ABSTRACT
This chapter describes the physiology that may be occurring in children and adolescents who display dissociative shutdown states during which they appear impervious to outside stimulation. These states may be due to a complex mixture of physiologically and psychologically based factors. These states are due to activation of the vagus nerve and characterized by a decrease in blood pressure and heart rate that resemble the freeze response of animals in the wild attacked by predators, and augmented by autohypnotic phenomena. To counter these states, the therapist should arouse the client safely, identify triggering thoughts and feelings and process the traumatic reactions, practice new response patterns involving direct communication, and help the client out of environmental binds that may sustain dissociative coping. Therapists can teach clients to proactively identify and confront situations and thoughts that make them feel trapped, and rehearse new responses that empower them. The therapist may need to extricate the child survivor from binds that keep them feeling trapped in family life, school, or the legal arena. Sleep dysregulations such as sleep-walking, dysregulated sleep cycles, sleepiness, and nightmares may also be evident.
