““Whereas we’d once believed that the symptoms and behavior exhibited by our clients primarily reflected their psychological defenses—a view that attributed a degree of intentionality, no matter how unconscious—now, we better understood the symptoms as manifestations of instinctive brain and bodily survival responses. We understood that sympathetic activation fuels anxiety and rage, parasympathetic dominance causes shutdown and passive-aggressive behavior, flight responses spur fleeing the therapist’s office, and fight responses lead to verbal or physical aggression or violence turned against the self. When clients self-harm, for example, these days, we understand their actions to be instinctive, rather than thought out—an effort to regulate or relieve, rather than punish.””
