Fight-or-flight worksheet

While the fight-or-flight response is a normal reaction to a threat, this survival mechanism can become overactive in clients with a trauma history or those with anxiety disorders. 

This fight-or-flight worksheet provides an overview of the fight-or-flight response along with examples to use with clients. 

We’ve included a free downloadable fight, flight, or freeze worksheet that you can save to your electronic health record (EHR) and use in your practice. 

What is the fight, flight, or freeze response?

The fight, flight, or freeze response is the body’s response to perceived danger. The fight-or-flight concept was introduced by Harvard physiologist Walter Cannon in 1915 to describe the evolutionary reaction that enables humans and animals to survive life-threatening situations, such as being attacked by a lion, by preparing to either fight the threat or flee (flight). 

This human alert system was later adapted to include two further responses to threats: the freeze response, which causes immobilization, and the fright response, which involves a startled reaction, temporary immobilization, and may lead to a fight-or-flight response. 

The fight-or-flight system works through the body’s alarm center, situated in the part of the brain called the amygdala. When it detects a threat, it signals the hypothalamus, which then instructs the rest of the body to respond through the autonomic nervous system. This system controls crucial bodily functions by releasing stress hormones, which regulate your breathing, heart rate, and blood pressure. However, the body responds slightly differently depending on how the threat is interpreted and whether the person responds with fight, flight, or freeze.

Some trauma-informed frameworks also include a fawn response (appeasing or people-pleasing to neutralize a threat) or a fright response (an immediate, startled shock).

While we’ve adapted as a species, the body’s response system is still innate in how we respond to stressors and perceived dangers, including:

• Work or academic-related stress

• Responding to a health emergency

• Psychological threats, such as social situations, phobias, or public speaking

• Chronic stress

• Physical threats, such as natural disasters or encounters with wild animals

• Traumatic events, such as violent acts or a car accident 

• Environmental stressors, such as unsafe living conditions, pollution, overcrowding, and noise

While most people recover from the fight-or-flight response when the threat passes, the system can become overactive, especially in people who have experienced trauma or have an anxiety disorder. 

In a maladaptive response, the brain may perceive a danger when one doesn’t exist, causing a cycle of anxiety or re-experiencing traumatic events. This prolonged stress response can lead to depression, anxiety, cognitive impairment, and even cardiovascular disease.

Fight-or-flight response examples

You can also find these examples, with reflection questions, in our fight, flight, or freeze worksheet:

• Fight response: The brain determines to confront or fight the danger directly. Through the release of stress hormones, including adrenaline and cortisol, the body responds by increasing heart rate, blood pressure, and respiration. Muscles may tighten, pupils dilate, the person might sweat, and blood flow is diverted away from functions like digestion and toward muscles to respond with strength. The person may experience anger or aggression.  

• Flight response: Similar to the fight response, fleeing from a threat also involves the release of stress hormones, sweating, reduced digestion, increased heart rate, blood pressure, and respiration. The muscles may become tense and prepare to run, which may cause shaking or trembling. The person may scream, feel anxious, or fearful.

• Freeze response: In the freeze response, the body becomes overwhelmed and starts to shut down by reducing heart rate, blood pressure, and breathing. The pupils may contract, sensory awareness may decrease, and the body may feel numb or immobilized. The person might feel exhausted, apathetic, and like giving up.

• Fright response: The person may be startled, experiencing immediate shock, heightened alertness, and an increase in heart rate and breathing.

How to use the fight-or-flight worksheet 

You can download and use the fight-or-flight worksheet in several ways:

• Use the worksheet and fight-or-flight chart as a psychoeducational tool about the stress response.

• Give the fight, flight, or freeze worksheet to the client to remind them of what you discussed during therapy. 

• Ask the client to reflect on the fight-or-flight worksheet between sessions, complete the prompts, and report their findings at their next therapy appointment. 

• Combine with related articles and worksheets, such as our triggers worksheet, CBT for anxiety worksheet, how to navigate through trauma, the cycle of anxiety worksheet, and EMDR Therapy.

• Share the fight-or-flight worksheet with coworkers or peers.

• Use the fight-or-flight response diagram in a therapy group to prompt participants to share instances when they have experienced the fight-or-flight response.

• Use the worksheet to provide training to interns or associates.

Sources

• Chu, B., Marwaha, K., Sanvictores, T., et al. (2024). Physiology, stress reaction. StatPearls Publishing.

• LeWine, H. E. (Ed.). (2024, April 3). Understanding the stress response. Harvard Health Publishing. 

• Sperber, S. (n.d.). Fight or flight response: Definition, symptoms, and examples. Berkeley Well-Being Institute.

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