By: Dr. Lindsey Tubaugh
Many have heard of the fight/flight response in the nervous system when our mind feels we are in either real or perceived danger. Did you know there are three additional states? And what does this have to do with sound sensitivity?
For those with extreme sound sensitivity and/or tinnitus, when an offending sound is heard, the body goes into one (or more) of these stress states. The difficulty is that once the mind/body has gone into one of these states, it can be difficult to come out of it.
Here is a brief outline of each of these 5 states the person may go into when hearing a sound that is intolerable to them:
FIGHT
This state occurs when the nervous system feels it is being attacked and feels it needs to “fight for its life.
Common feelings associated with this state are:
- Anger
- Rage
This is a common state seen in those with Misophonia (a hatred of certain types of sounds). Misophonia causes a reflex in the body which activates this fight response. It does not mean the person having a misophonic response will act on this state through physically fighting (though they may), however the feeling of anger/rage is a defining characteristic of a misophonic response.
Those in this state will often feel a tightness in the body in the jaw, hands, stomach, neck, and/or throat.
Regular activation of this state, particularly for those with sound sensitivity, can have a significant impact on well-being, mental health, relationships, and social interactions (including social isolation for fear of going into this state).
To read more about an experience I had being in this state, check out my blog post here.
This state can be a particularly bad cycle for those with untreated misophonia because when the body regularly goes into this state in response to sound, the body will continue to go into this state even when the sound is not even audible (e.g., the person masks the SOUND with other noise but can SEE a person making the offending sound or even KNOW it is happening in the other room.) If you are reading this and can relate—there is help for this by learning how to regulate the nervous system’s response.
FLIGHT
Flight state, as you may have guessed, is the state that makes us feel we need to escape or flee a situation that is causing this state.
Common feelings associated with this state include:
- Fear
- High anxiety
This is a common state for those with hyperacusis (extreme sensitivity to medium-loud sounds that are easily tolerated by those around them). They may exhibit a literal urge to run away from the offending sound or escape in some way.
This state can also show up as avoidance from emotion and the experience by:
- Compulsive and/or emotional eating
- Addictions (to bring the nervous system closer to pleasure and further from pain)
- Diversions and distractions (e.g., binging on Netflix in an unhealthy way, compulsive spending, excessive video gaming)
When activated much of the time, this state creates problems in being present in life and in the ability to enjoy relationships and social events. Chronic fear and anxiety also lead to mental health concerns.
While this state is crucial if you are being chased by a bear, it is detrimental when it is activated chronically for non-life-threatening events.
I can definitely think of times when this state has been activated (we probably all can)! Honestly, I am pretty open with my struggles with anxiety and though my siblings may disagree, for the most part I am all flight and no flight, lol.
One particular Black Friday is a good example from my life. The people + the noise + the chaos = Lindsey going into the store, panicking, and then going right back out to wait in the car while friends continued shopping undisturbed. I now only do Cyber Monday deals for exactly this reason!
FREEZE
In the freeze state a person looks frozen like a statue on the outside, while their mind is racing on the inside. The person may have wide-eyes, mouth agape, and immobilized. On this inside though, this person is panicking and may actually exhibit a true panic attack in this state.
Feelings commonly associated with this state are:
- Panic
- Racing Heart
- Sweating
- Dizziness
- Tensing of muscles
- Loss of feeling in their body
More subtle reactions to this state include:
- Inability to think clearly
- Thoughts and words disappear / mind goes blank
- Fumbling over words or stuttering
We may notice this a lot in children when the fight or flight states are not possible. An adult may have the option to get up and leave when a situation arises or even fight back when needed. Those are not options children usually have.
Many of us can relate to this state. Think back to a time in school (or work) when you were randomly called on to answer a question and your mind went completely blank. Inside you were frantically trying to come up with the right words, knowing everyone was looking at you and waiting. YIKES! It is a terrifying feeling!
While a silly example, here is a live-action clip of me going into the freeze state during a YouTube video Dr. JJ and I were making.
It was funny because JJ helped me laugh it off, but when in front of a group—or if this were a YouTube LIVE—it could have been more traumatizing! I remember many instances in college where I was asked a question in front of the class and went into a classic Freeze state–making me feel horrible long afterwards.
For those with sound sensitivities where there is no option for escape or fight-back, you may often notice this as the nervous systems response to overwhelming and/or traumatic stimuli.
ATTACH
This is quite common in children with sound sensitivities, especially young children, however, it happens with adults as well.
In the attach state, all a person’s energy is focused on finding someone to save them from the offending sound.
The feelings associated with Attach state may be:
- Sadness
- Afraid
- Dysregulated
- Panicked
- Pleading
- Whining
- Desperation
- Unsettled
They may verbalize (or internalize) statements such as “Please help me!” or “Please see that I NEED YOU!” On the inside, the person is very dysregulated and feeling unsafe. In this state, the person feels they have no way to cope on their own and are so overwhelmed they desperately seek help from someone (e.g., a parent, teacher, sibling, or friend).
The more helpless or dependent a person is, the more they will rely on the Attach state over other nervous system defensive states.
When this state is activated frequently, it can cause exhaustion, poor well-being, and the inability to feel safe being authentic.
Many parents have seen this in their child at some point. When a child gets extremely overwhelmed or frightened, they may cling to you as if their very life depended on you for survival.
SUBMIT
Finally, the submit state is when a person is willing to go along with whatever is happening just to feel safe. It is often a state used to prevent anger or rage in someone else.
It may look like a person is giving up or giving in to protect a real or perceived threat. It is often characterized by a person with slumped posture, sad eyes, and/or crying. Whenever I think of this state, Eeyore comes to mind.
Feeling associated with the submit state are:
- Depression
- Frustration
- Powerlessness
- Worthlessness
A child or adult who is in a submit state will be very concerned about “making waves” or causing any disruption so instead of saying or showing what they need in the moment, they try to prevent further feelings of danger by going along with anything. For a person who is regularly in this state, this feeling of worthlessness, hopelessness, and suffering is a significant concern for overall wellbeing and mental health. The danger of not seeking help when this state is continually being triggered is the lowering of personal expectations and the disasociation of personal awareness and needs.
I have seen this in my patients with tinnitus. Perhaps the other defensive states haven’t helped and their nervous system is stuck in this cycle of Submit. They may have given up hope. In our clinic we never give up hope.
What you need to know if you have tinnitus or sound sensitivities and are stuck in one or more of these states on a frequent basis:
- While these states are normal and helpful during truly life-threatening events, if you do not know the tools to prevent these states from hijacking your nervous system on a regular basis, it will take a significant toll on your mental health and quality of life.
- There is a way to help control and regulate these stages! And we have them!
- The key is beginning to recognize when you (or your child) is in one of these states and using tools to shift out of the state.
- There is freedom and hope by learning tools and techniques to change the state of your nervous system—and they really are not hard.
- While implementing tools to regulate these states does take effort and self awareness on the part of the sufferer and/or caregiver, the rewards are extraordinary because you (or your child) no longer need to be enslaved the natural response to tinnitus or sound sensitivities.
- The regulation tools we use for sound sensitivities and tinnitus translate into anything that is causing you to move into one or more of these states.
When a patient comes to us for treatment of a sound sensitivity (like hyperacusis and misophonia) or tinnitus, our treatment protocols involve these nervous system regulation tools as a necessary element to a well-rounded and person centered treatment.
For more information on how we treat these hearing differences, schedule a free 15 minute virtual consultation here.
For more information regarding our nervous system defense mechanisms and what chronic stress can do to our health, I recommend the following:
Understanding the Stress Response
Health Impacts of Chronic Stress