Monday, June 2, 2014

Fight, Flight AND Freeze, Fright

Fight, Flight AND Freeze, Fright by W. Hock Hochheim 



     "This fight or flight reaction is not all or nothing; it operates on a continuum. A mildly, moderately, or profoundly emotional experience elicits a mild, moderate, or profound autonomic reaction, respectively." 
- Dr. V. S. Ramachandran, world-renown neuroscientist

     "Fight or Flight. Fight or Flight. Fight or Flight."  Heard that tune before? Chances are you have. Chances are every instructor you've ever had has regurgitated that mantra before you. It is quick and catchy, almost like a song really, and so easy to remember. A snappy alliteration. You probably have locked the three-word, two-prong catchphrase deep into your “these truths we hold to be self-evident,” inner sanctum. The special place things go that never get questioned. The doctors we quote here later call it “ingrained assumptions.”

     Since the early wars with stones, clubs, spears, and swords, the militaries of the world have grappled with issues of bravery and fear on the battlefield, but the whole "fight or flight" catchphrase really seemed to begin as a psychological category in the very early 20th century. The issue was rubber-stamped into posterity in 1929 by one Dr. Walter Cannon with his original formulation of human threat response - "the fight or flight.” I repeat, 1929. Cannon stated that when frightened, we flee or fight.

     Fright is defined as fear excited by sudden danger from something strange, sudden, or shocking. Sudden ambush. Some the greatest armies of the world were defeated by ambush, as well as some of the best solo fighters. The University of Washington uses a popular “angry bear” example to explain this, an example dating back to the 1930s and copied by so many "down-liners" to describe the shock/surprise event. 

“It is a nice, sunny day. You are taking a nice walk in the park. Suddenly, an angry
bear appears in your path. Do you stay and fight OR do you turn and run away?”
     Simple enough as one, two, ... three. But four? Somewhere lurking free in our understanding is yet another vital “F-word,” freeze. From the cavemen confronted by the saber-toothed tiger on the prehistoric veldt to the soldier in Afghanistan, they and we gathered here all see and understand the ... big freeze. We all intuitively know that we must include “Fight, Freeze, or Flight” in the first milliseconds of an ambush of any type. 

     These three Fs are utterly and intrinsically connected to this study subject. Okay, we know this, so what does the latest research show? Modern experts agree. In the 2000s, they now define a fine distinction that not all freezing comes from fear or fright! You may freeze when shocked for several biological reasons that have nothing to do with bravery, courage, or lack thereof.

     I began reading about these other two Fs - Fright and Freeze - in the 1990s. I grew impatient with the constant repetition of Cannon's lonely two words, Flight or Fight. Without recognizing freeze and fright, the topic, the preparation training, and post-treatment will be stunted and incomplete. A real recipe for wrong.

     Also, impatient and tired with the over-simplistic Cannon two-pronged Fs, in 2004 in an issue of Psychosomatics of the American Journal of Psychiatry, five doctors specializing in psychiatry (see below list) petitioned their peers to change the flight or fight mantra. In an article entitled “Does Flight or Fight Need Updating,” they begin a challenging yet common sense dissertation on the subject: They want to add Freeze and Fright.

     “Walter Cannon's original formulation of the term for the human response to threat, "fight or flight," was coined exactly 75 years ago in 1929. It is an easily remembered catchphrase that seems to capture the essence of the phenomena it describes. It accurately evokes two key behaviors that we see occurring in response to threat. This phrase has led to certain ingrained assumptions about what to expect in our patients and, because of its broad usage, what they expect of themselves. It is a testament to the foundational significance of Cannon's work that the term he used continues to shape clinical understanding and to influence popular culture's understanding of stress as well. But the phrase has not been updated to incorporate important advances in the understanding of the acute response to extreme stress. Specifically, the term ignores major advances in stress research made since it was coined. Both human and animal research on the pan-mammalian response to stress has advanced considerably since 1929, and it may be time to formulate a new form of this catchphrase that presents a more complete and nuanced picture of how we respond to danger."

They go on - add Freeze and Fright:
     “The phrase 'fight or flight' has influenced the understanding and expectations of both clinicians and patients; however, both the order and the completeness of Cannon's famous phrase are suspect. "Fight or flight" mischaracterizes the ordered sequence of responses that mammals exhibit as a threat escalates or approaches. In recent years, ethnologists working with nonhuman primates have clearly established four distinct fear responses that proceed sequentially in response to increasing threat. The order of these responses may have important implications for understanding and treating acute stress in humans."

     The article reminds their peers that people freeze in place for reasons other than fear/fright. One might freeze from a hyper-vigilance and/or by just being overwhelmed by surrounding stimuli, not fear. Therefore, the act of freezing can be clinically different than fright. You can freeze from fright, and you can freeze from being overwhelmed in a sensory overload - which has nothing to do with fear. Many specialists such as Dr. Jeffrey Allen Gray state we all freeze FIRST to some degree! Then react.

So the experts summarize:
     “We propose the adoption of the expanded and reordered phrase 'freeze, flight, fight, or fright' as a more complete and nuanced alternative to 'fight or flight.' While we cannot hope to compete with the legacy of Cannon's phrase in the culture at large, adoption of this alternative term within the clinical community may help keep clinicians aware of the relevant advances in understanding of the human-stress response made since the original term 'fight or flight' was coined three-quarters of a century ago.”

     Medical professionals do use the full four Fs now in so many fields from speech therapy for stuttering to post-traumatic stress treatment for combat vets. But that common “culture at large” the doctors mentioned remains ignorant and still does love to sing the simple song of Flight or Fight. They sing on and on about the two Fs and the sympathetic nervous system and two-F shooting and two-F fighting and two-F thinking and two-F training, on and on.
     A martial training doctrine might well function with just the three Fs of "Fight, Flight, or Freeze."  After all, a freeze is a freeze whether it be from a sudden fright or a sudden sensory overload. Just please explain it to your folks. The "Fourth F of Fright" may only be mandatory in the psychiatric world in their post-event treatment world, where they grapple with traumatic stress syndromes.

     There are also many small hairs to be split in this subject. Is backing up just a few steps officially called a "flight"? What about under-reacting? Naive TV news viewers complain when they see films of citizens ignoring a vicious assault occurring on the street or say - on a pizza line - before them. They seem to freeze or ignore the crime! Dr. John Leach, author of Survival Psychology, teaches an advanced course in survival psychology at Lancaster University in England. Leach has a name for some freezing (and for people who seem to ignore crimes happening before them). "It's called the "incredulity response." People simply don't and can't believe what they're seeing before them. So they go about their business, engaging in what's known as ‘normalcy bias.'” Under-reactors act as if everything is OK and underestimate the seriousness of danger (also, this involves the Bystander Effect).

    “Some experts call this 'analysis paralysis.' 
People lose their ability to make decisions.”  

     Leach says that of the vast majority of us ... (80%) in a crisis, most will "quite simply be stunned and bewildered. We'll find that our reasoning is significantly impaired and that thinking is difficult. It's OK, and it doesn't last forever. The key is to recover quickly from brain lock or analysis paralysis, shake off the shock, and figure out what to do.”

      From Ben Sherwood's book, The Survivor's Club: "When people find themselves face-to-face with a catastrophe, be it a fire in a movie theater or a sinking cruise ship, the most common response is to think Something like this could never happen to me. People just don't believe it," says Sherwood. "The phenomenon, dubbed the incredulity response by survival expert John Leach, PhD, occurs when someone confronted with disaster loses his or her ability to make choices. Your brain just can't process what's going on, and it freezes up, leaving your body without instructions. So instead of fleeing, calling 911, or jumping to action, people often turn into statues, walk in circles, or carry on as if nothing is wrong."

A training doctrine MUST at least include the element of Freeze!

     Three Fs or four Fs, there is certainly more than just the two Fs. In today's mental health industry, Stress Management is a major challenge as well as a prosperous business. In terms of everyday sudden, short-term, and long-term stress, mental health experts can easily refer to simple "flight or fight" in their articles and treatment programs, even despite the above protests of their peers. For them, the majority of problems are marital, jobs, rush hour traffic, raising children, and the like. But, a training and treatment doctrine that includes routine violence and combat cannot function without this Freeze category in its equation. The first group deals with stress; the second group deals with proper response to sudden and planned combat.

     In terms of solving fighting and violent confrontation problems, my friend Nick Hughes, a martial and military vet who runs various combatives courses, suggests the experts even add two more Fs. "Front!" As in when shocked? Or seconds after - "get big!"  Put on a front. Very natural and swell up and out those shoulders and chest. Open the jacket. Look big and scary. And "F for Fold." You've heard the expression, "folding like a cheap suit?" For when a person when shocked or seconds after being shocked, bends up and folds up.

     Why haven't we known this for years? We only have our lazy, unquestioning selves to blame. We have let ignorant, neophytes disguise themselves as medical experts and self-proclaimed "human-combat factor" tacticians and let them preach decade's old, deceased doctrine into our empty minds. Mindless regurgitators then regurgitate and proliferate this misguided information. We memorize the words but never really understand the music.

The article doctors mentioned are:
H. Stefan Bracha, M.D., Tyler C. Ralston, M.A.
Jennifer M. Matsukawa, M.A., National Center for PTSD, Department of Veteran's Affairs, Pacific Islands Health Care

Spark M. Matsunaga Medical Center, Honolulu, Hawaii
Andrew E. Williams, M.A., Department of Psychology, University of Hawaii at Manoa, Honolulu, Hawaii
Adam S. Bracha, B.A., Biomedical-Research Consultant, Honolulu, Hawaii

Leach's Incredulity Response  Click here

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