Many years ago I was speaking to my therapist about some difficulties I was having with my moods. I noticed that whenever I sat down to write in my journal, I would always write about the same feelings; loneliness, hopelessness, despair, worry, confusion. Unsure of what this meant, I asked him: do I have depression? He considered this question for a moment, and then looked at me with a gentle curiosity, and asked: “Shaun, if I told you that you had depression, would that help you with your situation?”
To my own surprise, my answer was “no”. As we talked about this more, I came to realize that I didn’t really want a diagnosis, or a label. I was seeking a way to make sense of my experience. What I’ve since learned through continuing therapy and then moving on to study psychotherapy is that there are many ways to make sense of what is happening to us that doesn’t mean assigning a diagnosis.
I will admit that I’m rather biased against diagnoses. This is because I’ve come to realize that mental health diagnoses aren’t always as concrete as other medical diagnoses. Being told you have depression is not the same as being diagnosed with diabetes. This isn’t to say that depression isn’t real, or that these labels can’t be accurate and sometimes useful. But there is something very fixed and static about the mental health diagnoses we can so casually give people that I find unnerving.
One alternative way to make sense of our experience, particularly in times of distress, is a framework called the Window of Tolerance.
The Window of Tolerance
Developed by a clinical professor of psychiatry, Dr. Dan Seigel, the Window of Tolerance is a way of framing how we experience and respond to adversity. Pictured below, you’ll find that there is an ‘optimal’ zone in which we are able to cope with and respond to the everyday challenges of life. Outside of this zone are the places we go to when we lose our capacity to cope.
(Credit: https://www.nicabm.com/)
This can occur in two ways, which are intrinsically linked to our nervous system and the body’s trauma response; hyperarousal, and hypoarousal. As depicted, a state of hyperarousal refers to feeling anxious, angry or out of control. This state can be linked to a bodily desire to act by fighting or running away. Conversely, a state of hypoarousal refers to feeling zoned out, numb, frozen and flat. It’s a state of wanting to shut down, escape what’s happening, linked to a freeze response.
Being in either of these states can be referred to as being “dysregulated”. Our bodies have natural built in systems, such as hormones, which are designed to help us stay regulated. This works in the same way our body maintains our temperature by sweating when we’re hot or shivering when we’re cold. But if whatever is affecting us persists, we’re no longer able to remain regulated and instead are pushed into a state of dysregulation.
Struggling to Cope
Many of the mental health related phenomena and symptoms we experience can be mapped onto this window of tolerance framework. See, we first entered this world as infants with a rather small window of tolerance. Being too hot or too cold, hungry or thirsty, might send us into a tantrum until we are helped back to our optimal zone through the care of our parent/s.
And over time, as we developed we experienced the world in increasingly new levels of complexity. In an ideal situation, we learned to face and cope with new challenges that arose out of this complexity. For example, knowing how to calm down when we’re angry, how to deal with someone threatening, how to bounce back from rejection, and so on.
However, there can be things which disrupt this development, and therefore influence our capacity to cope with the challenges life throws at us. While there can be some overlap, they can be separated into two loose categories; unmet attachment needs and trauma.
Unmet Attachment Needs
As mentioned earlier, our parents play a role in helping us to develop the regulation skills we need to cope with life. Part of this is a simple matter of adults being better suited to navigating the world than children. Adults can, for example, find food, build shelter and fend off predators, whereas young children are ill equipped to do these things until they grow older. As such, if a child becomes upset over losing their toy or knocking over a glass of milk, the adult is able to recognize this as a trivial matter in the grand scheme of things, and help calm the child down because they themselves have not become dysregulated by the incident.
Things do not always work out this way though. For whatever reason, your parents may not have been able to help you to regulate when you became upset. This isn’t an excuse to blame them for all of your problems, or to suggest that they were bad parents. Sometimes this can occur quite innocently, for example, if a mother doesn’t understand why her baby is crying, or if a Father is too busy with the other children to devote his full attention to the youngest who is upset. Other times our parents could be dysregulated themselves, either due to the stressors of life or because they themselves never learned how to regulate.
These experiences can then influence the ways in which we engage in relationships as adult, and subsequently, what bothers us in those relationships. An example of this might be anxiety that arises when our partner doesn’t respond to a text message. While there could be a million reasons for this, we can easily be taken back to earlier experiences of neglect and abandonment in childhood, thus causing us to become dysregulated.
If we consider a spectrum of experiences, from those innocent occurrences above, to more severe incidents such as abuse or neglect, we can begin to imagine a whole variety of reasons why you might now be unable to regulate in certain situations. This brings us to our next major influence, which is trauma.
Trauma
Trauma is a difficult thing to define, simply because of the scope of experiences it can describe, as well as it’s subjective nature. Two people can experience the same event, and only one of them can be traumatized by it. We are innately designed to escape threatening situations, and the responses described above are our means of doing this; fighting, fleeing, or freezing. I hope you can already see how the window of tolerance is linked to trauma; by facing a situation that is outside of our ability to cope, we are forced into a state that drives us to respond to the threat, in order to eliminate it.
However, in cases when the individual is unable to escape the threatening situation and/or do something to protect themselves, they become overwhelmed and subsequently experience feelings of horror, terror and helplessness. Even after such experiences pass, they can stay with us, and affect the way in which we regulate, or fail to do so, in meaningful ways.
Those who have experienced trauma can often have a smaller window of tolerance. This means that it takes less for them to become dysregulated. Alternatively, they might have a relatively normal window of tolerance, but be affected by certain things that immediately force them out of their window of tolerance because they are linked to their traumatic experiences. An example of this might be a soldier who hears a loud banging noise and is reminded of gunfire and explosions on the battlefield.
Making Sense of Distress
As you can see, the Window of Tolerance is an alternative way of making sense of our experience of distress. Many mental health conditions, including the most common labels of anxiety and depression, can be mapped onto this framework. What I like about it is that there is an implicit sense of movement. One might be told they have an "anxiety disorder", but are they experiencing anxiety every living moment of every day? Or does it come in waves, an experience hyperarousal followed by a return to the window of tolerance through some form of regulation. This shifts the conversation from one about a fixed “disorder” or “illness” to instead a certain type of experience that can be mapped and charted across time, thereby allowing the person experiencing it to better address and manage their distress.
If this has resonated with you, you might be wondering how you might go about expanding your window of tolerance. You can read all about it in the second part of this blog post - How To Cope When You’re Upset: Expanding Your Window of Tolerance.