As part of my deep dive into trauma I wanted to write a post about the way trauma works in the body and brain, and the implications of this when we’re working with trauma personally. I want to understand which kinds of practices are likely to be helpful, and which risk retraumatizing us.
This is important given that many of the standard things that we ourselves – and even therapeutic professionals who are not trauma trained – may well assume are a great idea, are actually pretty risky. Particularly that applies to anything that involves staying with our experience – like mindfulness, the cathartic expression of emotions, or tuning into the body. We can think we’re doing something helpful when actually it can be keeping us locked into trauma responses.
When I’m talking about trauma responses here I’m following Steve Haines, whose book Trauma is Really Strange is a great overview of the research. He says that the body and brain respond in a pretty similar way whether the trauma we’re talking about is a sudden trauma (like surviving assault), developmental trauma (or cPTSD), and/or cumulative stress (like the marginalisation stress of ongoing discrimination, microaggressions, fear of hate crime, etc. that members of oppressed groups face).
Difficulties with including the body
Although I’ve read a few of the classic trauma books over the last few years, I find that the body/brain stuff is the part of it that’s most slippery for me and I struggle to hold onto it. This may be because neuroscience isn’t part of my everyday thinking and writing. That’s because many of the thinkers I follow tend to distance themselves from biological psychology. They do so because such approaches often attempt to explain everything at a biological level, reducing human experience to evolved patterns and neurons. Such approaches often essentialize complex human experiences like sexuality, gender, or mental health struggles, purely to the biological level.
The recent writing on trauma – however – is more biopsychosocial. The book I’m drawing on most here – David Treleaven’s Trauma-Sensitive Mindfulness – is an excellent example of how we might weave together understandings of body/brain, lived experience, and social injustice.
A more personal reason for my difficulty with the bodily – or somatic – aspects of trauma is that I haven’t generally found it easy to be in my body. This makes sense from a trauma-informed perspective because bodies often don’t feel very safe to occupy when you’ve experienced post traumatic stress. Many of us remain in our heads. My experiences of somatic experiences like yoga and body scan meditations is of a struggle to be present to physical sensations.
Why body knowledge is so vital here
These days my body is making it very difficult to continue this habit of detachment because it is telling me loud and clear that something is wrong. I’m experiencing things like full body twitches, a vice-like feeling across my chest when I get stuck in old patterns, panicked breathing during flashbacks, and disturbing pains in parts of my body that have been hurt in the past.
Strange as it may sound, I’m grateful for these feelings because they make it virtually impossible for me to override myself and keep doing things that hurt me as I have previously. Also such feelings give me a sense that I’m legit in claiming post-traumatic stress, not that I should need that, but given the level of cultural and personal denial about trauma, it does help.
Understanding how the body and brain operate when we’ve been traumatised is useful because we can then remind ourselves of what is happening internally when a trauma response hits. Given the high level of victim blaming that trauma survivors of all kinds experience, it is very easy to internalise self-blame, becoming angry with ourselves when we have these experiences and assuming that we should be able to easily think our way out of it or fix ourselves.
Understanding the science of how the nervous system works will – hopefully – help us to see why figuring out and rationalising aren’t generally helpful reactions when we’re in a trauma response. It will also help us to avoid practices that actively harm us when traumatised, and point us towards ones which are more helpful.
In his book, David Treleaven gives a nice overview of the literature on trauma and the body, and pulls out some good suggestions of what’s helpful given this. I’m going to summarise his material here which will inevitably be a big oversimplification of what is a hugely complex area and still a work in progress.
Trauma and the Nervous System
The autonomic nervous system is the part of the nervous system which supplies the internal organs. It regulates bodily processes like breathing and heart rate without our conscious effort. Once the autonomic nervous system has received information about the body (interoception) and the external environment (exteroception), it responds by stimulating body processes or inhibiting them. The sympathetic nervous system is the ‘accelerator’ which usually stimulates processes such as mobilising the fight/flight response to danger. The parasympathetic nervous system is the ‘brake’ which usually inhibits processes, promoting rest, digestion, etc. Together these systems regulate how we expend and/or conserve energy.
Stephen Porges’s polyvagal theory explains trauma in relation to three subsystems of the autonomic nervous system which function in our involuntary responses to threat. The vagus nerve is the longest nerve of the autonomic nervous system. The three subsystems are the ventral vagal complex, the sympathetic nervous system, and the dorsal vagal system.
Ventral Vagal Complex
The ventral vagal complex is the front branch of the vagus nerve. When it is active we’re able to be open, connected and present, relaxed and calm. We can also access the social engagement system meaning that we’re able to tune into – and communicate well with – others.
Sympathetic Nervous System (Fight/Flight)
When trauma hits, the sympathetic nervous system kicks in. This is the fight/flight response where adrenaline and cortisol are released to give us the energy and quick reactions needed for a crisis. Blood flows to the muscles and the focus is only on processes vital for survival, rather than digestion, rest, etc. This explains why we may not be able to hear as well, salivate, or cry in this state.
Dorsal Vagal System (Freeze)
If we can act on the fight/flight response and get to safety then our arousal will go back to normal. If not, our dorsal vagal system kicks in. This is the most primitive of the autonomic nervous system subsystems at the back of the vagus nerve, which extends to the stomach and lower gut.
When this happens our heart rate plunges, we can’t breathe, and we become immobile or faint. This is the animal freeze response which happens when fight/flight aren’t possible. It makes it possible that a predator may leave the animal for dead, and the endorphins released also mean that there will be less pain and consciousness if the worst happens.
Peter Levine’s work on somatic experiencing suggests that we become stuck in trauma if we’re unable to discharge the sympathetic nervous system activity – as animals do – after we’ve been traumatised. This is why we tend to cry and tremble after something shocking or stressful: we need to discharge the fear. However, cultural norms against expressing emotion work against this.
David gives a poignant example of a family crossing a road when a car comes towards them too fast. They run to get out of its way. On reaching the other side one little boy starts to cry and tremble, but his parent tells him off for doing so. The boy grips his jaw, holds his breath, and tightens his chest to prevent himself from sobbing. When this happens repeatedly, it isn’t possible to release the sympathetic response to trauma and it becomes lodged in the body, leading to post traumatic symptoms because we’ve been unable to integrate our experience.
Trauma and the Brain
Turning to the brain, again oversimplifying, we can understand this as being divided into three parts. The first two parts are what neuroscientist Joseph Le Doux calls the ‘emotional brain’: the parts that are responsible for survival and overall wellbeing. These are the early reptilian brain which controls all the things we can do when we’re born (e.g. sleeping, eating, cruing, breathing, urinating, defecating), and the limbic/mammalian brain which controls emotions and memory including the fight/flight/freeze response.
The neocortex is the ‘rational brain’ which is the part humans have which controls language, abstract thought, empathy, and making choices towards an imagined future. The frontal lobes of the neocortex develop by the second year of life giving us executive control over our bodies, behaviour and emotions so that we can navigate the complex social world, for example making decisions that may be better for us long term even though they bring short term pain or lack of pleasure.
In post traumatic stress, the coordination between the emotional and rational brain becomes out of balance so that the rational brain can’t suppress the emotional brain even if you want it to: the emotional brain keeps signalling that you are in danger and must act urgently, and no amount of insight or rationalisation can override this.
Under normal conditions of potential danger the amygdala in the limbic system sounds the alarm that there may be a threat. The hippocampus registers this and tells the neocortex the time sequence of the event: the beginning, middle, and end. The prefrontal cortex in the neocortex assesses the situation, makes decisions, and calms us down if the amygdala gave a false response.
In post traumatic stress the integration between these three systems goes wrong, meaning that we keep responding as if a threat was taking place. The rational brain is bypassed, and the hippocampus is disabled so that no message comes to the neocortex that the stress is over. The stress hormones continue to circulate and the survival system keeps going indefinitely, explaining our continued high anxiety and hypervigilance as we keep scanning for danger.
Implications for Working with Trauma
So post traumatic stress occurs when events exceed our capacity for integration, and when we’re unable to release sympathetic nervous system activity. Therefore we need to help our nervous system to process trauma by realising that this is normal, by feeling safe enough in the present (connected to our body, environment, and/or other people), and by allowing the emotional and bodily response required for integration, such as grief, shaking, etc.
Staying in the window of tolerance
David describes the ventral vagal social engagement response as the window of tolerance between hypoarousal (the dorsal vagal immobilisation response) and hyperarousal (the sympathetic nervous system fight/flight response). In hypoarousal we might experience emotional numbness, absence of sensations, our cognitive processes dulled, and little physical movement. In hyperarousal we might experience heightened sensations, emotional reactivity, hypervigilance, intrusive thoughts and images, and distorted cognitive processes.
A big part of the work with trauma is learning how to tell when we’ve gone into hyperarousal and/or hypoarousal and bringing ourselves back into the window of tolerance. This is why Love Uncommon’s emotional intensity thermometre is so helpful. Practices which put us into hyperarousal or hypoarousal, or keep us there, aren’t helpful with trauma.
Learning how to shift attention
David explains that people with post traumatic stress reflexively orient towards trauma relevant stimuli whether internally or externally: we’re tracking constantly for signs that something is wrong or that something bad is going to happen again. When we imagine we’ve experienced such a sign we go into a vicious cycle of fear and freeze, as the panic immobilizes us, everything constricts making us feel more frightened, and this constricts us all the more. Peter Levine describes it like this:
- The physiological sensations of trauma continue to activate the mind’s fear response
- Which, in turn, activates the physiological response to danger
- Which is the root of the physiological sensations of trauma
This sounds very familiar. For example I recognise that when I feel the physical sensations of fear and shame I often start to hypervigilantly scan my traumatic memories for things that I could have done differently in the past, search the present for anything that might be wrong, or imagine future possible traumas so I can be prepared for something hitting that I fear would overwhelm me. All those strategies intensify the bodly trauma sensations, resulting in even more desperate hypervigilance and scanning/planning.
So it’s useful to learn to shift our attention, when we feel the flicker, flame, or fire of such experiences, back to a stable anchor. This reorientation will help us come back to a more regulated state. What the anchor is differs for different people. Some find that focusing on the breath is helpful, for others that can be retraumatising. The same is true for bodily sensations, self-touch, visualising something pleasant or calming, or focusing on what you can sense with one or more of the senses (sight, sound, smell, taste, touch). The vital thing is finding what works for you. Often it helps to focus on feeling grounded in the body, and orienting to the environment. Both are also helpful reminders that the traumatic situation is over.
It can be very helpful to work with a trauma-informed practitioner because it can be hard indeed – at first – to unlearn old trauma habits. A practitioner can help us to notice when we’re drifting towards reactivity, or dissociating. They can slow us down, ground us, and the social engagement itself can help us to remain in the window of tolerance as we’re connected with another person.
Babette Rothschild talks about mindful gauges which can help us reestablish self-regulation, including bodily sensations, moods, feelings, and thoughts. This is about learning what the key signs are – for us – which tell us we’re going into a hyper- or hypo-aroused state. For me I’m noticing that my thoughts become noisy and churning, feelings of fear and shame come up, and I have a clenched, constricted, tight feeling across my chest making my breathing shallow. Things that can help me come back from that place include slowing my breathing, soothing self-touch, movement, kind self-talk, and bringing my attention gently to feelings and/or sensations, if that feels okay.
Feeling not figuring
Personally I found this material very helpful to understand quite what a profound impact being discouraged from expressing emotions has on kids. I was so struck by David’s description of the little boy gripping his jaw, holding his breath, and tightening his chest to prevent himself from sobbing. I’m also thinking about the link between this kind of reaction and shame around bodily functions: how clenched the entire body can become around tough feelings, physical sensations, and ‘embarrassing’ bodily functions like wind/gas, urination, defecation, and menstruation.
Recently I caught myself automatically going into clenching and carrying on, having hurt my finger in a cupboard door. I deliberately slowed down to let myself feel the pain and feel my feelings – both for the physical pain and for the automatic self-blame and push to continue what I was doing that came up. I’m trying now to pause and notice both physical and emotional pain, allowing time to experience and express it, instead of continuing the old habit of pushing it down. I still think the Pixar movie Inside Out is one of the best depictions of the potentially profound psychological impact of disallowing certain emotional states.
I also found the trauma material helpful for the explanation of why we can’t just think our way out of a trauma response. That’s definitely been my go-to way of trying to cope in the past, and it just gets me caught up in endless loops of self-blame when I can’t seem to figure it out or think any differently. Now I’m trying to focus on strategies that ground me in the body and/or in the environment around me. ‘Feeling not figuring’ has become a mantra for when I’m in that place: gently being with the feelings rather than trying to make sense of anything at that moment.
Welcoming the trauma response and what it has to tell us
I found it useful to learn that trauma responses often involve us reacting to interior signals as if they were exterior. Our nervous system is sending us warning alarms and it feels like we’re in actual danger, but we may well not be right now. All triggers land with the same intensity whether there is physical threat or emotional threat, and whether that threat is large, small, or just a reminder of a threat that happened in the past. The body and brain are not making these distinctions.
It’s good to remind myself that I’m safe enough in this moment and that this is what’s going on in the body. I was left with the question, though, of how to know whether the trauma response was telling me something important or not. I mean obviously I wasn’t in life or death danger as it sometimes seemed to be suggesting, but had it come up because I was facing a situation which could be emotionally dangerous to me?
Here I find it helpful to return to Buddhist teachings which suggest being with all experiences that come up in a warm, welcoming way. I’m finding it helpful to try to embrace the trauma feelings warmly and tell them they are welcome, rather than trying to avoid them, get rid of them, or figure them out, as I once would have done. It helps with this to remember that I’m grateful to them for trying to protect me. They are enabling me to notice, now, situations which could be risky to me, which I might’ve ignored in the past.
If the feelings are very overwhelming I recognise that having pushed this response down so much over the years means that it now has to scream to be heard. I promise the feeling that I will return to what it’s trying to tell me when I’m feeling clearer and calmer – once I can access the rational brain again – and I try to focus on soothing my nervous system for a while.
If the feeling is not so intense then I turn towards it and take it seriously. I try to be understanding of why whatever just triggered me might’ve done so, and I commit to putting some time into reflecting on that thing, rather than dismissing it or going to a habitual response (e.g fight, flight, freeze, or fawn).
Kindness and creativity
I also found it very helpful to read about how trauma takes you out of the social engagement system. I often blame myself harshly for how hard – if not impossible – I find it to be kind and empathic when I’m in a trauma response. This exacerbates the response further with fear and shame about whether that means I’m really a ‘bad person’. Now I can remind myself that I’m unable to access the social engagement system in that place.
I think this also explains why it’s extremely hard to be creative when trauma is very live – something else I’ve given myself a hard time about in the past. Now I can see that the main key to returning to a place of kindness and creativity is moving out of the trauma response. I can focus on doing the things that help with that.
However, again, it’s not about pushing yourself to get out of the response – which can be counterproductive – but rather trying to be with it warmly, along with everything else that is here in this moment, until it has passed.
Finally, the understanding about how the hippocampus is bypassed during trauma felt useful. I like Sarah Peynton’s work where she suggests that we can usefully time-travel back to traumatic times in our lives and experience them in safety, releasing any feelings, and putting a time stamp on the memory.
Of course this needs to be done slowly and carefully, perhaps with external support, but it feels good to have a way of relating to past memories which have haunted me, or been hard to approach, previously. I enjoy this creative way of addressing trauma, and the plural emphasis in Sarah’s work on accessing a kind inner witness to accompany you back.
Here are some links to videos by some of the main trauma researchers – and others who touch on these themes – which I’m planning to watch in order to continue these explorations:
- Peter Levine: How trauma gets stuck in the body and how to work with it, Somatic experiencing.
- Stephen Porges: Polyvagal theory.
- Bessel van der Kolk: How to detoxify the body from trauma, How to start feeling safe in your own body.
- Babette Rothschild: 8 Keys to Safe Trauma Recovery.
- David Treleaven: Trauma sensitive mindfulness.
- Sarah Peyton: Children, trauma, empathy, and neuroscience.
- Gabor Maté: The connection between stress and disease.
- Irene Lyon: Titration explained – never rush trauma healing.
- Rae Johnson: The embodiment of courage.
- Tada Hozumi: Cultural somatics & insecure cultural attachment.
- Alex Iantaffi: Somatic check-ins.
- David Berceli: Trauma Releasing Exercises.
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Plural tag: This post was written by James.