Why My Therapeutic Approach Looks Different—And Why That Matters

We’ve come to use the word trauma to describe everything from neglect to natural disasters. And while this shift has helped destigmatize suffering, it has also created a problem: it’s not specific enough.

When everything is trauma, nothing is clear. What’s actually happening inside the body often gets overlooked.

Instead of trauma as a label, I prefer to focus on what the body does in response to overwhelming experiences. I call these emergency cascade defenses. This is the language of the nervous system: not what happened, but what the body had to do to survive it.

These defenses are biologically wired. When the body detects danger—real or perceived—it automatically initiates survival responses. It might fight, flee, freeze, collapse, fawn, dissociate, or go numb. These aren’t choices; they’re adaptations. And they can become long-term patterns if the threat never truly ends or if no one helps the system come back to safety.

That’s why I find it more helpful to ask:

• What defense did this person have to rely on?

• What cues of threat are still running in their system?

• What safety has been missing, and for how long?

Understanding emergency cascade defenses helps us tailor support to the body’s experience, not just its story. It moves us out of abstract trauma talk and into the concrete, biological, and relational work of repair.

This model helps clinicians, survivors, and systems stop asking, “Is this trauma?” and instead ask, “What happened inside the body—and what does it need now?”

It’s a more precise, more humane, and more effective way to help people come back to themselves.

References:

• Forner, C. (2023). The Missing Ingredient: How Misogyny and the Patriarchy Sabotage Our Clinical Practice and Research. Clinical Neuropsychiatry, 20(4), 327–336.

• Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. W.W. Norton.

Levine, P. A. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. North Atlantic Books.