The main thesis of this website is that Idiopathic Parkinson's Disease is a manifestation of what happens when a person gets stuck in one of the "freeze" stress responses/survival instincts. In particular, the type of freeze in which stiffness or rigidity is pronounced, called by various names by different researchers: tonic immobility, death feigning, thanatosis, playing possum, catatonia, or "fright".
Previously we looked in depth at one of the best, in my opinion, articles on the topic “DISSOCIATION FOLLOWING TRAUMATIC STRESS: ETIOLOGY AND TREATMENT”, which explains how different types or stages of freeze occur as part of a “defence cascade” of stress responses, or survival instincts, as the perceived level of threat increases. We showed the characteristic features of the tonic immobility (the authors of the above mentioned article prefer the term "fright”) stage correspond closely to those of PD.
In recently re-reading this excellent article, it struck me that, as part of their own literature review, the authors describe what it is like on the inside to be in the fright response, and hence according to my thesis, what is like to be symptomatic with PD.
I therefore felt it was good idea to extract and annotate these descriptions and metaphors of what it is like on the inside. My idea for this is that it may help folks with a PD diagnosis to understand their own symptoms, and what is happening to them when they are symptomatic, as well as to provide caregivers and therapists greater understanding and better insights.
The section on fright in the article begins with a quote from Darwin,
‘‘The frightened man stands like a statue motionless... the heart beats quickly and violently, ... and the superficial muscles shiver ... the breathing is hurried ... the mouth becomes dry ... one of the bestmarked symptoms is the trembling of all the muscles of the body ... ’’ ~ Charles Darwin, The Expression of the Emotions in Man and Animals.
The article then continues with modern interpretations.
"The heightened muscle tonus, which enables better action performance, causes the muscles to be overly tense beyond a certain threshold, as well as rigid, and movements to become slow and difficult. At this stage overt behavioral actions are not an option; skeletal muscles tense to a stage of tonic immobility"
We folks with a PD diagnosis tend to have stiff, rigid and slow movements as a primary symptom.
"The immobility of the organism during the fright stage reminds the observer of spastic paralysis. It looks as if the organism is ‘‘frozen like ice’’ (temporary gross motor inhibition) because of the stiffness involved."
"In tonic immobility, the organism is emotionally aroused and full of fear, yet unresponsive to even painful stimulation and the posture, which may be held for long periods of time, often appears bizarre"
We tend to be stuck in anxious, fearful states. Although we may not be responsive to acute pain stimulus, chronic pain is heightened when symptomatic due to postural instability, and tightening and stiffening of the fascia.
"While the efferent [motor] pathways are already inhibited, the afferent [sensory] pathways and central processing capabilities remain still intact."
"The organism appears dead or unresponsive to exteroceptive stimuli, internally the animal is highly alert".
Research shows we tend to be stuck in busy anxious thoughts while symptomatic (beta brainwave frequency states, associated with a lack of movement).
"… with features such as immobility, decreased vocalization, analgesia,waxy flexibility,’ and evidence of alertness as well as the fixed eye gaze, reducing visual input from the offender and thereby decreasing distress and arousal."
"Thus, the core catatonic symptoms of stupor, mutism, and immobility are directly linked to tonic immobility."
"The patient remains entirely motionless, without speaking, devoid of any will to move or react to any stimuli. The general impression conveyed by such patients is one of profound mental anguish or an immobility induced by severe mental shock. All in all, these patients give the impression of the deepest mental pain, of being paralyzed after a great fright."
We tend to have great difficult vocalizing out loud.
"The lack of movement in unresponsive immobility has a fast on and off switch, but can last from a few seconds to many hours"
"…conveys that during extreme fear, human beings may be ‘scared stiff’ or ‘frozen with fear.’ A paralyzed conscious state with abrupt onset and termination is reported from survivors of attacks by wild animals, by shell-shocked soldiers"
Those of us who have been on dopamine replacing drugs for a while experience a sudden melting of symptoms when a dose of the drugs kicks in, and then a sudden re-emergence of symptoms as the dose wears off.
"The researchers noted as well a sensation of feeling cold and shivering. We assign the feeling of cold and trembling to the consequences of adrenaline and vasodilatation whereby body warmth is lost fast and leads to shivering (medical ‘‘shock’’)."
We tend to have cold extremities, and being cold tends to make the symptoms worse.
"Changes in body temperature, numbness, analgesia, suppressed vocal behavior, and vivid recall of details. Thus immobility functions to suppress anger in the victim and acts bidirectionally to inhibit aggression in a number of ways:"
"An organism in tonic immobility is immobile but is markedly tachycardic, vasoconstricted, hyperalert, and prepared to flee in a moment of opportunity, a state that also characterizes human catatonia. It is often followed by assaultive behavior, at times directly out of a stuporous state.”
Anecdotally, I have experienced this ability to suddenly exit the frozen state in order to fight or flee. Once, when I was being physically assaulted while I was quite frozen and symptomatic, I found I could suddenly move fluidly, jumped up and started defending myself, by pushing and punching back. After the fight was over though, I suddenly deflated again, sat down, and re-froze.
My purpose in sharing the above is to help folks with a PD diagnosis, see their symptoms not as illness or pathology, but part of their natural survival instincts at work, doing the job of trying to keep us alive. Hence, these are not maladaptive responses, but are due to our Nervous System doing the best can it in the face of a maladaptive modern world and culture which it was never designed to survive or thrive in, where stressors and threats that we cannot fight or flee from are ever present.
If my thesis is right, this is very important, because it tells us that PD is principally a fear-related response, but that misunderstanding what our symptoms are leads to us fearing the symptoms themselves. This sets up a massive vicious circle in which fear of our natural responses to fear becomes self-fulfilling. Conversely, through understanding this about ourselves, that our symptoms are tied in with our natural fear and stress responses, and hence are not something to be feared in of themselves, this can help break the chains of fear, and, ironically, this in itself can help to reduce our symptoms and suffering.