10 things to understand about TRAUMA.

The chances are, if you’re reading this, you or someone you love has experienced trauma.

It may be new to you, and you’re overwhelmed by conflicting, confusing information.

Or trauma may have been part of your life for many years, and you’re still walking the long road of understanding and healing.

Either way, I hope that what I’ve learned over the past 15 years — walking alongside my daughter, who lives with Complex PTSD (C‑PTSD) — offers you some clarity and comfort. My professional study and personal experience have brought me to a deeper understanding of what trauma truly is, and the profound effect it has on every aspect of the human body.

If you are suffering from trauma, I hope you come to realise that:

• The feelings, emotions, and reactions tumbling inside you are driven by a brain in panic.

• You are not broken.

• It is not your fault.

• You are not weak.

If you are watching someone you love struggle, and you feel pulled into the chaos of their world, I hope I can help you understand what is happening for them — and how much your presence, patience, and acceptance matter. You can make a difference. You are part of their healing.

Trauma has become a bit of a buzzword lately — sometimes used too loosely, sometimes misunderstood entirely. Many doctors, teachers, lawyers, and politicians still don’t fully grasp what trauma actually is. You may hear people say, “It was so traumatic.”

Often, it wasn’t.

It may have been distressing, sad, frightening, or even horrific — but not traumatic in the clinical sense.

The word trauma has earned the right to a deeper, more precise understanding.

Gabor Maté (2001) suggests that our evolving understanding of trauma may represent one of the biggest shifts in how we approach psychological, psychiatric, and even physical illness in our lifetime.

So, what do we know?

1. Trauma is a fear response that becomes “stuck”.

2. Fear becomes stuck in immature or fragile nervous systems.

3. The source of the fear response is not always obvious.

4. Trauma can be classified by the nature of the event.

5. A “stuck” nervous system changes the brain.

6. These brain changes alter the psychological and social self.

7. These brain changes also alter the physical body.

8. Traumatic memory sits just beneath the surface, waiting to be activated.

9. Faulty brain pathways form and become learned patterns.

10. The traumatic response can be switched off — healing is possible.

    
    

Let's look at each of these.

1. Trauma is a fear response that gets ‘stuck’.

At its simplest, trauma occurs when the human fear response — the system designed to protect us from danger — does not switch off after the threat has passed. Instead, it stays activated in the mind and body, sometimes for a lifetime.

All trauma begins with fear.

The fear response is normal, necessary, and deeply human. It alerts us to danger and prepares us to survive. When the body senses threat, the brain triggers a cascade of responses that mobilise us to fight or flee. Once the danger passes, the system is meant to stand down, and the body returns to balance.

But when the nervous system is unstable, overwhelmed, or not fully developed, it can’t reset.

It keeps refiring.

It keeps sounding the alarm.

It behaves as though the danger is still present, even when it isn’t.

This is trauma.

The nervous system becomes flooded with the energy that was summoned to protect us — energy that now has nowhere to go. It becomes trapped, like a short circuit, and begins to rewire the entire system. The very responses designed to save us begin to harm us.

We become stuck in trauma mode — hyper‑alert, overwhelmed, unable to regulate emotions or make sense of the world. The brain draws on every resource it has to try to calm itself, but a brain in survival mode is not easily convinced to stand down.

Eventually, when the system can take no more, it overloads.

The short‑circuiting, the fizzing energy, the constant alarm — it all erupts like a lightning strike, and the person experiences a traumatic episode: a complete nervous system overwhelm.

2. Fear only gets “stuck” in immature or fragile nervous systems

The fear response is not meant to get stuck. That is not how the human body is designed to work.

Most adult nervous systems are robust and mature enough to recognise fear for what it is and then switch the fear response off. A mature nervous system can “hover” above the moment, observe what is happening, and allow the emotional and rational parts of the brain to communicate. This capacity to adapt, reflect, and make meaning creates resilience — and resilience reduces the likelihood that a frightening event becomes a traumatic one.

But immature, developing, or insecure nervous systems cannot do this.

• They misread danger.

• They cannot step back and see the bigger picture.

• They cannot reframe the experience or rewrite the story of what was lost — safety, control, certainty.

• They cannot process negative memories in a healthy way.

These vulnerable nervous systems are most often found in children, and in adults whose nervous system development was disrupted during childhood.

Like most human conditions, nervous system development is shaped by both genetics and life experience. Some people are naturally more sensitive or reactive, but the greatest influence on nervous system maturity is what happens in childhood. Trauma, stress, instability, or unmet emotional needs can interrupt the development of strong, stable neural pathways.

A simple way to imagine this is to picture your nervous system as a beautiful crystal bowl, partly filled with still, clear water. Perfect in every way.

Each trauma is like a pebble dropped into the bowl.

The first pebbles fall before you are even born.

As you move through life, more pebbles — and eventually stones — are added.

The water level rises.

One day, it reaches the top and spills over.

The bowl always had the potential to overflow, but it was the accumulation of pebbles and stones over many years that caused the spill.

When our bowl overflows, we show symptoms of physical or psychological illness.

And once the overflow begins, it continues until we remove some of the pebbles, stones, and even boulders.

The human body can withstand enormous strain, but every stressor is stored somewhere. Over time, the buildup becomes too much, and the system cracks.

Research suggests there are two major risk factors that disrupt the development of a healthy nervous system in children:

1. Adverse Childhood Experiences (ACEs)

These include physical, sexual, or emotional abuse; neglect; exposure to addiction, mental illness, domestic violence; parental separation; or incarceration.

Too many ACEs — too early, too intense, too prolonged — overwhelm the developing nervous system and impair its ability to mature.

2. Attachment to caregivers

Attachment theory tells us that children have seven core attachment needs that help the nervous system make sense of the world:

• I am valued

• Someone is interested in me

• I can be with myself

• I experience and express delight

• Someone has my back

• I heal hurt and wrongs

• I can let go

When these needs are not met, children may experience fear, abandonment, mistrust, guilt, and insecurity — all of which disrupt nervous system development.

It’s important to remember that the human nervous system is remarkably resilient. Many people grow up without secure attachment, or with significant childhood fear, and still develop mature, stable nervous systems. Protective factors — love, connection, community, temperament, supportive adults — help reprocess stored fear memories and strengthen the system.

But for some, the balance tips the other way.

They enter adulthood with an immature or fragile nervous system, leaving them far more susceptible to trauma when they encounter frightening events.

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3. The source of trauma is not always clear

Trauma is deeply personal. What traumatises one person may not affect another in the same way.

We often associate trauma with sexual assault, abuse, neglect, or violence — and these can certainly be causes, especially in single‑event trauma like PTSD. But many sources of fear are far more subtle or even invisible.

A child from a loving home may still experience trauma from:

• separation from a parent

• bullying

• divorce

• moving homes

• feeling unseen or misunderstood

• being unable to be soothed

• getting lost in a shopping centre for a few minutes

We don’t fully understand why some children turn these moments into deep fear, and why that fear becomes trauma.

Sometimes the traumatic event is not obvious.

Sometimes it is not remembered.

Sometimes it was never consciously recognised at all — as is often the case in Complex PTSD.

4. Trauma can be classified by the nature of the fearful event

All trauma begins with a fear response that does not switch off.

The impact of trauma is the same regardless of the origins of the trauma, as the brain does not seem to know the difference.

The brain does not create a hierarchy of “big” or “small” traumas. But the nature of the event does influence how the trauma embeds itself in the body and how it is later expressed. Many trauma survivors also carry multiple, compounding layers of trauma.

Below are the main categories.

• Post‑Traumatic Stress Disorder (PTSD)

Single‑event, external shock trauma

PTSD occurs when a person is exposed to a horrific event involving actual or threatened death, serious injury, or a threat to their physical integrity or that of others. The experience triggers intense fear, helplessness, or horror.

Common symptoms include:

• intrusive re‑experiencing of the event

• persistent avoidance of reminders (people, places, thoughts, feelings)

• heightened arousal (insomnia, hypervigilance, irritability)

PTSD usually has a clear storyline — a beginning, a middle, and an identifiable moment of threat.

• Complex Post‑Traumatic Stress Disorder (C‑PTSD)

Chronic, interpersonal, cumulative trauma

C‑PTSD is a broad category used when trauma does not fit the single‑event PTSD model. It often involves interpersonal trauma, usually beginning in childhood, and typically occurs over a prolonged period.

It may include:

• neglect

• emotional abuse

• sexual abuse

• chronic instability

• subtle, repeated emotional injuries

• experiences that were never recognised as “trauma” at the time

Some people with C‑PTSD also meet criteria for PTSD, but many do not.

Complex trauma is called “complex” for good reason — it is layered, subtle, and often invisible.

As Gabor Maté writes:

“Trauma is not what happens to you. It’s what happens inside you as a result of what happened to you.”

• Transgenerational or Intergenerational Trauma

This form of trauma is passed down through families. A parent’s unresolved trauma can shape the emotional environment, attachment patterns, and even the biological stress responses of their children.

Research shows that:

• mothers who experienced childhood trauma can pass altered stress responses to their unborn babies

• trauma‑related behaviours and coping patterns can be transmitted across generations

• families may carry trauma without any single identifiable event in the current generation

  
  

The dramatic impact of this new understanding is the realisation that millions of human beings maybe dealing every day with past traumas without a clear understanding that their behaviours are driven by significant changes in their brain functioning, and not by character flaws or weaknesses or any observable event in their own lives.

• Active Trauma

Active trauma occurs when the traumatic situation is not only in the past but is still happening. The danger is ongoing and real.

Examples include:

• domestic violence

• living in homes affected by addiction

• ongoing emotional abuse

• war zones

• chronic instability or threat

In these situations, the nervous system cannot stand down because the danger has not ended.

Trauma pains you so you act out of pain. Trauma induces fear so you act out of fear. Trauma is not what happens to you, it’s what happens inside you as a result of what happened to you (Mate,1999).

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5. The “stuck” nervous system changes the brain

The most important job of the brain is to ensure that we survive. Everything else is comes second. When the brain is in survival mode it places all non-essential brain “business” on hold.

It’s a bit like your computer in ‘safe mode’ when it sees something is wrong- you get a message, “We are operating in safe mode, so some functions are currently not available”.  The traumatised brain is the same. It runs only essential services while it is trying to work out the problem.  If the brain believes that we are in danger, it makes physiological changes to protect us. All of the symptoms we identify as a part of a traumatic response, are the result of the brain telling the body to do things differently in order to protect itself. Our brain is confused about what our reality is and it’s basing its response on a past traumatic event which continues to fire distress messages (Van de Kolk, 2015). The brain changes may be direct or indirect, immediate, or cumulative and are very, very individual in nature and intensity.  

We must remember that our autonomic nervous system has two major operating systems — the sympathetic nervous system, which produces the body's stress response, also known as "fight or flight"; and the parasympathetic nervous system, which produces the body's relaxation response, also known as "rest and digest." This is our homeostatic state when the body is in equilibrium. Neither of these work in trauma survivors.

Trauma changes:

The Limbic system-The Emotional Brain (hypothalamus, amygdala, thalamus, hippocampus)

The Frontal Cortex -The Cognitive Thinking brain (the neo-cortex)

and

the delicate neural pathways between the two that create balance.

Our brain exhausts itself as it ‘fizzes’ with trapped energy.  The switch must be turned off, if the trauma is to be healed and the brain returned to a resting state. The symptoms we feel may be less, and we may manage them better, but the nervous system goes on ‘fizzing ‘in the background waiting for the next short circuit.  

Our society rightly hold people accountable for their behaviours and we spend our life -time hearing that we have choices. For trauma survivors this is only partly true. Our choices exist only within what physically and psychologically possible for our brain and our body. We would not ask a person in a wheelchair with paralysis to walk. We know it isn’t possible. We understand the limitations of choice. Yet, somehow, we assume the psychological body can override messages from its brain because we choose to? This is the most difficult thing for trauma suffers and their families to understand. This lack of acceptance of the overwhelming suffering and loss of control felt can destroy families and individuals.

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6. These brain changes alter the psychological and social body

Trauma changes the brain and starts a cascade of changes through all body systems and down to the cellular level. We become different organisms, physically, psychologically, socially, and energetically.

We need to remind ourselves that what we see as the problem is actually the body’s solution. These responses have kept us alive and functioning against great odds. They release pressure, ease the pain, and distract us from the reality we face (Mate, 1999). The body will fight us every step of the way when we try to override them.

When you consider the extensive changes to the brain that trauma instigates, it is not surprising that the resultant changes across the entire body for some people can be MASSIVE. Imagine it along a continuum. The effects will be similar, but the extent and impact can vary greatly.

Trauma survivors frequently experience a range of sensations, emotions, physical conditions, and social responses. They behave in ways which may initially seem random and unconnected.  We frequently see each of these behaviours as isolated issues. A trauma survivor can be receiving treatment for example for digestive issues, depression, auto immune conditions, and anger management without realising that they are connected and all trace their origins back to a change in the brain triggered to protect the body from a perceived danger.

Psychological responses of a traumatised brain

Trauma creates a rupture in a person’s life story.  Everything we thought to be true has changed. The impact on the psychological brain is immense and include:

Depression, deep sadness, and feelings of Impending doom:  In the case of a trauma suffer depression is a symptom of an altered brain. It is not a condition with an unknown cause. It is usually only successfully resolved when the trauma is resolved.

Bursts of impulsivity, emotional dysregulation, and risk-taking behaviour: These often arise when trauma survivors feel frustrated, thwarted, or misunderstood.  The frontal lobes has the job of stopping us from doing things that will embarrass us, hurt ourselves or hurt others. Ordinarily, the Pre-Frontal Cortex allows us to observe what is going on, predict what will happen if they take a certain action, and make a conscious choice. We hover calmly and objectively over our thoughts, we remember our past experiences, we acknowledge our feelings and emotions and then take our time to respond allowing the executive brain to inhibit, organise and modulate the automatic reactions program into our emotional brain. The traumatised brain can’t do this. The more intense the visceral and sensory input from the emotional brain, the less capacity the rational brain has to put a damper on it. The frequent consequence is that the emotional brain wins over the rational brain and this leads to impulsivity and emotional dysregulation. When we can’t emotionally self-regulate, we begin to rely on external regulation, from medication, drugs, or alcohol.

This dysregulation can be seen in sudden and unnecessary fight or flight response. The traumatised brain becomes a runner. It does not stop to ask questions. It just flees from people, places, and situations that it fears. It cannot talk itself out of the need to protect itself. If it feels cornered and if it cannot flee it will become dysregulated and come out fighting. It will be abusive with language and gestures designed by the brain to get the attacker to back down. The trouble is that the ‘attacker’ can be a loved one, a doctor or just someone passing by.

The cycle of stressful situations, danger, pain, drama, trauma, and negativity:  Trauma survivors will try to sustain the cycle of drama, pain, and trauma. “Attractors” are things that draw us in and motivate us to do something. They make us feel alive and are usually positive and not dangerous or painful. Painful experiences are “detractors” and normally we avoid them. For many traumatise people re-exposure to stressful situations becomes an “attractor”.  They engage in experiences or put themselves into situations that would frighten most of us and that we would try to avoid.

This is an attempt to re-traumatise themselves so that they feel alive. The sufferer wants to feel something- anything!The traumatised brain is numb. The body has shut down all stimuli that might cause panic or fear. Sadly, that includes all the positive emotions as well. The body does not feel alive and does not know if it wants to even be alive. The result is that sometimes trauma survivors feel nothing- no sensations, emotions, or connections. The numbness that pervades every day is overwhelming. Humans have a need to feel- something anything! The traumatised mind seek to reactivate pain through rage and shame, so they set up situations where they can feel these emotions (in the absence of anything else). Sadly, these situations usually lead to negative experiences and reinforce the “I am broken” self-image. The outbursts can often be directed towards those who are trying the hardest to help and are an attempt to “force them away” and confirm that non- one wants to help, can help or cares. Outbursts can also be directed towards those in positions of authority as fear of loss of control sets off alarm bells in the brain. Outbursts are, usually triggered by something that the suffer knows to be irrational, but fear of the sensation keeps on them escalating into a full body emergency.

This is an attempt to reach unresolved pain. Tolle’s (2011) work on “The Pain Body” says that any negative emotion not fully faced becomes unresolved pain we carry with us throughout our lives. This accumulated pain is a negative energy field that occupies your body and mind is highly active and destructive. Pain becomes a “bedfellow” that it seems impossible to live without. Thoughts and feelings you have about your life are deeply negative and the pain body will feed on anything that creates further pain in whatever form: anger, destructiveness, hatred, grief, emotional drama, violence, and even illness. Once the pain-body has taken you over, you want more pain. You become a victim or a perpetrator. You want to inflict pain, or you want to suffer pain, or both. You are not conscious of this, of course, and will vehemently claim that you do not want pain. But look closely and you will find that your thinking and behaviour are designed to keep the pain going, for yourself and others. If you were truly conscious of it, the pattern would dissolve.

Self-Sabotage is another way the sufferer ensures that pain continues and, their sense of inadequacy is reinforced. This includes personal neglect, creating professional issues, undermining personal relationships, and destroying all attempts to help you by active or passive resistance. 

Altered perceptions and an inability to hear the voice of reason.  When the limbic system decides that something is a question of life or death no amount of insight will silence it.^[1] Trauma results in a fundamental reorganisation of the way the mind and brain manage perceptions. The world is seen through a different lens and events are seen as a distortion of reality. The trauma becomes super imposed on everything around us. Once survivors have formed a new perception, of themselves, that world and others, no matter how far from reality it appears to others, they are immovable. Their altered perception becomes their new unshakable reality.  When our emotional and rational brains are in conflict a tug-of-war, the emotional brain will always win! Decisions can be erratic and illogical, potentially causing more harm.

Perception about possible futures can also be altered. If you are constantly pulled back into the past, the result is a failure to imagine and alternative future.  There is a loss of “mental flexibility” which allows the brain the reshape the future with new possibilities. With this lack of imagination there is no hope, no chance for change, no place to go, and no goal to reach.  Sufferers are frequently unable to see a place for themselves in the world. This frequently leads into an unshakeable belief that their life will be short and full of sadness and many state outwardly that they believe they will die young.

Perception of time is also altered. There is a genuine belief that “this will last for ever”. The lack of ability to see that the situation will pass is devastating as humans can survive just about anything if they believe it is temporary.

Hypervigilance: Trauma sufferers are continually monitoring or scanning their surroundings to make sure they are safe.  There is a hyper-sensitivity to potential threats in the environment and are chronically “scared”. Many traumatised individuals are too hypervigilant to enjoy the ordinary pleasures that life has to offer. Nothing brings them joy anymore. This leads to ‘over the top’ responses to people, places, or things that might be threatening or that remind them of the trauma. This heightened attention to potential threats makes it hard to pay attention, go to new places, or interact with new people. They return only to the ‘safe’ and familiar.

Lack of Trust: After you’ve experienced something unspeakable you lose trust in yourself and in everybody else. After that event, every action seems to affirm the belief that no one can be trusted to understand and help. After trauma the world becomes sharply divided between those who know and understand and those who don’t. People who have not shared the same experience as you cannot be trusted, cannot understand it, and cannot help. Survivors often will only trust professionals if they become one of them. They do not even trust those they love to understand them.  It becomes a “them and us” experience where unrealistic expectations are placed upon others and the belief that they will always fail you drives a refusal to “give someone a chance”.  Survivors blame others and constantly feel frustrated. They can become abusive, stating that they “don’t understand” and in reality, you never will, because they won’t allow you to.

Flashbacks, Intrusive imagery, nightmares, and night terror:  Trauma survivors face a life plagued with nightmares and flashbacks where the brain relives the traumatic event with strong visual images and visceral (gut) senses. These flashbacks activate the right hemisphere of the brain and deactivate the left and leave sufferers drained, distressed, wet with sweat and disorientated. The fragments of memory intrude into the present, where they are literally relieved. There is no way of knowing when the flashbacks are going to occur again or how long they will last.  Often reactions are irrational and outside your control.

Dissociation and Collapse: Dissociation is a mental process where a person disconnects from their thoughts, feelings, memories, or sense of identity to protect themselves from pain. There is a loss of the physical, embodied feeling of being alive and feelings of complete detachment, alienation, and isolation (living dead syndrome). It is a break down in how your mind handles information. This is the essence of trauma. Many traumatised people simply give up. Rather than risk trying new options they feel safer to stay stuck in the fear they know. The fight flight response has been thwarted, it gives up, and the result is either extreme agitation or complete collapse.

Deep sense of Guilt and Shame: Shame is a self-conscious emotion usually associated with a negative evaluation of the self; withdrawal motivations; and feelings of distress, exposure, mistrust, powerlessness, and worthlessness. Very often traumatised people are more haunted by the shame they feel about what they have or have not done than the traumatic event itself. Traumatised brains feel confusion about how responsible they are for the trauma they have suffered.^[2]Shame becomes the dominant emotion and hiding the truth the main preoccupation.^[3]Remorse and embarrassment come along-side the shame after the heightened emotions have subsided. Guilt soon follows when they believe—correctly or not—that they have compromised their own standards of conduct. Shame and guilt are strong drivers in the belief that you are broken and bad.

Seeking Soothing Behaviours: Our body leads us to find ways of self-soothing as we try to protect ourselves from pain. There are other ways to heal the pain but, we have decided (as children) they don’t work for us. Sufferers tell themselves that, “I can try and do this tomorrow, but I need pain relief right now to get through the day”. Soothing is numbing the inner wounds that all humans have, and industries make a lot of money providing for this basic human need (sex, alcohol, drugs, entertainment, food, coffee).

Loss of Agency: Agency is the term used for feeling of being in control of your life and that you have some ability to shape your circumstance. Trauma survivors do not feel in control so try to assert their agency and to make things happen. They may smash the wall with their hand in an attempt to main control. They may rage and abuse those that seem to thwart them. They are in a cycle between frantic activity (abuse of self or others) and total immobility (non-responsive) and fluctuate between two. There is also the unconscious shifting of responsibility.  After the emotional storm has passed, they will look for someone to blame. They behaved the way they did because you had done something and you “never listen to me”.

Loss of sense of purpose and direction: We get our sense of purpose from a combination of our “gut” feeling that it is right and our brains reasoning and planning. Many traumatised people lose this sense of purpose and direction as they are disconnected for the ability to feel what their body is telling them. They are also in cognitive overload with no ability to organise their thoughts. The thought ofcommitments and making decisions is too much.They will frequently be asked for advice for the most ordinary things and rarely chose to follow it. The relationship between their own in reality is impaired. How can they make decisions, or put a plan into action, if they can’t really define what the sensations in their bodies are telling them to do.^[4]

^[1] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 14

^[2] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 14

^[3] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 67

^[4] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 92Trauma creates a rupture in a person’s life story. Everything they believed to be true is shaken.

What are the Cognitive Responses of a traumatised brain?

Trauma changes not only how we think and what we think about, but even our very capacity to think. [5]

The Frontal cortex is responsible for executive functioning. It is the logical, thinking part of the brain. It has reduced capacity as the Limbic system, or the emotional part of the brain goes into survival mode. The cognitive symptoms are not dissimilar ADD and other learning difficulty and long-term trauma survivors may even receive these as a diagnosis. Whilst symptoms may look similar, the specific brain functioning that is impaired, and the cause of the cognitive issue and treatment is very different.

Impaired Memory and Concentration: Amnesia or forgetfulness, reduced attention, scattered thoughts.

Cognitive Overload: Difficulty sorting relevant information from irrelevant information and a sense of “too much information”. Trauma survivors fear complexity and want things to be simple as their brains are “busy” with other tasks. They experience mental blankness or spaced-out feelings and a reduced ability to formulate plans and to think ahead.

Difficulty with abstract thinking: Difficulty explaining abstract emotions, perceptions, and concepts.

Restricted Language: The traumatised brain works in images, not words. All trauma is stored in the brain as preverbal- simply there are no words available to explain it. There is enormous difficulty in telling other people what has happened to us and an inability to articulate feelings. We come up with what many people call their “cover story” that offers some explanations for their symptoms and behaviour for public consumption.[6]During the trauma and flashbacks the ability to speak may be lost.

Survivors will often withdraw from conversations and are not able to deal with complex, emotional or confronting conversations. They will struggle to plan verbal responses and put needs and ideas into words. Often sufferers also avoid verbal contact as it is confusing and hard to process and may resort to angry responses and withdrawal or shutdown.

Repeating the same mistakes and problems. Survivors have trouble learning from their experience due to poor sequencing and poor cause and effect connections. They are unable to grasp the long-term effects of their actions or create coherent plans for the future This is not as the result of moral failings, lack of willpower or bad character, but of the deactivation of the left hemisphere.

Social Responses

Being able to feel safe with other people is probably the single most important aspect of wellbeing and almost all mental suffering involves trouble in creating workable and satisfying relationships.[7]

Avoidance behaviour: Avoiding places, moments, activities, memories, or people.

Loss of self.  Without self it almost always makes it difficult to engage in intimate relationships with others. The cord of social connection, which is so vital to human survival and wellbeing, is cut. Even those you know you love, can become the enemy and there can be an intentional disconnection. Trauma survivors can conspire to make those that love them, hate them by hurtful actions or words. It is almost as if they are testing them and when they fail to live up to expectations, it will confirm the person’s perception of themselves as flawed and un-lovable.

Loss of sustaining beliefs and values. Trauma survivors no longer know what they believe to be true. The world has lied to them and cannot be trusted. Their values of right and wrong, connections at a religious or spiritual level and social norms are all thrown in the air.

Emotional shut down and excluding themselves from intimacy and relationships:

Trauma survivors often have an inability to love, nurture or bond with other individuals, excessive shyness, diminished emotional responses and lack of empathy.  When we are stuck in survival mode, our energy focus is on fighting off unseen enemies. This leaves little room for nurture, care, or love.[8] There is often a complete disinterest in sexual intimacy but at times sexual activity is used as a self- soother not for the intimacy it offers. Some theories put social relationships front and centre in understandings of trauma and suggests approaches to healing focus on strengthening the body system for regulating arousal.

Sense of Isolation and disconnect, non-belonging: Trauma can turn the whole world into strangers to whom you have no connection. Survivors exist in a bubble and lose all secure attachment to others. This can be very difficult for those that love them. Traumatised people find themselves out of sync with the people around them and have a searing sense of isolation. Well-functioning people are able to except the differences of others and themselves.  They are also able to “read” the body and facial expressions of others to draw support. Traumatised people are severe judges of any deviation from their expectations and are unforgiving in their criticism. They are not well attuned to the subtle emotional shift in people around them. Being ignored, dismissed, or viewed in a negative way can lead to rage reactions or mental collapse. To feel emotionally close to another human being, a defence system must temporarily shut down. Trauma survivors are unable to do that. Trauma survivors often find great relational comfort from animals, as they offer less complicated relationships while providing the necessary sense of safety.

7. These brain changes alter the physical body.

Energy is now focused on supporting the chaos, at the expense of overall health. The energy put into maintaining control over unbearable psychological reactions can result in a wide range of physical symptoms and illnesses.

Our body is one complete and perfectly interconnected creation coordinated by a very delicate and balanced nervous system. Trauma changes this nervous system and not surprisingly creates physically ripples (or tsunami’s) across our physical health. The evidence is mounting that people suffering trauma have very, very, very, very (get my point) more REAL recognised dysfunction and ‘genuine’ physical illnesses than non- traumatised people. It is suggested they have 3x the rate of hospital admissions, 4x the cancer diagnosis and die on average 5 years earlier than those without!!! This is alarming!!!  

What so often makes it difficult for these genuine physical conditions to be recognised and treated is the prevalence of medical self-sabotage in trauma survivors. The failure to be in touch with their body contributes leads range of somatic symptoms which seem to have no clear medical basis. With a well-documented lack of self-protection and high rates of revictimization trauma survivors can be dismissed and treatment denied with a suggestion that this is a ‘mental health’ issue.[9] Identifying any real illness is VERY, VERY complex for patients and doctors alike.

Medical self- sabotage cannot however explain the nature and numbers of these physical issues in trauma survivors. Something else is going on. Thinking is finally changing and there is recognition that an impaired nervous system destabilises ALL body systems and genuine illness exists which need to be treated (even when mixed in with medical self -sabotage).

Here’s the catch, the body's natural self-repair mechanisms only fully function when the nervous system is in relaxation response. Trauma suffers never get into this relaxed state- the body can’t do its job of healing and growth.

Physical responses include:

Altered sensory perceptions: Traumatised people cannot describe what they are feeling because I cannot identify what their physical sensations mean. They respond to a sensory shift by shutting down. They mis-read physical messages. In addition they can exist in sensory overload resulting in a desire to “block things out”.

Strong Visceral sensations: There are physical responses we all feel when in emotional pain. These include tight throat, thigh chest, stomach churning and headache. A healthy nervous system can tell the difference between physical and psychological pain. Trauma survivors feel these sensations in an acute and intense way. The feeling that our chest is caving in or that we’ve been punched in the stomach is a real, intense, and unbearable physical response.[10]

Altered Perceptions to pain: A healthy nervous system determines the level of response required for any pain message. It rates the danger and allocates the right amount of pain to get us to respond as it needs. The trauma survivor sees everything as a danger, every hurt as life threatening and all actions need to be immediate to keep us safe. This mis reading of the danger results in a misreading of the pian response needed to move us to act. Trauma survivors feel pain more intensely, more immediately and it last longer.

Increased physical ailments and disrupted body sensations and patterns:

·      Asthma or rapid or difficult breathing

·      Excessive sweating, cold feet, and hands

·      Increased heart rate and startle response

·      Chronically disturbed sleep, poor sleep wake cycles

·      Poor digestion and blood sugar regulation

·      Skin disorders

·      Numbness and tingling particularly in legs and fingers

·      Muscular tension and pains particularly in the neck and back and headaches

·      Extreme sensitivity to light and sound

Compromised immune system illnesses.  The immune system is focused on putting all of his energy into fighting the perceived threat. Trauma survivors are statistically dramatically overrepresented in a number of illnesses where the immune system does not function properly.

·      Sometimes the immune system not strong enough to protect you from toxins and pathogens (including bacteria and virus) and you are very susceptible to illness and become more unwell. Your body is slower to heal from illness and injury.

·      Sometimes, it is not just a weakness in your immune but that makes mistakes and sees other parts of your body as foreign. It releases proteins called autoantibodies that attack healthy cells. This is called an autoimmune disease and trauma survivors are significantly over-represented in a number of auto immune diseases especially Chronic Fatigue and Fibromyalgia. If your mind wants to die to get away from the pain- is it surprising that your body will be receiving the same messages, and it will attack you from the inside out.

Unspecified Illness

We are starting to see the recognition that trauma is possibly a causal factor for an increasing number of illnesses. It seems that the major shift in the nervous system has far reaching consequences. Many, illnesses today are listing trauma as a possible cause to help explain this dramatic over representation of trauma survivors.

Trauma is doing something to our physical bodies and western medicine is struggling to work out exactly what.

For example, the following nonrelated conditions all list trauma as a possible cause:

Fowlers Syndrome (a Urological condition) is an illness where the messages from the spine which control the bladder are impaired.

Mutli-Directional Instability (a musculoskeletal condition) is a weakening of the muscles around the shoulders which leads to constant shoulder dislocation.

Functional Neurological Disorder (a neurological condition) resulting in mobility issues and seizures.

 With vastly different symptoms, from totally different parts of the body and with seemingly different origins, these illnesses are just examples of dysfunction believed to have some link to past trauma.

Although there is a recognition that our nervous system is vulnerable to trauma there is no classification of nervous system disorders that specifically identifies trauma (the classifications are structural, vascular, degenerative, infections and functional). So, trauma is not classified yet as a nervous system disorder in its own right.

There are 4 VERY big issues when it comes to the current understanding of trauma in this medical context:

1.   We treat the symptoms not the cause.

In the past medicine was only able to identify and treat the symptoms a person displayed. The diagnosis was a just a description of these symptom (e.g., a bloated stomach) as we did not have the ability to understand or find the cause. That all change in the nineteenth century. We could see microorganisms, bones, bacteria, and our understanding of the body became so much more sophisticated. Symptoms became the indicators to a real diagnosis.  The result was a profound improvement in medicine.

When looking at understanding any human condition, establishing a diagnosis, and planning for treatment, you have to understand the cause.

Because the trauma experienced is the cause of the ‘illness’ it is immediately different. We know the cause! Hallelujah! We can treat the cause. But our medical system does not know how to do that very well. It gets hung up on treating the symptom because we lack the resources or mindset to do it any other way. It does it in physical health.  Obesity is a symptom not a disease. High Blood pressure is a symptom not a disease. Arthritis is a symptom not a disease. 

And the system struggles even more in psychological health. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) is the main professional resource for the diagnosis of all mental health issues. It offers an astounding array of over 300 disorders, many of which are simply symptoms. Trauma survivors can simply choose the 2 or 3 symptoms that best suits them and if they can’t choose there will be a psychiatrist willing to do it for them depending on the time of the day, the mood they are in, the trend of the day and the information the sufferer provides. How does Reactive Attachment Disorder sound for starters? Or the ever popular, Borderline -Personality Disorder. Maybe you’d rather Disruptive Mood Dysregulation Disorder, Non- Suicidal Self Injury, Intermittent Explosive Disorder, Dysregulated Social Engagement Disorder, or even Disruptive-Impulse Control Disorder. [11]The list goes on! It is no wonder trauma survivors end up with a list of diagnosis (and treatments) as long as your arm, none of which adequately describe them or lead to an effective treatment pathway.

If doctors can't agree on what is wrong with their patient, there can be no way that they can provide proper treatment. When there is no relationship between diagnosis and cause, a mis-labelled patient is bound to be a mistreated patient. [12]

2.We treat the parts not the whole.

The body is an interconnected whole. Our physical body and psychological body are designed to work together and to respond to each other in a delicate “dance”. There is a ripple, or tsunami effect on other parts of our body when one part is unwell. It seems unthinkable that we would consider psychological health and physical health as two separate disconnected bodies, but that is exactly how the current medical system works. Each specialist deals only where their suite of symptoms and there is often limited interaction between areas. The result is trauma survivors may have 3 different doctors treating 3 different but inextricably connected set of trauma-based symptoms.

3.Western medicine is big business.

Today, millions of dollars go into physical medical treatments for trauma suffers. The influence and power of large pharmaceutical and medical insurance companies is openly discussed. There is little doubt that their interest is directed into profit-making interventions. Many doctors are more comfortable treating the physical symptom that fall within their specific field of expertise then having the underlying triggers identified and treated first.  The initial response to physical symptoms is most likely to treat them with medication or surgery. The best you can hope for in many cases is some short-term symptomatic relief. The simple quick fix, high turn around medical interventions are balanced with the chronic diseases that guarantee a long term “cash flow”. Some would suggest that insurance companies, and many doctors, do not have the need or desire to take on the “complex” cases. They are already making enough profit. It is easier and more lucrative to treat a physical symptom, often repeatedly, than to put the effort and time into really finding the cause. If I was truly cynical (maybe I am) I would suggest that the industry has a vested interest in keeping us just sick enough, that we continue to “need” the treatment they provide. Healing is not always a good business move.

4.We interfere with the body’s ability to self-heal.

The body is designed to heal. Its job is to keep us alive, and it has been perfectly designed to do just that. Our cells divide and renew to keep us in a state of balance. We see the magic from a single cut, a broken bone, or an infection. Somewhere along the way we forgot how powerful our mind and body are when they get together, and we stopped listening. We put drugs and toxins in as a part of an attempt to help but these just further destabilise our nervous system that spend so much energy trying to turn on its innate healing.

8.The traumatic memory remains just under the surface- waiting to be activated.

“Long after a traumatic experience is over, it may be reactivated at the slightest hint of danger and immobilise disturbed brain circuits and secrete massive amounts of stress hormones”.

These hormones precipitate unpleasant emotions, intense physical sensations, and impulsive and aggressive actions. These post-traumatic reactions feel incomprehensible and overwhelming. Survivors feel out of control and expend tremendous amounts of energy to keep functioning while their brain is driving them into a state of panic. They are thrown into a traumatic episode by a seemly simple event which leaves them believing they are damaged to the core and beyond redemption.

Triggers come from an incident that activates our memory and tells us we are in danger.

Our memory is a dynamic process- it’s not a true reflection of what we lived- it is fact and fiction mixed together it will change as it constructs, stabilises, and transforms memories. For trauma survivors’ neural pathways are disturbed and memories fail to become stable. Many medications and drugs and alcohol keeps the memory from being stable.

9.Faulty brain pathways are formed and become learned patterns.

Trauma becomes normalise. Our pattern becomes so ingrained we think it is us and not unusual. It becomes us.

When the faulty brain circuit fires repeatedly, it can become a default setting within the brain and the response is more likely to re-occur. The behaviours, often negative and self-destructive, then become learned patterns and the brain doesn’t remember how to function any other way. We then feel stuck in destructive patterns, lack of confidence in an ability to see alternative patterns and keep returning to the same unhelpful default behaviours. We know they are unhelpful but cannot stop them because they are now the preferred neural pathway.

In, his book "The Body Keeps The Score," van der Kolk (2015), suggests that trauma is like a splinter— in the beginning you worry about the splinter but it is the body’s response to the splinter that causes the real problem. The splinter is the psychological ‘injury’. It is, however, the body’s response to that ‘splinter’ that is the problem. The original fear has moved for the psychological body and is now coded into the biological body and impacts right down to the cellular level. Every organ and every muscle is now on alert and flooded with chemicals to protect it. All healing is shut down to conserve energy. Thinking is simplified to clear the way for actions towards the threat. The body is preparing for further attack. My daughter says it’s like the message she gets on her computer, “My body is in operating in safe mode so not all functions are currently available”. The original fear is no longer the issue as the body now employs a system wide approach to the danger it senses.

10.The traumatic response can be switched off-Healing is possible.

If we reactive a memory- we need to make sense of it again in the Short Term memory and then store and stabilise it again in the Long Term memory. Every time we remember something from the past it can be altered by new information and is remembered differently- It can be enriched by new information. If we modify the content, we can modify the emotional charge of the memory- we can reduce or strengthen it.

We have discovered that trauma happens to everybody individually and collectively. We know that trauma is deeply personal interpretation of a fearful event.  It is not clear exactly why a frightening event becomes traumatic for one person and not another.  Trauma looks very different for different people. But we do know the devasting impact it has on individuals and those they love.

May these words help you in your journey of understanding, acceptance and healing. The journey may be tough, lots of love and support will be needed, but healing is possible, and every life deserves a chance to live well- we are all worth it.

Annie

[1] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 14

[2] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 14

[3] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 67

[4] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 92

[5] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 21

[6] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 43

[7] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 78

[8]  Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 76

[9] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 97

[10] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 76

[11] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 164

[12] Van Der Kolk, B. (2015) The Body Keeps the Score. Penguin Books. P 165