What is Global High Intensity Activation of the Central Nervous System?
Global High Intensity Activation is a label used in the Somatic Experiencing® world to refer to the nervous system state of certain clients.
When we have unresolved trauma, the fear/terror/overwhelm and other emotions from the traumatic experience live in our bodies along with the somatic memory of the events. Then, when we encounter a trigger, those feelings come alive again in the body. Some people with PTSD have periods of feeling good, calm, totally ok, then they get triggered and their system goes into high sympathetic activation and/or freeze.
For a person with global high intensity activation, their nervous system is always activated, they never experience feeling settled and safe. the feelings are constantly alive in the body, regardless of whether there is any current trigger that might be identified. In a sense you might say that for a person in a chronic GHIA state, simply being alive is triggering. The sympathetic nervous system of this person is activated – the impulse to fight and/or flee is always present – though not necessarily consciously felt.
And that sympathetic activation is covered over by a freeze. People with Global High are in moderate to high sympathetic activation all the time, and also in moderate to high freeze most or all of the time. So there is a baseline of constant but suppressed distress. The system is overloaded, there’s too much going on even before anything happens in the present moment. There is a pretty high correlation between GHIA and early developmental trauma because with early developmental trauma, the nervous system never learned how to regulate, never learned how to feel calm and safe to begin with.
But wait, there’s more!
When am terrified/angry/hurt/overwhelmed, but not actively feeling those feelings because they are being suppressed by a freeze, my body is still broadcasting that upset and dysregulation. So GHIA people frequently experience others, either individuals or groups of people, having adverse reactions to them. It feels like we are being singled out for criticism or complaint. “I don’t see how I did anything, so why is everyone behaving so strangely in relation to me?”
When there is great distress in my body, but I am in my head and interacting as if everything is totally normal, and particularly if I am making myself the center of attention in a group of people while exuding distress but acting like I’m fine, that presentation can shake up or disturb the ease and flow of the group dynamic. It’s not the GHIA person’s fault, they simply are who and how they are. But neither is it the fault of the group container, because the group is made up of humans who each have their own challenges and limitations.
How to work with a person who has GHIA? (Self or other)
If this describes you, or if you are living with someone who has GHIA, it is important to not over-stimulate the person. People with GHIA are already overstimulated, so anything that is provoking or challenging or even something intending to be energizing in a positive way will easily send the system into overload, causing the person to shut down and/or lash out.
Therapeutic approaches that challenge or poke or directly attempt to enliven the GHIA client will often lead to greater disorganization, greater distress, and possibly collapse or explosion.
With garden variety trauma, if that is even a thing, we want to support people to reference their resources, such as their past pre-trauma experience, and to lean on those resources as they make contact with the difficult emotions and body memories associated with the trauma, thus allowing an incremental opening and release of what has been held in the body.
With a GHIA person, the approach is quite different. The initial goal is not incremental release of held emotions and energies – the pattern is so deep, so embedded, that it really cannot be changed at all in any short or medium period of time. So the goal is to support stabilization and to diminish secondary activation.
We want to help the person to normalize and understand their baseline of distress, discomfort and vigilance. We want to support the person in finding compassion, insight, patience, forgiveness, and acceptance of themselves and their symptoms. It makes sense that they would have these feelings and symptoms, given what they, their bodies and their nervous systems have been through, in both the past and the present.
Here is what I mean by diminishing secondary activation. The initial activation is the actual hidden painful emotions from the original traumatic experience. The secondary activation consists of our reactions to our distress – criticizing ourselves for being so messed up, impatience with ourselves for not getting things done, fear that our symptoms mean that we am going crazy, and so on. The goal is to reduce and then eliminate these reactions through education – explaining how the nervous system works, and through practicing compassion and curiosity along with the GHIA person. So we offer normalization, generous listening and witnessing. We want to provide the person the chance to feel seen, heard and safe, we want to support deep self-acceptance and patience.
Healing modalities and Global High Intensity Activation: ISP™, IFS, SE™, NARM®, Shadow Work®, Voice Dialogue
Some modalities are a better fit than other for people experiencing GHIA. Based on my experience, I would say that parts work, through Shadow Work, Voice Dialogue or IFS (Internal Family Systems) can be a good fit because normalization, acceptance, compassion and curiosity are so deeply built into these systems.
Regardless of the modality, the practitioner is the key. To work effectively with a GHIA person, the practitioner needs to be able to be at ease and comfortable with confusion, suppression, fragmentation, inconsistency, emotional flashes, intense expression, and dissociation. If the practitioner feels unsafe, concerned or reactive about the client’s presentation, this will contribute to the secondary activation in the client who will sense the practitioner’s discomfort. Clients always pick up the automatic emotional reactions of the practitioner to the client’s distress. Because GHIA people tend to evoke discomfort in others, it can be difficult for a GHIA person to find a good fit practitioner.
Neither SE or NARM seems to do a great job of preparing practitioners for GHIA clients. NARM is particularly challenging since it has a strong cognitive framework and it’s quite common for GHIA clients to require support that is non-cognitive and non-linear. However, if the SEP or NARM practitioner has the personal skills and experience to hold space effectively for GHIA people, then the approaches can be effective even though they don’t seem to be a perfect fit.
ISP – Integral Somatic Psychology – can potentially be a great resource for GHIA people but again it depends on the specific practitioner.
I mentioned that the GHIA person has a baseline of sympathetic activation, based on the painful emotions of the original trauma. However, the person may not be aware of these intense emotions. The emotions are likely to be well hidden, and the GHIA presentation of the nervous system, where both the sympathetic and freeze responses are running high all the time may have led to various chronic health problems such as fibromyalgia, environmental sensitivities, migraine or many others.
Rosalie’s GHIA Story
I have lived with Global High Intensity Activation my whole life, I believe since before I was born, meaning that my sympathetic nervous system is always on alert and there is always also some level of freeze at the same time. In my healing journey in SE and other practices, there have been many moments when I’ve found myself in what seemed like a moment of respite, where I wasn’t feeling that strong sympathetic push. For a long time, when this happened, I labeled it as “freeze”. And sometimes it probably was. But not all the time. If I’m in the middle of a room full of people shouting and suddenly it’s completely silent, most likely I’m either deaf or dead or unconscious. But there is another possibility – maybe the shouting stopped. I am so accustomed to the constant backdrop of sympathetic activation – pushing – poking – expecting attack – defending – that if it’s not there, it feels odd, it feels like something is wrong.
So I’m offering this for everyone else who is on this same journey – besides doing our work to learn to regulate our nervous systems, we also need to learn to get used to a body-mind system that is not in a constant state of alarm. When I find myself in these moments, where everything just feels neutral, I want to:
– realize that neutral doesn’t mean anything is wrong
– and then realize that neutral is awesome, it means my sympathetic system is less aroused, it means that all of the good work I have been doing is having an effect
– and then let myself settle into being with this, consciously and intentionally. “Neutral is good.”
Affirming in this moment that “Neutral is good”, I feel my shoulders drop, I feel my head and neck start to make small movements. Sometimes in the past, this sort of lack of affect has meant that I am depressed. So am I depressed? I have some concerns, but I don’t feel the burden of the world on my shoulders. I can notice some sadness, and some fear. But no depressive thoughts. I could conjure up some depressive thoughts easily enough and I might be able to find my way to depression, it’s an old friend. But no, this does not seem to be depression. Neutral is good. I can learn to be comfortable here. Each of us can learn to be comfortable here, but we have to actively practice learning to be comfortable in neutral, when all we’ve ever known has been constant intensity. I wish for you and for each of us moments of respite, joy, and settling in each day.
Based on my experience, there are four categories of practitioners that a GHIA client might find themselves trying to work with:
People who were never GHIA themselves but who have done enough personal and professional work so that they are still adept at working with GHIA patients. These are our heroes. They can be extraordinarily helpful through a huge portion of our healing and growth work. Note that my experience tells me that there is an eventual limit to how far a GHIA client can get with a non-GHIA practitioner.
People who were never GHIA themselves and don’t have a clue what it’s like. Bad fit. They will fail to see you and will make up various stories about you, while believing themselves to be generous and compassionate.
People who have been and are still GHIA themselves but either don’t even know it or know it but have not done enough of their own work. Bad fit. They will project their stuff onto you in various ways, and you will be dealing with your deep distress and theirs as well.
People who have been – and might still be – GHIA themselves but who have done enough of their personal work that they know how to navigate their own nervous system and they know how to meet, see, hold and support a GHIA client. Based on my experience, these are the ones you want to find. When I sit opposite a skilled and aware practitioner with GHIA history, my whole body softens, and even delights, with a sense of relief and safety.