Succession: Health Crises And The Family

While Succession is widely known as an epic saga of corporate power and media empires, at its core it is a story about family under stress. The narrative is set in motion by Logan Roy’s hemorrhagic stroke, a medical event that destabilizes the family hierarchy and accelerates longstanding tensions around inheritance, loyalty, and control. The series dramatizes how a health crisis reverberates through a family system, revealing unresolved trauma and entrenched behavioral patterns.

The Roy children, Connor, Kendall, Shiv, and Roman, respond to their father’s crisis in distinct ways, reflecting trauma responses that arise from extreme or chronic stress and trauma. These can be understood through the lens of the Window of Tolerance, the zone of arousal in which an individual can manage stress effectively. When stress exceeds this window, people move into dysregulated physiological and emotional states, manifesting as fight, flight, freeze, or fawn.

• Fight Response: Activates to confront or resist a perceived threat. In healthcare, patients may argue with staff, challenge authority, resist procedures, or refuse instructions when feeling powerless. This behavior reflects a need to reclaim control. Kendall embodies fight, confronting his father while simultaneously seeking approval, keeping him in a state of chronic hyperarousal.
• Flight Response: Activates to escape or avoid perceived threat. Patients may avoid appointments, withdraw emotionally, leave against medical advice, or delay treatments. Connor exemplifies flight, disengaging from immediate family conflict and pursuing goals outside the family system, both geographically and emotionally.
• Freeze Response: Patients become immobilized or numb, showing dissociation, difficulty processing information, or flat affect. They may appear distracted or uninterested. Roman demonstrates this response through emotional numbing, risky and self-harming behaviors, and substance use throughout the series.
• Fawn Response: Patients prioritize others’ needs to stay safe, agreeing with providers, minimizing symptoms, or people pleasing to avoid conflict. Shiv reflects fawn, seeking to please Logan, maintain the status quo, and secure her place within the family while negotiating her own role.

Complicating these dynamics is a broader cast of characters, including siblings, partners, and advisors, each pursuing their own goals and interests. These competing agendas test the family system, amplify dysregulation, and intensify conflict, highlighting how a single health crisis can ripple outward, reshaping relationships and surfacing trauma in ways that physicians commonly observe in clinical practice.

For clinicians, understanding these dynamics is more than academic. Health crises often push family members outside their window of tolerance, triggering trauma responses that can complicate decision-making, adherence to treatment, and communication with the healthcare team. Recognizing patterns of fight, flight, freeze, and fawn allows providers to anticipate sources of conflict, tailor interventions, and support both patients and family members more effectively. By viewing families as systems shaped by past trauma, competing goals, and stress responses, clinicians can foster psychological safety, improve engagement, and reduce the risk of exacerbating tension. This ultimately supports your own ability to stay within your Window of Tolerance and subsequently improves the quality of care you can provide during some of the most vulnerable moments in our patient’s and their family’s life.

And for those familiar with Succession, there is an additional lesson in observation: those who learn to read these family systems carefully, understand motivations, and navigate them with strategic attunement may find themself to be the next Tom Wambsgans of the family meeting.