Understanding the ‘Fawn Response’

We are threatened with suffering from three directions: from our own body, which cannot do without pain and anxiety as warning signals; from the external world, which may rage against us, and from our relations to other(s). Suffering which comes from this last source is perhaps more painful to us than any other.

Freud, S. (1930). Civilization and Its Discontents, 1961. Reprint, New York: WW Norton and Co.

Introduction

Used with equal utility to describe both an innate defensive response and a maladaptive personality trait and seized upon in the flurry of research to identify the neuro-behavioural substrates that diagnostically differentiate Complex Post Traumatic Stress Disorder (as already recognised by the ICD-11 manual) and ‘plain’ PTSD, was the recent revivification of a 2013 study^(1.) proposing Fawning as the fourth-F of human stress/trauma/survival responses.

Despite not being an academically recognised (or “official” as some commentators have sensationally claimed) term, the Fawn Response has nevertheless resonated with a widespread audience, particularly amongst those caught in ‘the cycle of trauma’^(2.) or those in the many academic disciplines chasing the wave of interest in the life-long, cyclical health impacts of stress and trauma.

Trauma is trendy thanks to Gen Z

New York Times Sep 2023, Kato, B.

Commencing with an inconclusive interrogation of construct validity, this article retreats to furthering the ability of readers to understand fawning to the extent that they can recognise it in-the-moment in their own repetitive patterns of behaviour. Notwithstanding this, readers are advised that the term comes from a study of sufferers of complex-PTSD, thus rendering its general applicability poorly evidence-based at this time.

Attention all fawners

Fawning (vb): to praise someone too much and give them a lot of attention that is not sincere, in order to get a positive reaction.

The Cambridge Dictionary

Although clearly adaptive in increasing cultural capital (we all fawn over our benefactors- e.g. ‘customers’ & bosses- and those with the potential to increase our social status- e.g. celebrities), research for this article has found the same behavioural concept widely embedded in numerous words across many research disciplines connoting a fear-based, maladaptive (in the long term) aspect to fawning behaviour:

Viewed through this lens^(3-9.), this article may be of interest to those who identify strongly with:

• having a hard time saying “no”
• pretending to agree with someone
• doing what you’re told no matter what
• putting others’ needs before your own
• feeling scared to take up resources including space
• feeling invisible or like no one really knows you
• being unable to say how you really think or feel
• faking a show of emotions to fit in
• not being able to set interpersonal boundaries
• feeling responsible for the reactions of others
• over-seeking approval from others
• being a social chameleon- adopting and mirroring the values, beliefs, and opinions of others
• fearing being ‘found out’ as an impostor
• feeling emotionally removed or dissociated/disconnected from others in social situations
• feeling guilty that you are somewhat angry (and vice versa)
• keeping to yourself and flying under the radar
• going to great lengths to make sure everyone likes you
• feeling exhausted when around new people and/or in new social situations
• needing time and space away after spending long periods of time with others to recharge
• attempting to read or pick up on others’ emotions and feelings
• lacking a sense of self (e.g. self-esteem, self worth)
• a sense of self dominated by shame (I am bad) and guilt (I did something bad)
• self attack, criticism, demand, and judgement
• constantly in a watchful state; chronic anxiety

Conspicuously absent from most tertiary literature describing fawning are reported physical ‘signs and symptoms’ including:^(10.)

• pale skin
• a loud, pounding heart or a decreased heart rate
• restricted breathing or holding of the breath
• immobility/stiffness/heaviness of muscles
• coldness and numbness
• analgesia (including pre-existing pain)
• uncontrollable shaking
• eye closure/heaviness, jaw pain

Additionally, it has been associated^(2.) with:

• co-dependency- people pleasing/appeasing, enabling/fixing, compulsive caregiving
• attachment disorders- insecure/anxious
• high sensory sensitivity- giftedness, hypersensitivity
• ‘syndromes/complexes’- Imposter Syndrome, Cindarella Complex, Stockholm Syndrome, Compassion Fatigue & Burnout
• dissociation (detachment/disconnection from physical and emotional experiences) related to vagally mediated immobility defences
• disturbances of gut microbiome^(11.)
• immune system dysfunction
• oxytocin^{(12, 13.)},
• metabolic/molecular- including GABAergic, glutamatergic, cholinergic, and neurotropic signaling^(14.)
• eating disorders^(15.)

…and typified by people who are generally:

• externally focused (e.g. image, body, weight, awards, money) and validated
• dissociated from their authentic selves
• over-achievers, extrinsically motivated, perfectionistic
• chronically hypervigilant (mistrustful, difficulty trusting others, difficultly feeling safe in own body)
• sceptical or unreceptive to acts of non-conditional love
• ‘living in scarcity rather than abundance’, with thoughts predominantly negative/pessimistic/catastrophic

Finally, the literature reveals cross-cutting key resonances:

• ..fear without solution^(16.)..
• ..tolerance of the intolerable^(2.)..
• ..learned helplessness (Seligman 1975)

The aphorism “all models are wrong, but some are useful” is attributed to the statistician George E. P. Box in 1976, for whom ‘there is no need to ask the question “Is the model true?”. If “truth” is to be the “whole truth” the answer must be “No”. The only question of interest is “Is the model illuminating and useful?”’.

The following putative models are presented accordingly:

Fawning and appeasement, placation, and ‘people-pleasing’

Appeasement has been framed as an alternate explanation for what may be a strong survival tactic, a tactic not solely intentional, but dependent on the capacities of a resilient autonomic state (see below) as a resource.

A cursory glance at the tertiary literature reveals much overlap between definitions of fawning and , please/appease:

An individual exhibiting the fawn response (FR) behaves in a way that is other, rather than self-focused; by tactical acts of excessive love, service, compromise, listening, fairness and peacemaking, the fawning type wards off future threats of abandonment, neglect, and abuse by forfeiting their own basic needs, wishes and desires^(17.).

The FR involves people-pleasing to the degree that an individual disconnects from their own emotions, sensations, and needs. In childhood, this occurs because they must withhold expressing their authentic emotions of sadness, fear, and anger in order to avoid potential wrath or cruelty from a parent or caregiver. As a result, they turn their negative feelings toward themselves in the form of self-criticism, self-loathing, or self-harming behaviours^(18.).

Regardless of chosen terminology, many researchers have hypothesised that an unresolved fawn response can then become the root of co-dependence and other relationship dysfunction, depression, or somatic symptoms of pain and illness.

…if the predominant FR becomes an enduring pattern of internal, emotional experience and behaviour that lacks flexibility and is pervasive across a broad range of social and personal situations, Fawning may manifest maladaptively as co-dependency, trauma-bonding, and trait disturbances^(4.).

How is fawning related to ‘fight or flight’?

First taxonomically proposed in 1929, the Fight or Flight response (resplendent with alliterative allure) to a real or anticipated threat sought to explicate the two major branches of the autonomic nervous system (ANS) with regard to their role in homeostasis (evolved, subconscious maintenance of survival), with ‘rest-digest’ describing the opposing (parasympathetic) co-variable.

As research advanced phylogenetically (from lower animals to social primates), morphologically (from brainstem to cortico-limbic regions), and typologically (from predator-prey to conspecific threats), the ethological Freeze response^(19.) (as co-opted today by mental health clinicians as corresponding to hypervigilance -being on guard, watchful, alert- in humans) became widely adopted as “the third F” (preceding flight or fight) under the more accommodating banner of “the acute stress response“.

Continuing the trajectory away from the belief in a ‘unified stress response’ in humans, the ‘4-F model’^(20.) posits that a traumatised (i.e. where stress demand outstrips or overwhelms available resources^(21.)) individual may respond acutely, chronically or globally with a passive fear/faint or active Fawn response, or a combination of both defence/survival strategies.

When it feels safer to be submissive and obedient than fight or flee, people may turn to the fawn stress response. Most similar to the freeze response, “fawning” causes someone to please and appease the needs of someone else, instead of prioritizing their own well-being. For children, a fawn trauma response can be defined as a need to be a “good kid” in order to escape mistreatment by an abusive or neglectful parent. As an adult, a fawn trauma response means that in relationships you are consistently ignoring your own needs to conform to what you believe others expect of you.

Parallel synthesis of the Defence Cascade (see figure 1 below) and other teleological explanations (which consider the end result, in the context of the survival of the organism, as ‘reasons’ for particular biological processes) including Polyvagal Theory (PT)^(22-25.) (see figure 2), illustrate the evolution of our understanding of the functioning of the ANS in inescapable interpersonal threat/danger/stress.

Indeed, the ‘flight or fight’ of the early pioneers of modern physiology is not easily discernible in the current psychophysiological framework of ‘an allodynamic system, capable of very complex self-regulatory behavior involving feed-back and feed-forward loops and integration with rostral brain centers’^(26.).

Figure 1. Schauer and Elberts’s model^(10.) exemplifies a century of Acute Stress Response/Defence Cascade modelling^(27-31.) . Progressing along the ‘6-F’ defence cascade, ‘‘uproar’’ sympathetic arousal reaches a maximum at the fright stage, eventually superseded by the onset of dissociative ‘‘shut down’’ (grey area).

Figure 2. Fawning is more easily located within this impressively integrative analogue.

Importantly, the classification of fawning as an autonomic response is widely debated, with little evidence existing that the reciprocal attunement (subconscious co-regulation of arousal states) observed in early development implies a more general ability to achieve interpersonal physiological synchrony in response to threat/stress.

Furthermore problematic for the coronation of Fawning as the fourth (or any other) F, neurobiological literature asserts to the contrary that^(30.):

1. Specific circuits assemble responses to specific kinds of threat.
2. There are multiple brain circuit capable of initiating the same threat-related behaviour.
3. These circuits are interconnected, with multiple points for competitive interactions.
4. Throughout evolution, these systems have been incorporated into increasingly distributed networks.
5. Primate evolution has also endowed many (if not most) brain regions with cell types that are not present in lower animals.
6. The brain regions that contribute to threat processing are not limited to a “fear circuit” and include sensory and motor regions.

Fawning and Attachment Theory

Perhaps because currently there is no dedicated neurobiological attachment system, area, or network^(32.), Attachment Theory has been demoted academically, being deemed still too widely debated^(33.) for research and development stakeholders; it has fallen out of fashion.

Notwithstanding this, Attachment Theory (essentially “a theory about protection from danger”) has been crucial in highlighting the importance of behaviours that adaptively utilise the interpersonal threat protection resources available to higher primates (those essential to survival in childhood and advantageous in social groups) in explaining how we develop, from childhood, the ability to organise and create coping strategies in the face of threat and/or deprivation (abuse and/or neglect).

Although attachment ‘styles’ are not explicitly called survival responses, the similarities are striking, with the origins and characteristics of the please/appease/fawn response being widely documented in attachment theory as fear of abandonment-based anxious and disorganised attachment adaptations:

As one researcher^(4.) puts it:

…when stressed, sick, or frightened, a child naturally wants to seek comfort and protection from a loving parent, but what do they do when the same parent is the source of fear or distress? People with this style can get stuck in a threat response and/or swing between avoidance [anxiety] and ambivalence without much of an identifiable pattern.

Additionally, the theory posits that any adaptive attachment response that is learned early on in response to threat or danger, if repeated or left unresolved, can become a lifelong pattern of relating to others^(2.), with the earliest strategies or attachment adaptations being chosen by default in dysregulated arousal states.

Thus, fawning is often seen in various contexts involving maladaptive attachments including:

Intimate partner abuse: people experiencing abuse in intimate relationships may develop fawning responses to pacify their abuser and reduce the risk of further harm. In survivors of IPV, it is likely that the response was ‘learned’ in childhood and thus the default response to interpersonal threat involving other caregivers (providers of resources).

Bullying, where resource availability is a function of social status,

Institutional or systemic abuse, where multilevel social resources/safety threats/oppression impose a traumatic allostatic load.

Childhood abuse and/or neglect: childhood trauma is associated with poor health and wellbeing outcomes regardless of whether the trauma involved threatened or real neglect/withdraw or threatened or real attack/abuse.

Indeed, based on neurobiological studies, different forms of threat (loss/abandonment vs. abuse) appear to activate different behavioural systems, with “hostile threat, harsh treatment, abuse activating the right amygdala, and threat of withdrawal, disengagement or abandonment activating the left amygdala^(34.).

Importantly, the anxiety caused by the fear of abandonment, neglect, withdrawal or/and rejection appears to be the main motivator for a child to turn to the fawn survival response, although it is also associated significantly with threatened or real abuse/harm as well.

Notably, the 4-F model has already been adopted by the Australian government (Child and Youth Protective Services):

Fawn is a relatively new addition to our understanding of stress responses and is often linked with relational trauma – that is, trauma that happens within a close relationship.

Children who have experienced trauma may have been taught by their carers to deny their own needs. They tend to do this because they don’t feel loved or accepted by them and want to avoid further harm.

ACT Gvt publication “Staying safe: The ‘fawn’ response”

The publication goes on to enumerate the “signs of fawning” as indicators of trauma in children, stating that a child in fawn mode may:

• be overly compliant
• tell adults what they think they want to hear
• try to please or satisfy others – people pleasing
• put other people’s needs before their own
• not ask for help
• submit to what others want
• struggle to say ‘no’
• be easily peer-pressured
• have poor boundaries

Importantly, these contexts are also widely represented in complex PTSD and other dissociative disorders, as discussed in previous articles.

Fawning and (Polyvagal + Attachment) Theory

Our natural way of thinking about emotions is that the mental perception of some fact excites the mental affectation called the emotion…My theory, on the contrary, is that the bodily changes follow directly the perception of the exiting fact, and that our feeling of the same changes as they occur IS the emotion…

..Stated in this crude way, the hypothesis is pretty sure to meet with immediate disbelief..

James, W. (1892). Textbook of Psychology. London: Macmillan & Co. Ltd., p. 375 & 376.

Based on later evidence vindicating James’ counterintuitive assertion that it is the afferent feedback from the body that frames the emotional experience, Porges’ PT argues that safety and threat denote fundamental contexts that organise evolutionarily adaptive behaviours, with the autonomically distinct mammalian defence states being mediated by two types of parasympathetic activation (i.e., ventral vagal and dorsal vagal), as well as by sympathetic nervous system (SNS) activity.

It further asserts that humans inherited this panoply of mammalian defences; any of these states can emerge when stressful experiences exceed our ability to cope. These varied defence states generate the diverse symptoms reported in the traumatic-stress literature.

The visceral response to threat is a foundational survival circuit located in the brainstem and shared by several vertebrate species that preceded the evolution of social mammals.

These circuits coordinate sympathetic arousal or dorsal vagal shut down to support survival via defensive behaviours. The ability to be in the proximity of a life-threatening individual or event, without shutting down, fleeing, or fighting, requires the ability to access the social engagement system with its neurophysiological dependence on the ventral vagal complex that regulates primary structures (e.g. facial expression, the intonation of voice) upon which social connection and co-regulation are dependent^(23.).

The PT perspective is commonly taught using analogies including:

.. a fight or flight response is like putting your foot on the gas pedal. It’s what creates movement and momentum to fight or flee when we are in danger. Freeze is like putting your foot on the brake, disconnecting or dissociating from unsafe events and our bodies. Fawning can be seen as putting one foot on the gas pedal and one foot on the brake, at the same time. We have just enough social engagement to appease, while disconnecting from our true selves…

Interestingly, proponents of Polyvagal Theory have questioned the adoption of Fawning as the fourth F, asserting that fawning does not use the powerful biological forces of co-regulation (i.e. neuroception), proposing instead that (akin to people-pleasing/appeasing) it is a maladaptive way of creating safety in our connections with others by essentially mirroring the imagined expectations and desires of other people.

They further contest that appeasement can and should be framed as an alternate explanation for what may be a strong survival tactic, a tactic not solely intentional, but dependent on the capacities of a resilient autonomic state as a resource.

Many authors do concede, however, that

Activating the neural substrate to appease is a challenge to the nervous system and is not an easily accessible intentional behaviour. Rather, it requires a retuning of the autonomic state that opportunistically maintains sufficient inhibition over the adaptive threat reactions of the sympathetic nervous system (i.e. fight/flight) or the dorsal vagal system (i.e. shutdown, collapse, etc)^(4.).

and,

It is also unclear how one develops a resilient enough autonomic state to be able to have an appeasement response in the face of that threat^(2.).

In response to this debate, several theorists have proposed a hybrid polyvagal-attachment model which posits a parallel interpersonal threat response system in humans that allows for an ANS state where social engagement and sympathetic arousal systems are activated simultaneously.

It infers that some survivors may have the resource to express a type of ‘super social engagement’ that may enable them to engage and effectively co-regulate and calm their perpetrator.

This ‘parallel, secondary threat response system’ presumably enables access to the calming and social cuing of the social engagement system while simultaneously maintaining access to the energetic mobilisation sympathetic system to produce the type of so-called ‘please/appease’ behaviour observed in situations of prolonged and inescapable threat.

When dealing with specifically interpersonal encounters, rather than defaulting to fight, flight as the first line of defence, the hybrid theory proposes that people would default to the interpersonal threat response system. The attachment adaptations can be considered integral and formative survival adaptations of the infant and child (this model can also be adapted to include adult attachment patterns).

What about Co-dependence?

Although the language of fawn is not used in the academic literature, the construct of codependency (that emerged from research of adult children of alcoholics as well as dysfunctional families) seems to have clear links to the fawning response^{(15, 20.)}.

These authors operationally defined codependency as an immoderate focus on outside oneself, which is the result of growing up in a stressful family environment, and find it to consist of five factors: (1) other focus/self-neglect, (2) low self-worth, (3) hiding of self, (4) family of origin issues, and (5) medical problems.

A comparison between these two constructs suggests that what Walker refers to as the FR may be in actuality a similar construct to a codependent personality. Furthermore, the research supports that the FR is rooted in childhood trauma. A plethora of research, both historical and contemporary, show a link between childhood abuse and neglect, and maladaptive patterns of relating to others in intimate ways.

Fawning or codependency, in other words, is a behavioral response to childhood experiences that are not marked by mutual trust between child and caregiver, emotional safety or respect. As a result, the child learns to navigate the world through schemas (preconceived thought-belief frameworks of self-identity) that are designed to protect them from further emotional pain. The child is therefore plagued by internalised reflexes that suppress their natural impulse to self-protect, interrupt the development of a cohesive sense of self and force conformity to the expectations of those who exercise power in a manner designed to subjugate.

The consequences of Fawning

Most researchers agree^(20.) that the fawn response, although adaptive, has obvious negative consequences for individuals including:

• the loss of opportunities to develop a coherent identity that possesses schemas that would enable them to live their life in an authentic fashion, employ proper boundaries and feel safe in the absence of others.
• experiencing a ‘default’ state of freeze-alert that looks or feels like chronic anxiety and may extend to normal activities of daily living.
• being vulnerable to the attention of emotional abusers who exploit their people-pleasing tendencies.
• a disconnection from genuinely good people who want to satisfy their needs and make them feel ‘seen’ through healthy and supportive relationships.
• increased risk of other disorders associated with ANS dysregulation.

Self-help tips

The literature is replete with suggestions including:

Self-compassion: stop beating yourself up for developing the fawn response and blaming yourself for the distress you’ve been through. Acknowledge that this response once served and protected you—Think back and recognize why and how this became a pattern, and what it may look like when you do it. When you notice yourself doing it again, pause and think about whether or not it is truly necessary now.

Connect with yourself: start getting in tune with your own authentic needs and emotions. The fawn response involves a lot of turning AWAY from ourselves and turning toward other people. Healing involves beginning to ‘tune in’ and pay attention to yourself. You can do this through healing work like coaching or therapy, mediation, journaling, movement practices, creative practices, and more!

Pay attention to your body: a fawn response can lead you to disconnect from your own emotions, sensations, and needs. Therefore, it is important to practice listening to your body as a way to come back home to yourself. Start noticing what happens in your body when you feel like someone is upset. Do you feel tight in your chest or stomach, a lump in your throat, get sweaty or shaky? Do thoughts start popping in about how it’s probably your fault or you need to immediately find a way to fix the problem? Start growing your awareness over the ways you’ve learned that it’s not safe for other people to be upset, especially if they could be upset with you. Then work on tending to yourself and the fear that these interactions can bring up.

Start asserting yourself: you can start small with this e.g. by not saying “I’m good” when you’re not. You can start by making tiny asks like “is it okay if we don’t watch this show tonight, I actually feel like doing this other thing instead”. Start letting people see your true self in small doses, and allow yourself to receive love, care, and appreciation for who you are- not just what you can give to other people.

Speak your Truth: a fawn response can make it difficult to hear your own truth. Journaling can help you hear your voice so that you can access your inner wisdom. As an adult, you can give yourself permission to express your truth. Explore incomplete conversations or unfinished business from your childhood by journaling, and take the time to reflect upon what you wished you had said in a difficult situation. These prompts not only address the painful impact of trauma but also invite you to reflect upon your strengths. Remember, you can pace yourself with any healing strategy!

Value yourself: people who engage in pleasing behaviours may have built an identity around being likable. It can therefore be freeing to build self-worth outside of others’ approval. Some ways to do that might include: going after your personal goals and dreams, engaging in hobbies that make you happy, even if they aren’t your friends’ or partners’ favorite things, accepting that not everyone will approve of you, and making a list of your positive traits that have nothing to do with other people.

Healing And Recovery

According to Walker^(1.), in order to recover from the FR, the sufferer needs to first understand the nature of their problematic way of responding to real or perceived threat, and secondly, ‘they must grieve, which involves angering, ventilation of feelings and calming the inner critic’.

Regarding the former, he further asserts that variances in abuse/neglect patterns, birth order, and genetic predispositions result in individuals “choosing” and specialising in narcissistic (fight), obsessive/compulsive (flight), dissociative (freeze) or codependent (fawn) defenses, and reports that ‘many of my clients have reported that psychoeducation in this model has been motivational, de-shaming and pragmatically helpful in guiding their recovery.

Treatment modalities available alone or in combination include:

Eye movement desensitization and reprocessing (EMDR): A somatosensory form of stress/trauma therapy that helps you reprocess traumatic memories to reduce the emotional distress they envoke.

Cognitive behavioural therapy (CBT): A widely-used type of therapy that focuses on the relationship between your thoughts, emotions, and behaviours and challenges negative thought patterns and feelings to help improve overall well-being.

Other talk-therapies including Psychodynamic therapy, Dialectical behavioral therapy (DBT), Mindfulness, and : acceptance and commitment therapy (ACT):

For more information regarding how a highly trained and experienced psychologist can address the root causes of maladaptive fawning, please email us or call 07 3831 4452.

References

1. Walker, P. (2013). Complex PTSD: From surviving to thriving. Lafayette, CA: Azure Coyote Publishing.

2. Aigner, C.J. (2022). Love or Fear? The Please/Appease Survival Response: Interrupting the Cycle of Trauma. MA Thesis, Faculty of Education, Simon Fraser University.

3. Bailey, R., Porges, S.W., et al. (2023). Appeasement: replacing Stockholm syndrome as a definition of a survival strategy. European Journal of Psychotraumatology, 14:1, 2161038.

4. Schlote, S. (2023) History of the term ‘appeasement’: a response to Bailey et al. European Journal of Psychotraumatology, 14:2, 2183005.

5. Gewirtz-Meydan, A., et al. (2023). Between pleasure, guilt, and dissociation: How trauma unfolds in the sexuality of childhood sexual abuse survivors. Child Abuse & Neglect, 141, 106195.

6. Wallace, D., et al. (2023). Black Girls are Taught to Survive Historical Trauma and the Strong Black Woman’s Embodiment. International Body Psychotherapy Journal , The Art and Science of Somatic Praxis Volume 22, Number 1, Summer 2023, pp. 16-30.

7. Chambers, R. (2024). Trauma-coerced Attachment and Complex PTSD: Informed Care for Survivors of Human Trafficking. Journal of Human Trafficking, 10:1, 41-50.

8. Weinberg, M., et al. (2020). Personality traits and trauma exposure: The relationship between personality traits, PTSD symptoms, stress, and negative affect following exposure to traumatic cues. Personality and Individual Differences. Volume 177, 2021, 110802.

9. Zingela, Z., et al. (2022). The psychological and subjective experience of catatonia: a qualitative study. BMC Psychology. 2022;10(1). doi:10.1186/s40359-022-00885-7.

10. Kozlowska, K., et al. (2015). Fear and the Defense Cascade: Clinical Implications and Management. Harvard Review of Psychiatry, Volume 23, Number 4.

11. Sanford, L.D., et al. (2023). Modeling integrated stress, sleep, fear and neuroimmune responses: Relevance for understanding trauma and stress-related disorders. Neurobiology of Stress, 23, (2023): 100517.

12. Krol, K.M., et al. (2021). Genetic variation in the oxytocin system and its link to social motivation in human infants. Psychoneuroendocrinology, preprint.

13. Carter, C.S. (2022). Oxytocin and love: Myths, metaphors and mysteries. Comprehensive Psychoneuroendocrinology, 9 (2022), 100107

14. Iqbal, J., et al. (2023) The neural circuits and molecular mechanisms underlying fear dysregulation in posttraumatic stress disorder. Front. Neurosci. 17: 12; 81401.

15. Triantafyllou, P. (2023). The Connection Between CPTSD and Eating Disorders. Long Island University, MA Thesis, pre-print.

16. White, L., et al. (2023). Charting the social neuroscience of human attachment (SoNeAt). Attachment & Human Development, 25:1, 1-18.

17. Halberstadt, A.G., Green, L.R. (1993). Social attention and placation theories of blushing. Motiv Emot 17, 53–64.

18. Schwartz, A. (2021). The Fawn Response in Complex PTSD. https://drarielleschwartz.com/the-fawn-response-in-complex-ptsd-dr-arielle-schwartz/#.Y_zyg7TMLJ8.

19. Bracha, H.S. (2004). Freeze, flight, fight, fright, faint: adaptationist perspectives on the acute stress response spectrum. CNS Spectr. 2004 Sep; 9(9):679-85.

20. Owca, J. (2020). The Association Between a Psychotherapist’s Theoretical Orientation and Perception of Complex Trauma and Repressed Anger in the Fawn Response. Chicago School of Professional Psychology, Proquest 28086275, Thesis pre-print.

21. Egger, S.T., et al. (2020). Real-Time Assessment of Stress and Stress Response Using Digital Phenotyping: A Study Protocol. Front. Digit. Health, 2:544418.

22. Porges, S.W. (2021). Polyvagal Theory: A biobehavioral journey to sociality. Comprehensive Psychoneuroendocrinology, 7 (2021),100069.

23. Porges, S.W. (2022) Polyvagal Theory: A Science of Safety. Front. Integr. Neurosci., 16: 871227.

24. Porges, S.W. (2023). The vagal paradox: A polyvagal solution. Comprehensive Psychoneuroendocrinology, 16 (2023), 100200.

25. Porges, S.W., Kolacz, J. (2018). Neurocardiology through the lens of the polyvagal theory. In Gelpi, R.J., Buchholz, B.: Neurocardiology: Pathophysiological Aspects and Clinical Implications. Elsevier, Spain. ISBN: 978-84-9113-155-7 (In press, 2018).

26. Li Y, Zhi W, Qi B, Wang L and Hu X (2023). Update on neurobiological mechanisms of fear: illuminating the direction of mechanism exploration and treatment development of trauma and fear-related disorders. Front. Behav. Neurosci., 17: 12; 16524.

27. Venkataraman, A., Diaz, B.G. (2023). Expanding the canon: An inclusive neurobiology of thalamic and subthalamic fear circuits. Neuropharmacology, 226: 109380.

28. Katz, C., et al. (2021). Beyond fight, flight, and freeze: Towards a new conceptualization of peritraumatic responses to child sexual abuse based on retrospective accounts of adult survivors. Child Abuse & Neglect, Volume 112, February 2021, 104905.

29. Baldwin, D.V. (2013). Primitive Mechanisms of Trauma Response: An Evolutionary Perspective on Trauma-Related Disorders. Neuroscience & Biobehavioral Reviews, 37(8), 1549-1566.

30. Feola, B., et al. (2023). Altered bed nucleus of the stria terminalis and amygdala responses to threat in combat veterans with posttraumatic stress disorder. Journal of Traumatic Stress, Volume 36, Issue 2, pp. 359-372.

31. Menashri Sinai, Y., et al. (2023). Indices of The Autonomic Nervous System Predict Affect and Emotional Contagion, But Not Anxiety: A Two-Dimensional Autonomic Space Approach. ESS Open Archive May 02, 2023.

32. Koenig, J. (2020). Neurovisceral regulatory circuits of affective resilience in youth. Psychophysiology, 2020; 57: e13568.

33. Fonagy, P., et al. (2023). Attachment, Mentalizing and Trauma: Then (1992) and Now (2022). Brain Sci. 2023, 13, 459.

34. Lyons-Ruth, K., et al. (2023). Negative versus withdrawn maternal behavior: Differential associations with infant gray and white matter during the first 2 years of life. Human Brain Mapping, 44(12), 4572 –4589.

36. Keltner, D., et al. (1997). Appeasement in Human Emotion, Social Practice, and Personality. Aggressive Behaviour, Volume 23, pages 359–374.

37. Dirven, B.C.J. (2023). The neurobiological signature of susceptibility to traumatic stress. Radboud Repository of the Radboud University Nijmegen, pub. Promotie in Zicht. ISBN 978-94-6473-011-1.

38. Lyons-Ruth, K., Yarger, H.A. (2022). Developmental costs associated with early maternal withdrawal. Child Development Perspectives, Volume16, Issue 1, pp. 10-17.

39. McNicholas, Á., Brennan, J. (2022). Is it Possible to Recover from Childhood Trauma? Clinical Psychology Today, July 2022 vol 6 (1).

40. Laricchiuta, D., et al. (2023). The body keeps the score: The neurobiological profile of traumatized adolescents. Neuroscience and Biobehavioral Reviews, 145 (2023), 105033.

41. Poplin, T., et al. (2023). The unique face of anxious depression: Increased sustained threat circuitry response during fear acquisition. BioRxiv preprint doi: 10.1101/2023.10.17.562565.

42. Kampa, M, et al. (2023). The impact of past childhood adversity and recent life events on neural responses during fear conditioning. J Neuroimaging, 34:217–223.

48. Horn, A.R., Carter, C.S. (2021). Love and longevity: A Social Dependency Hypothesis. Comprehensive Psychoneuroendocrinology, 8, 100088.

49. Mercadante, E.J., et al. (2023). Beyond the fearful ape hypothesis: Humans are also supplicating and appeasing apes. Behavioral and Brain Sciences, Volume 46, 2023, e72.

50. Akiki, T.J., et al. (2017). A Network-Based Neurobiological Model of PTSD: Evidence From Structural and Functional Neuroimaging Studies. Curr Psychiatry Rep, 19: 81.

51. Levine, P.A., et al. (2015). Somatic Experiencing: Using Interoception and Proprioception as Core Elements of Trauma Therapy. Frontiers in Psychology, Dartmouth Scholarship. 884.

Share This Story, Choose Your Platform!