The fight or flight response is an automatic set of physiological and cognitive changes that are designed to aid survival in situations perceived as dangerous or threatening. It is extremely helpful for clients to understand the fight or flight response prior to engaging in exposure work for anxiety. Schauer & Elbert (2010) have described an elaborated account of these reactions as applied to trauma, but discussion limited to the fight or flight stages is often sufficient when working with anxious clients. The Fight Or Flight (CYP) information handout has been specifically designed for younger children and includes carefully simplified language. The full pack contains variations on the worksheet including a version which explains why these reactions occur, and a version which invites individuals to describe their bodily reactions to frightening events.
Information that is helpful for clinicians to be able to share is why particular bodily reactions are helpful responses to threat. The general answer to most bodily sensations is that “this prepares the body for action” but specific responses include:
- “The heart beats faster to move blood (fuel, energy) to the muscles, this makes you better at running away (or fighting if you need to)”
- “Breathing rate increases to move air (fuel, energy) to the muscles, this makes you better at running away (or fighting if you need to)”
- “Pupils dilate to let in more light and improve visual acuity, this helps you to see danger better”
- “The body diverts blood (fuel, energy) to the muscles and away from the digestive system, this makes you better at running away (or fighting if you need to) but you might notice symptoms in your tummy”
This handout can be used to stimulate a discussion between therapist and client. It is available in multiple versions, some with more information ‘up front’ and others which leave more space for exploration of the client’s experiences. Helpful prompts for discussion include:
- “Do you ever feel any of these feelings?”
- “What situations do you notice them in?”
- “What sets them off”?
- “What do you think about these body feelings?”
- “When you notice these sensations what do you think they mean?”
- “What does it say about you that you experience these sensations?”
- “When you feel scared or anxious what feelings do you notice in your body?”
- “When you feel scared or anxious what do you notice in your mind?”
- “What do you think about?”
- “What do you notice and focus on?”
Therapists should aim to help clients to understand why these reactions occur. Therapists will need to adapt their explanation to the child’s developmental level and knowledge concerning physiology, but helpful questions include:
- “If there was a lion chasing you, why might it be a good thing for your heart to beat faster?”
- “If you were in a situation where you are in real danger would you want a brain that thinks slowly or quickly? Why?”
- Cannon, W. B. (1916). Bodily changes in pain, hunger, fear, and rage: An account of recent researches into the function of emotional excitement. D. Appleton.
- Schauer, M., & Elbert, T. (2010). Dissociation following traumatic stress. Journal of Psychology, 218, 109-127.