Clinician Freeze Response

Two female clients in group started yelling at each other.

That’s it. Nobody threw anything. Nobody put hands on anybody. Two adults in community mental health raising their voices in a room that had contained way worse.

And my body thought I was somewhere else.

I felt the tears coming before I knew why. By the time I pulled myself together, the clients had already stopped. They were looking at me. One of them asked if I was okay. Another one said, “Wait — are you crying?”

The moment I was somewhere else

I was. I hadn’t meant to. I wasn’t trying to model vulnerability or make some kind of clinical point. My nervous system just decided, without asking me, that I was back in residential five years earlier and the yelling meant somebody was about to bite me again.

That’s what van der Kolk means when he says the body keeps the score. Trauma doesn’t file itself away as a memory. It stays in the nervous system, waiting. Two women, raised voices, small room — my body read that pattern and reacted to the old one.

I told the clients the truth. I said I’d worked at a job before where chaos reigned supreme and my body had a subtle reaction that got ahead of me. That was it. We went back to group. They stopped fighting. I think they felt bad — not about me, exactly, but bad enough that the heat came out of the room.

Three days of thinking about it

Then I spent three days thinking about it.

Because nobody tells you this part. When you’re the clinician, you’re supposed to be past it. The trauma, the hard years, the jobs that broke something small in you — you’re supposed to have processed it and put it somewhere tidy. You’re supposed to be the regulated nervous system in the room. When your body decides it hasn’t moved on? That’s when the shame starts.

If I was a client I would be telling myself something completely different.

That’s the sentence I keep coming back to.

📚 This is Blog #28 in the New Clinician Survival Kit Series (Click to explore the series)

Weekly honest support for the struggles every clinician faces: “I hate group therapy.” “I can’t do this.” “My client hates me.” “I’m making it worse.” “I can’t say no.” “They’re going to report me.” “I’m too tired to care.” “What do I even say?” “I don’t know enough.” “They keep relapsing.” “Am I documenting wrong?” “My supervisor doesn’t get it.” “I can’t handle this caseload.” “Nobody told me about the paperwork.” “I don’t like my client.” “My client’s cute.” “My client likes me.” “I got a complaint.” “I want to quit.” “My coworker is terrible.” “The most underrated job in mental health.” “My client scares me.” “Fear of losing a client.” “Fear of what they show you.” “My client died.” “I’m worried my client is hopeless.” “I don’t practice what I preach.” “I freeze in crisis situations.”

These aren’t signs you’re failing. They’re signs you’re human.

View All Posts in This Series →

The Original Freeze

The freeze I keep coming back to happened in residential. Tween girls. I was short then and I’m short now, not intimidating by any stretch. A client bit me. Another one started yelling. Thirty seconds later the community room had turned into something I couldn’t stay in, and my body made a decision before my brain did.

I ran out.

I don’t mean I walked out. I ran. Deer in headlights, through the door, out of the room. The other staff members — the ones who’d been doing this longer, the ones who got obedience through strength — looked at me like somebody who’d just made their night harder. Because I had. Now they had to catch the clients. Now they had to call the police. Now there was going to be paperwork. Lots of paperwork.

Good job at the takedown

Nobody checked on me afterward. That wasn’t the culture. The only feedback I remember getting my whole first year was after my first solo restraint. They told me I did it right. Good job.

Good job at physically containing a child’s body. That’s what I got feedback on.

Not “are you okay.” Not “that was scary, let’s talk about it.” Not “your freeze response makes sense given that you were just attacked.” Just: nice technique on the takedown, kid.

I cried on the drive home. I kept asking myself why I was scared of a bunch of girls. I was as big as some of them. I had training. I had a license. I had every qualification that was supposed to make me the adult in the room, and my body still wasn’t buying it.

I didn’t know what I know now. I didn’t know freeze is a nervous system response, not a character flaw. I didn’t know short, unimposing women working in places that reward physical dominance are set up to feel that exact way. I didn’t know my body running out of that room was doing its job — keeping me alive in a place where nobody else was going to.

At the time I just thought I was bad at it.

What I Know Now

Porges named this one in his polyvagal theory — the dorsal vagal response. When fight and flight aren’t viable, you drop into the older, deeper branch of the nervous system. Shutdown. Immobilization. Freeze. It’s not a choice. It fires before your thinking brain can even get in the room. That’s why you can know every fact about trauma responses, teach workshops on them, quote the research — and still end up frozen in a community room wondering what the hell just happened.

Most clinicians I talk to don’t know their menu. They know the concept. They can teach a client about fight, flight, freeze, fawn. They just haven’t mapped their own. And when their body does something unexpected in a session, they don’t see it as a pattern. They just feel like they failed.

Fawn is The One Not Really Talked About

Freeze and flight get all the attention. Fight gets plenty. Fawn is the one that doesn’t make it into clinician training.

Where the term came from

The term came from Pete Walker, a psychotherapist who worked with complex trauma survivors — people who’d been through prolonged, repeated, usually relational harm. In his book Complex PTSD: From Surviving to Thriving, Walker named fawn as the fourth F alongside fight, flight, and freeze. He describes it as a response to threat by becoming more appealing to the threat. Fawn types, he says, seek safety by merging with the wishes, needs, and demands of others.

Fawn is when your nervous system decides the safest thing is to make the threat like you. Agree. Go along. Play your part instead of fighting back. I don’t experience this in session. I’ve been clear about that. But I’ve experienced it plenty in other moments of my life. I get people-pleasing, immediately child-like. I listen to instructions. I follow orders. I stop using my own brain.

How I know I’ve fawned: I regret it

Here’s how I know when I’ve fawned versus when I’m just being my usual people-pleasing self: I regret it afterward.

Chronic people-pleasing is who I am most days. I say yes when I shouldn’t. I’m a team player. I don’t really get mad at myself for it — it’s part of how I move through the world. That’s a longer conversation about boundaries and worth.

Fawn is different. Fawn is the moment I went along with something I knew wasn’t right. Ignored a sign I should have trusted. Played my part instead of naming what was actually happening. Fawn is acute. It happens in a specific moment, in response to something my nervous system read as a threat. The tell is that I regret it afterward — not because I was being nice, but because I wasn’t me. I was the shrunk-down version of me that shows up when I’m scared and don’t know it yet.

Chronic people-pleasing vs. acute fawn

Trauma therapist Arielle Schwartz makes a similar distinction in her work on fawn in complex PTSD. She describes fawn as a conditioned nervous system response that fires before conscious thought. Something you recognize on the way back, not something you chose on the way in. That matters because your fawn responses aren’t character flaws or people-pleasing gone sideways. They’re reflexes. And like any reflex, you can learn to notice them sooner each time.

If you’ve ever walked away from a conversation thinking “why didn’t I say something” — not because you were trying to be nice, but because you were somewhere else in your body — that’s probably fawn. Not your personality. A reaction.

Knowing the difference matters because chronic people-pleasing and acute fawn need different kinds of work. People-pleasing is a long project. Fawn is a nervous system pattern you can learn to catch.

The Tears

The tearing is its own thing.

Attunement vs. dysregulation

I tear in session sometimes. Not often. Most of the time it’s appropriate. I remember going through an ACE assessment with a client who scored a 10. She was telling me things that would make anybody who wasn’t dead inside get a little wet in the eyes. I didn’t say anything. I didn’t make it about me. It’s not about me. Tears during an ACE disclosure where the client is a 10 aren’t dysregulation. That’s attunement. That’s what happens when a competent person hears a survivor’s worst year out loud.

The tearing with the two yelling clients was different. That was my body telling me about a place I wasn’t in anymore.

Same physical response. Completely different thing going on underneath.

Knowing the difference is the skill, and I didn’t have it when I was newer. I used to lump every emotional reaction I had in session into the same category — unprofessional, embarrassing, a problem to hide. Now I can usually tell in real time whether what’s coming up is information about the client or information about me. That distinction matters because they call for completely different responses.

What to do with each one

Attunement tears during a hard disclosure? Stay with it. Don’t pull focus. Let the silence carry it. The client usually feels more witnessed, not less.

Dysregulation tears because your body is remembering? Name it briefly if you can, but don’t process it on the client’s time. That’s for supervision, for your own therapist, for your drive home. Your nervous system having a flashback in session isn’t a teaching moment. It’s a data point about what you need to take care of outside of session.

I’ve done both. Gotten them right sometimes. Gotten them wrong sometimes.

What I’d Tell the Younger Version of Me

If I could talk to the version of me running out of that residential community room — the one who cried on the drive home asking why she was scared of a bunch of girls — here’s what I’d say.

It was a big deal

I wouldn’t tell her it wasn’t a big deal. It was a big deal. She’d been bitten. She’d been surrounded. There was no real support on shift that night. Her body did exactly what it was supposed to do in a place where nobody else was going to protect her.

I’d tell her the staff who looked at her with disappointment — the ones who handled things through physical dominance — weren’t handling it better. They were reacting to the same environment in a different way. Some nervous systems respond to threat by fighting. Hers responded by freezing. One isn’t more professional than the other. One just gets rewarded more in places that treat children like prisoners.

I’d tell her the shame she carried home wasn’t proof of her failure. It was proof she was in a system that punished softness. That system shaped her sense of what a real clinician looks like, and she’s going to spend years unlearning it. Some of that unlearning is going to feel like wanting to quit. That makes sense too.

Five years from now, your body is going to remember

And I’d tell her this. Somewhere in the future, five years from now, her body is going to remember this night. It’s going to happen in community mental health when two adult clients start yelling. She’s going to cry in session. She’s going to be embarrassed. She’s going to feel like she should be past it by now.

She’s not going to be past it. Nobody is past it. You don’t get past having been hurt at work. You get better at recognizing when your body is telling you about it. That’s different.

The client who notices her tearing and asks if she’s okay isn’t going to judge her. She’s going to say something honest back. The group is going to settle. Nobody is going to report her. Her career is going to continue. She’s going to learn something useful she’ll eventually write about for other clinicians who are also walking around with nervous systems that haven’t agreed to be over it just because they got licensed.

I’d tell her to go easier on herself. Not because it wasn’t a failure — because it wasn’t. But because calling it a failure is the kind of thing she would never say to a client, and she deserves the same clinical accuracy she gives them.

The Hypocrisy I’m Still Working On

Last week I wrote about not practicing what I preach when it comes to self-care. This is the same thing in a different shirt.

At war with yourself

I know freeze is a nervous system response. I can teach a group on it. I can explain polyvagal theory like I invented it. I can tell a client, with total conviction, that their trauma response isn’t a character defect and doesn’t mean they’re broken.

Then my body does it and I call myself an unprofessional mess.

“But if I was a client I would be telling myself something completely different.”

That’s the gap. Not between what I know and what I don’t know. Between what I know and what I’ll let myself have.

Van der Kolk says it plainly in The Body Keeps the Score: as long as you keep secrets and suppress information, you are fundamentally at war with yourself. Clinicians do this to ourselves constantly. We suppress what our nervous systems are telling us because we think we’re supposed to be past it. We keep our own reactions secret because naming them feels unprofessional. Then we sit across from clients and ask them to do the opposite — notice their bodies, name their reactions, stop treating their nervous systems like enemies.

The goal isn’t to never freeze

I’m still working on it. I don’t have a clean ending where I’ve finally figured out how to give myself the same grace I give clients. What I have is a little more awareness each time. A little more ability to notice freeze before I’m fully in it. A little more willingness to tell a trusted colleague “hey, something came up this week and my body had a response to it” instead of white-knuckling it home in silence the way I did in residential.

If your body has frozen on you in session and you’ve been walking around ashamed of it, I want you to know you’re not bad at this work. You’re a person with a nervous system doing this work. Those aren’t the same thing and they shouldn’t be.

This is post #28 in the New Clinician Survival Kit Series — a collection of honest, non-cheerful blogs about the parts of this work that don’t show up in grad school. If you’ve been feeling something and can’t quite name it, this series is probably where you’ll find the words.

Until Next Week | The Underrated Superhero

📖 External Resources & Research

• 🔗 Codependency, Trauma and the Fawn Response — Pete Walker — The original article where psychotherapist Pete Walker named fawn as the fourth trauma response alongside fight, flight, and freeze, drawn from his work with survivors of complex relational trauma
• 🔗 The Fawn Response in Complex PTSD — Dr. Arielle Schwartz — Trauma therapist’s clinical writing on fawn, including the critical distinction between conditioned nervous system responses that fire before conscious thought and values-based choices made with intention
• 🔗 What Is Polyvagal Theory — Polyvagal Institute — Stephen Porges’ framework explaining why freeze and shutdown fire before the thinking brain can intervene, and why clinicians can know every fact about trauma responses and still experience them involuntarily
• 🔗 The Body Keeps the Score — Bessel van der Kolk — Foundational work on how trauma lives in the nervous system rather than in memory, and why the body reacts to present-day patterns that resemble past threats even when the conscious mind has moved on

📌 From This Series

• 🔗 Blog #22: “My Client Scares Me, Part 1” — When you start noticing the patterns in yourself and the people closest to you
• 🔗 Blog #26: “I’m Worried My Client Is Hopeless” — When doubt creeps in and the entire process is affected
• 🔗 Blog #27: “I Don’t Practice What I Preach” — The gap between what you know clinically and what you extend to yourself
• 🔗 Blog #19: “I Want to Quit” — When burnout stops being a bad day and starts being a career question