Babette Rothschild, a prominent psychotherapist and trauma specialist, provides a detailed understanding of trauma through her theory of Autonomic Nervous System (ANS) Regulation (Rothschild, 2000, 2017). Rothschild’s work emphasizes how trauma profoundly affects the autonomic nervous system, influencing individuals’ physiological reactions and emotional experiences.
Autonomic Nervous System and Trauma
Rothschild’s model builds on the foundation that trauma disrupts the autonomic nervous system’s balance, pushing individuals out of their “window of tolerance” into either states of hyperarousal or hypoarousal (Rothschild, 2000). The autonomic nervous system, responsible for automatic bodily functions (e.g., heartbeat, digestion, and breathing), consists of two branches: the sympathetic nervous system (SNS), associated with activation (fight-or-flight), and the parasympathetic nervous system (PNS), associated with calming (rest-and-digest).
Trauma, Hyperarousal, and Hypoarousal
Rothschild (2000, 2017) identifies specific physiological and emotional symptoms associated with each ANS state, making it easier for therapists to recognize and respond effectively to trauma responses in their clients. Understanding the differences between hyperarousal and hypoarousal states helps therapists tailor interventions to stabilize and regulate a client’s nervous system effectively.
- Hyperarousal occurs when the sympathetic nervous system dominates, producing symptoms such as anxiety, panic, hypervigilance, restlessness, and heightened emotions.
- Hypoarousal occurs when the parasympathetic nervous system becomes overly dominant, producing symptoms such as numbness, withdrawal, dissociation, low energy, and emotional detachment.
Rothschild’s ANS Regulation Table (Simplified)
Below is a simplified version of Babette Rothschild’s widely referenced table, which clearly outlines the physiological and emotional signs of each ANS state, making it a useful reference for psychotherapists working with trauma clients.
| ANS State | Physiological Indicators | Emotional/Behavioral Indicators |
| Hyperarousal (SNS Activation) | Increased heart rate Rapid breathing Tense muscles Sweating Dilated pupils Increased blood pressure Digestive disruption | Anxiety or panic Hypervigilance Anger or irritability Restlessness or agitation Difficulty concentrating Excessive emotional reactivity |
| Optimal Arousal (Window of Tolerance) | Stable heart rate Steady breathing Relaxed muscles Regular digestion Balanced energy levels | Calm and clear-headed Flexible thinking Emotionally balanced Capable of social engagement Present and focused |
| Hypoarousal (PNS Dominance) | Decreased heart rate Slow breathing Muscle weakness or heaviness Pale skin Fatigue Digestive sluggishness | Emotional numbness Dissociation or spacing out Feeling disconnected Depression or sadness Withdrawal or isolation Reduced responsiveness |
(Rothschild, 2000, 2017)