In our December 20 webinar, Support After Abortion CEO Lisa Rowe, LCSW, presented the window of tolerance as a tool we can apply for ourselves and our clients to assess how we handle stress and identify how it impacts us. She discussed what we can do to gain perspective and addressed skills and strategies we can use to restore calm and respond in effective, healthy ways to the demands and stresses of everyday life – and the holidays. She also unpacked the role trauma plays in our stress responses and how stress responses impact abortion experiences. She offered tips and techniques we can try when facing holiday stresses this month. 






Lisa began by emphasizing how important it is for us to name things that are going on in our lives and the lives of those we touch in order to have a sense of control. 






“Envision yourself in a submarine,” Lisa said. “As it gets darker and darker, all you can see is what’s in front of you.” She described the limited perspective in this situation and made an analogy to where we are – or where our clients are – and the anxiety and insecurity surrounding the unknown.






Then she asked participants to envision themselves on the top of a building. “Notice all the things you can see,” perhaps an airplane overhead, an ambulance racing down the street to an accident, a band playing outdoors, people walking, etc. “Imagine what a larger view and perspective would feel like” compared to the restricted view from the tiny submarine window.

Lisa then invited attendees to share in the chat feature their ideas of what that would feel like. Responses included that it would feel freeing, empowering, like being able to breathe deeply. One person wrote, “Exciting! From the building top all possibilities are laid out before you…exploring and adventures await!”






Lisa then segued into a discussion of the window of tolerance, which is a tool for examining our level of and responses to stress. She walked through the window of tolerance graphic illustrating how stress and trauma shrink our window of tolerance, what it feels like as we move into dysregulation and hyperarousal or hypoarousal, and how tools and training can expand our window of tolerance. 

“When stress, when trauma, when lived experience is causing pain in our life,” Lisa said, “Our ability to see everything, our ability to understand it, our ability to live through it in a healthy way begins to collapse.”

“That’s our goal today – what could you implement today for yourself and for those around you to bring a bigger scope, a bigger understanding,” Lisa shared. “Because when we can see everything that’s going on, the ability to make different decisions, the ability to see things that we couldn’t see [expands from the limited perspective] if we were only looking at it through that little submarine window.”


Lisa dove into awareness checklists for assessing symptoms of hyperarousal and hypoarousal – when our flight or flight or freeze symptoms kick in and may become out of control. She offered scenarios and client examples to illustrate the concepts. 

When experiencing these types of symptoms, Lisa recommended asking ourselves and our clients, Does this emotion really match what’s going on? If not, she encouraged identifying the reason behind a more intense reaction.










Lisa encouraged attendees to share what they do to help themselves or their clients to find a more balanced and less reactive space. Suggestions included deep breathing, using grounding tools, taking a timeout, working to stay in the present, body awareness, repeating a calming phrase like I’m safe, I’m okay

One provider said, “with clients we take a few breaths and change focus. We begin with questions that will encourage the client to be mentally and emotionally present. From there, we encourage the client to share pleasant experiences and guide them to the difficulties that trigger them to attempt to talk about it in a constructive way.”

Another advised, “Hear them,  acknowledge their feelings,  show concern and empathy.. say I’m sorry you are going through this.”












Knowing how to recognize your window of tolerance is crucial to being able to self-regulate and bring yourself back inside your window of tolerance when you notice it is shrinking and you are moving into dysregulation. Lisa addressed four steps to follow in this process:

  1. Pay attention to your symptoms – Listen to the noise in your mind and the feelings in your body.
  2. Identify symptoms you experience – For example, you might realize that the sick feeling in your stomach isn’t due to something you ate, but rather it’s because you’re feeling angry or sad.
  3. Identify your distress level – Ask yourself, Is this stressful feeling a 1 or a 10?
  4. Identify the cause – Ask yourself what’s at the root of your distress. For example, you’re sitting at the dinner table and Uncle Bruce starts picking a fight with someone, and you feel your stress level rising. “You feel scared. Ask yourself why?,” Lisa said. “Maybe you realize I’m scared because Uncle Bruce is having one of his outbursts, and I’m scared he’ll yell at me.












Lisa talked about various factors that cause our window of tolerance to shrink or expand. For example, our window of tolerance shrinks when fears and negativity rob us of feeling calm, cool, collected, and connected. Using self-soothing tools, positivity, and making new choices are some things that we can use to expand our window of tolerance and regain our equilibrium.

In the scenario with Uncle Bruce, Lisa suggested that to get to the top of the building, your first step would be to take a deep breath. Then consider your alternatives. “You don’t have to stay frozen in the dining room just tolerating his outbursts,” she said. “You might tell yourself I don’t have to be around Uncle Bruce. I can move to a different room, play with the kids, or leave the party.” 

She advised, “connect with yourself, understand why you feel frozen, and give yourself permission to see what other possibilities are there for you.” 

“For any situation,” Lisa continued, “Listen to yourself, connect with yourself, know what’s going on, and climb to the top of the building.”

“When you give yourself the space to be able to see things more objectively on top of the building, your ability to have more tolerance and handle the situation grows,” Lisa said. 

“The whole goal of handling our stress is to move from being able to see that moment or that experience through the submarine window to being able to get on top of that building and expand ourselves” using your soothing tools to feel more in control, regain your perspective, and move forward. 

“And just to reiterate,” Lisa added, “what’s going to shrink it are things that are our traumas, our triggers, our stressors.



“Our stress responses impact abortion experiences,” Lisa explained. She asked attendees to imagine various scenarios that clients might experience over the holidays and how to prepare clients for the resulting increased stress they might feel and to plan ahead how to handle stressful situations. 

Lisa gave an example in which a client who experienced abortion a few years ago, might find themselves suddenly reliving those memories when a family member shares their ultrasound picture. “All they can do is breathe,” Lisa said. She described their struggle to handle the dynamic of everyone’s joy and expectations and said, “Their window of tolerance just got sucked in – shrunk.”

She encouraged providers to talk with clients before the holidays for how they can help themselves climb on top of the building and regain perspective and calm. She advised doing the same thing for ourselves.





Q. What is your advice about sharing our perspective when someone talks about getting an abortion?

A: “Often we get asked about our perspectives, agendas, or belief systems. I urge people to display as much compassion and [lack of] bias as possible,” Lisa said. “My goal when someone is exploring the decision of abortion and is looking for support,  is always to stay as neutral as possible and to explore every angle. I want to get the client to the top of the building and ask them to do an inventory of what’s going on in their world.” She continued, “I never want to stop at my building and say Hey, this is how I feel about abortion and this is what I want you to do. Lisa added that if someone asks her opinion directly, “and it seems appropriate and healthy for me to be able to share, I am very careful about that. I might say I have met many men and women who have been hurt by abortion, so this decision has a lot of consequences.” Lisa explained that she encourages them “to explore before making this decision. That’s how I allow for my opinion to be heard, but not in a judgmental way.”

Q. I’m anticipating a painful situation with relational dynamics and sibling comparisons this holiday because one adult son is going to announce they’re expecting a baby, while another has been trying for many years to get pregnant.

A: Lisa advised that “the best scenario would be to get in front of this” and have a conversation about the anticipated announcement beforehand with the son who is struggling. 

Q: I haven’t told the struggling son because I’m trying to honor the expecting son’s desire to announce their pregnancy.

A: Lisa encouraged people to be prepared after such a reveal or issue to start a compassionate conversation afterwards with the struggling person by asking “What was that like for you?”

Q. Can cultural differences affect the window of tolerance?

A: “Religious, political, cultural perspectives – anything that can constrict your perspective can affect the window of tolerance,” Lisa said. “Remember those things are about the other person,” she continued. “Don’t let it shrink your window of tolerance. Stay on the building top.”

Q. Can the window of tolerance be applied to conflict resolution?

A: “Yes. If you notice your window of tolerance is getting smaller,” Lisa said, “just ask for a timeout. You can say This conversation isn’t going to end well. My vision is getting blurry and I can’t see everything I need to see right now. Can we take 30 minutes and come back to each other?

Q. Is there a connection between trauma and the window of tolerance?

A: “Yes. Trauma is a major root to our ability to get curious when we’ve had a really serious situation happen to us,” Lisa said. She told a story about a client who has been unable to move to the top of the building after her parents divorced. She had been very close with her dad, so when she learned about his affair, her world with him as her confidant and hero fell apart. She lost her ability to trust. She can no longer connect with her dad or the woman whom he married. And now her mom is getting remarried. The rest of the family has moved on, but she’s still stuck where she was back when she was 12 years old.

Q. How do we engage in conversation when a client seems to be shutting down?

A: “My favorite thing is to name that,” Lisa said. “I’ll say I noticed you’ve kind of shifted in the last 10-20 minutes. Have you noticed that? Would you like to tell me about that? or What do you think is happening?


Q. Is taking time to step aside and regroup the same as dissociation?

A: “No. Disassociation is a defense mechanism our brain uses to lift us out of a situation,” Lisa explained. “Separating from or leaving a situation is a coping skill. It’s saying I don’t have the skills in this moment to be able to handle or walk through this situation, so I’m going to take a break. It is a way of feeling responsive and empowered – making a choice to step away. And that’s healthy.” On the other hand, Lisa said, “If we’re thinking Holy cow that’s happening again and take off – that’s running; that’s a defense mechanism. So, they’re very different things.”



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