The Link Between Childhood Trauma and Adult Health
I have worked with many clients over the years who came to Salt City Bodyworks feeling discouraged and confused. They had been living with significant health problems and had seen countless doctors and medical health professionals with little or no change in their symptoms. “I’m in chronic pain but my tests always come back ‘normal’” is a phrase I’ve heard countless times. Quite often this means the cause of the physical symptoms is not genetic, congenital, mechanical, bacterial/viral or from toxic environmental exposure. If it were, the traditional medical model would have made that determination since these are all measurable inputs. Instead, the root can likely be traced to a long-term accumulation of toxic stress (aka trauma) which is much harder to detect in standard tests.
Nadine Burke Harris is a Canadian-American pediatrician currently serving as the Surgeon General of California. She is well-known for founding Center for Youth Wellness and her public efforts to bring attention to the negative health effects of toxic stress. In this TED Talk, she highlights the connection between “adverse childhood experience” (trauma) and poor outcomes in adult health.
Follow this link to learn more about the Adverse Childhood Experience Study (ACES) and even take the quiz to find out how you score: https://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean
What Does “Somatic” Mean: Part Two
In the previous blog post we explored how the word “psychosomatic” refers to the mind-body connection. Together the mind and body seek homeostasis—balance and stability. We maintain homeostasis by being able to feel when something is wrong so we can take action to correct it. Homeostasis works to ensure our mind-body’s number one goal: survival. Besides that, it just feels good. As trauma expert Bessel van der Kolk puts it, “If you have a comfortable connection with your inner sensations—if you can trust them to give you accurate information—you will feel in charge of your body, your feelings, and your self.” (The Body Keeps the Score p. 96)
This post explores how trauma changes all that. We’ll look at some of the main defenses the mind-body uses against traumatic impact. We’ll also see how those defenses both help and hinder us.
Trauma Disrupts the Mind-Body Connection
In the face of an immediate threat to safety, our basic self-protective responses are fight, flight, and freeze. By definition, trauma is what develops when these responses fail to keep us safe. In the words of trauma specialist Dr. Robert Scaer, “the combination of a life threat associated with helplessness is the prerequisite for trauma to occur.” (The Body Bears the Burden, p.100)
To withstand the sensory overload this threat creates, the somatic equivalent of a breaker switch flips in your mind-body circuit. The mind and body disconnect from one another, which disrupts your ability to effectively and accurately perceive your external and internal sensory experience. The result can be a feeling of detachment from reality, your own internal experience, your sense of self, or even all three.
Common Forms of Disconnection
Everyone has a threshold where an experience can become “too much”. This is normal. Yet there is a point at which that becomes problematic, even disabling. This usually happens when the disconnection becomes so frequent or intense that it impacts one’s quality of life. When this is the case, trauma is usually at the root. Although there are many kinds of disconnection, let’s explore some of the most common forms.
Dissociation
Dissociation is typified by a marked sense of disconnection from aspects of everyday living. Two main forms are:
- Depersonalization: a state in which your feelings and thoughts don’t seem real, as if they don’t belong to you. You begin to lose aspects of your own identity and sense of self.
- Derealization: a state where you feel detached from your surroundings; people and things seem unreal or dream-like. This is not a true break from reality (or psychosis) because in this state you are aware that it isn’t normal.
Denial
When something is too painful to accept, denial is the means by which your conscious mind blocks an external or internal event from registering. You feel the experience but then consciously reject it as being untrue or not real.
Intellectualization
One common way to avoid confronting a painful situation is by applying mental analysis (commonly referred to as “overthinking.”). In essence, you think an emotion rather than feel it.
Desensitization (or Numbing)
Desensitization is when the volume on your internal and external sensory experience gets turned way down. The results may be physical (e.g., a high tolerance to pain or heat), emotional (e.g., apathy, “cold-heartedness”), or both.
Projection
When you disconnect from your own feelings and then displace them onto someone else, you are projecting. For example, you feel enraged with someone but accuse them of being enraged with you.
Repression
Repression enables you to block intolerable thoughts, feelings, or memories from your conscious awareness. This is different from denial because it is your subconscious mind that creates the block. With denial, your conscious mind registers the experience, but then rejects it as untrue or unreal.
The Cost/Benefit of Disconnection
When a traumatic event is experienced, these defenses attempt to protect you from intense psychological pain. Otherwise, you risk complete overwhelm (e.g., a psychotic break or physical death). Seen this way, disconnection is actually useful because it helps you survive the intolerable. It works best in the short term as a temporary buffer. However, the reality is that disconnection in its various forms can often span months or even years.
Although the immediate benefit of the disconnection is survival, the long-term cost is a compromised perception of the sensations your body sends to your mind. Remember, your mind-body relies on these perceptions to maintain homeostasis. But without the ability to sense and feel, your ability to perceive danger—and then take action against it—is impaired. Living in a state of chronic disconnection makes you more vulnerable to danger.
Furthermore, sensations and emotions (i.e., pleasure, pain, anger, joy, grief, expansion, contraction, exhilaration, despair) are all essential to the basic experience of feeling alive. Without them, life loses vitality and meaning, which is why trauma survivors have often been known to describe themselves as “the living dead.”
Compensating for the Disconnection
Ultimately, disconnection between mind and body makes true homeostasis impossible. This often increases the incidence of panic attacks, chronic and acute anxiety, somatic syndromes, chronic pain, phobias, invasive thoughts, and personality disorders, to name a few.
Furthermore, when your internal means of achieving homeostasis (or self-regulation) are impaired, you must resort to external sources to achieve a sense of balance and stability. Examples of external regulation include codependent relationships, substance use and abuse, disordered eating, exercise bulimia, obsessive-compulsive behaviors, scrupulosity, addiction, and religious or political fanaticism.
In general, these forms of external regulation provide relief for a time—after all, that’s why they exist. But in the long run their effectiveness decreases and are eventually replaced with a sense of feeling out-of-control. It’s often at this point that an individual will seek some form of professional help. That’s where somatic therapy comes in.
In the third and final post in this series, we’ll examine how somatic therapy bridges the gap of mind-body disconnection.
SUMMARY
Trauma is created when an individual experiences helplessness after fight, flight and freeze fail to protect them from a threat to their survival.
A breaker switch in the mind-body connection is thrown in the face of such a threat. This disconnection helps prevent overwhelm (i.e., psychosis or death). The result is an ability to bear an otherwise intolerable experience of pain and overwhelm.
The benefit is survival but the cost is the ability to maintain homeostasis (or self-regulation). Another cost is losing the sense of feeling alive.
Loss of homeostasis gives rise to a host of symptoms. These may include panic attacks, phobias, chronic pain, and even personality disorders.
External regulation is often used in the place of self-regulation to create a sense of balance and stability. Examples of external regulation are obsessive-compulsive behaviors, codependent relationships, and substance use and abuse.
When external regulation loses effectiveness, professional intervention often is sought. Somatic therapy is an effective form of professional help. Its focus is bridging the gap in mind-body connection to restore self-regulation and homeostasis.
What “Somatic” Means and Why You’d Want to Know
Years ago, when I was a newly enrolled massage therapy student, I noticed the word somatic in a class titled “Psycho-Somatic Principles.” Like most people, I’d heard that psychosomatic meant an illness that was “all in your head.” But beyond that, I didn’t know much. And I had no idea then that my passion for bodywork would eventually lead me to a degree in somatic psychology.
This post begins a three-part exploration to help you understand what somatic is. That way you can know if a somatic approach to trauma healing is right for you.
- Part One: we’ll learn what the word “somatic” actually means and the elemental role it plays in the mind-body connection.
- Part Two: we’ll revisit the basic definition of trauma and highlight three specific ways it disrupts the mind-body connection.
- Part Three: I’ll show you the particular means by which somatic therapy brings the mind and body back into their proper relationship.
Let’s take a closer look.
The Mind-Body Connection
Let’s consider the word psychosomatic for a moment. The prefix psycho– comes from the Greek psykhē—the invisible animating principle that occupies and directs the physical body. This “animating principle” was originally understood as the life-giving, intangible essence of a human being. In other words, ancients Greeks used psykhē the way we might use the terms spirit or soul today. Our modern understanding of it has come to include mind or conscious awareness as well. Thus, the word psychological means anything relating to or originating from this part of who we are. The Greek word sōma, on the other hand, refers to the fleshy container that houses the psykhē. In short, it is the physical body.
Now we see how the word psychosomatic indicates the intimate relationship between the mind and body. Over time it came to represent theway an imbalance in the mind manifests in the body—essentially a physical ailment with psychological origins. In modern usage, however, the word acquired a negative connotation and so it’s not used as much anymore. These days, the shortened version “somatic” has replaced it. The field of somatic psychology concerns itself with anything related to the mind-body connection.
So what does somatics have to do with trauma healing? To explain that, let’s first examine the critical role the different systems of the mind-body play in your survival. This might feel like high school biology for a minute, but hang with me.
Your Mind-Body Works to Achieve Balance and Stability
The mind-body connection is sustained by the interweaving of complex physiological structures and networks. They work together around the clock to keep your internal systems stable and balanced. Homeostasis is the technical term that describes this state of equilibrium. If the balance in any system tips one way or another, your body will let you know. How? Sensory neurons create a sensation that tells you something’s wrong. Next, you get an urge to fix the problem. This urge signals motor neurons that some kind of action is needed.
For example, when you’ve used up all the calories from lunch, you feel hunger pangs that tell you it’s time to eat again. If you hold your breath for too long, a powerful need to breathe hits you. After a large Diet Coke, you feel the inevitable urge to visit the restroom. Or if a car swerves into your lane, you instantly react to avoid it.
In short, your mind-body provides the means of sensing danger and the actions to protect against it that ensure homeostasis. Why does this matter? It matters because homeostasis is the way your body achieves its number-one goal: survival.
But when you experience trauma, all of that changes.
Trauma Disrupts the Balance and Stability
If survival is threatened, trauma happens when the actions you take to protect yourself aren’t enough to keep you safe. With this in mind, my next post highlights the main defenses your mind-body has against threats to its survival. All of them involve a dramatic reduction in your ability to perceive and process sensation. Now that you know how essential that ability is, you can imagine the kind of internal chaos this creates.
Summary
Psykhē (-psycho) means spirit, mind, or conscious awareness. Sōma means the physical body. Psychosomatic (or somatic for short) refers to the mind-body connection.
Homeostasis is stability and balance in the systems of the mind-body. Homeostasis is maintained by the ability to feel something is wrong via sensation. The sensation is followed by an urge to take action that will fix the problem. Why? To ensure the mind-body’s number one goal: survival. Trauma happens when survival is threatened and the actions taken to protect yourself are not enough to keep you safe.
Learn MoreDoes Somatic Experiencing Really Work?
In this TED Talk, speaker and trainer Monica LeSage shares her experience with Somatic Experiencing. It was instrumental in the long road of her recovery from a major automobile accident over ten years ago. It’s true there is no “one size fits all” approach to trauma healing. At the same time, Monica’s story illustrates how well-positioned Somatic Experiencing is to treat the resulting symptoms of shock trauma. Her story may help you decide whether or not Somatic Experiencing is right for you. Take a look.
What Is Somatic Experiencing?
“What is Somatic Experiencing?” You’ve probably asked yourself this question if you’ve been reading up on somatic ways to heal trauma. Most of us are familiar with traditional approaches to trauma healing like talk therapy or pharmaceuticals. Somatic approaches to mental health care like Somatic Experiencing (SE) are not as well known but on the rise. In this post I’ll explain how SE works, for what kinds of trauma it’s best suited and a few of its limitations. To begin, let’s look at the body’s fundamental response to threat: fight or flight.
“Fight or Flight” is a Basic Response to Danger
When you experience a high-intensity threat to your safety, a protective circuit between the brain and body activates. The body tells the brain there’s danger and the brain responds with a boost of adrenaline and cortisol. These chemicals help you either fight off the threat or run away from it. If you successfully do either one, all the energy the adrenaline and cortisol recruited gets discharged. Your brain registers the discharge as a signal the threat is over. It shuts off the adrenaline and cortisol valve knowing you are now safe and sound. The brain-body circuit is complete and you can go back to business as usual. No trauma.
Sometimes Fight or Flight Fails
Now you see how “fight or flight” works so let’s take a look at what happens when it doesn’t. What if the threat strikes too fast, too suddenly or with too much force? What if it can’t be fought off or run away from? Your body blasts you with that rush of energy but the danger hits before you can use it. So where does the energy go? If there’s no discharge, how does the brain get the message that the threat is over? It doesn’t.Without the “all clear” from the body, the brain continues to supply you with adrenaline and cortisol. You remain in varying states of fight or flight from then on as if the danger were still present. This is how shock trauma happens.
Somatic Experiencing Makes Up the Difference
So how does Somatic Experiencing fit into all of this? SE is the life work of Dr. Peter Levine who studied how animals respond to threat in the wild. He wondered why humans get traumatized but wild animals don’t and he observed one critical thing. Let’s say a coyote is out looking for lunch and goes after a rabbit. The rabbit’s brain does what a human brain does: it preps it with what it needs to outrun the coyote. It makes a mad dash and with any luck, gets back to the safety of its little den. Once there, it shakes off all the extra energy it didn’t need to run away. The discharge signals the threat is over. The rabbit’s physiology is reset to normal and it goes on unaffected by its brush with death. No trauma.
Dr. Levine wanted to know if that could work with humans, too. If we could shed the extra energy like wild animals, could we avoid being traumatized? The answer is yes.The method he developed over decades of research taps into the trapped energy and helps it to finally release. A Somatic Experiencing Practitioner (SEP) creates the safety you need to let your body finish what it started. This happens gently and incrementally over several sessions so that the process does not overwhelm you. But what does that look like? In a typical session you allow your body’s involuntary responses to occur. You may experience trembling, a flush of heat, muscle tension or relaxation, the chills or other physical sensations, yawning, surges of emotion—any of the numerous ways your body has of releasing energy. This is the difference between talk therapy and SE: you’re actually having an experience rather than talking about an experience.
Is Somatic Experiencing Right For Me?
SE is a very effective tool for addressing shock trauma. Shock trauma is a one time event that overwhelms your fight or flight response (e.g., a car accident or physical assault). If you have been diagnosed with PTSD, it’s very likely SE will be useful to you.
SE is not, however, well suited for developmental or relational trauma—trauma that was sustained over long periods of time during the early years of your life and inside the context of important relationships. If you have C-PTSD, SE may be helpful as a supplement but not as the main course of therapy. If you have questions about whether SE is right for you, visit www.traumahealing.org or click here to schedule a free consultation.
Creating Lasting Change: Part Two
4 Ways to Create and Examine Lasting Change, Continued.
Certain types of change cannot be efforted
As New Year’s Day draws closer, I’m sitting down again to consider more aspects of creating personal change. In the post Creating Lasting Change: Part One, I explored how lasting change happens incrementally. It’s also more likely to occur when motivated by authentic desire as opposed to an external agenda.
Part Two looks more closely at the difference between change that relies on effort and the kind that doesn’t . Knowing the difference can spare you from unnecessary shame or disappointment if your goals meet with frustration.
Task-oriented goals are based in a step-by step effort.
Consider the nature of a task-oriented New Year’s goal. These include taking guitar lessons, organizing the garage, or planning a trip to Paris. Achieving this kind of goal depends on completing a series of tasks that lead to a final outcome. Take organizing the garage, for example. You might need to schedule time to do it, purge unwanted items or purchase shelves to store what’s left. I’m not saying it’s necessarily easy. My point is that achieving this kind of goal is a matter of completing steps that can be efforted.
Personal transformation cannot be efforted.
With that in mind, let’s take a look at a New Year’s resolution focused on personal transformation. This might include letting go of a grudge, being less judgmental or loving with an open heart. Contrary to some self-help philosophies, these kinds of changes do not come about from positive thinking, daily affirmations or exerting will power. These may support the change but when it comes to the actual shift, they don’t play an active part. “Emotional, spiritual and physiological processes are not subject to human will.” This powerful statement came from NARM founder Dr. Larry Heller at a symposium in Berkeley, CA I attended this past summer that explored the interplay of psychology and spirituality.
Approaching change from a NARM perspective assumes that these internal states are possible, of course, but they may be inaccessible due to a variety of reasons. These include environmental factors, the biorhythms of our timing, misinformation or a diminished awareness around the issue to begin with. Furthermore, because of the somatic nature of each of the processes Dr. Heller named, efforting is the wrong tool for the job. The part of the brain that’s responsible for rational, controlled action has no direct influence over the part that runs the autonomic functions of the body (including emotional experience). When we consider the variety of complex contributing factors of our inner experience, it makes sense that any simple approach will fall short.
Then why try to make lasting changes?
When you understand the complexity of these contributing factors you can avoid unnecessary self-blame or discouragement that might show up if you’re not able to effort your way into states like forgiveness, joy or compassion. It doesn’t mean it’s pointless to desire them. It means it’s helpful to be clear on what parts of those experiences you have influence on or not. This kind of clarity comes from patience, non-judgment and acknowledging you have the right to change or not (and that this choice matters).
NARM is a powerful clinical model that supports these kinds of complex processes, but this isn’t a plug for NARM. The kind of support that facilitates personal transformation comes from a variety of sources like a trusted spiritual leader, a true friend, communication with the divine or from your own intuition.
When you know the difference between short term, task-oriented goals and the delicate, nuanced path to inner transformation you can approach the new year from a wiser perspective when it comes to personal growth.
Learn MoreCreating Lasting Change: Part One
4 Ways to Create and Examine Lasting Change
Dietary supplements, self-help books promising lasting change, gym memberships, storage containers… the list could go on and on. These products grab for our attention each January and with good reason. If it isn’t the excess of the holidays that creates a momentum toward change, then it’s the turn of the calendar to a new year that prompts you to consider areas of your life that could stand a bit of improvement. I’m not opposed to taking personal inventory, setting goals, or cultivating personal growth. After all, the hallmark of my professional field is change and transformation. However, I do think it’s worth pausing to reflect on the dynamics and motivation for change. Doing so helps you proceed in a more deliberate and therefore satisfying fashion. In making change, here are some thoughts on what to watch for and consider.
Lasting change happens incrementally and often at a subtle level.
One of the critical facets of the NeuroAffective Relational Model (NARM)—the modality I use when working with developmental trauma—is to reflect back to my clients when change is happening. For example, a client may share an exchange with a friend in which they’ve set and held a good boundary. We pause to reflect on how that’s different from a month ago, six months ago, a year ago, etc. We do so to allow the difference to marinate at an emotional, somatic and intellectual level. Why take the time? The reality is that when it comes to our own process, we may be too deep in the forest to see the trees. In other words, we’re not likely to notice subtle shifts when they occur. Add to that the common cultural expectation for instant or dramatic gratification and we’re even less likely to register the difference as change.
Just as we use tools like a scale or a ruler to measure small fluctuations, objective observations from a therapist, friends or family can help us internalize the sense that we’re achieving what it is we say we want.
When a desire for change is genuinely our own, motivation goes up and the likelihood of success improves.
Consider one of the goals you may have for 2020 and then look at what’s driving the desire. The more honest you can be, the better. Is it social trends? Parental expectations? Job demands? If so, the motivation is coming from an external agenda. You’re probably familiar with the somatic characteristics of these kinds of pressures. They may show up as a headache, a weight in the stomach or tightness in the shoulders. If you give them some mindful attention, you may even notice the sensations carry a “rule” you learned growing up. Some examples are “authority knows best”, “trusting your instincts is bad” or “beauty guarantees acceptance.” To make it more complicated, these introjects (ideas and attitudes unconsciously adopted from others) may have been at work for so long, you might simply take them for truth and not see them for what they are—outgrown identifications subject to change.
The bottom line is that outside agendas aren’t well received by our authentic Self and tend to garnish some resistance. On the other hand, if our motivation stems from an inner-sanctioned source—a place within us we know we can trust—then the outlook for lasting change is better.
To continue learning about how to create and examine lasting change, please read part two in this series.
Learn MoreDefining Trauma: What is Trauma?
Defining Trauma: What is Trauma?
As a trauma specialist, I’m often asked, “How do you define trauma?” Trauma is a word we hear and use often, but what does it really mean? Before defining trauma, it’s important to acknowledge that while tidy definitions are helpful, the essence of trauma is anything but.
Trauma is often explained through many lenses. My own understanding is influenced by the leading voices in the field of trauma theory and somatic psychology. These leaders include Peter Levine, Bessel van der Kolk, Larry Heller and Donald Kalsched.
Now let’s take a closer look.
Trauma happens when something is “too much”
Consider that at any given moment your mind, body and psyche are processing innumerable pieces of information. It makes use of what it needs and gets rid of the rest. Take your gastrointestinal system, for example. When you eat an apple slowly, you’re giving your body time to take in what’s useful and discard what’s not. Taking the time allows you to absorb and metabolize the fruit. Imagine what would happen if you hurried through not just one apple, but four or five. Or what if you swallowed a whole bushel of apples all at once? Not only is it impossible to digest, but all the organs involved would suffer serious damage and collapse.
This last scenario obviously couldn’t happen in real life, but the dramatization helps get us closer to defining trauma. An experience that is “too” anything for you to process (rapid, intense, terrifying, unexpected, prolonged, etc.) and that carries a direct threat to basic safety and survival is considered traumatic. The resulting effect is a fragmentation and shut down of your internal systems on a variety of levels.
To understand more about different categories of trauma, please read the next blogpost: “Defining Trauma: Understanding Types of Trauma.”
Learn MoreDefining Trauma: Understanding Types of Trauma
Defining Trauma: Understanding Types of Trauma
The next step in defining trauma is understanding types of trauma. Trauma categories make it seem like trauma can be neatly analyzed, which simply isn’t true. The reality of trauma is far more complex. An important part of trauma healing is psychoeducation. This means using our brain to understand the process that our body, mind and psyche are going through.
To understand trauma, it’s important to recognize the three categories or types of trauma:
- Shock trauma results when our self-protective responses (fight, flight or freeze) fail to protect us against a one-time event that threatens our safety and survival. Such events might include: an earthquake, hurricane or other major natural disaster; car accident, physical or sexual assault, acute medical intervention like a surgery, intubation or being placed on life support; and witnessing a violent act, to name a few. The impact of shock trauma is mainly to a person’s physiology (circadian rhythms, appetite, mood, etc.) and may even result in a diagnosis of Post-Traumatic Stress Disorder (PTSD).
- Developmental trauma is significant impact to the development of the personality during the critical stages of human development (conception to young adulthood). This includes chronic exposure to abuse or neglect, suffering debilitating loss (e.g., forced migration or the death of a loved one), being teased and bullied, living with a chronic medical condition, or experiencing war-time conditions during the critical stages of human development. The main impact of developmental trauma is primarily to a person’s identity, sense of worth, ability to engage with others and maintain healthy relationships. If developmental trauma is severe enough, it can result in a personality disorder diagnosis.
- Complex trauma is the combination of the first two categories and may include a diagnosis of Complex Post-Traumatic Stress Disorder (C-PTSD).
If you’ve experienced any of these three trauma types, you may be a good candidate for somatic therapy. Please reach out directly for more information and help.
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