Trauma: The Wounds We Don’t See

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Trauma: The Wounds We Don’t See

trauma“I’m always on edge. I feel shaky inside. I’m so easily startled.”

“I feel numb. I don’t know what I feel. I’m not sure I can even feel at all. “

Emotional and/or physical trauma can impact a person’s thoughts, emotions, relationships, sense of self, and views of the world. A person who has survived a trauma (or multiple ones) may be able to easily identify how some areas of their life have been impacted, while others are harder to articulate. Some areas of impact may be completely outside of awareness. The person may have a sense that something has been altered (e.g., something is “off”) but may be unable to put their experience into words. Trauma is more often than not a profound, life-altering and complex experience. Using words to describe it is often not sufficient.

As humans, our bodies are centrally impacted by trauma of all kinds – perhaps most notably in experiences of physical or sexual abuse, illness, surgeries, accidents, physical attack, or natural disaster. However, its effect can also be observed in situations less directly associated with the body, as in emotional abuse, sudden death of a loved one, or witnessing violence. What we know about trauma is that it’s perceived less in terms of the event itself and more in terms of our subjective experience of it. In other words, our brains detect and respond to a traumatic experience before we are able to make meaning from it. As a result, the experience of it is often stored in our bodies. Recent neuro-imaging studies have shown that, during times of stress, speech centers of the brain actually shut down.

THE IMPACT OF STRESS & TRAUMA

When trauma is experienced, the brain becomes activated and prepares the body to react, whether through a fight, flight, or freeze response. We have an evolutionary drive to protect ourselves from harm. Blood flow is directed away from areas like our stomach and intestines, and towards our heart, lungs, and muscles to help us prepare to respond. Our bloodstream is flooded with cortisol, the “stress hormone,” which allows our muscles to react quicker; our pupils dilate, improving our eyesight; our hearing becomes sharper. While potentially life-saving, these physiological responses – increased heart rate, high blood pressure, heightened arousal and attention, elevation of stress hormones – put the body under a significant strain.

This activation process is engaged to some extent even during minor stressors, like realizing you’re running late or preparing for a midterm exam at the last minute. This response helps us spring into action. However, during a traumatic experience, which involves a threat or assault to your physical and/or emotional well-being, the degree of strain on your body is exponentially greater; it takes a greater toll on the physical and psychological systems. When the body is exposed to overwhelmingly harmful stimuli or chronic traumatic events, it learns to remain prepared for the fight/flight/freeze response at all times.

Studies have found that people who have experienced trauma, particularly through chronic or repeated events, are more likely to exist in a state of biological preparedness. This activated state can include baseline increases in heart rate and cortisol levels, which, in the long-term, can lead to cardiovascular complications (i.e., heart attack; stroke). In the short-term, this activated state can contribute to symptoms often associated with Post-traumatic Stress Disorder; hypervigilance, hyperarousal, feeling on edge, an acute awareness of one’s surroundings (e.g., how many people are in a room, location of doors, smells, etc.), an over-exaggerated startle response, or a state of feeling “shut down” through avoidance of arousal states, dissociation, and numbing.

CONNECTING THE BODY AND MIND

When dealing with the fallout of traumatic life-experiences, integrating the body and mind can be a very powerful tool. The physiological impact of stress is experienced primarily through the senses, with very little engagement of language centers of the brain.

So, what does it take to integrate these systems? In therapy, in can be helpful for trauma survivors to practice putting words to their physical sensations.

  • When you are feeling a certain sensation in your body, what kind of thoughts are going through your mind at that moment?
  • What words would you use to label your emotional experience?

Putting words to physical experience can take the thought, “I just don’t feel well,” to an awareness that “My thoughts are racing and my chest feels tight. I feel anxious and unsafe”. This expanded description is important because it can give you insight into how to help yourself feel better. Realizing that your chest feels tight can be a signal to take slow, relaxing breaths. Noticing that your thoughts are racing may be a sign to distract yourself with something pleasurable. Further, more understanding of what is happening can support a sense of control. It is also important to notice when you are unable to identify or label your experience. These moments can be further explored with your therapist to gain deeper understanding.

As you try to put words to your experience, be mindful of the way in which you verbalize your experience. Certain descriptors can make you feel worse (e.g., “awful”; “devastating”; “mind-shattering”). An important tool is to simply try to observe and describe your experience, without adding judgement. For example, saying “I have a terrifying pain in my chest that I can’t stand” can increase your fear. Instead, saying “I’m feel a tightness in my chest” can give you more room to be curious about the trigger for your experience and allow you to use constructive coping skills to manage it.

While therapy can be extremely helpful in developing skills to understand and describe your experience, there are also many things you can do on your own.

Yoga: practicing yoga helps integrate the body with the breath; it allows self-expression through the body, without relying on language. Since yoga has finally become so popular (and well-studied), you can practice it at home (there are thousands of free videos online), at a gym or yoga studio, or with a private yoga instructor.

Tai Chi: originally created for self-defense, tai chi uses slow, flowing movements to help reduce stress by incorporating deep breathing. Those looking for less physical impact often prefer tai chi to yoga. Practice is also available through online videos or in studios.

Meditation: meditation can take many forms, and is an easy skill to incorporate that does not require a lot of time, or a gym membership! A nice place to start can be downloading a meditation app, such as Buddhify, which offers guided meditations of varying lengths. Additionally, online videos and instructed classes are available.

Mindfulness: a variation of meditation, mindfulness can help you practice getting in touch with uncomfortable emotions and unpleasant thoughts in a more manageable way. There are several mindfulness apps available, such as Calm and Headspace. Additionally, free audio clips are available on our website: https://motivationandchange.com/online-and-in-print-resources/.

  • Kathleen

    You left out “massage.” Although most massage therapists are taught not to attempt to deal with the emotional issues we feel stuck in someone’s tissues, depending on the client, and more often than not, I help people recognize that their CNS is holding past traumas in their tissues and it can be quite amazing to literally see the steamy like energy releasing from their body. I got far more emotional healing from receiving massages daily and sometimes twice a day while I was attending massage school than any one on one counseling sessions I ever had. I imagine a combination of “healing arts therapies” are what works best.

    • Laura Shapiro, PhD

      Hi Kathleen – Thanks for reading and responding! Really glad to hear massage therapy has been so healing and transformative for you and your clients. We integrate massage treatment heavily in our inpatient program and are full proponents of its benefits. Given the complexity of trauma, I find that–like you’re saying–most people find a combination of treatments to be most helpful, especially when they integrate the body and mind.