[libribook.com] Traumatic Scar Tissue Management 1st Edition

Stress Adaptation Response
A vast array of potential stress responses exist. In any given circumstance one
may run like crazy, fight when cornered, stand perfectly still so as not to be seen
or gather with others; commonly referred to as fight, flight or freeze and
tend/befriend.
The phrase fight or flight was coined by Cannon in the 1920s to describe the
typical behaviors that occur in the context of perceived threat. A freeze response,
or tonic immobility, may occur in some threatening situations (Gallup 1977,
Barlow 2002). Tend and befriend refers to coping with stress through social or
group support (i.e. befriending) and providing or receiving protection, nurturing
or emotional support (i.e. tending to others or being tended to). Social isolation
significantly enhances risk of mortality, whereas securing social support results
in beneficial health outcomes, including reduced risk of illness and death (Cohen
& Willis 1985).
Fight, flight or freeze are recognized as the initial stage of stress response
adaptation. Fight may manifest not only as a physical exchange but also as
vocally aggressive or argumentative behavior. Flight can occur as escaping in
either a sensory way (e.g. social withdrawal, substance abuse or television
viewing – Friedman & Silver 2007) or a physical way (e.g. running away from
something perceived as threatening or toward something that is needed or feels
safe).
Freeze response may occur when fleeing or aggressive responses are perceived
to likely be ineffective (Barlow 2002). For example, tonic immobility may be
useful when attack is further provoked by movement or when immobility may
increase the chance of escaping, such as when a predator believes its prey to be
dead and releases it. Tonic immobility is hypothesized to be an inherent
biological response to extreme stress and shows some correlation with the
experience of extreme fear. High basal cortisol levels, which are related to
heightened stress responses, are predictive of freeze responses in the presence of
threat (Kalin et al. 1998; Schmidt et al. 2008).
Schmidt and colleagues suggest that freeze response is more highly associated
with certain cognitive symptoms of anxiety (e.g., confusion, unreality,