Trauma and Dissociation: Beyond Your ‘Window of Tolerance’

Person seated on bed looks out open windowIf you are already working on healing from a history of trauma, dissociation is likely a familiar concept. You are likely aware it is a system of coping that, in times of distress, offers protection from the full realization of trauma and its associated emotions, sensations, images, thoughts, and patterns of thinking.

The lack of realization and integration of these components creates the symptoms that bring people to therapy. The greater the extent and intensity of the traumas, the greater the complexity of the typical dissociative process and, of course, the treatment approach.

The “window of tolerance,” a concept introduced by Daniel J. Siegel, describes the equilibrium our systems need in order to heal from trauma. When we have unhealed traumas, our systems may not be fully present. They might not fully know or feel that the danger has passed and can become fixed in states of hypoarousal and hyperarousal or fluctuate between the two states.

Hypo- or hyperarousal can result from the dissociative symptoms linked to the trauma, which may be positive (adding to the experience) or negative (taking away from the experience). Positive dissociative symptoms might include intrusive images, emotions, sensations, and thoughts. Negative dissociative symptoms may include amnesia, derealization, and depersonalization.

When we are stuck in these upper and lower zones of hyper- or hypoarousal, the full integration and healing of trauma cannot occur. But in the middle, within the window of tolerance, healing and integration can occur.

The shift outside the window of tolerance into hypo- or hyperarousal is the dissociative process, and it may be subtle or extreme. In those moments we experience what I call the “quantum leap effect,” where aspects of our former self, still stuck in the original trauma, do not have access to what the present self knows. That keeps us stuck in the reliving of the traumatic material, even though a part of us—an inaccessible part, so long as we are dissociating—knows it is in the past.

Anchoring Yourself in the Present

After noticing a dissociative shift into hypo- or hyperarousal, it may be helpful to utilize a skill that anchors you mindfully to the present. The anchor is not just about noticing you are “in the now.” It is imperative you notice and acknowledge the present is different from whatever you think you are stuck in. “I know I may be seeing old stuff,” you might tell yourself, “but that old stuff can’t be happening because I am in this room now, and these are the ways it looks different.”

The shift outside the window of tolerance into hypo- or hyperarousal is the dissociative process, and it may be subtle or extreme.

A more specific example might look like this: “The wall is brown, there is carpet, and I am 22 years old. I can’t be in that old circumstance. I am in the same room as this brown carpet. It must be over, because I am in a different room and I am older. I wasn’t wearing these shoes. In fact, I couldn’t fit in these shoes if I was in that time.”

If you are trying to heal from trauma, think of this anchoring skill as a way to get aspects of your former self more current and stay within your window of tolerance. To really take root, it must be practiced over and over. But it is an essential coping skill for any trauma survivor, even before processing any traumatic material in therapy.

Reference:

Siegel, D. (1999). The Developing Mind. New York: Guilford.

© Copyright 2016 GoodTherapy.org. All rights reserved. Permission to publish granted by Sarah Jenkins, MC, LPC, CPsychol, therapist in Tempe, Arizona

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Lib

    June 23rd, 2016 at 11:25 AM

    For anyone who has suffered through a painful past this is a wonderful reminder that when we do and can choose to ground ourselves in the present, the here and now, the past can no longer hurt us.

  • Doreen F.

    June 24th, 2016 at 10:09 PM

    It is not a choice! I did not choose to be triggered. Living with PTSD, but I do choose recovery. Some people do not choose to be reliving there past! It just happens and it sometimes takes years to get your life back to a manageable productive lifestyle again. I feel I am never going to work again or laugh, but I will keep going to my sessions 3 times a week. Because I am going to have a whole new life!!! Someone I’ve never been. I’ve been caring all the secrets starting at age of 9. Triggered at 51!!!! Major breakdown at 52 another breakdown happening now! But I will not give up unless I lose the battle and it takes my life. It almost has twice😢

  • The GoodTherapy.org Team

    June 25th, 2016 at 10:29 AM

    Thank you for your comment, Doreen. If you are in crisis and feel you may be in danger of harming yourself, please call 911, visit your local emergency room, or call the National Suicide Prevention Lifeline at 1-800-273-8255 (TTY: 1-800-799-4TTY).

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    Please know you are not alone. Help is available, and we wish you the best of luck in your search.

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  • Shannan

    June 26th, 2016 at 11:36 AM

    Yes

  • Silas

    June 23rd, 2016 at 3:18 PM

    great read, quite informative

  • Catherine

    June 24th, 2016 at 9:34 AM

    I find that for most people they do this believing that this is the protection from all of the bad things that they choose to not remember or deal with, never understanding that hiding from it will never automatically make that pain go away. It might feel good in the moment but in the long term it is always going to be there, ready to sneak out at you when you least expect it. Deal with it now, process it now, and life can be so much sweeter as a result.

  • Melanie C.

    June 24th, 2016 at 2:44 PM

    Yes, I teach this to students and clients all the time. The ‘therapeutic window’, or window of tolerance, is one of the most important concepts for therapists to understand and to be sure clients are aware of. I find it makes perfect sense to them and it helps increase their patience and compassion toward their own progress. Great article!

  • Ed G., GoodTherapy. org member

    June 24th, 2016 at 3:39 PM

    Hi Sarah,
    Thanks for the clear info about the window of tolerance and being present to soften dissociation and become more in the present. I really agree, and have found how well client’s fine it useful. I also recognize how the sensory component of noticing compliments cognitive awareness, and help clients to embody their experience in therapy as well as to think about it. Knowing how problematic it often it for trauma clients to live in their own skin, helping them have satisfying experience of their sensation, can confirm present experience. For example, feeling the form and surface of the chair with one’s hand, the firmness of the floor under the feet, the taste of a drink of water moving down the throat, the sensation of the breath moving, the support of a pillow, or with educated, clearly-consented somatic interventions of a still, supportive contact with a hand, etc., all can contribute to expanded awareness for deep recognition and embodied experience of the present moment. Dissociated parts often have a hard time getting the attention they want and need in order to be calmer and less intrusive. I find the work of Kathy Steele et all extraordinary in complementing what you are saying. Her work The Haunted Self can be a fine resource for therapists and often for clients. Janina Fisher’s work with the Boston Trauma Center, and her position with Pat Ogden’s Sensorimotor Psychotherapy Institute give her a special positing offer additional theoretical and practical guidance about using Steele’s Structural Dissociation model in this complicated work of helping people with complex trauma histories. There is so much to learn about working with this mystery of Trauma. Thank you again for your contribution. Hope these ideas support your good work.

  • Joanne

    June 24th, 2016 at 3:53 PM

    Well said Catherine. I wonder though having experience with some of this technique that it can also leave one somewhat lost as bringing the old into the present is a strange thing to do – for it. Scrambling to get up to date with the rest yet still out of step, a child bought into their fifties, feeling as though its too late to get with very much at all but wishing I could. Anxiety has moved in more as the conscious mind is even more clear than before – before therapy. How to be now, what to do, which way to go, its very lonely too. Still am much better than before and more able to reach out at times though its very limited, the help as once you have been through a few things theres no going back. I have tried some medicines in the past and though the doctor is comforted, I never am and I dislike them in my system plus I now know many are only good for a brief time, not to be depended upon long term. Learning to focus on the good and learning renewed gratitude helps alot. The gratitude process can be like re introducing oneself into life. Best wishes everyone

  • Kathy

    June 26th, 2016 at 7:33 AM

    Well said and warm thoughts for you.

  • Nandakumar

    June 24th, 2016 at 4:35 PM

    Choosing a form of self expression was a big part of healing for me.

    When I was racing a car, the driving suddenly became effortless and was accompanied by a feeling of intense peacefulness.

    I’ve spoken to and read of a few similar accounts.

    I think practising a skill and striving for perfection(practising emptying your mind while engaging in action) everyday gets you into the window for healing.

    My out of body experience was my mind describing the dissociation to me. I had to find the person who was outside the body and integrate that person with the part of me that I was looking at.

    I’m not sure however if healing is possible without coming into contact with the unconscious.

    I had some visions and saw some symbols that have also been described by others and I’m starting to understand the real nature of the self.

    My therapist wasn’t able to help me with these visions or explain them to me. Even though I was questioning my own sanity.

    My own experiences eventually led me to Carl Jung s writings that I was able to corellate my own experiences with.

  • sheena

    June 24th, 2016 at 5:31 PM

    shouldn’t much of this eventually become about actually expanding the parameters of that window of tolerance?

  • darlene h.

    June 24th, 2016 at 6:23 PM

    I am finishing a book about my sufferring n pain I put it down in color pencil drawings over 20 years ago I finally am able to not only talk about it but share with all those who want to know its been a great healing for me to speak it

  • Penni W.

    June 24th, 2016 at 6:53 PM

    Trauma is hard: rape and incest were mountains I had to climb. Dissociation, sensations, numbing and being stuck all come to mind when I began healing from my memories. EMDR allowed me to process and let it all go. Nothing is ever easy but words often come to mind I heard a million times during my therapy “You’ve got this”!

  • Cindy G.

    June 25th, 2016 at 6:30 AM

    When I am able to ground myself in the present moment, this moment, I am given a reprieve from the traumas (little t’s and big T’s) of yesterday. Grounding is not an escape hatch, believe me I know all about being an escape artist. So, after 6 years (3 weeks no contact) of living with a narcissistic sociopath who was hell bent on destroying my mind, body and soul the reprieves are absolutely necessary. Peace to all who meet me here in this moment!

  • Anonymous

    June 25th, 2016 at 8:52 PM

    Dear Friends who have suffered from Trauma.

    It’s a long journey and a lot of work to get out of the feelings that trauma creates: disassociation, numb feelings, lack of socializing, depression, anxiety, and so it goes.
    Sadly, I didn’t know that this wasn’t normal. I grew up in a home with a Borderline Mother, an Alcoholic Father, and a Narcissistic Brother. The daily tram was unbelievable. Life continued to present me with the patterns of abuse until I found the right treatment with CBT, DBT medication and marc.ucla.edu/body.cfm?id=22

    I have made remarkable recovery, but it took me 61 years. I am now starting really to make Trans cranial magnetic stimulation
    en.wikipedia.org:wiki:Transcranial_magnetic_stimulation

    I met my Doctor for the Intake Evaluation. He asked me what my goals was for treatment. I told him I just wanted to laugh and smile.

  • Terry

    June 26th, 2016 at 5:07 AM

    Any ideas on what I could try to use as my anchor to the today?

  • Sarah

    June 27th, 2016 at 7:48 AM

    I appreciate everyone’s connection to this article and do hope that it gives folks additional support and ideas as part of their healing process. Yes, one’s window of tolerance can expand, allowing for one to keep one’s foot in the present while still processing the past, as opposed to reliving. Many of you clearly are aware of the importance of this is your own healing work. Also, for those of you who were asking about addional techniques for being in the “now,” I also agree with EdG and encourage you to read that posting for some additioanl sensory orienting techniques as those are well described in that post. Small world Ed, I provide consultation for therapists around the structural dissociation model and come from that exact approach. Life changing and necessary work. Nice to meet you on this site and find a like minded colleague ;) Thank you, everyone, for your interest in this article.

  • jeni

    June 28th, 2016 at 9:25 AM

    i guess as with anything there has to be practice in the healing process

  • Braden B

    December 8th, 2016 at 6:50 AM

    It makes sense that people who have been through something traumatic would have a hard time anchoring themselves in reality. It’s a good idea to have them go through therapy at that point. It’s important to understand what is real and what isn’t.

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