In 2019, 970 million people worldwide were struggling with stress, anxiety, and mental health issues (World Health Organization, n.d.).
Given these soaring numbers, many individuals would benefit greatly from developing better coping skills.
Skills such as resilience, adaptability and emotional agility (David, 2016) would broaden their ability to cope, their window of tolerance.
In this article, we outline the importance of the window of tolerance and, most importantly, offer key exercises and activities that can be used in therapeutic practice to help clients maintain optimum functioning.
Before you continue, we thought you might like to download our three Resilience Exercises for free. These engaging, science-based exercises will help you effectively deal with difficult circumstances and give you the tools to improve the resilience of your clients, students, or employees.
The window of tolerance is a model of autonomic arousal proposed by Siegel (1999) that focuses specifically on understanding the body’s nervous system regulation after experiencing trauma. The window of tolerance comprises a range of emotional and physiological states within which an individual is able to effectively cope with stressors.
When someone is within their window of tolerance, they are able to manage everyday stressors and challenges without becoming overwhelmed or shutting down. This state allows for adaptive responses to situations and enables effective problem-solving and decision-making (Larsen & Stanley, 2021).
However, not everyone routinely operates within their window of tolerance. According to Ogden (2010, p. 1), individuals who have been exposed to trauma may often experience “too much arousal or too little arousal,” which refers to the two physiological extremes of hyperarousal and hypoarousal.
When an individual experiences trauma or perceives a threat, their body’s autonomic nervous system (ANS) kicks into action to prepare the body for a response. The ANS has two main branches: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). These branches work together to regulate various bodily functions, including heart rate, respiration, digestion, and stress responses (Kemeny, 2003).
Sympathetic nervous system
When trauma or threat is perceived, the SNS can initiate a series of stress responses, including variations of the fight-or-flight behavior (Cannon, 1915; Schauer & Elbert, 2015). These stress responses are a physiological reaction aimed at preparing the body to confront or flee from perceived danger.
Key features of the SNS activation include:
Increased heart rate
The heart pumps faster to increase blood flow to the muscles, providing them with oxygen and nutrients needed for action.
Dilation of the pupils
This allows for improved vision to detect potential threats in the environment.
Bronchodilation
The airways widen to increase oxygen intake, enhancing physical performance.
Release of stress hormones
The adrenal glands release hormones such as adrenaline and cortisol, which further increase arousal and energy levels.
Suppression of nonessential bodily functions
Functions such as digestion and immune response are temporarily suppressed to conserve energy for the immediate threat.
Parasympathetic nervous system
The PNS acts as a counterbalance to the SNS, promoting relaxation and restoring homeostasis once the threat has passed (Porges, 2009).
Key features of PNS activation include:
Slowing of heart rate
The heart rate decreases to return to baseline levels, promoting a sense of calm.
Constriction of pupils
Pupil size returns to normal, reducing sensitivity to light.
Stimulation of digestion
Digestive processes resume as the body shifts focus from immediate survival to long-term maintenance.
In essence, the window of tolerance details “a range of optimal arousal states in which emotions can be experienced as tolerable” (Corrigan et al., 2011, p. 17), and operating within this range is vital for health and wellbeing.
How Trauma and Other Factors Have an Impact
In Bessel van der Kolk’s (2014) book The Body Keeps the Score, readers come to grapple with the growing evidence that traumatic experiences leave significant marks on the brain and the body, affecting how an individual thinks, feels, and behaves.
Therefore, when it comes to facing new stressors, those previously exposed to trauma can have severe emotional and physiological reactions.
Trauma or perceived threats can activate the ANS through various sensory pathways, including visual, auditory, olfactory, and tactile cues. These cues can trigger a rapid and automatic response that prepares the body to react to danger, even before conscious awareness of the threat (van der Hart & Friedman, 1992).
However, trauma can live in the body long after the event itself. Indeed, chronic activation of the SNS due to repeated trauma or prolonged stress can make the nervous system more sensitive and more easily dysregulated (Corrigan et al., 2011).
Below, we list three key ways trauma impairs functioning.
Emotional dysregulation
Trauma can disrupt the brain’s ability to regulate emotions, leading to difficulties in managing intense or distressing feelings. Individuals may experience mood swings, emotional numbness, or difficulty identifying and expressing their emotions.
This inability to apply emotion regulation can shrink the window of tolerance, as individuals may struggle to modulate their arousal levels and respond adaptively to stressors (Corrigan et al., 2011).
Triggers and reactivity
Trauma survivors may have specific triggers or reminders of their traumatic experiences that elicit intense emotional and physiological reactions (van der Hart & Friedman, 1992).
These triggers can cause individuals to rapidly shift from within their window of tolerance into states of hyperarousal or hypoarousal (Corrigan et al., 2011).
The unpredictability of these reactions can further narrow the window of tolerance, as individuals may feel constantly on guard or overwhelmed by their responses to perceived threats.
Avoidance and coping strategies
To cope with trauma-related distress, individuals may engage in avoidance behaviors, repress emotions, or use maladaptive coping strategies such as substance abuse, self-harm, or social withdrawal.
While these unhealthy coping mechanisms may provide temporary relief, they ultimately limit individuals’ ability to tolerate distress and expand their window of tolerance (Littleton et al., 2007).
Instead of confronting and processing their emotions, trauma survivors may remain stuck in patterns of avoidance, further narrowing their window of tolerance over time.
For therapists and those working with traumatized clients, knowledge of how the autonomic nervous system and stress interact is vital for determining a successful treatment plan.
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Understanding Hypoarousal vs. Hyperarousal
When stressors exceed a person’s window of tolerance, individuals can become stuck in states of either hyperarousal or hypoarousal (Siegel, 1999; Corrigan et al., 2011).
Hyperarousal
Hyperarousal involves an overactivation of the body’s stress response system. When someone is in a state of hyperarousal, they may feel constantly on edge, anxious, or overwhelmed (Weston, 2014).
Their nervous system is in a heightened state of alertness, which can lead to symptoms such as:
Increased heart rate and breathing
Muscle tension
Racing thoughts
Irritability
Difficulty concentrating
Hypervigilance (being excessively watchful or wary of potential threats)
Anxiety and panic attacks
Anger outbursts
Hyperarousal can make it challenging for individuals to relax, concentrate, or engage in activities of daily living. It can also interfere with sleep and lead to chronic fatigue or burnout if not effectively managed (Riemann et al., 2010).
Such a heightened state of arousal, often seen in clients with post-traumatic stress disorder, narrows the window of tolerance further, making it easier for individuals to become overwhelmed by everyday stressors.
Hypoarousal
Hypoarousal involves a state of underactivation or dampening of the body’s stress response system. When someone is in a state of hypoarousal, they may feel disconnected from their emotions, numb, or emotionally detached (Corrigan et al., 2011).
Their nervous system is in a lowered state of alertness, which can lead to symptoms such as:
Feeling emotionally numb or flat
Dissociation (feeling disconnected from oneself or the surrounding environment)
Reduced heart rate and breathing
Fatigue or lethargy
Difficulty concentrating or focusing
Memory problems
Apathy or lack of motivation
Withdrawal from social interactions
Hypoarousal can make it challenging for individuals to engage with their surroundings or connect with others emotionally. It can also lead to feelings of emptiness or detachment from life (Brantbjerg, 2021).
Both hyperarousal and hypoarousal are common responses to stress and trauma, and they can have significant impacts on an individual’s functioning and wellbeing. Therapeutic interventions often aim to help individuals regulate their arousal levels and find a balance within their window of tolerance to promote emotional stability.
10 Useful Questions for Therapists
Therapists can use a variety of questions to help clients expand their window of tolerance and develop greater resilience in managing stress and regulating emotions. Below, we outline 10 useful questions.
What are some situations or triggers that typically push you out of your comfort zone or make you feel overwhelmed?
Do you notice when you’re approaching the edges of your window of tolerance? What physical sensations, emotions, or thoughts do you experience?
Can you identify any patterns in your responses to stressors? Are there certain coping strategies or behaviors that tend to help you stay within your window of tolerance or that make it more difficult?
What are some activities or practices that you find grounding or calming when you’re feeling stressed or anxious? How can you incorporate more of these into your daily routine?
Are there any negative beliefs or thought patterns that contribute to your emotional dysregulation or difficulty coping with stress? How can we work together to challenge and reframe these beliefs?
How do you currently approach self-care and relaxation? Are there any additional self-care practices or hobbies that you would like to explore to help expand your window of tolerance?
Can you think of a time when you successfully managed a stressful situation without becoming overwhelmed? What skills or strategies did you use in that situation, and how can you apply them to other areas of your life?
How do your relationships and support networks influence your ability to cope with stress? Are there any changes you would like to make in your social connections to better support your emotional wellbeing?
What are your long-term goals for expanding your window of tolerance and building resilience? How can we break these goals down into smaller, manageable steps?
How do you envision your life looking when you have a wider window of tolerance and greater emotional flexibility? What values or priorities will guide you on this journey?
These questions can help therapists and clients collaboratively explore the factors influencing the client’s window of tolerance and identify personalized strategies for expanding it.
By promoting self-awareness, skill building, and goal setting, therapists can support clients in developing the resilience and coping skills needed to navigate life’s challenges more effectively.
6 Strategies for Expanding the Window of Tolerance
Therapists can use various strategies to help clients expand their window of tolerance. Primarily, strategies center around increasing the client’s capacity to manage stress and regulate their emotions effectively. Some common approaches include the following.
1. Psychoeducation
Providing clients with information about the window of tolerance and how stress affects the body and mind can help them understand their own responses better (Wessely et al., 2008).
Psychoeducation empowers clients to recognize when they are approaching the edges of their window and to implement coping strategies proactively.
2. Mindfulness and grounding techniques
Practices such as mindfulness meditation, deep breathing exercises, and grounding techniques can help clients stay present-focused and connected to their bodily sensations (Follette et al., 2006).
These techniques can be particularly useful for regulating emotions and managing hyperarousal symptoms by calming the nervous system and reducing anxiety.
The gift and power of emotional courage
For more information on the importance of grappling with the gamut of emotions individuals can experience, check out the following TED talk by Susan David on emotional agility.
3. Emotion regulation skill training
Therapists teach clients specific skills to regulate their emotions and physiological arousal levels. This may include techniques such as progressive muscle relaxation, guided imagery, or sensory self-soothing activities (Rausch et al., 2006).
By learning to modulate their arousal levels, clients can expand their window of tolerance and cope more effectively with stressors.
4. Trauma-informed approaches
For clients who have experienced trauma, therapists use trauma-informed interventions to address underlying emotional wounds and build resilience. This may involve techniques such as trauma-focused Cognitive-Behavioral Therapy, eye movement desensitization and reprocessing, or somatic experiencing (Vaughan et al., 1994).
These approaches help clients process traumatic memories and sensations in a safe and supportive environment, gradually expanding their capacity to tolerate distress.
5. Cognitive restructuring
Therapists help clients identify and challenge maladaptive thought patterns and beliefs that contribute to emotional dysregulation.
By reframing negative or catastrophic thinking, clients can develop more adaptive ways of interpreting and responding to stressors, which should help them stay within their window of tolerance.
6. Interpersonal skill training
Developing healthy interpersonal relationships and support networks is essential for expanding the window of tolerance. Therapists may teach clients effective communication skills, boundary-setting techniques, and conflict resolution strategies to improve their relationships and reduce relational stressors.
Overall, the goal of these strategies is to help clients develop greater self-awareness, emotional regulation skills, and resilience, ultimately enabling them to maintain a wider window of tolerance.
6 Window of Tolerance PDFs and Worksheets
All individuals will experience trauma at some point in their lives; luckily though, there are numerous evidence-based exercises that therapists can draw upon to help their clients navigate through stress and expand their window of tolerance.
Below, we outline worksheets designed for practitioners to use with clients struggling with trauma, anxiety, and stress.
Coping With Stress worksheet
The Coping With Stress worksheet helps clients build self-awareness and adaptive coping strategies by first asking individuals to identify their emotional and physiological reactions to particular stressors before outlining healthy ways to cope with or reduce stress.
Without self-awareness, individuals will not be able to actively expand their window of tolerance.
Coping: Stressors and Resources worksheet
This coping stressors worksheet can be used with clients to help them identify sources of stress and the resources that are available to them.
Stress is unavoidable throughout life, so enabling clients to identify their available resources and sources of support can encourage them to build positive coping skills.
Growing Stronger From Trauma worksheet
In the growing stronger worksheet, therapists can work with their clients to help them identify the silver linings of a traumatic experience and think about the ways they have grown, particularly by focusing on the strengths they have used and gained during traumatic times.
Interacting With Your Emotions worksheet
In this mindfulness-based exercise, clients are invited to imagine a series of different life scenarios that might occur and what they might feel in each scenario. In doing this exercise, clients can learn that it is safe to have feelings and sensations.
Understanding Your Anxiety and Triggers worksheet
This worksheet helps clients identify which anxiety triggers lead to avoidance. Individuals are first invited to identify a number of triggers before considering how they react to each trigger, the change in behavior it causes, and the sensations it elicits.
Compassion Formulation worksheet
This compassion worksheet is useful for clients who exhibit high levels of self-criticism, as it aims to help develop self-compassion. Individuals are invited to explore the source of their self-blame, shame, or self-criticism; reflect on their key fears; consider their defense mechanisms; and examine their impact on future behavior and the self.
17 Tools To Build Resilience and Coping Skills
Empower others with the skills to manage and learn from inevitable life challenges using these 17 Resilience & Coping Exercises [PDF], so you can increase their ability to thrive.
Beyond worksheets, there are numerous other resources that can be instrumental for therapists looking to help their clients expand their window of tolerance.
Individuals who have experienced trauma can exhibit difficulty attending to their inner emotional and physical sensations (van der Kolk, 2006). Mindfulness is therefore an excellent pathway to help clients engage with feelings.
Our guided imagery article gives an excellent overview of what guided imagery is, why it’s important, and how it can be incorporated into therapeutic practice.
This article provides seven stellar grounding tools and techniques for therapists to help their clients with anxiety and hyperarousal.
This article on post-traumatic growth provides a treasure trove of worksheets (26 in fact!), including worksheets specifically helpful for clients struggling with post-traumatic stress disorder and trauma.
Life is no walk in the park; it is filled with complexity, uncertainty, and suffering. As Susan David poetically states in her TED talk,
Tough emotions are part of our contract with life. You don’t get to have a meaningful career, raise a family, or leave the world a better place without stress and discomfort. Discomfort is the price of admission to a meaningful life.
If stress and discomfort are therefore inevitable, individuals must learn to ride those waves by building effective coping strategies.
Interventions that seek to regulate an individual’s stress response and broaden the window of tolerance can be particularly crucial for promoting resilience, self-acceptance, and quality of life.
Yet the benefits of enhanced emotional resilience are not reserved solely for the individual, but for society too, whereby stronger, more empathetic communities can emerge and flourish.
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Corrigan, F. M., Fisher, J. J., & Nutt, D. J. (2011). Autonomic dysregulation and the window of tolerance model of the effects of complex emotional trauma. Journal of Psychopharmacology, 25(1), 17–25.
David, S. (2016). Emotional agility: Get unstuck, embrace change, and thrive in work and life. Penguin.
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Vaughan, K., Armstrong, M. S., Gold, R., O’Connor, N., Jenneke, W., & Tarrier, N. (1994). A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder. Journal of Behavior Therapy and Experimental Psychiatry, 25(4), 283–291.
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About the author
Kirsty Gardiner, Ph.D. is a Social Psychologist with a passion for using research to power social change. She holds a doctorate in Psychology, a masters in Applied Positive Psychology, and is a registered chartered Psychologist with the BPS. On completing her Ph.D. she taught on the MAPPCP programme for several years. Currently, she is based in the UK as the Research Director at Ardent - a DEI consultancy.
In 2019, 970 million people worldwide were struggling with stress, anxiety, and mental health issues (World Health Organization, n.d.).
In Bessel van der Kolk’s (2014) book The Body Keeps the Score, readers come to grapple with the growing evidence that traumatic experiences leave significant marks on the brain and the body, affecting how an individual thinks, feels, and behaves.
Therapists can use a variety of questions to help clients expand their window of tolerance and 
All individuals will experience trauma at some point in their lives; luckily though, there are numerous evidence-based exercises that therapists can draw upon to help their clients navigate through stress and expand their window of tolerance.
