Our culture has a huge problem with separating and atomizing us. This has a huge effect on the general world and an outsized effect on the recovery trauma, I also see a huge impact of eating disorder recovery (there is a high overlap in trauma survivors and disordered eating). We are told that our body and mind are something we have to control, have to be the masters of and this feeds poor self-image and toxic control.
But the truth is we are our bodies is in every way. This is a fact we know now, we can see the way every part of our emotional and mental experiences manifest in physical sensations, in our physiology, in the way we move and in our new ways of imaging of the brain. For those of us with trauma, this understanding is key to help bring empowering knowledge and true healing.
What does disconnection look like, and what does embodied look like?
Often we feel that we have to force our brain to something like somehow we are greater than our brain. But the truth is our brain is us! All of the thought processes we experience are part of us, this doesn’t mean every negative thought is true or intrusive thoughts define you, what it does mean is that we have to work through this and with our brain not against it. We can take back our power by learning what is going on with us and treating our minds with compassion. Failure to do so worsens symptoms that are never dealt with, causes depression to worsen when we can’t manage ourselves. It leads to being paralyzed in a state of spinning without moving, the emotions rule us through our trying to rule them.
As for our body, so much of the culture teaches us that our bodies are something we have to master. “mind over matter/body” type of thinking, this is so not true. We try and outthink and overthink our bodies, become alienated from what it’s telling us. but we can never truly become separated. Instead of trying to white knuckle yourself into recovery we have to inhabit our bodies fully.
Physical health is destroyed when we don’t take time to listen to what our bodies are really telling us. Our nutrition suffers, addictions form and pain that we might be able to handle on our own can consume us.
Not listening to the feelings in our own bodies also limits understanding of trauma. How are bodies reacted in trauma often extends into our adult lives, constantly stressed, shutdown physical processes and fatigue become constant. Certain signals like feeling pain in the genitals can even send us messages of what happened to us.
We over-intellectualize our experiences and disconnect the idea of feelings from logic and understanding, this influences our understanding of self and has seeped into our understanding of philosophy and politics. If we only operate in the left brain mindset of forcing ourselves to think and feel one way we can never truly understand ourselves or be able to regulate leading to behaviours like addiction, disordered eating, overworking, cutting ourselves off from each other and self-harm to try and regulate the pain we are in.
Being in sync with our emotional and physical selves promotes connection, attachment and attunement with others. A healthy culture starts with an understanding of being whole people. This is called embodied recovery, hopefully this can be the start of your journey of full healing.
Neurological & Nervous System Effects of Trauma
Trauma has a real impact on our neurobiology and subsequently throughout our whole body. The mental scars of trauma are in the body. The fact of the matter is all dimensions of our health (social, familial, mental and physical) are important to our well being. Our experiences with child sexual abuse are worked into our whole being and that is seen in our bodies.
Something to keep in mind with this section is that when abuse and trauma happen to young children the effects on the brain and body are more pronounced, this is down to the fact that the brain is not fully developed at birth, far from it, so the younger the trauma it can affect more of the development. The brain is not fully developed until age 23. Chronic and complex trauma also increase the effects on the body and brain.
Trauma shifts what side of the brain is used the majority of the time. The right hemisphere is overactive in those with trauma over the left hemisphere. The right brain is more emotionally reactive and acts more on instinct, the shutdown of the use of the left brain causes a lack of executive function. Meaning our ability to sequence events, think through decisions and translate feelings into words.
Brain Development Over Time & How Trauma Alters It
Notes: This break up is not the only way of viewing the brain others group the sections of the brain differently based on what functions you are considering. Other things like TBI also affect these functions but we are focusing on the trauma caused by events like CSA.
- The Brain Stem and Hypothalamus (reptilian brain) are the only sections of the brain already formed and functioning at birth. These are the most basic parts of the brain that control homeostasis. The mother’s trauma can affect the development as her health and stress can harm the child in utero. Later trauma can lead to dysregulation through neuroplasticity and in children neuron pruning can affect this and lead to dysregulation. Damage to the connectivity of the regions of the also has a huge effect on proper function. Dysregulation in these regions can affect our most basic health and our understanding and connection to the signals our body is sending. Damage here and with connections to the rest of the brain causes problems with the brain connecting to the central nervous system in the spinal column and into the periphery.
- The limbic system (amygdala, hippocampus, thalamus, basal ganglia, and cingulate gyrus) starts to form and start to have influence after birth. Early childhood trauma has huge effects on this section of the brain, it is also highly impacted in all of those who experienced trauma. The limbic system includes the portions of the brain chiefly involved in emotional reactivity, how the survival instincts are directed and our ability to connected emotional with others and function in social networks. One of the major effects childhood trauma has in this group of brain sections is if our brains are allowed to healthily grow and become specialized in forming relationships, co-operation and curiosity or does it become locked in survival mode (what trauma does). It has a huge effect on the fight/flight response. Later trauma can shift the brain and allow it to start to function in a more fear directed way. Due to neuroplasticity means overtime those with childhood trauma can help it be able to work to form better emotional understandings. (we discuss more specific sections of the brain below).
- The above two sections are the emotional brain. It works highly on reactivity, internal patterns, implicit memories and on a kind of “autopilot”. In contrast to the rest of the which functions more orderly and methodically.
- The Neocortex doesn’t start to form till age 2 and is not fully finished until adulthood. Using word effectively, identity formation, abstract thinking, properly mirroring and attachment to others, self-regulation and organization are all managed by this section of the brain. Much of the major functions of cohesive consciousness and identity are solidified by age 6 (sometimes not till 9). This idea of identity cohesion is why severe dissociative disorders like Dissociative Identity Disorder (DID) and Other Specified Dissociative Disorder 1A/B (OSDD-1A/B) can not form after this as this degree of dissociation severing of the sections of the brain can not happen later in life.
- The last section of the brain to fully solidify is the prefrontal cortex and the full pruning of grey matter neurons and the full development of white matter. The prefrontal cortex involves the control of impulses and decision-making. When this section is not fully formed or has been damaged it leads to a lack of control, recklessness, irrationality and irritable behaviour. We go into more detail on the ventromedial prefrontal cortex in the next section.
Specific Regions of The Brain Damaged by Trauma
The major regions of the brain that trauma affects include the hippocampus, amygdala, and ventromedial prefrontal cortex. Cortisol and norepinephrine are two neurochemicals that trauma changes and play a role in why these structures are damaged. The structure of these affected areas can be altered to make the shape and size markedly different to non-traumatized individuals. The connections between these areas of traumatized brains can become distorted so information and stimuli can become warped during the brains normal functions.
- The ventromedial prefrontal cortex is dysregulated and decreases in size after trauma. This region of the brain is used in regulating negative emotions & fear. Dysfunction in the ventromedial prefrontal cortex is key in the hyperarousal symptoms experienced by those with trauma.
- The amygdala is seen to be larger and more active than in non-traumatized people. This change in the size denotes that it will be in overdrive. With an amygdala in this hyperaroused state, it lowers the ability to control emotions and triggers the stress responses.
- The hippocampus is smaller than average and it plays a huge role in memory repression and the problems survivors have with both short and long term memory. Short term working memory is held in this region of the brain, which is why trauma also affects short term memory, but the hippocampus also works to process the memory to move it to the long term memory. One of the things happening in this process is linking all the sensory inputs, actions and emotions into a cohesive retrievable package. With this dysfunction, it can influence why flashbacks happen as it does not process it as a fully integrated memory and you re-experience it. It also plays a role in why some memories are disaggregated (think body memories).
Common Mental Health Conditions Related to Trauma:
- Anxiety disorders: Generalized anxiety (GAD), Panic Disorder, Phobias, Selective Mutism, Separation Anxiety Disorder, and Social Anxiety Disorder (SAD). The change in the way the body understands arousal and fear predisposes the victim to anxiety.
- Borderline Personality Disorder (BPD): BPD is based heavily on dysregulation and attachment difficulties which are connected with trauma, especially childhood trauma. A study in The American Journal of Psychiatry showed that childhood trauma is associated with BPD, 81% of patients with BPD had early childhood trauma.
- Depression: Including Major Depression and persistent depressive disorder. An understandable outcome of events that cause despair and are quite honestly depressing events.
- Dissociative Identity Disorder (DID): DID is caused by severe chronic and complex trauma before the age of 9.
- Eating Disorders: Including Anorexia nervosa, Binge eating disorder, bulima nervosa and other specified feeding and eating disorders (OSFED). Connected to the loss of control and dysregulation trauma causes. Within Sexual abuse survivors things, conditions are also linked to things like trying to be as sexually appealing or unappealing to possible abusers.
- Insomnia: The dysregulation of arousal effects the ability for the body to reach a resting state and then recovery from it. Fear and triggers related to nighttime, sleep rituals, or the vulnerability of sleep can also prevent sleep. Fear of nightmares is also important.
- Other Specified Dissociative Disorders (OSDD): Like DID they OSDD forms from chronic childhood trauma.
- Post Traumatic Stress Disorder: Trauma is part of the diagnostic criteria and formation of this disorder.
- Substance Abuse Disorders (SUD): Substance abuse is high in those with PTSD to self manage the symptoms of PTSD and often can form into a health problem
- The proposed Disorders of Complex-Post Traumatic Stress Disorder (C-PTSD) and Developmental Trauma Disorder (DTD) both have traumatic experience(s) as part of their development in patients.
Another effect of trauma is a raised susceptibility to addiction and self-injurious behaviours. This is linked to trauma disrupting the normal function of the nucleus accumbens (pleasure centres of the brain) and the regulation of dopamine and the state of chronic hyperarousal brought on by trauma. This is important because along with the needs to punish oneself, warped self-image, conditioning by other people, need to forget or numb out, manage anger or other circumstance based and cognitive distortions associated with addiction the physiological changes predispose traumatized people to suffer from these problems.
The “Fight, Flight, Freeze, Fawn” Response & Trauma
Along with the amygdala and hypothalamus the spinal column, pituitary gland and wider nervous systems are affected by trauma and this changes the way the hormone system runs throughout the whole body, this highly linked to the states of hyperarousal. The important chemicals involved in this process are cortisol, norepinephrine and adrenaline. Chemicals involved in The previous brain structure changes are in a loop state with this function.
These effects highly change how the autonomic nervous system functions. Specifically, the Fight & flight response which is the part of the sympathetic nervous system response. The sympathetic nervous system is part of the autonomic nervous system, the involuntary functions of the nervous system. It is the way our bodies handle input that we read as fighting and/or a threat.
The hyperarousal leaves in people constantly in a state of stress which can set people on edge leaving them in a place where they can be easily triggered into a panic state, a state of anger, flashbacks and other strong emotional reactions based in trauma.
Extremely sensitive sensory responses are also common.
Types of Stress Responses:
Fight Response: The urge to push back against the aggressor is what is happening. It can be as simple as punching & kicking a literal fight. It can also refer to verbal fighting as well as more abstract fighting depending on the situation. But it’s an aggressive response.
It tends to be most common, and effective, during a one-off event like an attack. It tends to be less common in child victims of assault as they are literally much smaller than the attacker and not likely self-defence masters. Long term abuse also tends to weaken this response as it is obviously not being effective so changing response can happen. It might not entirely fade but become conditional or something that someone starts with this response during an episode of abuse but then stops and switching to one of the others.
Flight Response: This is essentially running away. A pretty effective and common response to all kinds of stimuli. Running away can work really well, this is often commonly connected with some degree of the other responses. Running away keeps you from being hurt if it works, and is a pretty primal urge to not be hurt. Though running does not mean “run” only. It includes crawling or any other way someone tries to escape. Flight Responses, unlike fight, is common across all groups. But like Fight it can fade during long term abuse.
Freeze Response: This is just as it sounds, a person expiring this will go almost or completely still. From the outside, it can often look like “deer in the headlights”. Sometimes a person goes completely stiff or might go “limp” or a “ragdoll”. It can often involve dissociation, or the ability to disconnect from the world around you. This response is starting to be understood and mentioned more often which is very good. It’ something very important for people to better understand to combat a lot of the “well why didn’t she Fight/leave” rhetoric around abuse and sexual assault. Also to help people who are confused about why they did freeze up or felt like they wanted to scream but couldn’t.
Fawn Response: This is also called the “please”, “feign” or “submit” response. This is essentially just doing what the assaulter or abuser wants you to do. This isn’t a response that happens with many kinds of stimuli like an earthquake or fire. It only happens when someone is being assaulted or abused. It is often the victim trying to be exactly what the abuser wants them to be. It is a survival response like the other three, it’s an attempt to avoid being hurt and to try and often get affection/love from the abuser. The Fawn response is mostly seen in children as this response is not seen in most adults due to the way to the brain has developed and the social development. Though a version of this can be seen in long term abuse of adults in domestic violence situations.
Lower Nervous System Changes:
The nervous system is important to understand as the function of the whole system is changed not just the brain. Hyperarousal and over sensitization start in the amygdala and prefrontal cortex but overtime the rest of the nervous system is altered. The spine is the lower part of the central nervous system, and the peripheral nervous system is the rest of the nerves extending out into the body.
- The spine’s connection to the brain stem can be altered as discussed above. This means that the signals can often be read as more of a threat then they are. The brain can also under respond, or not even read signals at all.
- Management of involuntary functions can be altered by trauma. The stress hormones and neurotransmitters that alter the brains’ ability to regulate also affect the spine’s regulation without the signals reaching the brain.
- The Parasympathetic nervous system responses also start in the spinal cord. The same dysregulation we discussed in the above section carries into the spines responses.
- The peripheral nerves become hypersensitive because trauma has caused everything to be read as a threat.
- The dysregulation extends into all of the nerves which means the entire body feels the trauma. Stress reactions like pain, sweetings, muscle tension and more are dysregulated at the nerve level.
- Pain perception can be affected, which is linked to the overlap with conditions like Fibromyalgia.
- This can be part of general sensory processing issues those with trauma can experience.
The Body Carries Our Trauma Too, Be Kind
The main ways trauma seeps into the rest of the body is cortisol, norepinephrine and adrenaline. Cortisol is good on in short bursts as it allows the body to protect itself and manage short periods of extreme stress. It’s a huge part of the Light or Fight response. Long term periods of high stress can cause cortisol to become toxic and never fully stop called cortisol drip. This chemical is meant to keep your body in Fight, flight, freeze and feign mode even when you don’t need to be. This becomes a state that radically affects the limbic system. The ability to calm down naturally is compromised and means that even the positive effects cortisol does have started to be taxing and maladaptive.
- Toxic cortisol effects: Suppressing the immune system, heightening inflammation, slowing digestion, disrupting, blood sugar regulation and creating sensory hypersensitivity.
- Toxic adrenaline effects: increase blood pressure, redirect blood flow, change the metabolic process, raise blood sugar, disrupt the ability to sleep, raise heart rate and disrupts normal heart rhythm.
- Toxic norepinephrine effects: Creates conditioned fears (can influence triggers), insomnia, mood dysregulation & energy modulation.
Health Conditions Linked To Childhood Trauma :
- Angina Pectoris
- Chronic Fatigue Syndrome (CFS)
- Cyclical Vomiting(and other unspecified vomiting)
- Decreased immune function causing slower healing times and more infections
- Dysautonomia ( a chronic dysfunction of the nervous system which has many effects)
- Executive Dysfunction
- Gastroesophageal Reflux Disease (GERD)
- Gastrointestinal Problems
- Heart disease
- Sensory Processing Disorder (SPD) (Extreme sensitivity to light, noise, touch, sensory overload etc)
- Severe allergic reactions
- Stomach Ulcers
- Hypertension (High blood pressure)
- Inflammatory Bowel Disease (IBD)
- Intestinal Malabsorption
- Irritable bowel syndrome (IBS)
- Memory and cognition issues (short term memory, issues relating to the maintaining or accessing of memories, and brain fog)
- Multiple Sclerosis
- Obstructive pulmonary disease
- Osteoarthritis & Osteoporosis
Not only does this relate to diagnosable health conditions, but it can also cause symptoms that don’t work out to a discrete diagnosable condition. Including fatigue, heart palpitations, chronic pain, psychogenic seizures, headaches, nausea, syncopal episodes, spasms, painful digestion, paralyzation and other symptoms. These feelings are called somatic symptoms of mental illness, in the case, it’s also part of the wider dysregulated body systems.
Sometimes these might be attached to the diagnosable conditions that are ignored and just called “anxiety” or “stress” dismissively or even if it is purely psychogenic we know that they are real and important. That it still needs real attention because our brains are not disconnected from our bodies. Sometimes these can fall in what is called conversion disorder(s) and sometimes can act as referred pain (when one part of the body is injured/sick but the pain is felt in a totally different part of the body.
Disordered eating also plays a role here, severely disordered eating rather linked to a discrete eating disorder or not the behaviours used can cause physical damage to the body. So while there is ultimately a psychological root to the problem there has to be medical attention paid along with emotional support.
Bulimia: Acid damage to hands, anaemia, chronic gastric reflux, chronic involuntary vomiting, dehydration, diarrhoea, dry skin, electrolyte imbalance, fainting, haemorrhoids, irregular heartbeat, malnutrition, menstrual issues, pregnancy complications, oesophagal damage up to rupturing, and tooth decay.
Anorexia: Acid Reflux, amenorrhea, anaemia, brittle nails cavities, constipation, cramps, difficulties concentrating, dizziness, dry skin, enamel erosion, fainting/syncope, fatigue, hair loss, heart damage, hormonal irregularities, insomnia, irregular heartbeat, irregular periods, lanugo low thyroid levels, low potassium, low blood cell counts, low body temperature, low blood pressure, malnutrition, muscle wasting, poor wound healing, swelling around area of salivary glands, swelling of feet, weakened immune system, yellowing of skin.Anorexia:
Intergenerational trauma refers to the way that a parent or guardian who has suffered trauma passed this down to those they raise, their emotional struggles and the way the act of their history gives the child some of the same issues they did. Intergenerational trauma also has a social portion in the way that groups that suffer historically continue to pass the struggles within family structures and because the culture and systems have not repaired themselves either.
We have even started to see that the way genes are expressed and past down can possibly be affected by trauma. Mostly this has been shown in the studies of epigenetics. This creates a physical manifestation of intergenerational trauma. The health problems from chronic stress are passed down on a cellular level.
As we discussed in the brain development section before a child is born the health and therefore trauma of the mother is passed down to the kid because the traumatic changes in the mother’s body are passed into the baby throughout gestation. Therefore the health of the child can be influenced including brain development and other organs. Things like addictions as well can affect the health of the baby.
However, parents who heal and have their own resilience become a source of strength for their kid and allow them to grow up stronger. A resilient family can raise resilient kids. The parent’s trauma doesn’t have to hurt the kid, even with the involuntary health issues that can be passed down. Parents who healed give the kids strong attachment, healthy attunement, a physical/emotional refuge, better self-esteem and self-regulation skills which are some of the best ways to prevent traumatization.
We’ve seen in studies ( Including Phenotype of Blood Lymphocytes, Enhanced Cellular Immune Response in Women With PTSD Related to Childhood Abuse, in PTSD Suggests Chronic Immune Activation, and Epigenetic and Immune Function Profiles Associated with Posttraumatic Stress Disorder) that we can see changes in the immune profile of people who have experienced childhood trauma and have PTSD. In women with incest, they noticed that their immune systems were off balance and hypersensitive leaving them open to autoimmune disorders as their bodies are primed to read more things as threats and misread threats. On a cellular level, the ability to understand threats has shifted.
One way people understand childhood trauma’s effects on health is the Adverse Childhood Experience (ACE) scores model. These studies looked at large samples of people and had them mark negative childhood experiences, things that are generally traumatic. Ace Scores covers issues of exposure to violence, child abuse, sexual violence, loss and parental instability (mental health, divorce, incarceration).
Ace scores are shown to be at the route of major depression. The prevalence of chronic depression in populations of highly traumatized people is greater than those with trauma. 66% of women & 35% of men with an ACE score of four or more have chronic depression compared to the 12% rate of depression of those without traumatic experiences.
The studies show that having ACEs negatively affect health and the higher your score (the more experiences of trauma a person had) the worse your health outcomes were common. Multiple ACE’s were common as they tend to be interrelated events. The worse outcomes with higher scores make sense as complex and chronic trauma has larger effects on people then singular events of trauma.
Health risks associated with higher ACE scores as compared to a score of 0:
A score of 4 :
- 2X risk of having cancer
- 2.5X risk of chronic obstructive pulmonary disease
- 2.5x risk of Hepatitis
- 4.5x rise in rates of depression
- 12x rise in Suicidality
- 400% rise in emphysema
- 700 % rise in alcoholism
A score of 6:
- 5,000% increase in attempted suicide
- 4,600% greater chance of IV drug usage
- <5% chance of dying from the 10 leading causes of death in the US.
A score of 7:
- 3x rise of lung cancer
- 3.5x rate of Ezcheemic heart disease
So what does being in sync with ourselves actually mean?
When we find our thoughts and emotions siraling out control, it’s time to respect our struggles, not fight them. There is no use in telling ourselves to just “stop it” because that never works, instead take a step back and ask “what am I feeling?”, “what triggered my thoughts to come to this point?” and “what do I need to cope with this.” Becoming connected and living with yourself in a state of respect will allow better emotional and impulse regulation, it makes using coping skills easier and can counteract the lack of ability to communicate with others.
Self-concept, control, empathic and emotional regulation will improve with this connection to our brains as not the enemy.
Listening to the physical ways our bodies are dealing with, holding and processing the trauma we’ve been through. Listening and respecting our physical selves and the way we feel we can learn to care for our health. Physical health and mental which we now know are not that different.
Living in the body mindfully is the key to learn to feel safe again and learn self-regulation. The constant fire alarm trauma sets off can not be stopped by talk alone, the full extent of the trauma is only heald through letting yourself feel safe on a visceral level, not just intellectually.
Embodied recovery comes through awareness of yourself as whole, not just the different parts that make you up. When you feel at home in your body and can recognize where you in thoughts and space trauma will lessen it’s grip on your life. Trauma is not just the words to describe events, its a full body changes, sounds, emotions, pain and confusions we have to understand and live as such.
Therapists are finally starting to focus on the truth of neurological changes, physical feelings, attachment to others and dysregulation. So thankfully new options for recovery are becoming ever more present.
Here are some examples (i have plans to make future posts on these latter)
- Art Therapy
- Dance Therapy
- Eye Movement Desensitization and Reprocessing (EMDR)
- Equine Therapy
- Internal Family Systems (IFS)
- Martial Arts Therapy (MAT) including: Tai Chi, Aikido, or Karate
- Movement Therapy
- Music Therapy
- Play Therapy
- Self-Defence Training
- Somatic experiencing
- Sensory motor processing
- Theatre therapy
- Trauma Informed Fascial Manipulation
- Trauma Informed Message
- Trauma Informed Mindfulness
- Trauma Informed Yoga
It’s important to understand that the body holds and understands trauma to the same degree as if not more than the conscious brain. Our minds are more layered and complex then we are ever told. Knowing this can help us gain power over the pain and confusion we feel.
Understanding and knowing what we are experiencing is the first step to being able to heal it. It’s just the start of the work of course, but having a foundation to move forward means we can build a solid structure.
It’s also key for a more effective treatment for an abuse survivor, to treat people dealing with chronic illness and even change part of our public health programs.
Hope this helps all of you,
-Admins 1 & 2
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