Trauma – a worn out word that we hear banded about far too often in this generation. Unfortunately, it is a real phenomenon that affects many people and the results can be devastating and debilitating. Many are walking around unaware that they have post-traumatic stress disorder (PTSD), the clinical name for trauma, although if you ask me it is a not a ‘disorder,’ but rather the normal reaction to extremely stressful events. They may be suffering from a myriad of symptoms, that affect one’s emotional and physical health.
Traditionally, in the Western world, psychotherapists have treated trauma by talking about the event. Emphasis is placed on going over the narrative, organising it and putting it in context. Whilst these methods are valid, the connection between the body and the mind has been largely overlooked.
In many cases, the trauma remains trapped in the body even long after the conscious, rational brain has processed it. Therefore, the body also needs to learn that the danger has passed in order to live a healthy life and thrive. No one sums it up better than Bessel van der Kolk, a psychiatrist, and trauma specialist, who coined the phrase ‘The Body Keeps the Score’.
In the last few years, mental health professionals have begun to understand that retelling the trauma narrative with traditional talk therapies does not always automatically change the physiological responses held in the body. On the contrary, sometimes going back into the story is counterproductive and retraumatising.
When a person has been traumatized they often function in a state of hyperarousal - more likely to become panic stricken; to startle in response to loud sounds; always on the alert for danger and quicker to enter into a fight/ flight response. This state can also be experienced as rage. Alternatively, when the fight/flight mode does not take care of the threat, we activate a third response known as a freeze or collapse state where we become physically immobilised.
At this point I would like to debunk a myth. We do not choose our response to traumatic events. There is often a huge amount of shame attached to trauma survivors (such as war veterans or firefighters) who find themselves immobilized, unable to fight back or run. And many domestic violence survivors or rape victims find themselves frozen, sometimes for years, unable to escape their marriage or their abuser. The terror is too overwhelming. In fact, freezing is actually the most sensible choice, given the alternatives. The danger or repercussions of standing up for themselves or trying to run away are too great. Immobilization is nearly always at the root of trauma and is the most primitive response to danger. It can also look like a dissociation (spacing out for long stretches) or a numbing, non reactive shut down, in which we are unable to connect to others.
In this disconnected mode, people often feel cut off from the world and find it hard to form close relationships. Picasso’s famous painting Guernica, an icon of war and trauma, epitomizes this state of shut down, in which no one is making eye contact or comforting each other. Peter Levine, a doctor and pioneer in the trauma research field has spent time observing mammals in the wild and has seen the immobility (freeze) response also known as ‘playing possum.’ The impala may play dead and let itself be dragged to the cheetah’s lair. At some point the impala could awaken from its frozen state and make a last-ditch attempt to escape. When it is no longer in danger it will shake off and discharge the energy and hormones released through the nervous system.
After a near death experience, the impala will not be traumatized by its experience because it knows how to discharge the energy.Levine suggests that since humans were historically caught in a situation between playing the role of both the predator and the prey, and due to the way our brains have developed over time, today we do not always know whether to flee or fight. Our rational, human brains and instinctive impulses are confused. This uncertainty makes us particularly vulnerable to the effects of trauma since we often freeze in fear when we are in the face of danger, thus leading to the creation of traumatic symptoms. Whilst animals in the wild instinctively discharge their energy, by shaking it off, humans usually do not. If we do not shake off the residual energy, then it will remain trapped in the body and could persist in many different forms and symptoms such as anxiety, depression, addiction, psychosomatic and behavioural problems amongst other things. Another vital piece of the mind-body connection puzzle is the groundbreaking contribution to the field by Stephen Porges. He has developed the polyvagal theory, which explains the crucial role of the vagus nerve – a cranial nerve which connects the brain to the heart, lungs, stomach and intestines. In simple terms, his theory explores the relationship between our gut reactions and the voices and faces of others around us. In other words, our social connections effect our nervous system.
As humans, we are highly attuned to other people around us. If someone gives us an unfriendly look or a raised eyebrow we react to it. We may end up feeling sick or anxious. We also have mirror neurons in our brain which help us read other people. An open, smiley face will send the message to our brain that we are safe and not in threatening company. We attune to others using our mirror neurons. That is why when a baby sees a kind, smiling face or hears their mother’s soothing voice they will feel safe, soothed and calm down. When we are calm and feel safe, the vagus nerve is engaged. It sends messages to the heart and lungs regulating our breathing and heart rate. The many branched vagus nerve has different paths which include ones which run to the muscles in the face, throat, middle ear and larynx. Porges, describes three different physiological responses to danger. At first, when there is a threat to our safety we turn to be soothed by another human being.
Meanwhile , our throat gets dry and our heart rate speeds up, and if there is no one available to help, we move into fight/flight state and if that fails, we go into an immobilised state, in which the emergency vagal system (the dorsal vagal complex) is activated. This part of the nerve reaches down to our stomach, kidneys and intestines. Our gut stops working or empties out and we freeze or collapse. The polyvagal theory is brilliant but too complex to explain within my limited remit on these pages. Suffice to say, there are two main take home points. One, many parts of our bodies and vital organs may be affected by danger, social disconnection and trauma, leading to chronic or life-threatening illnesses.Two, having the awareness that social contact, feeling safe and belonging are part of the calm functioning of our autonomic nervous system is crucial. Social connection is a key part of healing from trauma.
In fact, The Beatles were not far off from prophetic when they sang ‘All you need is Love.’ When we feel loved, safe and calm we can relax and so can our nervous system. Understanding the mind body connection is transforming the way we deal with trauma and the healing process. There are now many mind and body linked trauma therapies available. Levine has developed a body-based therapy called ‘Somatic Experiencing.’ This is known as a bottom- up approach which primarily focuses on healing symptoms first, before talking it out or even hearing the details of the traumatic story.There is also EMDR which combines rapid eye movement with bilateral stimulation of the brain, whilst focusing on a snapshot image of the traumatic event along with thoughts, emotions and body sensations. Internal Family Systems is also attentive to somatic parts.
Where no therapy is available massage, yoga, dance, acupuncture and even just shaking one’s body are not to be underestimated in regulating the nervous system and healing trauma. Group therapy, choirs and theatre programs have proven to be effective too since they provide people who may be shut down, with a place to reconnect and belong. Whichever path we choose we can no longer ignore the inextricably deep bond between the mind and the body.Facing one’s trauma is like embarking on a heroic journey into the underworld and great courage is needed.
However, when we are able to resolve our trauma it can transform our lives into a more enlightened way of being, leaving us healthier, more enriched, thriving, connected and bringing great gifts of healing, wisdom and untold contentment.
Written by Maria Beider