Understanding the window
The Window of Tolerance, a term coined by Dan Siegel, describes the band of autonomic arousal in which a person functions best. Inside the window, we can feel an emotion without being run by it, think while we feel, and stay connected to another person while something hard is happening. It is the zone where integration is possible.
Trauma narrows the window. The nervous system, having learned that the world is dangerous, gets pushed out the top into hyperarousal or out the bottom into hypoarousal with very little provocation. So the first job of trauma therapy is not processing. It is widening the window and building the client's capacity to come back to it when they leave ~ which they will.
You cannot process what you cannot tolerate. Expand the window before attempting memory work.
The three zones
Above the window is sympathetic mobilization. Below it is dorsal vagal shutdown. Knowing which way a client has left the window tells you which direction to regulate ~ down from fight/flight, up from freeze.
Interventions, by direction
Match the intervention to the direction of the exit. Bring a hyperaroused client down; bring a hypoaroused client up. Each set runs from in-the-moment to capacity-building over time.
Bringing down from hyperarousal
Sympathetic activation ~ fight / flight / panic
- Grounding (5-4-3-2-1 sensory)
- Slow, extended exhales
- Bilateral stimulation
- Cold water on face / wrists
- Progressive muscle relaxation
- Mindfulness and body awareness
- Orienting to the present environment
- Titrated exposure to triggers
- Trauma processing (EMDR, DBR, SE)
Bringing up from hypoarousal
Dorsal vagal ~ freeze / collapse / numbness
- Movement and physical activation
- Orienting (look around)
- Strong sensory input (cold, texture)
- Vocalization (humming, singing)
- Social engagement (eye contact, voice)
- Rhythmic movement (walking, rocking)
- Gradual activation exercises
- Yoga and mindful movement
- Desensitization of phobias of body sensations, emotions, trauma memories, relational intimacy
- Parts work (IFS) for frozen parts
- Somatic processing of freeze (SE, Sensorimotor)
- Trauma processing (EMDR, DBR)
Do not use release breathing for hypoarousal
Long, slow exhale work calms a revved-up sympathetic system ~ but used on a shut-down, dorsal-vagal client it deepens the collapse. When the client is below the window, the goal is gentle activation, not further down-regulation.
The polyvagal map
Stephen Porges' Polyvagal Theory gives the window its neurobiological floor. The three autonomic states map directly onto the three zones: ventral vagal is the window, sympathetic is hyperarousal, dorsal vagal is hypoarousal.
The newest parasympathetic pathway. Enables social connection, safety, and calm engagement.
The fight/flight response, activated when we perceive threat and need to mobilize for action.
The oldest parasympathetic pathway. Causes shutdown, freeze, or collapse when threat is overwhelming.
Nervous system sensitivity screening
Elaine Aron's research finds that 15~20% of the general population are highly sensitive persons (HSPs), but closer to 50% of therapy patients display the trait ~ more often if they had a troubled childhood. A highly sensitive nervous system is one of two criteria widely used in diagnosing Borderline Personality Disorder.
A client's baseline sensitivity directly informs how you calibrate the work above. Highly sensitive clients have a narrower window and need more gradual titration during processing. For Aron's research and clinical resources, see hsperson.com.
The four defining features of high sensitivity (DOES)
Aron, E. (1997). The Highly Sensitive Person. · Richey, D. (1999). Holistic Inventory of Stimulus Sensitivities.
Processes information more deeply and thoroughly.
Easily overwhelmed by stimulation.
Stronger emotional responses, both positive and negative.
Notices subtleties others miss.
A short sensory- and emotional-sensitivity screen ~ Aron (1997) & Richey (1999). Interactive and downloadable PDFs live with the other pre-session screenings.
Session language
Words that do the work in the room ~ to assess, to down-regulate, to up-regulate, and to frame the long arc of widening the window.
- On a scale of 0 to 10, where is your activation right now?
- What sensations are you noticing in your body?
- Are you feeling more revved up, or more shut down?
- What's happening with your breathing right now?
- Let's slow things down. Can you feel your feet on the floor?
- I notice your breathing has quickened. Let's extend your exhale.
- You're safe here in this room. Let's orient to the present.
- Can you name five things you can see right now?
- I'm going to invite you to look around the room slowly.
- Can you press your feet into the floor and notice that?
- Let's try some gentle movement ~ can you wiggle your fingers?
- I'm here with you. Can you hear my voice?
- We're working to widen your window over time.
- This is about building capacity to stay present with difficult experiences.
- Notice how you can move in and out of activation ~ that's regulation.
- Your nervous system is learning that it's safe to feel these sensations.
References
- Siegel, D. J. (1999). The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. Guilford Press.
- Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. Norton.
- Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the Body: A Sensorimotor Approach to Psychotherapy. Norton.
- Aron, E. N. (1996). The Highly Sensitive Person: How to Thrive When the World Overwhelms You. Broadway Books.
This material is covered in The EMDR Deconstructed Workbook, Chapter 3: Foundations. See the workbook page.