Trauma and the body: Part 1

Why a post on Trauma and the Body?

Despite the devastating effects trauma has on psychological well-being, trauma is a highly physiological state. Body memories can occur, and our Autonomic Nervous System gets re-programmed. This can lead to physical illness, hyper-vigilance, hypo-vigilance and impair our ability to function. Research has also shown that the front brain (the rational part of the brain- also associated with language, abstract thought and decision making) shows a lot less activation during a stress response. This means that the back brain (the instinctual which also controls automatic functions of the body) is more active- during a traumatic stress response: we switch to instinctual/ survival mode. Additionally, as trauma has such a profound effect on the nervous system, a variety of physical illnesses can occur (an increased risk of heart disease, IBS, cancer, breathing difficulties and amongst many others).

Distinguishing Between ‘Bad Experiences’ and ‘Traumatic Experiences’.

We can’t process trauma in the same way we process positive, neutral or bad experiences. To define the distinction between a bad experience and a traumatic one, we can say that traumatic experiences cannot be talked about, remembered as well, felt as well and stored in their correct place in history like we can with bad experiences. Trauma overwhelms the individual and the experienced helplessness shuts off the rational mind and engages the ‘flight, flight or freeze’ response. What is considered as an overwhelming experience can vary between individuals, this is true also in regards to situations which people feel helpless. Common traumatic experiences include: accidents, sexual and domestic abuse, neglect, violence and war. Some of the overlooked causes of trauma are: being bullied, emotional control/manipulation, surgery, loss and bereavement, disrupted family settings.

The Body’s Response to Trauma- The ‘Fight, Flight or Freeze’ Response.

To understand the response to Trauma, it is worth taking a brief look at the Autonomic Nervous System (ANS). The ANS has two main branches- the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS). These two systems are working in conjunction with each other, when one branch activates, the other decreases to complete current tasks before equilibrium is restored. The PNS also has two main branches which I will elaborate on later. First, let’s take a look at the SNS.

The Sympathetic Nervous System- Fight or Flight

When the SNS is highly activated, the we are said to be in the classic ‘Fight or Flight’ survival mode. Here, as mentioned, the prefrontal cortex is under-activated: the rational mind is not in control, we are literally running on instinct. In this state, we are mobilised: our heart rate can increase, blood rushes to the muscles.

As a species, this has been crucial to our survival. We are ready to run if we need to run, ready to fight if we need to fight. It prepares us for action, however, when the system is activated highly the rational brain is significantly low in activation: the evolutionary origins are “stop and think… and you are a prey animal’s dinner”. We are literally running on instinct in this mode.

When fight or flight is successful, our nervous system can calm down, regain homeostasis, and we start to feel safe and relaxed again. However, if we are overwhelmed highly or repeatedly (like in trauma) we can become conditioned to this threat response and re-programmed to live in fear. This is made worse due to how the mid-brain scans the environment for threat and alert the nervous system of danger before the conscious mind can tell what is happening (experiencing fear & anxiety whilst having no idea why and can instigate trauma memories). Over activation of the SNS is often associated with anxiety disorders.
If fight or flight is unsuccessful, we can drop into freeze mode (Hypo-arousal), our bodies are ‘playing dead’.

The Parasympathetic Nervous System- Freeze

The PNS also have two branches (myelinated and non-myelinated). When the non-myelinated branch of the PNS is activated we enter the “freeze” mode. Here, we are immobilised. For example, our breathing can slow down, movement significantly decreases, heart rate decreases, pupils constrict, our blood can divert away from the surface of the skin and we go pale. We quite literally flop, a state of terror- we are literally, scared stiff.

This is also witnessed in animals in the wild. Sometimes, animals would lose interest when their prey plays dead. It is a process we do not control, it is automatic response when our systems for coping are completely overwhelmed and we see no way of escape.

Again, it is also witnessed in animals that when threat has gone, animals can restore balance and go back to normal. What is different for humans is that we become stuck. Other ways this system helps us is by numbing and dissociation and is associated with dissociative disorders. It is a protective measure which is supposed to help us in threat, and it can work and if it worked in the past it can become habitual. Like the behaviours which result from SNS activation, they are adaptive attempts at survival. This issue for trauma is when we are conditioned to respond a certain way, even when threat is not there. In trauma, we perceive threat, real or imagined, and our emotions, thoughts and behaviours are no longer adaptive but interfere with life and our ability to cope.

The Parasympathetic Nervous System- Rest, Digest and Repair

When the myelinated branch of the PNS is activated, we are in the calm zone. Our heart rates and breathing are normal, our pupil size is regular (in accordance with light conditions), we feel safe and are optimised for social engagement. Here we are not anxious or dissociative, we are calm, and our bodies are able to rest, digest and repair itself. This is the zone we like to be in ? well, that’s not strictly true, sometimes we enjoy healthy levels of stress such as in sport or work, as long as we can regulate ourselves and come back here at the appropriate time, all should be well ? well, unless we are ill ☹

Successful recovery from trauma, will include learning how to spend most of our time in this Zone, and learning to return to it when knocked into Hypo or hyper-arousal.

There will be more on trauma, the Autonomic Nervous System and the body coming in later blog posts.