Updated: Jan 20
DR. ESSLIN TERRIGHENA on the window of tolerance and how it helps to process trauma in therapy.
In therapy, we speak about the window of tolerance in which we see therapeutic effects and healing happen. But what is the window of tolerance?
Keeping it simple, we can have three states of arousal with different mental, emotional, physical, and behavioural experiences.
We can be in a state of hyperarousal. Here we may experience intense anxiety, anger, sadness, guilt, shame or other distress (emotional). Our thoughts may be racing or confused (mental). Our sympathetic nervous system is activated, triggering physiological processes (physical) to prepare us for a survival fight-flight response (behavioural). This is a state in why our emotional pain may feel most intense and overwhelming.
We can be in a state of hypoarousal. Here we may experience disconnection, dissociation, numbness, detachment, or depression (emotional), fatigue and passiveness (behavioural), dulled thoughts or slowed down thinking (mental), and a ‘shut-down’ freeze response (physiological). This is a state in which we may feel entirely disconnected from feelings, people, or the world around us.
Both of these states are characterized by an intense threat response – in hyperarousal, the distress disables us by its intensity and pushes us into fight-flight behaviours; in hypoarousal the numbness disables us in its disconnecting nature and pushing us into freeze behaviours. Neither of these states are conducive to therapy and healing as they are both extreme states in which our higher executive functioning and mental processing capacity is inhibited or overridden by our survival modes. For more information on how executive functioning is restricted during trauma, please see here.
The third state, the Window of Tolerance, is a state in which we are able to access our vulnerable feelings, while also maintaining our higher executive functioning. In other words, we can feel and think at the same time. In this state, we may experience a range of emotions (emotional), including distress and discomfort, but these feelings are tolerable. We can access rational thoughts, analyze the situation and communicate clearly (mental). Our bodies may be activated, but in proportion to the emotional distress we are feeling and we are not pumping adrenaline through our veins like in survival mode (physiological). We are not engaging in automatic fight-flight-freeze-fawn behaviours, but are able to maintain conscious control over our behaviours and make choices on how to respond (behavioural).
In the Window of Tolerance, we are able to make connections between trauma and our healthy cognitive framework that holds our beliefs and values. This can help us to process our feelings in a healthy way, create context and meaning from our experiences, and allows us to engage in healthy adaptive responses rather than trauma-driven reactions that can be more damaging in the long-run. In this state, we are able to heal from trauma, and moved toward enhanced wellbeing.
To find out more about how trauma therapy can help you recover from past trauma, book a consultation with psychologist Dr. Esslin Terrighena, please contact (852) 2521 4668 or firstname.lastname@example.org.
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