Following up to last week’s post, what is happening when you go along with what a medical provider (or anyone) says/wants/does even though you think/want/know differently?
The short answer, the fight-or-flight (F/F) system activates. To get a broad overview, read my earlier post on the F/F system here.
The F/F system (a system designed to keep us alive) takes over our brain when it perceives we are facing a threat. A system that is fantastic when we are facing a mountain lion. But what kind of threat is a medical provider? For women and BIPOC, a big threat. Due to the systemic sexism and racism built into our western medical system, women and BIPOC often do not receive the same level of care as men or white people.
Origin of fawning
In school, most of us learn about the F/F stress response but never hear about the fawn aspect of that response. The person credited naming the fawn response is a psychotherapist out of California, Pete Walker, who wrote the book Complex PTSD: From Surviving to Thriving.
Fawning is basically when you attempt to please the threat. I usually give the example of possums playing dead or humans
playing dead when facing a brown bear. When the threat assumes you are dead, it becomes appeased and moves on because you are no longer a threat to it.
This same behavior shows up with people pleasing. If the person likes you because you are amenable and easy to get along with, that person becomes less of a threat to you. A study done in 2020 out of Israel showed that a history of trauma results in people’s nervous system going straight to a fawn response.
Fight or Flight Ladder
Flee
Another way I explain the F/F system is as a ladder. When faced with a threat, the first option your nervous system will want you to do is to flee. If a dinosaur was running down the street, you would start running the other way. Every once in a while, there will be a social media video featuring random people seeing others start running in one direction, and they too will begin running. This is because your nervous system decided to interpret the behaviors in others as evidence of a threat and encourage you to run too.
Fight
The 2nd behavior your nervous system will choose if running is not a viable option at the moment, is fight. I specifically say “at the moment” because the F/F response will constantly be trying to find an opportunity to run. An example of this is say a mountain lion drops onto the path behind you. You cannot outrun a mountain lion. So, your F/F response is going to send you the energy and chemicals you need to punch, kick, bite your way out of this threat.
Fawn
The 3rd behavior is fawn, which shows up if you can’t fight your way out of the threat. I have a hypothesis as to why we are seeing more fawn responses than fight responses to day-to-day threats, such as interactions with a medical provider, at work, sometimes in our relationships. I think as we move away from accepting a physical response (i.e., fight) we are leaving people with either flee or fawn, and most of us can’t easily flee our jobs, our homes, or the medical system. Every day I reframe my clients’ stories within the fawn response. Some of those stories start out with a client frustrated that they didn’t stand up for themselves, and others are stories of sexual assault and the client is blaming themselves because they didn’t say no or fight back.
When it comes to women, fawning is an important piece of the puzzle. As a culture, we often label fawning as selflessness, caring, and kindness. We reward girls for being amenable and nice. If you are doing something nice for someone in hopes they are please, less scary, won’t remove privileges, you are fawning.
Now, I want to stress, that fawning is a completely acceptable response to a threat and is by no means less valuable than fleeing or fighting. It is keeping you safe. However, if you see yourself in these examples, I encourage you to work with a mental health provider to understand why you are feeling threatened and if you can do something about it.
The Tale of the Two Pre-Op Nurses
Returning to my story from last week, why did I just go along with the pregnancy test? Because appeasing the 2nd pre-op nurse was the safest thing for me to do. The threat at that moment wasn’t necessarily the nurse, it was the hospital system in general. I was cornered. It was Dec 30th, the final day of the year the hospital was having scheduled surgeries. What if me refusing the pregnancy test was escalated to the point that someone decided that unless I did it, my procedure couldn’t happen. And if my procedure couldn’t happen that day, I was going to have to pay my deductible all over again when it was rescheduled. So, I fawned. I placated the system because in that moment, fighting the system wasn’t an option for me. And that is okay because maybe next time I can fight or maybe next time, I don’t want to risk care being pulled from me, and I will fawn again. Regardless, my fawning isn’t a character flaw that I am to be blamed for, but rather, evidence I am interaction with a system that feels threatening to people like me.
What about the fawn response speaks to your experience?
Any information provided about medical matters is purely educational and the author is not a medical professional and is not recommending any specific intervention for any specific person or giving medical advice. Please consult your own medical provider for information about your own situation
This blog post is for informational purposes only and does not create any type of therapeutic relationship. For specific assistance, please consult your own medical and/or mental health provider.
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