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Fear and the Defense Cascade: Clinical Implications and Management.

Kozlowska K, Walker P, McLean L, Carrive P - Harv Rev Psychiatry (2015 Jul-Aug)

Bottom Line: Each of these defense reactions has a distinctive neural pattern mediated by a common neural pathway: activation and inhibition of particular functional components in the amygdala, hypothalamus, periaqueductal gray, and sympathetic and vagal nuclei.Understanding the signature patterns of these innate responses--the particular components that combine to yield the given pattern of defense-is important for developing treatment interventions.Effective interventions aim to activate or deactivate one or more components of the signature neural pattern, thereby producing a shift in the neural pattern and, with it, in mind-body state.

View Article: PubMed Central - PubMed

Affiliation: From the Disciplines of Psychiatry (Drs. Kozlowska and McLean) and of Paediatrics and Child Health (Dr. Kozlowska), University of Sydney Medical School; Brain Dynamics Centre, Westmead Millennium Institute for Medical Research and University of Sydney Medical School (Dr. Kozlowska); The Children's Hospital at Westmead, Westmead, New South Wales (Dr. Kozlowska); Peter Walker & Associates, Randwick, New South Wales (Mr. Walker); Brain and Mind Research Institute, University of Sydney Medical School (Dr. McLean); Westmead Psychotherapy Program and Sydney West and Greater Southern Training Network, Western Sydney Local Health District (Dr. McLean); Department of Anatomy, School of Medical Sciences, University of New South Wales (Dr. Carrive) (all Australia).

ABSTRACT
Evolution has endowed all humans with a continuum of innate, hard-wired, automatically activated defense behaviors, termed the defense cascade. Arousal is the first step in activating the defense cascade; flight or fight is an active defense response for dealing with threat; freezing is a flight-or-fight response put on hold; tonic immobility and collapsed immobility are responses of last resort to inescapable threat, when active defense responses have failed; and quiescent immobility is a state of quiescence that promotes rest and healing. Each of these defense reactions has a distinctive neural pattern mediated by a common neural pathway: activation and inhibition of particular functional components in the amygdala, hypothalamus, periaqueductal gray, and sympathetic and vagal nuclei. Unlike animals, which generally are able to restore their standard mode of functioning once the danger is past, humans often are not, and they may find themselves locked into the same, recurring pattern of response tied in with the original danger or trauma. Understanding the signature patterns of these innate responses--the particular components that combine to yield the given pattern of defense-is important for developing treatment interventions. Effective interventions aim to activate or deactivate one or more components of the signature neural pattern, thereby producing a shift in the neural pattern and, with it, in mind-body state. The process of shifting the neural pattern is the necessary first step in unlocking the patient's trauma response, in breaking the cycle of suffering, and in helping the patient to adapt to, and overcome, past trauma.

No MeSH data available.


Related in: MedlinePlus

Freezing in a rat. The rat is stopped in midmovement. Despite being immobilized, the rat remains alert; it continues to scan the environment; and its body is tense and poised for action. Its ears are flattened. If the predator attacks, freezing will give way to flight, and the rat will attempt to dart away to safety.
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Figure 3: Freezing in a rat. The rat is stopped in midmovement. Despite being immobilized, the rat remains alert; it continues to scan the environment; and its body is tense and poised for action. Its ears are flattened. If the predator attacks, freezing will give way to flight, and the rat will attempt to dart away to safety.

Mentions: The freeze response is also referred to as attentive immobility, hyper-reactive immobility, and reactive immobility. It has been most extensively studied in rodents45,60 and monkeys (see Figure 3).61–63 Freezing occurs in the context of predatory threats—detection of a predator—or in laboratory situations where the animal is reexposed to a context or discrete cues that have previously been associated with an aversive event.9,46,60,61 In predator-prey interactions, this attentive immobility functions to decrease the likelihood of detection since the visual cortex of mammalian carnivores is programmed to detect moving objects.16 Attentive immobility enables the animal to continue scanning the environment and readies the animal for an active response such as flight or fight.16,45,61 In the laboratory situation, the fourth author has observed rats to freeze for periods as long as 20 minutes. In wild rodents, freezing up to a period of 60 minutes—at which point the researcher had to interrupt his observations—has been described.†††,34 There can be marked differences in freezing within species across different genetic strains and research paradigms.61,64,65


Fear and the Defense Cascade: Clinical Implications and Management.

Kozlowska K, Walker P, McLean L, Carrive P - Harv Rev Psychiatry (2015 Jul-Aug)

Freezing in a rat. The rat is stopped in midmovement. Despite being immobilized, the rat remains alert; it continues to scan the environment; and its body is tense and poised for action. Its ears are flattened. If the predator attacks, freezing will give way to flight, and the rat will attempt to dart away to safety.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4495877&req=5

Figure 3: Freezing in a rat. The rat is stopped in midmovement. Despite being immobilized, the rat remains alert; it continues to scan the environment; and its body is tense and poised for action. Its ears are flattened. If the predator attacks, freezing will give way to flight, and the rat will attempt to dart away to safety.
Mentions: The freeze response is also referred to as attentive immobility, hyper-reactive immobility, and reactive immobility. It has been most extensively studied in rodents45,60 and monkeys (see Figure 3).61–63 Freezing occurs in the context of predatory threats—detection of a predator—or in laboratory situations where the animal is reexposed to a context or discrete cues that have previously been associated with an aversive event.9,46,60,61 In predator-prey interactions, this attentive immobility functions to decrease the likelihood of detection since the visual cortex of mammalian carnivores is programmed to detect moving objects.16 Attentive immobility enables the animal to continue scanning the environment and readies the animal for an active response such as flight or fight.16,45,61 In the laboratory situation, the fourth author has observed rats to freeze for periods as long as 20 minutes. In wild rodents, freezing up to a period of 60 minutes—at which point the researcher had to interrupt his observations—has been described.†††,34 There can be marked differences in freezing within species across different genetic strains and research paradigms.61,64,65

Bottom Line: Each of these defense reactions has a distinctive neural pattern mediated by a common neural pathway: activation and inhibition of particular functional components in the amygdala, hypothalamus, periaqueductal gray, and sympathetic and vagal nuclei.Understanding the signature patterns of these innate responses--the particular components that combine to yield the given pattern of defense-is important for developing treatment interventions.Effective interventions aim to activate or deactivate one or more components of the signature neural pattern, thereby producing a shift in the neural pattern and, with it, in mind-body state.

View Article: PubMed Central - PubMed

Affiliation: From the Disciplines of Psychiatry (Drs. Kozlowska and McLean) and of Paediatrics and Child Health (Dr. Kozlowska), University of Sydney Medical School; Brain Dynamics Centre, Westmead Millennium Institute for Medical Research and University of Sydney Medical School (Dr. Kozlowska); The Children's Hospital at Westmead, Westmead, New South Wales (Dr. Kozlowska); Peter Walker & Associates, Randwick, New South Wales (Mr. Walker); Brain and Mind Research Institute, University of Sydney Medical School (Dr. McLean); Westmead Psychotherapy Program and Sydney West and Greater Southern Training Network, Western Sydney Local Health District (Dr. McLean); Department of Anatomy, School of Medical Sciences, University of New South Wales (Dr. Carrive) (all Australia).

ABSTRACT
Evolution has endowed all humans with a continuum of innate, hard-wired, automatically activated defense behaviors, termed the defense cascade. Arousal is the first step in activating the defense cascade; flight or fight is an active defense response for dealing with threat; freezing is a flight-or-fight response put on hold; tonic immobility and collapsed immobility are responses of last resort to inescapable threat, when active defense responses have failed; and quiescent immobility is a state of quiescence that promotes rest and healing. Each of these defense reactions has a distinctive neural pattern mediated by a common neural pathway: activation and inhibition of particular functional components in the amygdala, hypothalamus, periaqueductal gray, and sympathetic and vagal nuclei. Unlike animals, which generally are able to restore their standard mode of functioning once the danger is past, humans often are not, and they may find themselves locked into the same, recurring pattern of response tied in with the original danger or trauma. Understanding the signature patterns of these innate responses--the particular components that combine to yield the given pattern of defense-is important for developing treatment interventions. Effective interventions aim to activate or deactivate one or more components of the signature neural pattern, thereby producing a shift in the neural pattern and, with it, in mind-body state. The process of shifting the neural pattern is the necessary first step in unlocking the patient's trauma response, in breaking the cycle of suffering, and in helping the patient to adapt to, and overcome, past trauma.

No MeSH data available.


Related in: MedlinePlus