Oxygen And The Freeze Response

[sun seeker]

This is an interesting article on why some people freeze or become catatonic under threat while others fight. Its premise is that a tendency to freeze is based on a lack of oxygen at some point early in life, and focuses on the time around birth. I am thinking there is no reason why a lack of oxygen later for whatever reason, but probably still early in life, could not cause the same imprint.

http://cigognenews.blogspot.ca/2013/08/on-catatonia-and-freeze-response.html

Some of the reader comments are a little weird, but I liked the article.

 

[sonicwhite]

I froze solid at the thought I was standing before God and about to be judged......I call it a OCD spike that later gave me nightmares of this theme.

 

[Born to Run]

I am sorry, but this guy has so many facts wrong, that I find it difficult to follow. The topic could be very interesting indeed if studied properly.

 

[sun seeker]

this guy has so many facts wrong, that I find it difficult to follow

I would love it if you would explain what he has wrong. I could relate to some of it, but I am have not studied this much and would like to understand it better. Can you help?

 

[Born to Run]

Yes, of course I will. I'll come back to you later today or tomorrow on this, ok.

 

[shimmerz]

but this guy has so many facts wrong,

Born, I would be interested in your thoughts too. Do you go catatonic? I went into catatonic states every day for over 7 years (sometimes for days on end). I think he has it down pretty well. I would love to know what your experience has been.

I don't think he was studying her. I think he was attempting to help her. And I must agree with him. People who go catatonic are treated like absolute piles of :poop::poop::poop:. It is disgusting.

 

[joeylittle]

Brief thread-jack:

I just want to say that catatonia is a bigger condition than just a freeze response with mutism. It is also linked to organic mental illness, not just the fear stimulus. And I probably sound like a broken record about it :), but it isn't any different from how we can get around here when someone says being cheated on can trigger PTSD.

I'm not saying no-one here has experienced catatonia - because there's no way for me to know that - but it has diagnostic criteria as well. You might have only been in a catatonia-like state. Or semi-catatonic.

(So, one of the things the guy has wrong is his understanding of what catatonia is).

Gets off soapbox before being pushed off :ninja:

 

[shimmerz]

And I probably sound like a broken record about it :), but it isn't any different from how we can get around here when someone says being cheated on can trigger PTSD.

I am not sure I understand this part Joey. Would you mind clarifying for me?

I'm not saying no-one here has experienced catatonia - because there's no way for me to know that - but it has diagnostic criteria as well.

Yes, it does. I am not schizophrenic but was catatonic. I suppose the DSM had best keep up with me. :laugh:

While catatonia is only identified as a symptom of schizophrenia in present psychiatric classifications, it is increasingly recognized as a syndrome with many faces. It appears as the Kahlbaum syndrome (motionless catatonia), malignant catatonia (neuroleptic malignant syndrome, toxic serotonin syndrome), and excited forms (delirious mania, catatonic excitement, oneirophrenia).[7] It has also been recognized as grafted on to autism spectrum disorders.[8]

• Stupor is a motionless, apathetic state in which one is oblivious or does not react to external stimuli. Motor activity is nearly non-existent. Individuals in this state make little or no eye contact with others and may be mute and rigid. One might remain in one position for a long period of time, and then go directly to another position immediately after the first position.

There are many faces of catatonia, but I was the 'stupor' one. I am not certain if you are saying that I do/did not have catatonia?

 

[joeylittle]

The quote you've got is from a 2003 publication, @shimmerz, and is not totally accurate anymore.

I don't want to derail the thread too much, so I'll just try and clarify.

Your experience with catatonia would probably be referring to the diagnosis of a Catatonia Specifier. Catatonia specifiers are seen with mood disorders, the bi-polar spectrum, and the schizophrenia spectrum. Basically, it's one of those symptoms that crosses through many other diagnoses, but it is a strong enough feature to get its own label.

In order to have "Catatonia Associated With Another Mental Disorder" (catatonia specifier), you need to meet three of twelve criteria. They are:
Stupor, catalepsy, waxy flexibility, mutism, negativism, posturing, mannerism, stereotypy, agitation without external stimuli, grimacing, echolalia, and echopraxia.

From what you've described, it sounds like you displayed stupor, mutism, and probably negativism (basically, being non-responsive, but to an extreme degree)

The other two types of catatonia diagnosis are catatonic disorder due to another medical condition, and unspecified catatonia. "Another medical condition" means anything non-mental health related. That's where catatonia fits into the realm of general medicine.

An example of my point would be this: A person in (medical) shock will usually demonstrate stupor. They are also probably not speaking, but that doesn't mean they are displaying mutism. They may be non-responsive, but it's because they are occupied with the situation that caused the shock, not because they are displaying negativism.

I've jumped on my little soapbox in a few other threads involving catatonia, just because I figure, hey, knowledge is power - and there is a common mis-perception that stupor = catatonia. That's all. There could be someone out there freaking out because they think they were catatonic, when actually they were just extremely dissociated, say. And not many people connect agitation with catatonia, but when it shows up in a manic phase of bi-polar 1, (maybe along with grimacing, echolalia, and posturing), that's what's happening.

I'm absolutely not saying that you (or others on this thread) were not catatonic. It's incredibly difficult to diagnose, actually, both from the outside and from being inside the experience of it. They are pretty clueless about what causes it, neurologically. The DSM V did a big overhaul of the whole thing, which had been a long time in coming, and it reflects a much more up-to-date understanding of the various symptoms and how they track through different disorders.

Argh, this is very long-winded (sorry!) - catatonia is sometimes the right word for what someone is going through, but sometimes it isn't. Being really "up" isn't necessarily mania, being sad isn't necessarily depression, a really intense, frightening experience isn't necessarily PTSD-grade trauma, and not moving or speaking isn't always catatonia.

Think of this as a catatonia infomercial :)

 

[shimmerz]

Your experience with catatonia would probably be referring to the diagnosis of a Catatonia Specifier.

*Deep breath*. Okay, seems like this is a red button topic for me. Thanks Joey, that is good to know. I understand what you are attempting to do here and recognize it is for the good of the board - for awareness. Based on my personal experience - well it comes across as a challenge and minimization of my daily experience for over 7 years. So let me just clarify that yes, I did suffer from catatonia. It would be seen to be in remission right now. Hopefully for good.

I suffered from more than 3 of the symptoms that you list. It was a horrifying experience. The diagnosis was put into place because the benzodiazepine challenge showed a clear and sustained easing of my symptoms. However, when doctors could not fit me into the schizophrenic box, that gave them reason to accuse me of malingering.

I was slapped, punched, my friend was told to not 'put up with my shit and that I was taking advantage of her', I had a catheter shoved up me while the nurse said she was going to 'make sure it hurt', I was left bare assed in an open ward with visitors, I had a nurse violently release the back of a hospital bed and sneer at me that if I was going to make her life hell, she was going to return that favour. There is more but I don't want to bore you.

When I was eventually transferred to a different hospital and finally given my benzoids and came out of the state, I reacted in a 'I just want to walk in front of a bus' mode, which I would say is pretty normal after being violently abused in a hospital setting. For that, I was put into lockdown. What was the 'cause' of all of this? Because if I didn't fit catatonia as the medical establishment saw it, then I was malingering and deserved whatever kind of abuse staff deemed fit to dole out to me. And all the while I can hear everything and can't f*cking move or fight back. It is one thing to be abused by an abuser. But to be abused by a nurse(s)? Nobody believes a 'mental' patient over a nurse or any other medical staff.

Just because I don't fit what current medical scientific studies say I should be, does not make my experience of catatonia any less real. Fighting a medical establishment who couldn't think outside of their current box (DSM), which changes with every revision I might add, is humiliating, can be dangerous, and is dehumanizing. I can't tell you the traumas I experienced in hospitals due to my catatonic episodes. Silly me, I thought one went to hospitals to receive care.

So please, studies are great but if they were definitive then we wouldn't have iteration after iteration of the DSM. Studies are done for people who don't fit current criteria. And before the studies are done there are people like me who don't fit in the box. It doesn't make their experiences any less real.

 

[Born to Run]

Thank you @joeylittle to have hijacked along the line.

@shimmerz I am deeply sorry for your experience as you describe. This is so inhumane and devaluating, it is just terrible. I see now why you have very good reasons to hate hospitals. And no I have not had catatonia, I have been extremely frozen.

I have taken the article quite apart and am interested what you think. Just was a fun thing to do, man this guy :eek:

1. Catatonia and freeze are used interchangeably, which is nonsense. In addition to what joeylittle already has written about the fact that catatonia is a whole different disease with different diagnostic criteria.
- Freeze is not a disease or symptom of a disease, but a survival response from the ancient reptilian brain.
- The purpose of freeze is survival, while catatonia is not about survival, at least not in the sense as perceived by the reptilian brain.
- The freeze positions are always to minimize detection by a predator/abuser by making yourself small or hide, while in catatonia the positions do not seem to be related to minimizing or hiding.
- The freeze response elicits potentially lethal physiological changes (i.e. dramatic slowing of heart rate, cessation of breathing, and dropping of blood pressure) and I could not find these changes in catatonia.
- Freeze is about feeling numb, catatonia about feeling negative.
- Catatonia can not be triggered, as it is not a response; freeze can be triggered.

2. There are three, and not two, responses to imminent threat: fight, flight, freeze. The author omits flight. If fight and flight are not an option; freeze is the last resort to protect yourself.

3. Paragraph 2 seems about intrauterine experiences without any introduction; freezing is not the first primal response to danger; it is the last.

4. "We see this so clearly during the trauma at birth where the baby heavily anesthetized has to withhold breathing deeply to conserve oxygen. These are the later breath holders." This is implicitly saying that people without birth trauma with enough oxygen, could not be breath holders later. People without birth trauma can have a trauma later that elicits a freeze response, as it is an instinctual response, and they too will hold their breath during the freeze response.

5. "Go back to our three levels of conscious"?? Followed by ...? What?

6. "Anxiety reaction with aggressive responses" (the sympath) and "anxiety reaction with freeze (the parasympath)". I think this is a wrong representation of the sympathic-parasympathic nervous system. The sympathic nervous system reaction reacts to fear/anxiety with hyper arousal symptoms, not aggressive responses. The parasympathic nervous system responds to fear/anxiety with hypo arousal symptoms and not with freeze.

7. "The imprinted reaction governs our life forevermore." Nonsense it is instinctual driven by the reptilian -survival- brain. Nothing imprinted.

8. "One has to “breathe life” in them to get them going. And why? Because something could have happened during womb-life or birth that diminished oxygen to dangerously low levels." Could be a womb experience, but any other experience as well. I am sure that not all ptsd sufferers have endured womb issues with low oxygen. All freeze responses are accompanied by cessation of breathing, and this is an inherent part of the instinctual response to survive. As it is instinctual learning or imprinting has nothing to do with it.

9. "And what is the danger? Nothing external; something internal…..sensations (of suffocation) or feelings (something closing in). When the patient who is coming into our therapy gets provoked she goes into the freeze—catatonic response first, for an hour or five." Plain Nonsense.

10. "This is what the freeze response is defending against….not enough oxygen, which produces terror." The freeze response is triggered by an overwhelming terror. Having not enough oxygen is by default part of the freeze response, as your breathing stops. The freeze reaction is not triggered by not enough oxygen, it is a symptom of the reaction. Of course, if the author only reasons from the womb experience without enough oxygen, the lack of oxygen could be a trigger too, but fact remains that the lack of oxygen is a symptom of the freeze response regardless the trigger. I have never found that when going through a freeze response in therapy, the lack of oxygen was a cause for terror. It was just inconvenient.

 

[StarChild]

I was slapped, punched, my friend was told to not 'put up with my shit and that I was taking advantage of her', I had a catheter shoved up me while the nurse said she was going to 'make sure it hurt', I was left bare assed in an open ward with visitors, I had a nurse violently release the back of a hospital bed and sneer at me that if I was going to make her life hell, she was going to return that favour.

Oh my... @shimmerz, I never dared to mention this, because of fear and deep shame, and because I didn't understand what it was that "came over me" during a hospitalization several years ago. But I experienced the same horror in a hospital similar to you, where I live. When this "state" or whatever it is called came over me, they (nurses and doctors) would get mad at me and pinched the skin of my sternum, even twisted my skin. They also slapped the back of my hands so hard again and again, that I got black / blue haematoma all over both hands. I got yelled at, my bed was kicked several times. One doctor did took blood from the artery on my wrist (checking the oxygen saturation). But by doing so, she started to move the needle, (which was very painful) laughed at me, and told me "Feel this? Hope you enjoy it!" And I couldn't move one f*cking inch!

Later on, no doctor, not even a nurse at all came. They just sent the pissed of assistant nurse to slap, pinch and yell at me. While the patient in the next bed, desperately begged them to stop this behaviour. - I still live in fear of what will happen, if this catatonia will happen again.

Sorry for thread jacking, but for the first time in my life I simply had to talk about this horrible experience.