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.
Robert fears energy storms in his upper chest, feeding thoughts that he is not liked and not safe (or vice versa), raised by an anxious mother and depressed father.
Tanya often wakes up with dread in her belly, freaks out if she has bodily symptoms like a rash. 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. This detailed blog is for their understanding and NOT intended as treatment. Please pace yourself as some of this information may be activating.
“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. It can emerge unexpectedly 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 relating 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, I find SE and NARM to be complementary
With SE, the work includes grounding, orienting to the present, building containment for high arousal so as to be less overwhelmed. 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. 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. I love how supporting the mediastinum (i.e., connective tissue) can soften the heart space for more ease with emotions. [With Jill who suffered from neglect, as we supported her heart space, she felt heaviness in her lungs as she touched into losses in her life, then energy flowed and a sense of well-being.]
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 just 5-10%, 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)
Perhaps now is a good time to pause, to digest the material above. Then if you're interested in reading some of my clients' processes that show how I use SE, NARM, Co-regulation touch, they are at the end of this blog.
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, nurturing rest/digest with good sleep and eating habits, etc. It’s a joy to see them reconnect with their aliveness bit by bit.
With deep gratitude to all my teachers and clients who allowed me to use their stories.
Some Clients’ Processes Shared with Permission and Names Changed:
When Tanya felt an irregular heartbeat in our session, she contracted. Through a NARM exploration, she uncovered a deeply held belief, "If I'm alive, I'll die." This GHIA reactive pattern of not feeling safe in her body emerged 10 years ago when she witnessed her father dying of cancer in horrible conditions. I invited her to feel into all sides of her feet, move her ankle joints, raise her heels to open the leg channels, let go into the holding of the chair. Taking a long time to orient to big trees outside her window, a deeper breath came spontaneously and her body relaxed. She felt safer. Then she flashed on a friend who has cancer which is very frightening for her. And again back to grounding and orienting.
After some time, I invited her to focus on unbracing between sessions by softening her tongue, moving her pelvis, arms and legs, to build some structure for holding high charge. It was hard at first but she caught the spikes again and again, used tools to rest down a little bit instead of shutting down. This has given her confidence to stay present, not freak out but tolerate activations that sometimes show up with no triggers (nameless dread), and regulate a bit. She's seeing how she can move through the activation/deactivation cycle vs. being stuck in high arousal and shut down.
She now has more capacity and resilience. In recent sessions, as we worked with her chronic bracing which included intensifying it - her body discharged survival energy with subtle shaking in her throat and neck. She processed some pain and grief of her early life. There was wonder on her face as she saw how she ran from fear of annihilation her whole life. As her neck/spine relaxed, she said, "I'm here, I exist, I'm alive." I once heard Dr. Heller say that the fear of death for folks with very early trauma is really about the fear of living.
* * *
For Chris, who’s been anxious his whole life, GHIA pattern emerged when he moved in with his partner. He was able to settle a bit as he worked through his internal conflict of wanting deep connection while also fearing it. He would obsess about one thing, then another also kept busy to avoid feeling nameless dread in his belly. After some co-regulation touch (me holding his brain stem, ankle joints, etc), he let out a deep breath and dozed off. He dismissed that he may have dropped into some parasympathetic rest, saying, ‘Oh, that was jetlag, I was sleepy.’ He has a hard time noticing small shifts after regulation exercises. I ask, ‘What’s scary about letting down a bit?’ He says, ‘Something bad will happen.’
For this client and others who live mainly in two nervous system states (high sympathetic arousal and parasympathetic dorsal shut down), it can be long hard work because noticing shifts of 5-10% may not be obvious. Perseverance and patience is needed. Without pressure, I invite them to train the brain from danger to notice little differences - in GHIA, everything seems bad. Perhaps brief moments of warmth, tingling, a breath, less muscle tension.
When Chris is afraid someone will be mad at him, his GHIA in the form of anxiety spikes. He placates, believing bad things will happen if he speaks up. By allowing himself to feel the energy of protest/anger, he feels less scared and anxious and more emotionally and autonomically regulated. He becomes more connected to his strength and able to set boundaries. I’ve heard Dr. Heller say that underneath anxiety, there is often a lot of anger.
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For Simon, GHIA emerged when his grandmother died two months after a car accident. As he was very shut down, we stood up and did some bouncing and twisting to increase his energy. We had to go slow when opening his arms and leg joints as he would feel bad if too much charge gets released. We explored what was driving his anxiety which manifests as intrusive thoughts about how bad he is. It was what he already knew, a distraction from feeling the pain and loss of his grandmother which also triggered the unprocessed grief of his father’s death when he was a teen. I explained that opening up the body allows more room for the grief to be digested without overwhelm.
He has a lot of shame, guilt, and is hypervigilant about what he says/does, believing he is bad. I reminded him what he wants for our work together is to connect to his true self and be happy. He softened and yawned a lot when he saw how hard he was on himself. I learned from Dr. Heller that children blame themselves for environmental failures, turning anger against themselves which leads to self-hatred.
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Norman’s GHIA showed up at the store one day. Working together in the present, he flinched from the memory of the gaze from the store clerk. The activation felt endless, and centered in his neck. Offering remote touch, I invited him to let go into my energetic hands on his neck, his belly softened. (Neck has to do with trust and hypervigilance.)
We explored what was driving this social anxiety, and he saw how he contracts after deep connection with friends. He's recognizing the pattern of wanting to pull away/curl up, feeling hopeless as he tells himself he’s not able to connect with others. By witnessing and giving space for it, knowing that he is having deep connections, his capacity to tolerate closeness continues to expand.
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For 75-year old Fred, consistent work with NARM and daily use of SE regulation tools, as well as remote co-regulation touch, he has worked through a lot of self-hatred and is able to come out of freeze on his own. Though sometimes tending towards collapse and despair, he no longer wakes up with nameless dread in his stomach. As a child, his mother was there but never close. What he yearned for was closeness, care and interaction to feel he existed. A challenge for him is that when he feels his aliveness, he can get flooded with painful feelings of how isolated he's been his whole life. He's learning to orient to the present, regulate/discharge etc. Most of his life, he’s feared connecting with others but now has more capacity to be social at work and even beginning to explore the possibility of an intimate relationship with someone.
Brianna Ho Delott, 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.