The Unseen Wounds of Trauma and Mental Health

Trauma and mental health are related. But, how does trauma change the brain? How does trauma affect the body or how does it affect relationships? Let’s answer these questions.

Perilous stress experienced from unexpected life events, ranging from extreme violence or a car accident, to confronting feelings of being unwanted and misunderstood, can unsettle an individual, psychologically and physiologically. Such experiences can be unnerving, daunting and overwhelming. When events, such as these, have inundated an individual’s neurological system it causes an upheaval of emotional responses. This is called as ‘trauma’. The American Psychological Association defines trauma as “an emotional response employed to deal with an extremely negative event.” Traumatic experiences thus can be defined as one or multiple events that involve direct or indirect exposure to actual or threatened death, serious injury, or threat to emotional and physical integrity. A traumatic experience can be strong enough to change the social fabric of an individual. This is how trauma affects relationships. Sometimes, a chronic exposure to a traumatic event can manifest into complex trauma influencing emotional regulation. Complex trauma can emerge even after years since the individual had experienced the last traumatic event. How trauma affects the body is of utmost importance as physiological changes are a cornerstone of trauma. We have all come across this phrase, which says, “it all starts in the brain!” It is thus paramount to understand how trauma changes the brain. So, what exactly happens in the brain and the body when an individual experiences trauma?!

The nervous system can be divided into 2 parts – the central nervous system (CNS), also known as the body’s control unit comprising of the brain and the spinal cord and the peripheral nervous system (PNS), our body’s link to the outside world. PNS encompasses the autonomic nervous system (ANS) and the somatic nervous system (SNS). The ANS is responsible for controlling involuntary body functions like respiration, heart rate, digestion and operates without any conscious direction. The SNS controls voluntary and reflex movements of the body.

The ANS has two primary components – sympathetic nervous system and parasympathetic nervous system and a more recently discovered enteric nervous system. The sympathetic nervous system acts like an accelerator in a car. It is associated with the fight, flight or freeze response and the release of stress hormones like adrenaline, noradrenaline and cortisol in the bloodstream. The parasympathetic nervous system, on the other hand, soothes the body by bringing it back to homeostasis. More so, both the sympathetic and parasympathetic nervous systems work in tandem and rhythmic alteration. The enteric nervous system, also known as ‘the second brain’ is capable of acting independently of the brain itself and is responsible for producing 95% of serotonin and 50% of dopamine, thus influencing our mood.

The resultant arousal is mediated by the limbic system – a group of brain structures that play an important role in survival behaviours, emotional regulation, memory, motivation and learning. One such region is the amygdala – an almond-shaped structure, best known for its role in emotion perception including fear. A life-threatening situation activates the amygdala, which sends a distress signal to the hypothalamus, which acts as a command center. The hypothalamus communicates with the rest of the body by signalling the sympathetic nervous system in preparing an individual to fight or flee. Once the event passes by, the parasympathetic nervous system brings the body out of the fight and flight response. However, trauma interferes with this by causing dysregulation in the body’s natural way of functioning. Individuals can also experience a state of immobilization or dissociation – a state of freeze, which ranges on a continuum from mild sensations of fogginess, drowsiness, memory lapses to accessing different personalities.

Chronic ongoing experiences of trauma causes the amygdala to go on an overdrive. These fearful responses become conditioned in the nervous system, resulting in states of hyper or hypo arousal. When a fight, flight or freeze response occurs, it hijacks the amygdala and overrides the functioning of the neocortex, which is involved in higher-order functions, such as sensory perception, generation of motor commands, decision making, spatial reasoning, language, etc. This revved up state makes it difficult for the mammalian brain to think rationally and critically, causing a state of anxiety and internal instability.

The re-emergence of symptoms leads to re-traumatization and the cycle continues. If the response remains unprocessed, it acts as a traumatic memory that lies dormant in the body. Due to this repressed memory, any subsequent stressful event that occurs, is perceived to pose a serious threat. This causes neurochemical and biological changes in the brain, which involves excessive release of stress hormones and changes in involuntary biological mechanisms like breathing, pupil dilatation, heart rate and gastrointestinal functioning.

Living with trauma can lead one to experience a lack of control, anxiety, panic, overwhelm and despair. To understand this state better, Dr. Dan Siegel, founded the “Window of Tolerance” to describe the emotional turmoil that occurs during times of extreme stress. When one is feeling balanced, calm and able to engage well in everyday life, s/he is said to be in an optimal arousal zone, which is also known as the window of tolerance. In other words, when one is not in the survival mode, s/he can respond thoughtfully, empathetically, think clearly and is able to manage the daily ups and downs. When one is outside the window of tolerance, s/he is said to be in a survival mode, causing hyperarousal state (fight or flight response) or hypoarousal state (freeze or shut down response.) One might also experience both the states simultaneously or shift rapidly between the two.

The former is characterized by excessive activation in the form of anxiety, panic, fear or emotional flooding. The latter is characterized by exhaustion, depression, numbness and withdrawal behaviour.

Disconnection or dissociation may arise at varying levels during a stressful situation. Since it is an involuntary response, it is difficult to control or monitor it. These emotional and physiological responses interfere with daily functioning, dislodging an individual out of the window, which may then take minutes or hours to recover from.

Displacement from the window of tolerance impacts self-awareness, emotional regulation and even social skills. Disruption of the social skills leads to a number of ramifications like social withdrawal and avoidance. Trauma causes internal disturbances and at the same time distress for people around. A difficulty in maintaining relationships with friends and family is one of the important consequences of trauma. Marital relationships are compromised with the escalation of insecurities, attachment and trust issues which can manifest into overprotective or overdependent behaviour.

Trauma not only brings about neurological changes but also affects the psychosocial functioning of an individual. The impact of unresolved trauma and mechanism employed to deal with it can be subtle, insidious, or outright destructive. However, learning why our body responds the way it does and how the brain reacts, leads to awareness and empowerment. By caring for ourselves and understanding our self-protective responses, we can release shame surrounding the inability to act, and heal the unresolved wounds left behind!

Authorship: Team Synapsium (published by vigyaa.com)

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