Accelerating Healing After Catastrophe II

Understanding Your Protective Responses and How They Can Hurt You.

The first article of this series discussed how conventional medicine and rehabilitation often fail to support optimal recovery after catastrophic illness or injury.

I argued for the integrative medicine approach that has enabled healing and recovery for so many people who felt stuck, like they had tried everything. Integrative medicine is grounded in the best practices of medicine and rehabilitation. But it has a broader diagnostic and therapeutic toolbox that addresses the underlying biology of debilitating symptoms and impaired healing responses.

So it’s scientifically based. However, it’s tailored to each person and not limited by medical dogma.

To optimize and accelerate recovery, understanding your protective responses is crucial.

Protective responses are built into your body-mind system. They are mobilized in response to illness, injury, and perceived danger. Sometimes they fail to “turn off” and impair healing responses. So it is crucial to recognize overactive protective responses and bring them into balance with healing responses. Let's start to unpack that.

When the Protector Becomes The Villain

Your body-mind system has brilliant, multi-layered, and integrated protective systems. Whether facing trauma, perceived danger, severe infection, or life crisis, your emergency responses are essential for survival.

But what if these emergency crews don’t stand down? What if, long after crisis or injury, the danger signals keep firing and your body keeps fighting—even when it should be healing?

We have growing evidence that overactive danger response signaling is a big driver of chronic illness and pain. It can show up as prolonged physical pain, emotional distress, digestive symptoms, fatigue, cognitive impairment, and failure to reach functional goals.

Overactive protective responses are underlying biological balances that, over time, can generate disease. And in the short term, they make you feel crummy and keep you from getting back to yourself after illness or injury.

So it’s essential to recognize and turn off the protective responses that are no longer serving your life.

This is one of the key principles in optimal recovery.

The Architecture of Protection

Every system in your body is involved in the protective response to acute danger, illness, or injury. That includes all of your bodily systems—metabolic, immune, digestive, musculoskeletal, nerves, and brain. And it includes your mental-emotional processes, colored by all of your memories and previous life experiences.

In response to danger or injury, your protective defense/survival responses work for your good: the cells mobilize metabolic energy, the mind becomes alert, the immune system goes into surveillance and attack mode, the gastrointestinal system becomes more permeable and responsive, integrated muscular and neurological activity prepares you for action, and stress hormones surge and support the increased acute mobilization of protective resources.

But clinical experience and growing research demonstrate what happens when danger signaling and protective responses persist. The alarm keeps ringing, keeping systems in defense mode.

The lingering danger-system activation doesn’t just slow healing. It can generate chronic pain, inflammation, emotional exhaustion, impaired movement, and drive metabolic and degenerative diseases.

If you’ve just survived a health crisis or illness, the challenge is that the chronically activated danger system is not a typical “disease”. When it shows up in various organ systems, it can wreak havoc on your well-being and capacity to recover. Prolonged protective responses are like “pre-illness”. But there are no diagnostic codes for it yet. Most doctors don’t think about protective responses because they’re looking for the disease entity. Or they’re medicating symptoms.

Maybe you’ve been through the process.

In most hospitals and rehab units, the person with a persistent lack of motivation or low energy is seen by a psychiatrist who recommends antidepressants. The person with chronic digestive symptoms gets blood tests and maybe an endoscopy, which leads to a diagnosis of irritable bowel syndrome. The person with widespread pain gets diagnosed with fibromyalgia and put on pain meds or off-label psychiatric meds. Others get meds for hypertension or new-onset diabetes. Others get increasing doses of pain medications because nobody asks about stress and anxiety that came on after the trauma or surgery-gone-wrong.

They might get put on multiple medications to treat the symptoms, but none of them are getting at the root of the symptoms.

To accelerate and optimize recovery, we must go beyond symptom control. The key is to identify and turn off the stuck protective patterns so that your inherent healing capacity can manifest. So you can mobilize repair and personal evolution that takes you from surviving to thriving.

So let's unpack “protective responses” so you can get clarity about it. So you can deal with it head-on.

The Three Domains of Injury Response

I find it helpful to think of three domains of body-mind functioning. They are like “windows” into understanding what is out of balance, and what kind of interventions you can use to support the healing process. It’s a useful model to understand protective responses, too. The three domains are:

• Mental-Emotional: your thoughts, beliefs, attention, and emotional responses.

• Metabolic-Biochemical: All the stuff that is happening in your blood and cellular biochemistry. That includes energy metabolism, immune function, hormonal activity, circulation and cardio-pulmonary activity, etc.

• Movement-Structural: The integrated functioning of your muscles, nerves, bones, joints, connective tissues, and brain movement centers.

These three domains are completely integrated with one another. You are one system, and your protective responses operate throughout the system. When your system gets stuck in danger mode, dysfunction can happen in any or all of these domains, depending on you and the kind of challenge or insult that you faced.

We break it into the three domains because they help us understand the dysfunction, and suggest therapeutic strategies to bring your whole system toward greater well-being and function.

The Autonomic Gatekeeper

Before we unpack the three domains, let’s acknowledge the system-wide role of the autonomic nervous system (ANS). The ANS is like a brain inside your brain. But like your brain, its activity is distributed throughout your body. It’s a system within your system, which helps decide whether your system should be in danger/protection/survival mode, or healing/thriving mode. And it mobilizes your biology toward survival vs healing.

There are two parts to your autonomic nervous system.

You have a “stress response” which is sometimes called “fight/flight/freeze”.

Also known as the sympathetic nervous system. It mobilizes every organ and system for action, so you can “get up and go”. It is turned on when your system senses danger, whether real or imagined. “Danger” is not only a mental perception of danger. Danger signalling is turned on by anything that your organism or cells consider a threat. It includes physiologic changes like inflammation, pain signalling, infection, blood loss, or low blood pressure, low blood sugar, overheating, and chemical toxicity. It’s about survival.

You also have a “relaxation response” which is sometimes called “rest/digest/repair”.

Also known as the parasympathetic nervous system. It gets turned on when the danger is over. When your body-mind shifts into absorbing nutrients, removing waste, healing, interpersonal connection, and pleasure. It supports positive intention and creativity.

The autonomic nervous system influences all of the bodily systems. And it integrates and influences the three domains of Mind-Body, Metabolic-Biochemical, and Movement/Structural systems.

Accelerated and optimal healing depends on a balanced and autonomic nervous system. For instance, you need your sympathetic nervous system in order to generate motivation and metabolic energy so you can do exercise and rebuild strength or coordination. But you need a state of calm and safety to sleep, heal wounds, absorb nutrients, or process physical or emotional pain. The main thing is that the system has the balance and flexibility to respond to the aspect of healing and growth that is needed.

Unfortunately, the autonomic nervous system often gets “stuck” in fight/flight/freeze due to physical. Mental, or emotional trauma, which can include severe illness or injury. It’s like living with your foot on the gas and the brake at the same time. You might experience it as tension, anxiety, difficulty sleeping, increased pain, irritability, and so on. Meanwhile, your organ systems are biased toward survival, not toward thriving and healing. Over time, that can prevent you from healing. And it can make you sick.

The next article is going to start going into detail about the three domains of Mind-Body, Metabolic-Biochemical, and Movement-Structure. We will understand more about how overactive protective responses disrupt healing and recovery in each of those domains. And will will explore evidence-based interventions that can bring your system back to healing. So you can recover and get back to life.

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Thanks

Andrew David Shiller, MD