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  • Writer's picturejackie bristow

The 4 Fs of Trauma - In Complex PTSD Treatment

Updated: Sep 4, 2023

A number 4 representing 4Fs of Complex Trauma.
Complex PTSD Treatment - The Four Fs Types

You might have heard of the 3 Fs before when it comes to trauma but often people don't know what the 4th one is or people have only heard of 2: fight and flee. Here I will attempt to describe the 4Fs: Fight, Flight, Freeze and Fawn and explain their function in protecting us from harm. Client's often tell me that understanding these elements of trauma is motivational towards healing and decreasing the ever present shame that comes along with trauma.

If you experienced decent enough parenting, you will grow up to become a relatively healthy adult, with a repertoire of flexible responses to danger. This means someone when faced with real danger will have access to chose between the Fight, Flight, Freeze and Fawn responses, and to choose based on what will ensure safety. For example, the Flight response insures strong boundaries and a healthy level of assertiveness that can go toward a more aggressive self-protective behaviour if necessary. Someone that does not suffer from PTSD will be able to then easily access the second of the 4 F's, Flight, allowing a person to disengage and remove themselves when the continued confrontation would exacerbate the danger. Freeze is the next response and when used appropriately, we decide to quit struggling when further struggling is futile or counterproductive. And the last and least well known is Fawn, which is available to chose in situations where we need to comply or compromise. Someone with a healthy response to Fawn is able to listen, help and compromise as readily as their ability to assert and express themselves and their needs.

Anyone who is repetitively traumatized in childhood (also known as developmental trauma) often relies on 1 or 2 of the 4F responses. This is often due to the fact that the chosen responses were the only options they could exercise that effectively that protected them from their perpetrator. This fixation unfortunately prevents access to the other Fs responses, and further impairs one's ability to relax into an undefended state and truly feel safe. Once these responses are habituated, they can act as a distraction from the intense and overwhelming feelings of current or past alienation, as well as unresolved past trauma.

Complex PTSD as it relates to Attachment Disorders

Polarization to any of the four Fs (fight, flight, freeze or fawn) is not just a child's unconscious attempt to avert danger, but also helps them to buy into an illusion of attachment. All the four Fs types commonly struggle with real intimacy because getting close to someone so easily triggers flashbacks which are painful emotional reminders of the original trauma that came from their earlier and closest attachments: their parents. In particular to note, a flashback that is solely emotional in nature is one that show up without imagery of the original traumatic event like typical PTSD flashbacks, and can come on instantly and sometimes create prolonged regressions back into the intense, overwhelming feeling states that were present in childhood where the abuse and neglect were present: fear, alienation, shame, rage, grief and depression. Habituated 4F responses are there to offer protection against further abuse and abandonment, and do so by acting as a deterrent to any type of vulnerability with others that may invoke childhood feelings of being attacked, unseen and unappreciated.

Let's give an example here with each type in a habituated traumatized response:

Fight type - Attempt unconsciously to avoid any real intimacy by alienating others with their display of angry and controlling demands geared towards meeting their unmet childhood needs of unconditional love.

Flight type - Attempt to stay perpetually busy and industrious to avoid triggering interactions.

Freeze type- May hide away from others and create a rich inner world that allows them to split off from reality and the pain of being isolated and abandoned.

Fawn type - Avoids any deep emotional investment and sticks to superficiality as a way to avoid any potential disappointment by completely seen. Often Fawn type will act like a chameleon in public as a way to have people like them so they won't be faced with hurt or abandonment. These people often are the ones that you see who over-listening or overdoing to others by being a service to them but never risking showing their true selves or identity which prevents true intimacy.

Now let's break down these four Fs further and the type of therapy or interventions that might be useful. I will be including other blog posts in the near future about Flashback Management and Shrinking the inner critic in Complex PTSD but for now I will highlight each of the Four Fs and what psychoeducational interventions are specifically healing for each type.

Complex PTSD Treatment for Fight Type as the Narcissistic Defense

You might recognize this person as someone that is driven by power and control. Fight types believe that power and control can create safety and prevent abandonment and secure love. Children who are often spoiled and are given insufficient limits (which can be a unique kind of abandonment pain) or children who are allowed to imitate bullying behaviours from a narcissistic parent can develop a fixated fight response to being triggered. When dealing with feelings of abandonment, fight types often respond with anger that can lead to contempt which is an amalgamation of narcissistic rage and disgust used to intimidate and shame others into acting the way they want. Fight types may often bond with freeze or fawn types and may even enslave them into a dominant-submissive relationship. Excessive monologuing is common with Fight types and they will often prey on more submissive types to provide audience to this. Fight types that are more extreme tend to become sociopathic and can range on a continuum of extremeness, and this can seriously impact their ability to get help.

A man yelling on the phone exerting is fight response to gain power and control.

Treatment for Fight: A treatable fight type can benefit from psychoeducation about the price they pay for controlling others and using intimidation. Less intense fight types are able to see how those close to them can become so afraid or resentful of them, that they are incapable of showing warmth or true liking toward the fight type, which is not fulfilling their desperate desire. The downward spiral of power and alienation can look like a Fight type using excessive use of power which then triggers emotional withdrawal in the other person, making the fight type feel increasingly abandoned which then fuels their rage and contempt even further. This dynamic results in greater distance between themselves and the other person to which they crave the intimacy with, with whom ends up withholding more warmth, ad infinitem.Fight types benefit from learning how to become aware of their impulse to instantly fight a person whenever they are triggered into feeling abandoned, and to avoid acting on the fight impulse, instead developing self-understanding and compassion towards the pain they experienced as a child at the hands of their caregivers. As they become more aware of their abandonment feelings and the toxic shame associated with it, they can then focus on processing these feelings without transmuting them into rage or disgust, or grandiose overcompensation that can turn into excessive demandingness.

Different than other 4Fs, fight types see themselves as perfect and will project their inner critic's concept of perfectionism onto others which results in an endless supply of rage towards others that feels utterly justified. The goal is to get the Fight type to take self-initiated timeouts at the first sign of a trigger allowing them to slow down and see how their condescending and moralistic high-ground attitude alienates others further increasing their present abandonment. This response instead allows a Fight type to focus on grieving their hurt feelings from the past and working through the original abandonment from their parents rather than destructively placing it onto others who are close to them and pushing those people away further.

Like all 4Fs fixations, Fight types need to focus on becoming more flexible and adaptable in using the other 4F responses especially their polar opposite and complementary fawn response, which will be described next. Learning how other people feel (also known as theory of mind), they can learn to understand how one might feel in response to their Fight behaviours.

Fawn, Freeze and Flight responses will be added soon - stay tuned!

Copyright of Jackie Bristow Psychotherapy. No copying or republishing allowed.

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