Survival Physiology
Understanding Survival Physiology in the Context of Complex Health and Trauma
What is Survival Physiology?
This term differentiates threat physiology from non-threat physiology.
It refers to high tone sympathetic state (high arousal) and high tone dorsal parasympathetic state (freeze). These can be triggered when we perceive threat. These exist at the two far ends of the spectrum of sympathetic or parasympathetic response. The responses are supposed to be time-limited, however when a person endures a repeated or constant exposure to stress, illness or trauma, ‘survival physiology’ can last for extended periods or time, or indeed become a permanent way of being. Existing in these survival states takes a large toll on us physically and causes a high allostatic load.
Once a shift into survival physiology is initiated, our rational mind ceases to exist as a means for rationalisation or control. We are driven by a physiological survival imperative and our system responds accordingly.
‘Survival physiology brings urgency and extinguishes curiosity and creativity’ (Kathy L. Kain & Stephen J. Terrell — Nurturing Resilience)
Sympathetic Vs Parasympathetic Activation
When we exist in high sympathetic activation, we experience changes in our physical systems including our heart rate, blood pressure, our hearing and the brain’s ability to process and make memories. These changes cause us to filter our environment and search for threat. When we search for threat, we will most certainly find it.
At the opposing end, when we activate a high dorsal parasympathetic tone, we may disconnect from ourselves and the world around us, become numb to our experience and in most extreme circumstances fall into a physiological ‘freeze’ or shut down state.
Understanding the nature of survival and the importance of a healthy ANS
‘Survival Physiology’ is not compatible with logical thought, connectedness to self or a balanced/healthy response to others and the environment.
It effects both our exteroception (experience of our environment) and interoception (experience of signals and sensations within the body). When existing in survival physiology, effects span across all layers of self — physical, mental/emotional, behavioural and social.
If we have a healthy foundation to our physiology/ANS development, our survival mechanisms will likely be time-appropriate; kicking in at the sense of danger and ending when the danger has passed. Our level of response will likely be an accurate match to the level of threat.
‘To effectively switch from defensive to social engagement strategies, the mammalian nervous system needs to perform two important adaptive tasks 1) assess risk and 2) if the environment is perceived as safe, inhibit the more primitive limbic structures that control fight, flight or freeze behaviours. Any stimulus that has the potential for increasing an organism’s experience of safety has the potential of recruiting the evolutionary more advanced neural circuits that support the prosocial behaviours of the social engagement system.’ (Porges 2009,88)
This means, when we experience safety , we are more able to stay within the social engagement system (ventral vagal), that our survival physiology will function only in the face of true threat and be able to self-regulate once safety is perceived again.
On the other hand, if we have not built a healthy foundation to our physiology/ANS or had its foundation disrupted due to stress, illness or trauma, we may not be able to perform the task of accurately assessing danger and safety. If our foundation is steeped in an experience of danger, then our survival physiology may ‘operate as a chronic background state (or filter) for everything we do and experience’. (Kathy L. Kain & Stephen J. Terrell — Nurturing Resilience)
In the context of complex health conditions, the ANS may experience this chronic background state of survival physiology that causes physical and emotional symptoms to develop, and over time with no appropriate self-regulating strategies available, these symptoms may worsen or overflow into additional presentations.
Varying Responses
Our response to threat may vary based on:
- Initial ANS Foundation (ANS is developed largely during pregnancy til age 3 based on healthy attachment and may be effected/altered through life experience, exposure to stress, illness, trauma and core relationships)
- Intensity and duration of threat
- Unique predisposition to threat based on life experience.
Responses to threat become more loaded, the more extreme the survival physiology. That is, the more attuned and experienced we are to threat, the more extreme our responses can become. Responses may vary across physical, mental/emotional, social. Over time, survival physiology may become a ‘new normal’, meaning that we exist in a constant response to threat. In this way, there is no reliable access to self-regulation and the safety accessed by ventral vagal. So, we may exist in a state of sympathetic activation (fight or flight defensive mechanism) or a state of parasympathetic dorsal activation (freeze/shut down, which may present as numbness or apathy). It is also possible that the system switches between the two ends of the spectrum, unable to find equilibrium.
Maladaptive responses stem from the lack of healthy neural platforms to access self-regulation, co-regulation and social connection/sense of belonging. These are the things we most need to shift out of survival physiology. As a result, working with neural repatterning, self-regulation and co-regulation may support the improvement of complex health presentations. A somatic approach may be considered.
Understanding the concept of control in survival physiology
The idea of control often comes up in association with complex health conditions. We may form a sense that the illness is ‘out of our control’; that we no longer have control of our body. This experience may lead to a miscalibration of neuroception/somatic experience — so that both interoception and exteroception are geared towards danger — that is the external world becomes a threat to the internal world and there is no sense of agency to ‘fight’ against it or regain equilibrium. Essentially, there is no access to internal control, the ability to self-regulate and access safety.
This perceived lack of control may interfere with our ability to self-regulate, co-regulate and respond to the environment.
American Psychologist Julian Rotter developed the model of internal and external locus of control in the 1950s.
In a nutshell, those with a strong internal locus of control more commonly believe that they are able to influence the outcome of their experiences. Those with a strong external locus of control more commonly believe that their life is controlled by external influences.
‘Those with a stronger external locus of control tend to be more stressed and prone to clinical depression’ (Benassi, Sweeney and Dufour 1988). A sense of self-efficacy and an internal locus of control are both protective factors affiliated with resilience (Shonkoff and Phillips 2000).
A healthy ANS supports a healthy continuum between external and internal locus. This develops a sense of agency in our ability to influence our external environment and to also feel safe knowing that certain things are out of our control; or to relinquish control with ease.
Without a healthy ANS (that is dependent on healthy attachment and social connection), our locus of control may switch to existing primarily in the external, which can lead to the feeling of extreme loss of control or a sense of victimisation (‘the world is out to get me’) and hopelessness. These elements may lead to dysregulation in multiple systems, a permanent shift to ‘survival physiology’ and a distorted relationship to control; either it’s loss or the reverse — a need to rigorously control certain aspects of life in order to maintain a sense of safety.
Defensive Accommodations
When we are unable to access safety or co-regulate, we may adopt strategies to substitute it — defensive accommodations. These may span across somatic and physiological strategies as well as intricate behaviours and belief systems. These defensive accommodations arise as substitute for genuine self-regulation. In a way we are organizing our knowledge to both self-regulate and self-protect. As Jean Piaget developed the term ‘schema’ ‘to describe how we organize our knowledge — how we create our own personal worldview, so to speak’ (Gruber and Venice 1977).
The concept of defensive accommodations derives from Bradchafts work on ‘pathological accommodations’ surrounding developmental trauma and a child’s attempt to self-protect by adopting strategies to protect himself from ‘intolerable pain and existential anxiety’ (Brandchaft 2007).
In adults, the dynamics of defensive accommodations continue to exist and underpin much of how we relate to ourselves and the world around us. Defensive accommodations miscalibrate physiological responses that then effect all levels of self.
When considering complex health conditions, defensive accommodations may a) be in play prior to onset of condition, propelling an unhealthy neural platform that sparks symptoms or b) may develop throughout the complex condition as an attempt to self-regulate. In either case, the defensive accommodations fuel survival physiology and deter us from accessing true self-regulation and ventral vagal access.
Understanding how defensive accommodation patterns form and the faulty neural platforms that they derive from, is essential to accessing a path to recovery. They stem from base survival urges and often the sense of loss of personal control at a very physiological level. Defensive accommodations tend to create limitations on how we experience our lives. When these arise to a certain extreme, we may find the absence of a felt sense of internal peace and quiet — an absence of somatic safety. As such, working with somatic resourcing can be a way to restore the internal safety needed to start recalibrating our neural platforms.
Defensive Accommodations span across the following categories:
Denial
Regression
Acting Out
Repression
Dissociation
Compartmentalization
Projection
Reaction
Intellectualisation
Rationalisation
Sublimation
(Nurturing Resilience Kathy L, Kain and Stephen J. Terrell)
Somatic Symptoms and Responses
When working in the context of complex health, we explore the physiological patterns of survival that develop from both developmental trauma and traumatic stress. One of the qualities of such somatic symptoms is that they are constantly changing or evolving. It is as if there is no access to somatic safety, so the physiology keeps seeking out and experiencing danger. Oftentimes, even when a symptom can be eased, it may return after a short period of access, perhaps worse than before.
Symptoms may include:
- Non-diagnostic presentations — symptoms that are unexplainable or unable to fit within a known diagnosis
- Complex presentations that present as syndromes rather than diagnosable conditions. i.e. a series of symptoms that are non-specific but may meet multiple criteria. E.g. fibromyalgia and chronic fatigue.
- Poor response to medications; either non-effect, side-effects or worsening of symptoms
- Extreme sensitivity to light, sound, smell, touch
- Difficulty to track somatic experience (some level of dissociation)
- Extreme responses to external stimuli
- Sensitive physiology — quick and abnormal to move into high sympathetic or parasympathetic response
- Sudden escalation of responses — can move from feeling fine to extreme unwellness with little or no warning
- Delayed responses to therapy intervention — it is as if there is been no response and a couple of days neural reorganisation is accessed and response registered.
Understanding that this pattern of symptoms stems from survival physiology and miscalibrated neuroception leads us to an access point for recovery; that is achieving somatic safety and self-regulating strategies that will recalibrate neural platforms to support accurate interoception and exteroception. It is perhaps through returning to a felt sense of safety that reparation to our physiology can begin.
