted.

230
00:16:13,910 --> 00:16:18,290
Perhaps this is because the
man faced no repercussions.

231
00:16:19,160 --> 00:16:21,280
He simply walked off
like nothing happened.

232
00:16:22,480 --> 00:16:24,670
There was no justice in this scenario.

233
00:16:24,830 --> 00:16:29,030
So the fight activation,
the anger lingered.

234
00:16:30,640 --> 00:16:36,390
But something else happens when her
aunt blames her for the man's actions.

235
00:16:37,600 --> 00:16:40,710
Courtney immobilizes while in a fight.

236
00:16:42,250 --> 00:16:48,190
She is stunned into a brief freeze,
but exits it and again uses her

237
00:16:48,310 --> 00:16:50,350
fight energy to demand action.

238
00:16:51,360 --> 00:16:54,790
When her aunt persists in blaming
Courtney, she enters a shutdown.

239
00:16:55,720 --> 00:17:00,370
The shutdown is further solidified
when her aunt outright rejects

240
00:17:00,800 --> 00:17:03,320
and bans her from coming back.

241
00:17:05,090 --> 00:17:11,230
That is freeze, the tense mixed
state, flight or fight plus shutdown.

242
00:17:11,670 --> 00:17:13,460
Gas and brake at the same time.

243
00:17:14,070 --> 00:17:17,860
And it's the first of the mixed
states where the primary states start

244
00:17:17,860 --> 00:17:23,090
combining into the fuller range of
what we actually feel day to day.

245
00:17:24,140 --> 00:17:27,580
Next time we'll, we'll do a
lighter one, play and motivation.

246
00:17:28,510 --> 00:17:33,250
The mixed state of safety plus
flight or fight and why it

247
00:17:33,250 --> 00:17:35,440
matters maybe more than it sounds.

248
00:17:36,700 --> 00:17:40,310
If you wanna take this chapter
further, the written book has journal

249
00:17:40,310 --> 00:17:45,560
reflections for it, along with
primary source quotes and no ads.

250
00:17:46,410 --> 00:17:49,840
It and the next two books are
linked in the description if

251
00:17:49,840 --> 00:17:50,950
you'd like to support the show.

252
00:17:51,780 --> 00:17:53,370
Thank you so much for listening.

253
00:17:53,850 --> 00:17:54,110
Bye.