In the early stages of my recovery, I began to learn about the relationship between trauma and addiction. It lead me to recognise that the body responds to protect itself which plays into substance use.
The nervous system responds to the environment to keep us alive and safe from harm. It is said to work in three different states:
Firstly, when we are safe we function in a relaxed, open and curious state.
Next, when we feel danger, our bodies elevate our energy to run away or to fight – we mobilise.
Finally, if the body feels an overwhelming threat to its own life, it may respond by immobilising – freezing or collapsing.
When our nervous system shifts states to mobilised or immobilised, we experience thoughts, sensations and emotions of survival and being unsafe.
Substance use can be thought of as a way to induce a change in the state of the nervous system. Alchohol and benzodiazepines would induce calmness during a mobilised state of anxiety, hypervigilance or being on edge (i.e. hyper-arousal).
Stimulants like methamphetamine or cocaine would induce excitement and energy, in order to pull oneself out immobilisation – when the body is shutting down or getting stuck in a collapsed or frozen state (i.e. hypo-arousal).
When we have experiences that push our nervous system beyond it’s capacity, such as trauma, the nervous system may adapt by heightening it’s sensitivity to future sources of threat or danger. It may respond to a threatening stimulus rapidly and with intensity, and the time it takes to return to safety may increase significantly.
If we pay attention to our thoughts, emotions and body sensations, we can tune in to the state of our nervous system.
Identifying nervous system states
Mobilisation – Bodily Sensations ( “Fight or Flight“)
- Rapid, shallow chest breathing or holding your breath
- Racing heart, elevated blood pressure, and a surge of physical energy
- Muscle tension, particularly in the jaw, shoulders, and thighs, preparing you to run or fight
- Cold hands and feet (vasoconstriction redirects to muscles)
- Digestion slows or stops, leading to butterflies, nausea, or a tight stomach
- Eyes dilate to scan for danger, and ears tune out human speech to listen for sudden, low-frequency sounds
Mobilisation – Emotions
- Anxiety, panic, frustration, impatience, or rage
- Hypervigilance, feeling overwhelmed, or out of control
- A sense of urgency, irritability, and being constantly “on guard.”
Mobilisation – Thought patterns
Thoughts can become ‘hijacked’ by the survival system, executive functioning goes offline when fully mobilised. Our memory is also not accessible.
- “This is a problem, and I have to fix it right away.”
- “The world is dangerous, and I can’t trust anyone.”
- “I am trapped”
- “Time is running out.”
- Thinking is highly repetitive, going around in loops
- Hyper-focused on worst-case scenarios
Immobilisation ( “Collapse or Freeze“) – Body Sensations
- Very slow, shallow breathing and a drop in heart rate and blood pressure.
- Extreme fatigue, heavy limbs, or a feeling of literal weight on your chest.
- Numbness, a lack of physical sensation, or a feeling of being “spaced out” and disconnected from your body.
- A cold body temperature and low muscle tone (floppiness or collapse).
- Disrupted digestion, often resulting in constipation or a completely deadened appetite.
- Sounds seem muffled, distant, or echoey.
Immobilisation – Feelings
- Hopelessness, helplessness, shame, and deep sadness.
- Apathy, numbness, or feeling completely blank and emotionally flat.
- Isolation, loneliness, and a sense of being invisible or discarded.
Immobilisation – Thought patterns
- “What’s the point? Nothing I do matters anyway.”
- “I just want to disappear,”
- “I am completely invisible.”
- “I am broken,”
- “I can’t do this.”
- Thinking is foggy, slow, fragmented, and heavily focused on resignation and giving up
Safety – Bodily Sensations - Deep and effortless diaphragmatic breathing
- Calm heart rate
- Warm hands and feet (good circulation)
- Facial muscles relaxed, eyebrows relaxed
- Open posture and body language
- Easy eye contact.
- Active digestion (quiet, comfortable abdominal area).
- Middle ear muscles tuned to the pitch of human speech, making voices sound warm and clear.
Safety – Emotions - Calmness
- Curiosity
- Joy, happiness, contentedness
- A sense of groundedness and being “at home” in your skin.
- Emotionally flexible – it doesnt feel like every emotion is hitting hard
- Capable of empathy, or even turning it into action through compassion
- Connected – speaking easily without inhibition
- Humour and laughter
Safety – Thought Patterns - I belong here
- People are safe and well-intentioned.
- I am safe to explore the world
- I can handle the challenge
- I can generate creative ideas
- I can access wider purpose and meaning
Body sensations related to emotions
Source : Bodily maps of emotions – Numenmaa et al 2013 – https://www.pnas.org/doi/10.1073/pnas.1321664111
Returning to Safety and Connectedness
Multiple simulataneous changes occur as we return to safety from mobilisation
Downregulation of the Amygdala: The brain’s threat detector quiets its alarm signals.
Vagal Brake Activation: Safety cues activate the ventral vagal complex. This slows down your heart rate, lowers blood pressure as we transition to “rest and digest” state.
Prefrontal Cortex Engagement: In order to speed up reactions in an emergency or threat environment, the prefrontal cortex goes offline. The PFC is the area responsible for logic, executive functioning, and social communication).
When we start to feel safe, our clear thinking, emotional regulation, and social engagement returns. While the ‘amygdala hijack’ can begin within milliseconds and only starts to settle down in 20 – 60 minutes.
Oxytocin Surge: Oxytocin, the bonding hormone, is released in response to social safety cues (like a warm smile or hug). It dampens anxiety and fosters feelings of trust, empathy, and security.
GABA Increase: The brain increases production of GABA -gamma-aminobutyric acid – which is the primary inhibitory neurotransmitter. GABA acts as a natural tranquilizer, slowing down overactive neural firing and inducing physical calmness. ( Both alcohol and benzodiazepines activate the GABA inhibitory system.
Serotonin & Dopamine Stabilization: Levels of serotonin rise to stabilize mood and promote a sense of well-being, while dopamine shifts from driving frantic, survival-based motivation to supporting relaxed satisfaction and curiosity.
HPA Axis Deactivation: The Hypothalamic-Pituitary-Adrenal (HPA) axis stops its emergency signaling.
Cortisol Drop: Levels of cortisol (the primary stress hormone) begin to decline. This allows your metabolism, immune system, and reproductive systems—which are suppressed during stress—to resume normal, healthy functioning.
Adrenaline & Noradrenaline Reduction: The adrenal glands halt the flood of adrenaline and noradrenaline. As a result, your breathing slows, muscles loosen, and internal inflammation markers decrease.
Key Routes back to safety
Neuroception of safety
Before the mind can register “I am safe,” the nervous system has to detect safety cues below conscious awareness — a steady voice, a relaxed face, an unhurried pace, familiar surroundings. Without these cues present, no technique will land, because the system is still scanning for threat.
Co-regulation before self-regulation
Humans are wired to borrow regulation from another regulated nervous system before we can do it alone — a calm presence, warm tone of voice, attuned eye contact. A therapist, recovery colleague, friend, partner etc can help in co-regulating the nervous system.
Techniques for Returning from Mobilisation (Fight/Flight)
The sympathetic system has generated real physical energy that needs somewhere to go before the body can settle.
- Discharge the mobilisation energy — shaking, stretching, brisk walking, pushing against a wall, vigorous movement — letting the body complete the “action” it was preparing for
- Extend the exhale — breathing where the out-breath is longer than the in-breath (e.g. in for 4, out for 8) directly engages the vagal brake
- Orient to the environment — slowly looking around the room, naming what’s seen, heard, felt — eg the 54321 method
- Grounding through the body — feeling feet on the floor, weight in a chair, pressing hands together — brings attention back into the body and out of threat-scanning
Techniques for Returning from Immobilisation (Dorsal Vagal Freeze)
Freeze is a low-energy, shut-down state, so the direction of movement is different — it usually needs gentle activation first, not immediate calming, since there’s often too little energy present to “calm.”
- Small, rhythmic movement — gentle rocking, tapping, swaying — reintroduces a small amount of mobilising energy without overwhelming
- Sound and voice — humming, singing, toning — vibration of the vagus nerve through the vocal cords is one of the more direct ways to shift this state
- Warmth and contact — a blanket, warm drink, or safe touch can help counter the numbness and disconnection of freeze
- Gentle orienting — softly naming things in the room, a warm voice speaking to the person, eye contact if welcomed — slowly re-establishing social engagement
5 4 3 2 1 Method:
5 – See: Acknowledge five distinct things you can see around you (e.g., a pen, a shadow on the wall, a tree).
4 – Touch: Acknowledge four things you can physically feel or touch (e.g., your feet on the floor, the fabric of your shirt, a cool desk).
3 – Hear: Acknowledge three external sounds you can hear (e.g., traffic outside, a humming refrigerator, birds chirping).
2 – Smell: Acknowledge two things you can smell (e.g., coffee, soap, fresh air).
1 – Taste: Acknowledge one thing you can taste (e.g., the leftover taste of mint or coffee, or just the inside of your mouth).
Voo breathing
Here is the step-by-step process for practicing Peter Levine’s “Voo” breathing to help settle your nervous system:
- Find a comfortable position: Sit or lie down in a relaxed upright posture. Place your hands gently on your belly so you can feel the movement and vibrations.
- Take a deep, slow breath in: Inhale fully but comfortably through your nose, letting your abdomen expand and fill with air.
- Exhale with a deep “Voo” sound: Open your mouth slightly and make a low, resonant, foghorn-like sound: “Voooooo”. Focus on producing the sound from deep within your abdomen, feeling the vibration resonate throughout your belly and chest.
- Sustain the sound: Let the exhale trail out completely and naturally until your lungs feel empty. Do not force or strain your breath at the very end.
- Pause and rest: Wait a moment before your next breath. Let your body naturally take over the next inhalation without forcing it.
- Notice your sensations: Spend 30 to 60 seconds tracking your internal physical sensations. Pay attention to any shifts, warmth, or relaxation in your body before repeating the cycle 2 to 3 times.
Physiological Sigh:
Step 1: Take a deep inhale. Breathe in deeply through your nose, filling your lungs almost completely.
Step 2: Take a second, sharp “top-off” inhale. Without exhaling, immediately sneak in a quick, short second breath through your nose to completely fill your lungs.
Step 3: Breathe out with a long exhale. Slowly and completely release all the air through your mouth with a gentle, relaxed sigh.
Calming and grounding techniques
EFT Tapping
Butterfly Hug
Body Scan Meditations
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