Deep survival impulses may play a key role. Here’s how it is for some of my clients (names changed and used with permission):
Jill is enraged for hours when a colleague withdraws from her after a conflict, triggering wounds of not existing from mother’s neglect.
Kathy gets overwhelmed with sensations and goes to tears easily. She has chronic pain. Her mother was under extreme stress during pregnancy.
Tanya often wakes up with dread in her belly, freaks out if she has bodily symptoms. Her birth was unwanted by mother.
Chris obsesses about one thing then another. His mother had unprocessed transgenerational and early traumas. He has migraines.
Each of these clients felt helpless about their physiological responses and relieved when I tell them about Global High Intensity Activation (GHIA), a term I learned from Somatic Experiencing (SE) trauma healing. A lot of what I’m sharing about GHIA, I was grateful to learn from Dr. Glyndie Nickerson while assisting her with an SE training.
According to Dr. Nickerson, GHIA is not uncommon and is on a continuum. We live in a culture that's often overwhelming including our jobs, health challenges, rapid pace of change, as well as social, historical and transgenerational trauma, etc. Roughly a third of my clients have GHIA that causes a lot of suffering for them. Please note that this blog may be activating. Please pace yourself.
“GHIA… involves massive stimulation and arousal of the entire central nervous system…. the entire organism moves toward end-stage survival responses.” These folks can go from zero to 100 quickly with reactions like fear, anxiety, crying and rage that take a long time to settle. It can feel uncontrollable, endless and inconsolable. For self-preservation, they shut down/freeze.
Traumas that can form GHIA include pre-natal or maternal stress, drugs or toxins in the womb, being unwanted, pre-maturity, medical procedures, separation from mother as an infant or newborn, adoption, mothers who were anxious, depressed, and neglectful.
An infant needs co-regulation from settled, responsive caregivers to act as the ventral vagal (soothing) system. This develops a parasympathetic (rest down) capacity to self-sooth, e.g. I experience a little upset, I can settle again. With GHIA, that capacity is lacking or not well-developed.
If a mother is stressed or ambivalent about being pregnant, or if the womb is extremely toxic, the fetus may adopt a strategy of becoming invisible, feeling shame in existing that remains throughout life.
GHIA can also form when breathing is compromised from drowning, high fever, or sustained high stress such as growing up with racism, poverty and war, plus any trauma that shocks the entire body like intense drug and near-death experiences. But the focus for this blog is on GHIA, related to womb or preverbal traumas.
SE teacher Ariel Giarretto (LMFT, SEP, CMT, CSB) explains GHIA as an activation which happens very quickly, lodging in the torso and affecting our organs, our lungs, our heart, our digestion. Everything clenches up and clamps down. Our attempts to regulate by constricting, locking the jaw, tightening the body to get smaller and so forth only makes it worse.
Dr. Nickerson says pattern can be a deep constant in the background causing big reactions to life stressors, and it can intensify unexpectedly such as in new relationships, with authority figures, long meditations, and life transitions such as getting married, having a baby, divorce, death of a loved one, new job, moving, etc.
Some with GHIA avoid feeling high arousal by keeping busy such as with work or excessive exercise. Others may be chronically collapsed or depressed. Still, others hold back arousal with high muscular tension and strong will. They may push through things, not discerning when it’s too much, unable to accept that it’s OK to have limitations. It’s common to flip between two or three of these GHIA presentations.
Because of early and profound systemic dysregulation, some with GHIA are more prone to inflammation & autoimmune disorders. They may have issues like chronic fatigue, fibromyalgia, asthma, IBS, skin & digestive, migraines, ADHD and OCD.
Since NARM (Neuro-Affective Relational Model™ for healing attachment, relational and developmental trauma) is foundational in my work, I’d like to share some insights I see relates to GHIA from the book, Healing Developmental Trauma by my NARM teacher Laurence Heller, PhD, and Aline LaPierre, PsyD.
An infant’s reaction to early developmental or shock trauma is one of overwhelmingly high arousal and terror. The vulnerable infant, who can neither fight nor flee, cannot discharge the high arousal caused by the uncontrollable threat and reacts with physiological constriction, contraction, core withdrawal and immobility/freeze. This state of continual sympathetically dominant global high arousal remains in the nervous system into adulthood. The experience for the adult may manifest as a constant underlying nameless dread, which can be fear of death, a phobia, real or perceived deficiencies; a persistent kind of threat that tends to project itself onto the current environment. Having an identified threat is better than nameless dread. Managing external conditions to try to feel safe doesn’t work. Many cope by living in their head or dissociating from their body.
In the NARM model, connection is the first developmental theme which includes belonging in the world (right to exist), and a longing for connection. But a deep fear of it as a result of feeling unloved, unprotected and unsupported in the first stage of life which can lead to a tendency to isolate and feel alone.
Working with GHIA with different modalities....
With SE, the work includes grounding, orienting to the present, building containment for high arousal so as to be less overwhelmed as well as for resting down. Eventually when there's enough capacity to tolerate small bits of high arousal energy, slowly unbrace from bound survival energy so it can discharge. Clients learn to be more present and to down-regulate with tools, rather than feeling trapped and helpless. I also use tools from Linda Thai for somatic embodiment & regulation.
With NARM, we explore psycho-biologically what’s driving the anxiety. It can show up as avoidance of emotions like anger or sadness, internal conflict between authentic self and disconnecting from self to be accepted/loved, between the need to connect with others and the fear of it, self-hatred, etc.
I find co-regulation intentional touch to be supportive even via Zoom as it’s done with Presence. I learned from Kathy L. Kain, PhD, and Stephen J. Terrell, PsyD. to calm structures that relate to our stress responses such as hypothalamus-pituitary-adrenals, stomach, etc. Early trauma sets up the system to be chronically on high alert–vigilant, stressed, ready.
From Dr. Raja Selvam, my Integral Somatic Psychology teacher who’s also a SE teacher, I’ve learned to support clients to expand their body/container–such as opening leg and arm channels, lessening the intense activation that tends to be the core of the body. SE teacher Giarretto says in the case of crying or anger, standing up and feeling the floor, or taking the energy out through the arms can lessen the intensity. These need to be practiced over and over again, hundreds of times.
Dr. Nickerson notes if a client’s energy is shut down, the high activation is constricted underneath the surface. Body awareness/container needs to first be awakened through movement, yoga, bodywork, gardening, etc. Then we work to lower the activation and to tolerate a bit more energy in the body without triggering overwhelm and collapse.
Reactive patterns may show up in all aspects of life or several different areas. What’s important is to catch the sympathetic nervous system arousal from a thought/feeling/sensation before it spikes. Because the dysregulation underneath is what drives the huge reactions, we work with patterns rather than specific events or content.
I support clients to get better and better at recognizing their pattern–what triggers it, where it shows up in the body, often in the midline (i.e., throat, chest, belly, pelvis) and often with a quality of buzziness and urgency. The goal is to interrupt the pattern by grounding, orienting, resourcing and self-touch, etc. What’s important is to notice and stretch out the small shifts and how it feels to not be caught.
Noticing little bits of down-regulation, even for 5 seconds is important to break the pattern again and again. The interoception (how we sense ourselves internally) provides feedback to the reptilian brain that we are not stuck; that we are a little bit safer. Research shows that the bits can accumulate and build momentum for bigger shifts.
Then when clients have enough capacity, to come into direct contact with the survival energy underneath the chronic freeze/collapse, discharging little bits at a time, rather then using so much of their life energy to keep it away from the surface. I share words I heard from SE teacher Dr. Abi Blakeslee, not specific to GHIA, like "fear is a physiological state; the feeling of terror in the body are sensations of a time you felt fear a long time ago; stay with what's happening now. You had to dissociate to survive and now you can take some time to release some of that charge/ terror (titrated, with skilled guidance)."
Some basic SE tools I teach clients to support resting down and coming into the present moment, rather than being driven by implicit memory (unconscious and automatic), e.g. what was scary then feels as if it is now.
Orienting: Take time for the eyes to go to what’s interesting or pleasant, to come out of hypervigilance, into curiosity, to safety. Can also orient through sound or smell. Orienting can help slow down the danger signals from our implicit memory (e.g. what was scary preverbally is happening now), to come into the present moment.
Grounding: Letting go into gravity, feeling the weight of the body and the holding of the chair, weightedness of feet on floor, etc.
Waking up, unfreezing or opening (movement/touch) leg and arm channels so that strong activation in the core can flow out. (Infants are not aware they have arms and legs.)
I was surprised to see how flaccid (no muscle tone) the ankle joints were in a 45-year-old client in shut down mode even though he was an athlete in high school.
When another client moved her feet and ankle joints, instead of feeling energy there, she felt it in her head, which may explain why she goes to tears easily.
If one is really shut down, in freeze/dissociation, it’s important to titrate, that is, not release too much activation which can cause overwhelm.
Self-touch: Such as hand on heart or on belly. One hand on forehead, other hand on occiput can regulate emotions and quiet the mind. Squeezing big muscles in deltoids or thigh muscles if we are overwhelmed can feel containing.
Co-regulation with calm friends & family, and pets: Taking in their soothing presence.
Looking for and taking in bits of goodness and what’s working well daily, e.g., a child’s smile, nice breeze, good meal, gratefulness, etc.
Softening the tongue and moving the pelvis can help unbrace down our midline. (When we're scared, we pull up from pelvis all the way up our midline to our jaw/neck - from SE teacher Dave Berger MFT, PT, LCMHC, MA, SEP)
To sum up, learning to see the GHIA pattern, catch it before it escalates, building containment to avoid overwhelm by grounding down, orienting, bringing arms and legs back online etc. Inquiring into what’s driving the anxiety from the high arousal is also important. Working with the pattern of freeze/collapse is also needed.
I encourage clients to practice daily, down-regulating exercises to unbrace, taking in moments of ease many times to break the pattern of high sympathatic, nurturing rest/digest with good sleep and eating habits, etc., reconnecting with their aliveness bit by bit.
With deep gratitude for all my teachers and for the clients who allowed me to use their stories.
Brianna Lia Ho, MBA, BBA-PSYC is a Master NARM Practitioner & Somatic Experiencing Practitioner, also certified in Integral Somatic Psychology as well as in spiritual counseling with the American Institute of Health Care Professionals. She’s also a Co-regulation Touch Practitioner trained in Transforming the Experienced-Based Brain & Somatic Resilience Regulation. She sees clients internationally on Zoom. www.BriannaHoDelott.com
Disclaimer: Please note that I am not a psychotherapist or mental health counselor. The info above is not a substitute for licensed medical, psychological or psychiatric help.