Stress is the body and minds natural preparation response to perceived demands, threats, or challenging situation. If stress rises high enough, the peak can trigger the Freeze, Fawn, Flight, Fight Emergency Protocol, which can strongly affect cognition (thinking), mood and behaviour. We can refer to this peak as a Crisis, Meltdown, Anxiety Attack or a Panic Attack. It can also be the point of Self-Harm or Suicidal Ideation. Short-term stress can be helpful in motivating actions, however, chronic or overwhelming stress can be problematic. Stress Mountain is a visual metaphor for tracking the process of overwhelming stress – from the Trigger Event changing your Baseline, through the Rumble Warning phase for Early Intervention, to the Distressed phase which indicates Late Intervention ending in Harm Minimisation if the peak Crisis / Meltdown phase can’t be averted, and then the Recovery phase, which is vulnerable to being Re-Triggered. Being able to visualise the phases and responses of Stress Mountain enables you to better determine what you can do for each phase to either return you to your Baseline quickest, or at the least minimise the harm.
At the end of this we have a brief rundown on the Safety Plan, which can be used in conjunction with Stress Mountain.
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Understanding Crisis Behaviour
eg Meltdown, Outburst, Panic Attack
The Point
When humans are in a Crisis, their Brain often switches to Survival Mode, triggering Crisis Behaviours, which may not be helpful.
‘Meltdown‘ is an infantilising term used to describe the Crisis Behaviour of generally Autistic People, generally triggered by runing out of the ability to manage the current Situational Demands due to low Internal Resources (Spoons). Meltdown is synonymous with some other behavioural descriptions.
Summary: Crisis Behaviour
- What: Crisis Behaviours are unhelpful behaviours triggered by being in a Crisis, the peak of Stress Mountain.
- This is mostly commonly caused by running out of Internal Resources aka Spoons.
- “Running Out” means that the Situational Demands exceed the person’s ability to Supply.
- Meltdown is an infantilising term to describe Autistic Crisis Response and is synonymous with:
- Outburst / Anger behaviour / Tantrum etc,
- Anxiety / Panic Attack,
- Crisis.
- This is mostly commonly caused by running out of Internal Resources aka Spoons.
- Why: Acopia (literally not coping) due to inadequate available Internal Resources (Spoons) to the Demands (perceived or actual),
- Mechanism: Essentially part of Freeze, Fawn, Flight and or Fight reflex,
- Caution: Often mistaken for a trauma response or naughty behaviour
- It isn’t, you are just out of spoons.
Meltdown = Anxiety Attack = Panic Attack = Crisis.
Discussion
“Meltdown” is the common infantilising and disparaging term used to describe the Freeze, Fawn, Flight and or Fight response Neurodivergent People enact (such as Autistic, Intellectually Disabled, or ADHD people) have to a situation where Neurotypical People (average common people) would feel at most discomfort.
This same Crisis Behaviour are known by some other common names.
Meltdown more refers to what an external observer would note when seeing someone who is going through the Stress Mountain peak.
People don’t choose to have a Meltdown.
Behind the Crisis Behaviour are background factors that are generally socially and professionally misunderstood, leading leads to poor education for the Neurodivergent Person and bad advice. Many Neurodivergent People have poor interception, making it additionally hard to figure out what is causing the Crisis.
So let us examine what causes triggers a Crisis, and thus Crisis Behaviours.
Crisis Behaviours Synonyms by Survival Root
- Fight:
- Aggressive Outburst, Outburst, Aggression, ‘Anger‘ behaviour, Tantrum, Tanty (Australian slang),
- Defiance Outburst / ODD (Oppositional Defiance Disorder).
- Flight:
- Anxiety Attack: where you feel overwhelmed but retain a small amount of cognitive capacity,
- Panic Attack: which is an Anxiety Attack plus loss of cognitive capacity,
- Avoidance: Running away, failing to turn up, ignoring communication, various Mutism.
- Fawn:
- People Pleasing behaviours, Submission, ‘Stockholm Syndrome’.
- Freeze:
- Dorsal Vagal Shutdown, Hypoarousal, and Shutdown,
- Going ‘Non-Verbal‘, various Mutism,
- Flattened Affect,
- Black out, Dissociation, Blank / missing memory.
Crisis Behaviours are atypical behaviours. That is, not the common or mostly observed behaviours.
Crisis Behaviour Causes
The Point
Fundamentally, the base root problem is a Supply and Demand problem where compensatory Adrenaline fails to resolve the problem.
Summary: CB Causes
The Supply of Spoons (Internal Resources) does not meet the Situational Demand for Spoons, leading to a compensatory Adrenaline surge which fails to resolve the Supply inadequacy.
- Demand can vary:
- Objectively: additional demands or mistakes in initial assessment,
- Subjectively: Unknown requirements,
- In time and situation.
- Supply can vary:
- Between people, or
- Due to :
- Derailment,
- Missed personal upkeep (Meds, Food, Rest),
- Hormones, allergies, external demands.
Definition: Spoon Theory
Spoon Theory helps us to understand how all tasks require the use of resources (internal energy, finances, time, friends, knowledge etc), and if we don’t have those resources, we are out of Spoons, and thus can’t do the thing (demand for the resource exceed the supply). Knowing that different tasks cost different Spoons for different people and circumstances helps us better understand why other’s may find your task easier or harder to do than you and sometimes you can do a thing, sometimes you can’t do a thing, and what you might do to change that.
Discussion
Fundamentally, the base root problem is a supply and demand problem. The person’s supply of available resources (Spoons) does not meet the apparent demand for Spoons, leading to a compensatory Adrenaline surge which fails to resolve the supply inadequacy, leading to a Survival Mode response, which is a Crisis Behaviour.
- While Supply of Spoons is greater than the Demand for Spoons, then you are at Baseline or greater.
- If your Supply of Spoons decreases but the Demand for Spoons remains the same, then you may fall below being able to Supply the Demand of Spoons, leading to an increase in Stress, outlined by Stress Mountain.
- If the Supply of Spoons remains the same, but the Demand for Spoons increases, then you may also fall below being able to Supply the Demand of Spoons, leading to the same increase in Stress, outline by Stress Mountain.
- If the imbalance of Supply and Demand is not met, then you will reach Crisis, the peak of Stress Mountain,
- Survival Mode activates, which releases Adrenaline,
- Behaviours will switch to Crisis Behaviours.
Let us break this down a bit using a case example.
Definition: Objective Demand vs Perceived Demand (for ‘adequate resources‘)
Perceived Demand: How much you estimate you’ll need for the task.
Objective Demand: How much you Practical External Resources + Spoons you need for the task.
Depending on how ‘making boxes ‘ is defined, their may be a static Practical External Resources, or fluctuating if you and I have different requirements for ‘making boxes’.
Spoons is variable between both people (you have a different level of Spoons Available and Spoon Cost Per Task), and time (you now versus you later may have different Spoons Available and Spoon Cost Per Task).
Case Example – The Box Maker
Thought Experiment:
Imagine a problem before you, perhaps making boxes. To do this, you’ll need Practical External Resources (materials to make the boxes out of and tools), and Personal Resources (time, energy, skill, knowledge, ‘Executive Function‘ [focus, concentration, alertness, working memory, cognition, problem solving etc]). If you don’t have these, the task cannot be started. Enteroception allows you to know about the Personal Resources (Spoons as a simplified way of describing this) and with sufficient Spoons, you have the Executive Function to check if you have the practical External Resources.
How Demand and Supply can vary:
- Demand:
- “I began making your boxes, then saw that I had misread how many you needed, and I didn’t have enough materials,”
- “I was about to finish your boxes, then you told me you needed 6 more, and I don’t have the materials or time to do that,”
- “When I agree to make you 3 boxes, I didn’t really know how big you wanted them, or made out of what, so I made 3 of several sizes, and each of those out of several materials…”
- The cost for you to make the 3 boxes is much cheaper since you know the size and materials you wanted to make them out of,
- Supply:
- “I was doing passably well, then I forgot to (eat / take meds / take a break), and ran out of Spoons“.
- Both:
- “I was making your boxes, and things were going well – and then my mother turned up to help me,”
- Demand for resources for the boxes may not have gone up, but the Demands on my ability did as I needed to continue making the boxes AND manage a social interaction with my mother, causing a Supply deficit.
- “I got about half way through making the boxes, when I was reminded that I need to go shopping. I just didn’t have it in me to do both, so I freaked out and did neither.”
- The upcoming task’s expected cost demand did not meet the expectation of how many Spoons I’d have to do that task, which then interfered with my ability to do this task.
- That is:
- I wouldn’t have any Spoons left to go shopping, and so I had to stop spending Spoons on this task.
- In failing to complete this task, I spend those Spoons I saved trying to solve how to deal with that failure, which left me with no Spoons to do the next task.
- “I was making your boxes, and things were going well – and then my mother turned up to help me,”
- There are many more permutations for how the perceived and actual demand can vary.
Objective Changes
In the The Box Maker case example, there were a number of scenarios that were illustrated that can lead to Resource Supply no longer meeting Task Demand. Some of these were due to objective practical problems, which are relatively easy for most people to agree cannot be rectified without a practical change, such as getting more materials and allocating more time.
Subjective Perception Changes
If I am not prepared for the problems, or the reality of the task, that may impact the practical material aspect, and it may lead to additional actions and stresses that are harder to externally observer or measure. If I am making the boxes for you, we may have a good understanding of what is ‘good enough’, while if I am making them for someone else, that may be a problematic misunderstanding of what would be ‘good enough’ – assuming they actually have a stable and static definition (not toxic or Abusive).
Temporal Changes
I need to factor in the upcoming likely Demand Costs of at least the next task – and possibly a temporally more distant task if it is expected to be particularly taxing. Discovering that there is either a new task (Derailment) or a missed task, can change that temporal expectation.
If you are struggling to understand what this means, consider this. Let’s change Spoons to a dollar value. You have $100 to spend today. The Boxes are going to cost you $50 to make. You also need to go shopping, which usually costs $80. You have to go shopping, or your sick relative will go hungry. You thought they had enough food until tomorrow, where you’ll have a fresh $100 to spend, but now you discover it has to be today, but you only have $50 after completing the boxes. They need all $80 of that shopping today. You can’t turn $50 into $80.
This isn’t a perfect analogy – in theory you could just get $50 of immediately needed goods and get the other $30 tomorrow, or you could borrow some money from someone else. However, you don’t really have that option with Spoons. You either have it, or you don’t.
Situational / Environmental Changes
While the box making itself may go smoothly, the environment where I am making the boxes may change, which may change the overall Demands to the Resources I can Supply. If someone comes who can help me, that may decrease the Demand Costs, however if someone comes who increases other expenses, I may not have enough Spoons to meet both making boxes and managing them. If plans change, I can become derailed – change can cost quite a few Spoons to rejig the plan for the day.
Common Internal Reasons why available Spoons Diminished
- Meds – did not take medication
- Hunger – not eating recently enough (often the last 4 hours)
- Hormones – menstrual and or adrenaline etc
- Fatigue – poor sleep, or recent over exertion
Common Reasons why a Supply & Demand may vary
- Derailed: when needing to switch from one task to another, but the time given is insufficient
- More tasks: someone or something asks more of us, tipping the energy demand over what is in supply
- Incompatible method: someone asks you to do a thing that is not compatible with your efficient for you method, thus it costs more, beyond what you have available
When Spoon Supply fails to meet Task Demand Cost, or Derailment occurs, our brain may automatically trigger Survival Mode, which delivers some compensatory Adrenaline to help make up for the deficit. That is kind of like borrowing some extra Spoons, but they aren’t Spoons that are good for this task.
Specialised Spoons
- Some Spoons are specialised and are efficient for certain tasks, eg Social Spoons, or Creative Spoons.
- I can run out of being around people, but can still create.
Spoons and Adrenaline
The Point
Neurodivergent People are generally low on Spoons (vs healthy Neurotypicals). Spoon undersupply triggers compensatory Adrenaline, which may or may not address the problem caused by the deficit. Even if it does, Adrenaline has a later cost.
Summary
- Spoon is shorthand for “cost to do a task”, mostly referring to internal energy resource.
- Neurodivergent People usually have fewer Spoons than healthy Neurotypical People.
- Neurotypical (Life) Strategies work well for Neurotypicals, but are more expensive for Neurodivergent People (Autistic, ADHD etc), with poor results, leading to wasted Spoons.
- That is, a double cost to Spoons.
- Running out of Spoons leads to Emergency Adrenaline, which leads to Crisis Behaviours.
Discussion
A common factor for Neurodivergent neurology is insufficient resources, aka Spoons (see the Spoon Definition above, or jump to the Spoon Theory page).
While Neurodivergent (neurologically divergent) is often used to mean Autistic, it can also be many other neurodiverse cohorts (eg ADHD). Most Neurodivergent people have co-morbidities (cooccurring) diagnoses with other neurological, psychiatric and or biological conditions (eg ADHD or Chronic Pain). It is fairly rare to have these co-occurring condition recognised and diagnosed properly, leading to many Neurodivergent People not having the correct useful medication, supports, and or strategies (management, mitigation, & Quality of Life) in place.
A common experience in ADHD, for example, is fatigue, simply because your Dopaminergic System is struggling. ADHD medications typical support this, however if you have not been diagnosed, your medication is inadequate, or you have another confounding condition, it won’t address that fatigue even if you look energetic. That is, you may have a diagnosis of Autism, which helps explain certain chunks of your life experience, but if the diagnostician missed (or wasn’t qualified to notice) your ADHD, you are probably struggling just because of inadequate medication. My my experience as a therapist, almost all people diagnosed with Autism benefit from a diagnosis of ADHD and the ADHD medication that helps the dopaminergic system. Low amounts of neuronal Dopamine, Noradrenaline and Adrenaline lead to increased difficulties thinking, feeling and acting, which leads to exhaustion and chronic low Spoons.
Definition: Neurotypical Strategies vs Neurodivergent Spoons
- Neurotypical ‘Life Strategies‘ work well for neurologically typical people doing typical things in this society, that is evolved for Neurotypical People.
- Neurotypical Strategies often work poorly for Neurodivergent People, costing more to do with often poor results.
Unfortunately, there is a fair chance that most of these Neurotypical strategies are more difficult for a Neurodivergent Person to use. That is it costs more Spoons to enact that strategy for the Neurodivergent Person than the Neurotypical Person. Developing individualised efficient strategies takes time to personalise, and a safe environment to develop those improved strategies. Neurodivergent people can often find themselves in a-typical situations (outside of typical to Neurotypical People), which mean that those Neurotypical Strategies are even more expensive to try to use, with often neutral to negative outcomes, leading to even greater loss of available Spoons.
What this amounts to is, if you are a Neurodivergent Person, you are probably confused, tired, and out of Spoons and still have things you are expected, or that you expect yourself, to do.
A standard solution to this is to start substituting Adrenaline via Stress, often Negative Stress (eg ‘Negative Self Talk‘, catastrophising, Rejection Sensitivity) to compensate for that fatigue. Initially this will work.
In a typical unexpected Spoon ‘Insufficiency Situation‘ (ie this occurs rarely), this mechanism is fine. You can rest later, once the situational crisis is over, and the negative impact to your self esteem will heal.
For Neurodivergent People, though, there’s a problem. You didn’t have enough Spoons to get through a Healthy Neurotypical Person’s day, so you can’t rest later. You just need to pump out more Adrenaline to keep going. That means you can’t recover, you can’t heal, and you just continue to rob your own resource pool.
When you run out of Adrenaline to substitute (you only make so much), or you run out of other neurochemicals to manage how to positively use the Adrenaline, we stitch to Survival Mode.
Survival Mode may interpret Adrenaline via either the Anger or Fear circuits.
How the Survival Mode brain protects you and what it looks like from the outside will be covered below under the Crisis / Meltdown Phase.
Survival Fear Series
We evolved to survive predators with by utilising the Fear Response part of our brain’s Survival Mode. To understand this, we will look at the Survival Series in terms of how we would respond to a predator in the wild.
In our modern context, we almost never deal with predator animals in the wild
– the predators are now other humans, or sometimes ourselves…
- Freeze
- Evolution: As you become aware of a predator, it may not be aware of you. The Freeze Reflex prompts you not to draw attention to yourself. If the predator doesn’t see you, then you can’t be targeted by it.
- Appearance: You may become still, non-verbal, or muted in some other way. You may become indecisive, or just ramble to avoid a commitment.
- Helpful: Sometimes the best thing to do is not draw attention to yourself. If you can’t do something about the problem, wait a bit and see if the problem (predator) removes or resolves itself. Why fight off the predator if it is just going to walk away?
- Unhelpful: If the Freeze Reflex is too strong, you may not be able to switch to one of the other actions and become helpless. Predators are not going to be kinder to you just because you aren’t fighting back.
- Fawn
- Evolution: The predator has noticed you. Perhaps if you feed the predator, it won’t think of you as food. You try to please the predator.
- Appearance: People Pleasing
- Helpful: If it is unusual for this person to be upset, then doing things to help them feel better will resolve this situation and then hopefully they will self manage, or perhaps you can help them with the actual problem.
- Unhelpful: Many abusive people take advantage of people with People Pleasing reflexes.
- Flight
- Evolution: The predator has noticed you. Before it can attack, you back off and get out of its range. Most animals the predate on humans are ambush or pounce predators. Humans have a better ability to maintain a run than most predatory animals, so if we get out of range, the predator won’t bother and will look for other food. It can’t hurt you if you aren’t there.
- Appearance: Anxiety, Fear, exiting the situation early, not going outside, agoraphobia
- Helpful: Often the situation is best avoided by not being there. When someone tries to entice you into a fight, the best option is not to reward them with a fight. If the same person keeps enticing you to fight, they are someone you probably don’t want in your social group.
- Unhelpful: Abusive humans will go out of their way to find victims. Exiting early is often not helpful in asserting good boundaries and defeating predator humans.
- Fight
- Evolution: The predator has noticed you and is coming in to attack. You can’t turn and run, it is too late, it would just attack your back, making you more vulnerable. It is now time to choose to fight or get hurt. If you can defeat or hurt the predator, the rest of your tribe will be safer.
- Appearance: Aggression, either verbally or physically
- Helpful: Sometimes it is necessary to fight. This should be a rare exception.
- If you decide that this is the right call, then win.
- Most fights don’t need to be violent. Work out the way to take action to defend yourself and your loved ones that is non-violent. For example, court, police, peer group agreements, using the rules etc.
- If you are being physically attacked, then physically defend yourself. Then call the police.
- Unhelpful: Often this is the wrong call to make.
- In the absence of a direct physical assault, you had best be very sure that it is the right call to make.
- Physical violence is best only if you need to physically defend yourself from a clear and present physical attack. In all other instances, a non-violent fight (as outlined above) is the better solution.
Notes: Primary Feeling Default Actions
- We should progress through these in the numbered order.
- Because these are primary, they are also basic.
- That means that it doesn’t include nuanced decisions and reasoning.
- For most people, by the time this is needed, the threat is big and clear enough that it needs a basic solution and you’ve run out of time to think of something more complex.
- For someone with a disorder, this is likely an over reaction instead of a survival action, so the Default Action isn’t actually helping the situation.
Stress Mountain
The Point
Understanding the Phases of Stress Mountain helps us to identify if we are escalating (arousal), why elevating reduces our choices, but knowing about the Phases allows us to better know what to do about Escalating and how best to Recover if we go through Crisis.
Summary: Stress Mountain
- Stress Mountain describes the process of escalating from a Baseline State towards being in Crisis, where Crisis Behaviours (Eg Meltdown, Suicidality etc) may adversely affect our life.
- Knowing what the Phases are and how that affects our inner state, and thus choices and abilities, allows us to make wiser recovery and mitigation decisions to return to the Baseline either prior to reaching the Stress Mountain Peak aka Crisis, or after it.
- There is a high risk of re-triggering another escalation to Crisis while recovering.
5 Phases of Stress Mountain
- Baseline: Where we mostly live
- Rumble Warnings: The early warnings that we are not coping
- Distressed: The late warnings that we are not coping
- Crisis / Meltdown: The temporary time we are unable to function, often with behaviours that are not desirable
- Recovery: the post peak return to the baseline state
Discussion
Stress Mountain describes the very human process of struggling in adversity, failing to accommodate, and thus entering Crisis. Crisis is where our brain switches from normal operating mode (mostly System 1 [automatic / autopilot] or System 2 [conscious, present, deliberate, explicit / declarative]) to Survival Mode and enacts Crisis Behaviours aka Survival Behaviours, via an Adrenaline surge – see Brain Modes for more.
The failure in Supply of Spoons may be due to impaired cognitive function due to neurological chemical imbalance (eg running out of Dopamine). A common response to Crisis is to surge Adrenaline release, which if you didn’t already have compromised cognitive functions, can disable higher cognition (approximately Executive Functions, but it is complicated). Either way, people in Crisis are not generally thinking well, have compromised mood and impaired decisions making ability – they are having a Meltdown of Normal Functions aka freezing, anxiety attack, panic attack, aggressive behaviours, self harm, suicide attempt or some other stress response.
The full Stress Mountain has a number of phases. We can generally act in the early stages, as we rise through the Rumble Warning phase and Distressed phase. If we can act correctly identify the cause of the Supply and or Demand problem, then addressing those can return to Baseline efficiently, otherwise Crisis Phase is likely, with Crisis Behaviours.
See Crisis Behaviours Synonyms by Survival Root above for the full list of potential reactions to Crisis (peak of Stress Mountain).
Phase 0 – Prevention
The Point
While Stress Mountain is a natural response to Supply & Demand disruption, the disruption itself isn’t necessary. Through Prevention, going up Stress Mountain can be avoided.
Summary: P, R & O
“Prevention is better than cure,” Unknown.
Prevention incorporates a balance of investing in:
- Maintaining current positive Spoon resources,
- Resilience protection against external stressors,
- Optimisation of Tasks for Spoon efficiency,
- Monitoring of the yourself and the situation.
Caution: Beware of overspending Spoons to do the above, rather than reducing Tasks to match your Spoons, and a timely change of plans.
Discussion
The Baseline State is our basic normal functioning level – our most common daily experience, not the peak (Crisis) or exceptions. So long as our Supply of Spoons is equal to or higher than the Demand for Spoons, we will stay at our Baseline State.
While in the Baseline Phase we can do some actions to maintain good functional Baseline state.
4 Prevention Primary Features
- Maintaining our current ability by ensuring we take meds, eat food and get rest.
- Improving Resilience by investing in Exercise, suitable feel good activities, quality food, maintaining a safe environment and positive social networks.
- Optimising Tasks to reduce Spoons Costs by investing in better tasks methods.
- Monitoring our Spoon Supply, Spoon Demand and Spoon Synthesis via enteroception.
Should we have sufficient Spoons, we may take actions to Maintain our current functionality, increase our Resilience, Optimise Tasks for future Spoon availability, and Monitor if the situation changes and take appropriate actions. See the break out box Improved Resilience & Optimising.
We will cover the concepts of Supply and Demand a great deal, as it is core to why you begin to struggle to cope, leading to escalating up Stress Mountain.
Each of the Prevention Steps costs Spoons. If you have insufficient, then just trying to do these can lead to escalation, a rise up Stress Mountain. However, if that is the case, then perhaps you shouldn’t be doing tasks either, instead take your meds, eat some food and rest.
While actioning these Prevention Steps, we want the actions themselves to be efficient, so apply the Optimising Tasks heuristic to them.
Prevention Steps Balance
- Frequency of the check:
- Not too often that it is too costly,
- Not too infrequently that you miss change.
- Complexity of the check:
- Not too complex that it costs too many Spoons,
- Not too simple that it doesn’t help you enough.
Maintaining, Improved Resilience, Optimising Tasks & Monitoring
Maintaining our current situation and being mindful of the next few upcoming tasks allows us to:
- Maximising current Spoons & Spoon Synthesis (making extra body resources available):
- Food, Meds, & Rest as needed,
- Plan our actions to make good use of our available Spoon Supply to manage expected Spoon Demand.
Car Analogy: Checking that you have enough fuel to reach your destination, and then get to a fuel station. If you don’t, time to visit a fuel station or plan to visit one on the way. You don’t want to run out of fuel part way there without the ability to top up.
Improved Resilience increases the odds of being able to meet increased Demand on our Resources that unexpected external events may trigger.
- Environment monitoring that it is as expected, having some basic plans for reasonably likely interruptions, and being aware when circumstances do change.
- Having positive trusted social network, either present when circumstances are uncertain, or available when not present.
Car Analogy: You have more time to put fuel in the car, ensuring that your fuel tank is full and ready to do tasks and enjoy life. You know you can call on someone to help if things get messy., which improves your confidence to go.
Optimising is about using your Spoons more efficiently.
- Task Optimisation is complex, so please check out our Task Cost Optimisation page to read up on how to make changes in how to do things to cost less Spoons for the same tasks.
- In brief:
- This invests some Spoons where you can to making upcoming tasks far more efficient, and thus cheaper – saving more Spoons than you invested.
- Sometimes that is a one off deal, sometimes that is an ongoing saving.
Car Analogy: this is like having both a more efficient engine in your car, so you can go further on the same amount of fuel, and working out a better route so you don’t use as much fuel per kilometer, saving even more fuel (Spoons) for each trip (task).
Monitoring your Spoon Supply so that you can take appropriate actions (Early Intervention) if you begin to run low, Spoon Demand to ensure you can meet it and it hasn’t changes, and ensuring that Spoon Synthesis is keeping up with Spoon Demand before Spoon Supply runs out, or resting to give yourself time to catch up.
Bio-Psycho-Social Plus Model, a ramble
The Point
“Maintaining your health is conceptually simple. Take your meds, eat food, get rest, exercise; have a healthy social circle; have enough money to handle most things; have reason in and for your life. AKA the Bios-Psycho-Social Plus model.
How to do that, and then doing that, is the hard part.“
Joshua Davidson, BSW
I was talking to a psychiatrist about 30 years ago about what can be done to minimise the effects of mental illness. He pointed me to the Bio-Psycho-Social model, pointing out that all 3 of these fields affect our ability to function (I’m saying this far more concisely than he did), and that if we look after those fields ‘health’, then at least those aren’t making our symptoms worse. I’ve expanded on the model (in the link).
In my experience, often what triggers people to have experiences like Stress Mountain in the absence of a specific external trigger is not managing the biological aspect of their body. That is, not taking medication (as prescribed), or medications that aren’t actually treating the cause of the problem; not eating regularly or well, and or not knowing the foods that we react poorly to; hormones; and fatigue. There is huge benefit to being fit over being sedentary.
External stressors increase the likelihood of an external trigger sending us up Stress Mountain. When we manage our social circles well, then we are generally around positive and supportive people who inspire us to better growth. We can rely on our friends and family (when we have good family) to give us support – we don’t have to do all of this alone.
Having some level of financial safety is also important. It is hard to feel safe and able when we don’t have any financial resources to put towards problems. Financial stress easily pushes our stress levels up so that we are on the Pre-stress Baseline instead, increasing our reactivity and increasing the odds of having a Meltdown.
Having no goals in life can indicate that we are in a general default Survival Mode. It is hard to Thrive without a future goal, or having reasons behind what we are doing now.
With these things being maintained, you will find the number of times that you travel up Stress Mountain decreases.
Phase 1 – The Baseline
The Point
Baseline represents when we have the highest generally available functionality.
Summary: Baseline
Baseline is the goal for functionality. If we leave it, then we want to take actions to get back to it.
Supply of Spoons is greater than or equal to the Demand for Spoons.
Characteristics:
- Brain Mode: Wise mind -> balanced between feelings are useful, and intellectually reasoning OR a level of Content Autopilot.
- Cognitive Space: Positive available Cognitive state,
- Feelings: Moderate informative & useful mood,
- Actions: Situational (based on what you are doing),
- Choices: A large range of Free Will choices.
Pre-Stress represents pre-existing stressors (health, low resources, or recovering from a recent Crisis), which can impede our functionality and increase our vulnerability to escalating up Stress Mountain.
Discussion
Our Baseline is our general capable well functioning self – where we can Thrive the most. That is, we can mostly do what we want to do, and we are able to use the behaviours we like to use, being the version of us that we are proud of. Some people may find that this is a rare state to be in, and that indicates that something is wrong in either your environment (Abusive people or incompatible to you) and or your medication (poor medication may indicate an erroneous or missing diagnosis).
Recognising Baseline
We have good Functional Capacity and Ability:
- Our Brain Mode is Wise Mind.
- Our Feelings are generally mild and suitable to the situation.
- People with a mood disorder may feel some anxiety or anger, but this is usually at a controllable level.
- Our Cognition is at its good normal ability and not compromised in any noticeable way.
- In our Baseline state, we are free to make any choices we want to, given the situation and our wants.
Wise Mind is a good blend of Balancing Feelings and Cognition. We call it Wise Mind, because you make wise choices – good decisions based on the information you have, the understanding you have, and the available resources you have.
Cognition is about considering the evidence, understanding the situation, solving any problems and choosing an action. This is often referred to as Good Executive Function (although that is technically misleading). So long as our Feelings are mild and accurate, we can put our brain to something far more intellectual, or if there is no situational demand on our minds, then we can switch to autopilot and enjoy cruising (not disassociation, just not being as energetically active).
Our Feelings give us a quick shortcut understanding about what ourselves and our environment. Being able to identify that our Feeling is accurately reporting the situations to us allows us to either use the default actions our Feeling recommends, or a skill that we have learned for these situations.
Our Cognition may recognise that our Feeling is in error, so we should ignore the Feeling, the Feeling Attribution and the Feeling’s Default Action; and instead work on better understanding what is actually causing our discomfort and what we should do.
Erroneous Feelings
Feelings are a cheap, quick method to be informed about a situation. If they are in error, they can be costly.
Feelings can be wrong in 3 ways:
- Type – The Feeling doesn’t match the situations.
- Eg, you feel Fear at a restaurant when no one else does.
- Scale / Strength – The Feeling is appropriate, but is either too strong or too weak for the situation.
- Eg, you feel appropriate angry at the situation, but instead of responding to a 3/10 problem with 7/10 anger.
- The additional 4/10 anger is something else.
- Misattribution – The Feeling is correctly informing you that something is up, but you have misattributed the Cause to the wrong thing.
- Eg, you are feeling Anxious, and you think it is because of the experience you had last year, PTSD style.
- However, you haven’t eaten in more than 4 hours, and the Feeling is supposed to be reminding you to eat (hunger).
- Food frequency is critical when you are, or are at risk of, Burnout.
Pre-Stress Line
If we are dealing with a previous stressor, whether we hit the peak of Stress Mountain or not, we will have fewer Spoons (internal resources) to manage ourselves, and so our Baseline will be elevated compared to our normal.
Pre-Stress compromises the Rumble Warning Phase, resulting in reduced early warnings and thus:
- Reduced time to act (Early Intervention Strategies),
- Less resources to act, and
- Likely a stronger Distressed Phase experience
- with similar ‘reduced’ problems with Late Intervention Strategies.
Being aware that you are Pre-Stressed enables you to give yourself more time and take on less responsibility until you have fully Recovered.
Trigger Event
The Point
Trigger Event represents the transition from Supply of Spoons exceeds Demand for Spoons, to Supply of Spoons doesn’t meet the Demand for Spoons, which may be due to Internal and or External factors.
Summary: Trigger Event
Trigger Events can be:
- Internal Biological Supply of Spoon issues:
- Primary response: Meds, Food, Rest,
- May be: Hormones, Sensory
- Internal Memories or Thoughts increasing the Demand of Spoons:
- Primary response: Therapy,
- May need: Trauma Therapy.
- External Threat or Suprise increasing the Demand of Spoons.
- Primary response: Threat management,
- May need: Therapy (if not a confirmable threat).
Discussion
A Trigger Event is the point at which you have switched from normal responses to your environment in the Baseline Phase to starting the Rumble Warning Phase. This due to the Supply of Spoons no longer meeting the Demand for Spoons.
An event can be an Internal or an External Event.
Internal Event, Biological or Memory / Thought
The Triggering Event can be due to either an Internal Biological cause, or due to a Memory or Thought.
Biological Triggers
Biological Triggers compromise the Supply of Spoons by costing unnecessary additional Spoons and or interfering with the Synthesis of Spoons.
The Top 6 “I’m Feeling Weird” Causes covers what to check for and how to address these, summarised in the box “Internal Biological Shift Causes“.
Internal Biological Shift Causes
- Forgot to take medications or took a substance that isn’t helpful:
- Meds: Take your meds if safe to do so.
- Substance misuse: Depending on the situation, either wait for the substance to stop affecting you – while you do nothing! – or go to the Emergency Department of your local hospital to get help.
- Didn’t eat food in the last 4 hours, or you ate an allergen / food you’re intolerant to:
- Forgot to eat: Eat safe Crisis / Meltdown prevention foods.
- If you have an Eating Disorder that has affected this, take the specific steps needed to manage that.
- Allergen / Intolerance: Either wait for the effects of the bad food to pass (while doing very little), or go to the ER if needed.
- Forgot to eat: Eat safe Crisis / Meltdown prevention foods.
- Hormones such as menstruation, an adrenaline surge, cortisol or thyroid problem:
- Menstrual: if you have active ovaries, check out our PMDD page for lots of discussion on this.
- Adrenaline: if you have had an adrenaline surge, we have discussed most of that above in Understanding Neurodivergent Energy, and that section has links for further reading.
- Cortisol and Thyroid: talk to your GP.
- Fatigue from poor sleep and or having completed a hard task (for you):
- Poor sleep: go to sleep if you can. If you have sleep problems, check out Beating Insomnia and Beating Pre-Sleep Anxiety.
- Sensory trigger, such as:
- The environment has become too loud,
- Touch irritants (surfaces that you need to touch feel bad),
- Hay fever style ongoing allergens,
- Bad smells,
- Changing lights,
- etc
- Most of these can be managed if you have identified what the irritant is.
This is covered in detail in Weird Mood or Thoughts – Top 6 Causes.
Internal Memory or Thought
Psychological experiments have demonstrated how choosing to think specific kinds of thoughts can change our level of emotional arousal – up or down. In essence, this is how calming exercises such as mindfulness and grounding exercises work – when we are feeling heightened, we deliberately bring to mind the kinds of thoughts that brings our emotional arousal state down.
The reverse can be applied to hype ourselves up.
We can often accidentally think certain kinds of thoughts which trigger a physiological response, in this case, concerningly up. If we are in a higher Baseline state due to a Pre-Stress situation, then we are even more prone to accidentally have these kinds of thoughts (similar to touching a wobbly tooth with your tongue), have intrusive disturbing thoughts, have spiralling self feeding thoughts, and or have a stronger reactions to such thoughts than we normally would.
While medication may be an essential helpful part of treating these, talking therapy can give you skills to recognise and manage these to head off problems before they escalate.
Unwelcome Memory / Thought Types
- Negative Self Talk:
- Discussed in:
- This is where we say to ourselves, either in our own voice, someone else’s voice, or just a feeling that reflects, a very negative impression of ourselves or the situation.
- Self talk is natural. It helps us to highlight to our conscious brain what is going on.
- What isn’t helpful is if that is biased and worse, uselessly repetitive.
- For that, it is important to consciously change the internal dialogue narrative via mindful counter messages, challenging the essence of the negative self talk.
- Instrusive Thoughts:
- Discussed in Suicide and Self Harm.
- Persistent thought that disrupts your thinking and being present due to the disturbing nature of the thought.
- Thought Spiral:
- Where a thought leads to another concerning, worse, thought.
- Eg: Catastrophising, or Slippery Slope thoughts.
- Thought Loop:
- Where a thought repeats itself and won’t move on.
- Indicative that you are out of Dopamine.
- Where a thought repeats itself and won’t move on.
External Event
External Events can increase the Demand for Spoons, resulting in an increase in Discomfort, which can elevate our position on Stress Mountain.
External Trigger Categories
- Threat:
- The external change may be due to a Clear and Present Danger:
- Clear and Present means that you can both see it and it is obvious. Threats are not generally subtle, and if it is subtle, then usually a subtle solution is warranted.
- Danger means inaction will lead to you, or someone else, being physically hurt.
- Moderate risk:
- This means that a fair chance of physical, cognitive or emotional harm is likely to occur.
- The external change may be due to a Clear and Present Danger:
- Surprise:
- Additional task requirements:
- If we are at our resource limits, then we may not be able to cope with additional demands on our resources. This could be:
- Additional sensory stimuli (music, people talking, lights, smells etc).
- People.
- New task parameters (which leads to the next category about derailment)
- If we are at our resource limits, then we may not be able to cope with additional demands on our resources. This could be:
- Derailment due to change / switching tasks:
- Derailment is to do with how we have optimised our resources to deal with this situation, not the new one, and the struggle to switch tasks. We discuss it in more detail here.
- Additional task requirements:
Phase 2 – Rumble Warnings
The Point
Once our Demand for Spoons exceeds our Supply of Spoons, we will get some early Ramble Warnings that help us know we need to assess and likely apply Early Intervention Strategies.
Summary: Rumble Warnings
Characteristics:
- Brain Mode: Either, Oblivious to the change, or Alert to differences,
- Cognitive Space: Partly hindered,
- Feelings: Dysregulating, but not yet compromised. Early feelings are trying to warn you about the problem.
- Actions: Behaviours are likely being affected, increase in agitation or loss of performance.
- Choices: Partly reduced, should focus on Early Intervention.
Rumble Warnings Can Look Like:
- A change in Behaviour,
- A change in Feeling,
- A change in Ability.
Early Interventions:
- Can be cognitively simple or complex,
- Aim to help you get back to your Baseline quickly by addressing the imbalance between Supply of Spoons and Demand of Spoons.
Discussion
The Rumble Warnings Phase tells us that our situation has changed and we no longer have the resources to deal with the present or upcoming demands – Demand for Spoons exceeds Supply of Spoons.
If we missed the transition (the Trigger Event above), we should notice our change in Mood via enteroception (feeling strong emotions), Behaviour (pacing, repetitive questioning, rocking, aggression, clumsiness or suddenly becoming still), and or Ability (doing the task, not doing the task, struggling more with the task).
A Rumble Warning is not a promise of going into Crisis. Early Intervention Actions can strongly mitigate the risk of rising up Stress Mountain and going into Crisis.
Sometimes we do some of these actions (Eg Stimming) for self comfort without it being a Rumble Warning. Noting a Rumble Warning is an indicator do a check – checking your Spoons, your Biological Systems, the current and expected Demands and see if things are doing okay. Doing this too frequently becomes its own drain on resources, so no more than once every 15 minutes for most people most of the time, and again when switching to a new task or extending the task beyond your original estimates.
If you experience more signs that this is a proper Rumble Warning, then it is time to implement some Early Interventions Strategies.
A good tell that you are experiencing Rumble Warning signs is that you feel like you are Struggling.
That ‘struggle ‘will look different for different people, and we call these warning signs Rumble Warnings. If you note them, and as stated above, they aren’t just comfort stimming (comfort stimming can be a cue though), then you will likely need to move on to Early Intervention actions.
Stereotypical cues for the Rumble Warnings
- Externally Observable Behaviour:
- Pacing,
- Rocking,
- A significant fidget increase,
- Sudden stillness,
- Withdrawing,
- Vocal stims,
- Repeated clearing throat,
- Echolalia,
- Mouth clicking.
- Verbal and non-verbal expressions of discomfort.
- Internal Cues:
- Feelings shift significantly (dysregulation),
- Hunger or Medication wears off:
- Anxiety increase,
- Aggression increase,
- Feeling disturbance.
- Noting an unexpected action behaviour change,
- Finding yourself avoidant of new tasks or continuing the current activity.
- Cognitive Cues:
- Struggling to comprehend things you normally would,
- Forgetting things faster than normal,
- Mood behaviour shift,
- Motivation shift,
- Making 3 minor errors in quick succession or 1 major unexpected error,
- Finding it hard to make choices.
Early Interventions
The Point
Early Interventions are simple to semi-complex methods to regain control and return to your Baseline.
Summary: Early Intervention
- Primarily Early Interventions address the decrease in Supply of Spoons and or the increase in Demand for Spoons.
- Secondarily, Early Interventions can be actions to regulate the mood to make space to address the Spoon issue above.
- These can be semi complex as cognitive capacity still exists.
As stated above, Rumble Warnings are about having an insufficient Supply of Spoons to meet the current Demands for Spoons, or the expected Demand for Spoons of the next task.
We have explored above there may be a discrepancy due to an increase in Demand for Spoons (environment change, unexpected complexity in the task, or new stressors), and or a problem with the Supply of Spoons (running out of Spoon stores, not enough Spoon Synthesis [making more internal resource], or something that is blocking access to your Spoons).
In Top 6 “I’m Feeling Weird” Causes, we cover the most likely causes of these early Warning Rumble signs and what to do about them. The top 5 are directly managing biological causes that either lead to problems Synthesising Spoons (making more), or block or cost existing Spoons. The bottom 2 are addressing external changes in Demand for Spoons (since Sensory covers both). These strategies are numbered in the order of most likely (lowest number) to the least likely (highest number). Often, we mistakenly think it is the other way around.
We cover the summary of the Top 6 Reasons here, and below we discuss what to do when the situation has changed.
Top 6 “I’m Feeling Weird” causes and what to do about them:
- Medications:
- Did you forget to take them, or are they wearing off? Can you take them now?
- A change in your usual medications may be affecting you.
- You may have taken a substance that has a medication like effect, such as caffeine, tobacco, nicotine or something else.
- If this is the case:
- How long should you expect it to last for?
- How will you be safe while that is happening?
- Should you seek aid?
- If this is the case:
- Food:
- If you haven’t eaten in the last 4 hours, you are likely hungry and this is what hunger feels like to you.
- If you have eaten recently, did you eat something that you have a food allergy or intolerance to?
- Hormones:
- Is this an adrenaline reaction? If yes:
- Medical condition: Do you have a medication or calming method to manage that, and if so, do it.
- Otherwise: Is the Adrenaline compensating for something? Often we feel Anxiety or Anger as an Emergency Response to the Adrenaline we are using to try to compensate for exhaustion or medications wearing off.
- Menstrual
- Take a look at our PMDD section for PMT, mid cycle crash and other related sex-hormone effects.
- Cortisol and Thyroid
- These are often long term and typically very rare, but in neurodivergent people it can be the case. Neurodivergent people often present atypically. If you have frequent mood issues, get these checked via your GP to ensure they aren’t an issue – better to rule them out, just in case.
- Is this an adrenaline reaction? If yes:
- Fatigue:
- Sleep
- Many neurodivergent people don’t sleep well due to Pre-Sleep Anxiety, Insomnia and or Chronic Pain.
- Exhaustion
- If you have just done a task that exhausts you, you may need to rest. Often Adrenaline is used to compensate… see above.
- Sleep
- Sensory:
- Pain,
- Allergies such as hay fever (and other background irritants),
- Overwhelm (too much stimuli for the amount of Spoons you have),
- Underwhelm (too little stimuli to keep you engaged).
- Threat, Clear and Present:
- We often think we are responding to a threat when we begin to act out, but often this is a mistake.
- To tell the difference, if the ‘Threat‘ is not Clear and Present, that is, right there with you and very obvious, then you probably not responding to a ‘Threat‘ – you are actually experiencing one of the above causes and misattributed it to ‘Threat‘.
When the situation has changed, it can lead to a higher Demand for Spoons than we reasonably have. That might be addressed by taking a break to allow more time for Spoon Synthesis, and also in that time, rethink your strategy to see if a more efficient method can be enacted that works within your Supply of Spoons.
It is important to know when to stop, call for help, or ‘persevere then rest‘.
Time to Stop
- If you are struggling a lot, then you may have gone past the Rumble Warning and may have escalated to the Distressed Phase.
- Assessing the situation, you recognise that you do not have sufficient resources to complete the task. Considering modularisation (discussed in Task Cost Optimisation) in your assessment:
- You might assess continue to a better point to resume later, or
- You may just abandon the job until you can get extra resources rather than make things worse.
Call for Help
If the task needs completing, and you lack the Spoons, assets or skills yourself, you may be able to get help from someone else, or if you don’t know what to do, then getting some other opinions can be helpful.
Help may be:
- Additional resources:
- Active: Someone who can actively help,
- Passive: Someone who will Body Double passively.
- Body Doubles help unlock ‘doing’ Spoons,
- Body Doubles can give assurance, spot problems, or suggest solutions.
- Advice:
- Others may have the knowledge of how to solve this new problem, which may mean you can continue with what you have,
- Others may be able to figure out a solution that you can’t, or help you do so, even if no one has the specific knowledge you were seeking,
- Note: A decision you make is on you, a decisions a group makes shares the responsibility for that decision.
Persevere then Rest
Sometimes we need to keep going. When that happens, we must recognise that we are going to have a Spoon Deficit – we effectively borrow Spoons form the Future. That debt has to be paid, and the sooner it is paid, the better. That is why it is “Persevere then Rest“.
Spoon Debt – Persevere then Rest
- Decrease other Spoon Spending:
- Decrease costly socialisation,
- Decrease other tasks,
- Refuse new tasks.
- Manage moods and behaviours:
- You will likely feel increased Anxiety and Aggression. Knowing this:
- Make a plan for how to keep it within manageable levels,
- Make a limit to watch out for, and if you reach it, Stop Persevering,
- Warn those around you about what is likely going to happen and why.
- You will likely feel increased Anxiety and Aggression. Knowing this:
- Future plans:
- Cancel the plans you have for the next half day after the task is done (or 3 days or so depending on your rate of recovery),
- Work out the Rest and Recover self-care for once you have finished, ensuring that happens.
Finally,
If you have done all of these checks and are still struggling, it is time to have some quiet time and do some calming exercises.
Phase 3 – Distressed
The Point
Fundamentally, the discomfort of not being able to meet the Demand for Spoons with the Supply of Spoons has led to Survival Mode being activated. Survival Mode isn’t smart, and sometimes leads to costly outcome. Strong and effective cognitively simple Late Intervention Strategies are needed, which may include Harm Minimisation.
Summary: Distressed
Characteristics:
- Brain Mode: Focused on Crisis Preparation, entering into Survival Mode,
- Cognitive Space: Cognition is low, likely reactive,
- Feelings: Things feel Urgent; Fear Survival Actions are likely to be enacted Impulsively,
- Actions: Mostly on Autopilot, as little Cognitive Space exists to make complex choices.
- Choices: Severely restricted.
We enter the Distressed Phase if we either:
- Did not notice the Rumble Warnings, or
- Early Interventions Strategies did not work.
Distressed can look like:
- Behaviour dysregulation,
- Mood dysregulation,
- Cognition is impaired,
- Suicidal Ideation, Self Harm Ideation, some Self Harm occurring.
Late Interventions:
- Needs to be Cognitively Simple, as Cognitive State is Impaired,
- Strong and effective, as Early Intervention has failed,
- Harm Minimisation Strategies may need to be encated, if you have a history of risk.
Discussion
We enter the Distressed Phase if we either:
- Did not notice the Rumble Warnings, or
- the Early Interventions Strategies did not work.
Fundamentally, the discomfort of not being able to meet the Demand for Spoons with the Supply of Spoons has led to Survival Mode being activated.
Survival Mode evolved to manage threatening circumstances and is being mis-triggered by the strong discomfort from the imbalance of Supply and Demand, often leading to a misattribution of the current state to an external unperceivable threat. In nature, against an active predator threat, we don’t have time to philosophise – we need to take Urgent Actions.
Survival Mode isn’t smart, and sometimes leads to costly outcome.
The Illusion of Urgent
The Distressed Phase is mostly characterised by very strong urgent feelings, often mostly based on Adrenaline. This is triggering our Survival Fear Series – Freeze, Fawn, Flight and Fight Emergency Survival Response (explored above).
The stronger that our feelings are, the harder it is for us to think clearly. We evolved to manage threats, so when we experience a threat driven Adrenaline explosion, we base our decisions on the Clear and Present Danger. However, Stress Mountain occurs when there is no Clear and Present Danger, and so our evolved Survival Mode strategies impede our ability to make wise decisions against an the unidentified threat, which is most likely a misattribution of what has disrupted our Supply of Spoons, or exacerbated the Demand for Spoons.
To re-state that, making this distinct from just a fear response, if there were a visible active threat, we would be having a justifiable fear response, rather than in the absence of that Clear and Present Danger, we are having an unjustifiable feeling response (which might be fear, or anger or something else). If there was a Clear and Present Danger, we would be doing something about that threat (even if that is freezing or running), and we would know why we are distressed. In the absence of a clear cause, we are distressed for no good apparent external reason, thus this is a part of the Stress Mountain. If you cannot identify a Clear and Present Danger, then the problem is most likely an internal biological problem – see the section on Tigger Events above.
When we are in the Distressed Phase, thinking is hard. Our Prefrontal Cortex – PFC (responsible for higher order thinking) is either lacking neurotransmitters to think clearly (hence triggering Distressed), or has been shut down due to Survival Mode being triggered.
With a compromised PFC:
- We find it hard to understand things,
- Hard to work out what to do, and
- Very difficult to solve problems.
Our brain is gearing up to survive anything, as it is sure that some crisis is on the way – aka Crisis Preparation.
Your brain can’t load any particular action because you can’t identify what the problem actually is (since the PFC is compromised), so our actions are whatever our Survival Mode Autopilot guesses will keep us safe and our ability to choose is severely limited (because of the comproomised PFC).
We are very reactive to anything that might give us a reason why we feel like we do, mistaking any clue as the natural reason why we are distressed. We are in a vulnerable state, and highly suggestible, unless that suggestion contradicts the ‘reason‘ we have attributed this situation on (which is likely wrong).
This difficulty to think and rationalise is why it is important to have a good plan of what to do when we are Distressed and compromised, where our choices are fairly easy to make based on easy to identify markers of distress. That is, a good Safety Plan.
If you are helping someone who is distressed, then you need to give gentle but firm simple redirection to help them manage this, prompting for what is in the Crisis section of their Safety Plan (covered in brief below).
Late Intervention
The Point
Late Interventions are needed when either Early Interventions have failed, or you have gone past the point where Early Intervention can work. Late Interventions need to be simple, strong and effective.
Late Intervention Strategies
Due to limited cognitive capacity, Late Intervention Strategies need to be:
- Clear about:
- How to tell what to do,
- And when to do that,
- Simple to enact, as low cognitive ability and untrustworthy feelings,
- Strong and Effective,
When we have reached the Distressed Phase, due to the decreased Cognition it is hard to make plans to solve the problem(s) of this situation, so we need to simplify or responsibilities and tasks.
Late Intervention Strategies, ideally from a Safety Plan, are what we use to hopefully avoid going into Crisis and head us back to our Baseline. Each person (thus plan) is going to have a different Late Intervention Strategy that is tailored to their specific symptoms and needs, expected default actions and preferred outcomes.
We don’t have the ability to look after adults (who aren’t dying), instead we need to focus on our own needs. If we can get another suitable adult to temporarily look after dependents (like children), that is best.
Common Late Intervention Themes to Consider
- Who you can call for support.
- Clear markers to indicate which particular plan you may need to use, for example:
- If aggressive, calming medications.
- If looping, Beta Blocker.
- If migraine, sleep.
- Note: These are just samples, not what you should have.
- PRN Medication:
- PRN medication prescribed by your GP or psychiatrist.
- PRN stands for Pro Rata Nata, which means “as you need it”.
- This should be something that addresses distress, is safe to use, unlikely to be misused.
- PRN medication prescribed by your GP or psychiatrist.
- Minimising harm in case you cannot head of the Crisis / Meltdown (see the following sections).
- Do you need to go to hospital?
Harm Minimisation
The Point
People who are Distressed will either harm themselves (or others), are at risk of harming themselves (or others), or may do harmful behaviours when in Crisis, assuming the Late Intervention Strategy fails.
Summary: Harm Minimisation
- Harm Minimisation is about reducing risk.
- Risk can never be completed eliminated, but it can be reduced and mitigated.
- Harm could be to yourself or to another person / object.
- Harm Minimisation needs to be easy to implement.
- Harm Minimisation needs to be factored in while you have some capacity to choose to be safe, as in Crisis you won’t have that capacity.
Based on prior Crises, identify what the likely harms are and make a plan for how to decrease those risks.
Because the types of harm we may enact or varied, you will need to work out what your risks are and how to mitigate those. Work with a trusted friend or therapist to help brainstorm what those are and what the minimisation strategies look like.
We cover this in more detail in our Safety Plan page.
Harm Minimisation EG: If you are likely to self harm by cutting, before you get to the peak of Distressed, remove yourself from blades, or put the blades in a timer box that won’t open for 1 hour.
Phase 4 – Crisis, The ‘Trauma Coaster’
The Point
Fundamentally, Interventions have failed, Survival Mode has fully kicked in, control has been lost, and all that is left is waiting until the ‘Trauma Coaster‘ comes to a natural halt.
Summary: Crisis
Characteristics:
- Brain Mode: Survival Mode,
- Cognitive Space: Cunning, repeat cycle, or absent,
- Feelings: Freeze, Fawn, Flight, Fight,
- Actions: Survival, Autopilot, Survival Plan,
- Choices: None, just react.
We enter the Crisis if:
- Late Interventions Strategies did not work.
Crisis can look like:
- Behaviour dysregulation,
- Mood dysregulation,
- Cognition is impaired,
- Risky behaviours, Suicidal Ideation, Self Harm Ideation, some Self Harm occurring.
Discussion
During the Crisis, your brain has switched to Survival Mode.
In Survival Mode, your ‘auto-survival-pilot‘ kicks in and bypasses your prefrontal cortex (the bit of your brain that holds the “I think I will do this” or “I understand that” part of your awareness), and will do whatever your autonomous reflexive brain thinks will help you survive this moment (based on either a plan you’ve made or defaulting to the Survival Mode reflexes – Freeze, Fawn, Flight or Fight).
Survival Mode isn’t concerned with good outcomes, it just wants you to be alive a bit longer – it focuses on this next moment and puts everything it can into getting past that. Then the next moment, then the next. Survival Mode isn’t a long term thinker, it isn’t a smart thinker. Survival Mode is about ‘surviving this next moment through cunning’ system. Cunning – not smart.
Whatever doesn’t kill you, allows you to survive long enough to fix it later…
That means that any solutions that doesn’t actually kill you is good enough for Survival Mode.
Being alive later means you can fix all those problems you didn’t have time to worry about, because you were Surviving.
The measure of success for Suvival Mode is that you are alive later to fix those pesky problems.
In Crisis Mode, it is very hard to think clearly. If we had a genuine Crisis with a clear problem to fix, we would most likely be hyper focused on this real world problem. However, as Survival Mode has been erroneously triggered, we cannot figure out what it is we are supposed to be surviving, and we lack the cognitive resources to figure out what to do.
We default our actions to things that worked in the past to keep us alive, even if that wasn’t a happy alive. That often defaults to aggression, substance use or self harm / suicide.
We can train into ourselves Crisis Safety Action plans.
This gives us the option to enact these actions instead, so long as we have pre-created that Safety Plan.
It is too late to try to train these in to ourselves in the middle of a Crisis, so we have to plan and practice them when we are feeling safe, and then practice them again when we feel stressed but haven’t hit Distressed yet. With the loss of cognitive ability, in Crisis we don’t have much if any decision making ability – we have no choices.
In Crisis, our emotion centre has switched to Freeze, Fawn (rare), Flight and or Fight. We can start at one and move to another of these feelings. As we have no real cognitive ability, we will generally act on these feelings without critical thought or any wise plan – aka impulsive illogical and irrational behaviour.
The feelings are very strong, so we assume they feeling is real and valid. Due to believing we are in a Crisis and being in Survival Mode, we believe we have no time to think, fact check or plan before acting, because we feel like we are about to die or suffer some horrible outcome.
Crisis Story and Impulsive Actions
- We find it very hard to test the story we create:
- During the Crisis Phase, and
- After when we have recovered.
- This often leads us to believe the false story, even though it seems psychotic or delusional to other people.
- We trust our Autopilot Survival Mode reflexive action, because we don’t believe we have time to understand, reality check and plan:
- That is, Freeze, Fawn, Flight or Fight actions,
- That is, our actions are all Survival Mode Autopilot because we can’t really think, so we can’t choose our actions – just react as our Survival Mode Autopilot selects, based on our emotional feeling and what seems to be right without Critical Thinking.
Crisis Neurology and Survival Mode
Why is it so hard to think in this state of mind?
Our Prefrontal Cortex, the bit of our brain just behind our forehead, evolved for higher thinking. We use this part of our brain to gain deeper understandings of situations, and from that we can create much better solutions.
It is quite slow compared to our Autonomous Thinking, but far more creative and logical. As it is much slower, we can only use it when we have time to do so, and we use the strength of our feelings to judge how much time we have available to solve the problem.
In the long run, using our Prefrontal Cortex saves us time and energy because of how much better our solutions are compared to our Autonomous ones. This is what gave us our modern living compared to hiding in caves.
For more, see:
In the middle of our brain is our Amygdala. It is part of the Limbic system, which includes the Thalamus and the Hypothalamus, which contain the template for being able to tell if this situation is ‘safe‘ or ‘not safe‘. The Amygdala is closely connected to our Cerebellum, which is what all of our sensory system reports to. The Amygdala compares our Sensory Perception (Cerebellum) to our memories (Thalamus & Hypothalamus ‘not safe/safe‘ template) and calculates if our Perceived Environment matches ‘not safe‘ or ‘safe‘. If the Amygdala is hindered from making this calculation (eg too much or too little Noradrenaline it’s primary calculating Neurotransmitter), then it assumes ‘not safe‘.
If the result is ‘safe‘, we can feel comfort, happy, content or other helpful feelings, and suggests that we either ‘rest‘, ‘recover‘, ‘repair‘, or ‘prepare‘.
If the result is ‘not safe‘, we feel Fear (a Clear and Present Danger; triggers the Survival Fear Series), Anger (something needs attention or it likely will get worse; triggers the Anger Series), Disgust (something will make you sickened; triggers repulsion or hate) if it can, or just discomfort if we can’t identify why we are ‘not safe‘.
The Amygdala doesn’t tell your Prefrontal Cortex ‘what is wrong‘, just ‘what it Feels like‘. Your Prefrontal Cortex uses that clue to try to quickly identify what is the source of the feeling. This ‘feeling based threat detection‘ system is very fast, but not always helpful.
When we are switched to Survival Mode, resources are diverted from our slow Prefrontal Cortex to our fast Amygdala, because we are more likely to survive then. That means our responses are faster to actual threats, and likely to keep us alive. They are awful when we don’t know what the problem is.
Dopamine and other necessary neurotransmitters are no longer enabling the prefrontal cortex to be able to solve what to do and take intelligent actions. When you talk to someone in this state, they often can’t give you answers, or the answers are very simple.
Some actions are seeking to trigger additional emergency neurotransmitters to shock the system back into some form of balance. This can lead to Self-harmful / Suicidal behaviours.
Shutdown
Internal experience:
- Disassociation: feeling absent, unplugged, blacking out, unable to act
- Looping thoughts: “I don’t know what to do”
External appearance:
- Going non-verbal, or paucity of words
- Rocking, pacing, small repetitive action loops
- Being very still and non-responsive
- Weeping or keening
Both the Anger Series and Survival Fear Series have shut-down modes: either Passive (watching) or Freeze (non-action, often with non-thought).
Flight / Run aka Anxiety / Panic Attack
Both the Anger Series and Survival Fear Series have avoidant modes: either Run (Anger – “I can’t win this battle”) or Flight (“It can’t hurt me if I’m not here” / “I’ve got to get out of here”).
Internal experience:
- Run (Anger)
- I can’t win this battle
- Flight (Fear)
- “It can’t hurt me if I’m not here”
- “I’ve got to get out of here”
- Fixation on the assumed cause of the fear or anger.
- It is almost always focused on a thing that is not actually a current problem, because that wasn’t the cause, it is what your brain has latched on to that might explain this feeling.
External appearance:
- The person wants to leave immediately
- The person is distressed if they can’t leave
- The person seems to be having an anxiety attack (they think things are getting worse, they have some but very limited cognitive function)
- The person seems to be having a panic attack (they are not cognitive, just actions of panic)
Fight aka Aggressive Behaviours
Both the Anger Series and Survival Fear Series have aggressive modes: Fight
The Fight aggression can be verbal or physical, to the self, objects or to another person.
Internal Experience:
- I am a terrible person and I need to be punished. If no one else will do that punishment, then I will.
- This person is a direct threat and I have to stop them, or let everyone else know that they are a direct threat
External Appearance:
- The person is aggressive in their spoken words or harmful actions, to themself, objects or people.
- Spoken words
- Self: “you fat stupid b*tch”.
- Others: saying whatever the cunning brain thinks will hurt them the most, regardless of if it is true or false.
- Harmful actions
- Self harm / suicidal actions
- Flipping tables, wrecking furniture
- Attacking a person / picking a fight
- Spoken words
The Trauma Coaster
Having a Meltdown is hugely disempowering. While here, you have not real choices. To make a choice, you need to have the awareness of the choices you can choose and the resources and skills to enact that choice. When we are in Crisis, we don’t have much if any cognitive ability. Our brain has surrendered to our Survival reflex. Without cognitive ability, we don’t have skill or cognitive awareness, so choices are gone. We are just reacting however our Survival Brain thinks we keep us alive.
We have lost the power of choice.
Many of us have been put into situations where our choices were taken from us by abusive people. Having a Crisis of circumstances push us into Survival Mode feels very similar to when we were abused. That similarly to a prior trauma situation can be traumatising all over again. Worse, carers and staff often try to make us feel bad for having a Meltdown and any of the actions we took when we were in Survival Mode. Too little attention is traditionally spent on looking at why we had a Meltdown and thus prevention, and focusing on what we did when we had no choice. That adds salt to that re-opened wound. A standard tactic of abusive people is to blame the victim for what the abuser did, that is, blaming the victim for what was out of their control.
After a Crisis, especially when we have had a Meltdown, what we need is comfort and support. Later, when we are more stable, we need to analyse what went wrong and how to prevent that and was our Safety Plan and Harm Minimisation Strategies adequate.
Phase 6 – Recovery, or …
The Crisis phase has passed and the Meltdown has happened. As cognition returns, choices are becoming possible again. We are still not at the Baseline and it is important to recognise that we are in a vulnerable state where we can Re-trigger. Abusive people love to re-trigger us, so it is important to have a plan for how to get away from them since we won’t have the cognitive resources to manage them.
In the Recovery Phase, the adrenaline is decreasing which is allowing our cognitive functions to begin to work again. This is also known as Let Down in some circles. Our Feelings are beginning to become more accurate to the circumstances, but we are still reactive and easily Re-Triggered. It takes some time to recover to the Baseline, so we need to allow ourselves time to rest and recuperate.
Natural Recovery
We will have a default system in place to return to Baseline which we will refer to as Natural Recovery. Unfortunately, some of us have developed bad habits that lead to Hindered Recovery. If we are thoughtful, ahead of time, we can systematically work out what gives us Improved Recovery.
For most people, Natural Recovery is having some quiet time to rest, contemplate and recuperate. This should be done in a quiet environment with only supportive safe people around.
Improved Recovery Routine
Improving on the default can get us to the Baseline faster and better.
Step 1: Get Safe
We entered Survival Mode because we felt unsafe. If you feel unsafe after you have exited the Meltdown, then it is important to change for safety. That can include asking people to move away, or moving yourself to a safe location. It should be somewhere that you feel safe. Often that includes more enclosed, darker and quieter, but your personal needs may be different. Move away from likely triggers and or dangers.
Step 2: Recuperate Resources
We rose up Stress Mountain because our internal resources didn’t match the actual or perceived demands of the situation, prompting us to switch to Survival Mode to get through the actual or perceived Crisis. Survival Mode actions likely burned up even more resources.
To restore those resources may include medication, food and drink. Food should include a small amount of fat, sugar and carbohydrates and a moderate amount of general nutrition. Ideally you are including a food ingredient that has Tyrosine, which is vital for being able to make the Dopaminergic Neurotransmitters, which you are likely very low on right now. Your body can extract Tyrosine from any meat and many soy products. Many people can get Tyrosine or a more developed version (it changes a few times on the way to becoming Dopamine) called phenylethylamine in chocolate, aspartame (a sugar substitute), or from protein powder supplements (beware of too much caffeine in those powders).
Some people benefit from some caffeine, while some become more anxious. Choose this based on whether caffeine usually helps you feel calmer or more agitated. Drinking anything non-alcoholic is helpful for helping your brain recognise that the crisis is over. Sip slowly.
Step 3: Recover Calm
Once we have some food and safety, then calm is a state of mind. Our mind is in our brain, and our brain is in our body. We need to send some signals to our brain that we are now safe and it is time to step down from Survival Mode.
Calming Down is a specialty in and of itself, covered in the linked page.
- Controlling Breath
- ie Breathing Exercises
- Controlling Thoughts
- Distracting from Negative Thoughts
- ie Mindfulness
- Choosing Deliberate Thoughts
- ie Guided (& self guided) Meditation
- ie Mantras / Affirming Phrases
- Distracting from Negative Thoughts
- Controlling Feelings
- ie Music
- ie Mantras / Affirming Phrases
Breathing exercises can also speed up cognitive recovery.
1) take a medium speed deep breath in via your mouth, then breath out firmly and slowly through pursed lips, almost as if you were whistling.
– Breathe out along your extended arm and see how far down your arm you can feel the wind you generate.
– See how long you can go before you need to take a breath in again.
– Say to yourself, in your head, “This is a false alarm; There is no clear and present danger and no one is clearly hurt or in harm’s way; There is no action that needs to be taken” while you are doing the exhalation.
This breath method is the one that your cerebellum responds to most for decreasing the rate or your heart and feeling of anxiety.
Hindered Recovery Routine
Sometimes we expect too much from ourselves. We think that we can immediately get up after a Meltdown and immediately return to our normal level of functioning. This is just physiologically not accurate and is setting ourselves up for becoming Re-triggered and worse, increases our default paths to self-sabotage.
While the things that can self sabotage are many, there are a few common features I see.
Mistake 1: Not resting
As outlined above in Improved Recovery, we climbed Stress Mountain because we didn’t have enough resources, and then we expended even more in the Meltdown. We need to rest to recover, and not letting ourselves rest is anathema to recovery. If you feel the need to not rest, here are two questions that are worth considering:
- Who is pushing us to go straight back to being “functional”.
- If it is someone else, they are either
- misinformed about what is needed (educate them later), or
- abusive (they won’t listen to the education – check out the Toxic People Mind Toolset and keep in mind Grey’s Law)
- If it is yourself, why are you being mean to yourself?
- If it is someone else, they are either
- Who will need emergency hospital care if you rest?
- If you can identify someone, then yes, this sacrifice may be worthwhile.
- Should you call the emergency number for Fire, Police and Ambulance? If not, then this may not be an actual emergency.
- If no, then you are being mean to yourself, or someone else is (see above).
- If you can identify someone, then yes, this sacrifice may be worthwhile.
Mistake 2: Staying in a stressful location
Our Amygdala does its best to work out if we are “safe” or “not safe”. If you have an anxiety disorder, then it already struggles to figure this out. What doesn’t help is staying around people who are stressful, or an environment that is triggering to you. Triggering environments can be due to lighting, sound, reminders of tasks, or bad memories.
Mistake 3: Not eating, or eating poorly
We’ve covered food a few times. We need to eat something to help us recover some biological resources. See above for what to try to eat.
What we should avoid are things that are not compatible with us. For example, I personally react poorly to chocolate and gluten. For many years, my recovery food included chocolate. I didn’t know at the time that I respond poorly to chocolate, so it took a while to figure out that this food should be avoided, especially after I am trying to recover from a Meltdown.
A large proportion of Neurodivergent people have a food allergy or intolerance (estimates are around 30%). If you experience intestinal pain, IBS, or strange moods / energy levels that begin up to an hour after you ate, then you likely have something you should investigate.
Phase 7 – Re-trigger
Re-triggering is where you perceive another threat or another demand while you are still vulnerable while you are Recovering back to the Baseline.
The Recovery Triggers can be Internal and or External. We’ll cover a few of the common ones here.
Internal Experience:
- Ruminating on thoughts and memories
- See Controlling Thoughts in Recover Calm above.
- Hunger
- See Recuperate Resources above
- Medication has reached the end of its effect
- Can you take your next dose? Or is this the end of the day for that medication for you? Talk to your script writer if this is a frequent problem, or therapist for strategies if you cannot modify your medication to address this.
External Appearance:
- Unexpected noise
- Actual or perceived demand beyond your current ability to manage
- Actual or perceived stressful person
Wellness and Safety Plan
If we frequently struggle to manage our mood and behaviours, then it is a great idea to have a developed Safety Plan that can help us maintain our Wellness and guide us through recognising the various stages of Stress Mountain. For that, we have a Wellness and Safety Plan. While we have aimed to make the use of it fairly intuitive, in my opinion it becomes intuitive once you understand how it is supposed to be used.
In short, the top row is how you can tell that you are currently at Baseline, aka Well. Signs that you are doing well are important for you to know that these signs mean I am well. Often my clients don’t know how to tell, and figuring these signals out for you helps your enteroception (ability to look within and know your inner state). On the left is what you can do to maintain this (pre-emptive steps) and on the right is what is likely to decrease your wellness, aka avoid.
The second line is your Rumble Warnings. What warns you that things have got to this stage. On the left is how to get back to being Well, aka Early Intervention Strategies. On the right are the things to avoid so that you do not become worse.
The third line is your Distressed phase. List what are the indicators for you and or someone else that you are now needing help, but we aren’t at Crisis yet. On the left are the things you can do to improve, aka Late Intervention Strategies. On the right are the things you should definitely avoid, aka the opposite of Harm Minimisation.
Last of all is the plan for when you are in Crisis / Meltdown and who you should contact if you can’t keep yourself safe.
On the reverse side are your contacts, including who is good for what kind of support, and who you shouldn’t contact when you are in this state. Additionally, instructions for current medication in case you need to get someone else’s support, need to go to hospital, or you are struggling to know what to do. Allergens are listed so that other people can avoid those too.
All of this is covered in detail on the Wellness and Safety Plan page. Below is the front and back of the Wellness and Safety Plan.
