Case reports of fighting immobilization: The paradoxical contribution of flaccid and tonic immobility to the fight.

OBJECTIVE

Immobilization, or death feigning, is a survival strategy induced when the fight-or-flight response fails. Internally and externally, the near-death condition of immobilization can cause pathological problems, including posttraumatic stress disorder (PTSD), making it a therapeutic target. However, we have observed clients with PTSD who use immobilization to actively fight traumatic stresses. The key to their recovery was not releasing them from immobilization-related problems but rather admiring their fighting strategy. The therapeutic basis of this "fighting immobilization" (FGI) differs entirely from the hopelessly overwhelmed condition of immobilization. Therefore, because differentiating the two is crucial for treating PTSD, this study aimed to clarify FGI's characteristics.

METHOD: We evaluated commonalities between two cases of PTSD with FGI, including the patients' clinical symptoms, personalities, and cognitive tendencies.

RESULTS

Eleven commonalities were identified as characteristics of FGI.

CONCLUSIONS

Although FGI appears to be an inherently contradictory condition, it can be considered a bioecologically reasonable strategy in terms of an individual's social instinct. It is also linked to philosophical beliefs about the pursuit of life through the acceptance of death, which has been practiced in various cultures (e.g., Buddhism and Bushido). Clarifying FGI may contribute to the development of an understanding and the utilization of immobilization for treating PTSD. (PsycInfo Database Record (c) 2026 APA, all rights reserved).