The Body Keeps the Score
In this blog post, I aim to explore the impacts of trauma on the body, drawing insights from the book 'The Body Keeps the Score' by Dr. Bessel van der Kolk. By delving into the intricate connections between trauma and the body, I hope to offer a deeper understanding of adverse experiences and the toll they take on individuals. Additionally, I will discuss some helpful tools and strategies that can be utilized in the journey toward healing and recovery.
Impact of Trauma
Trauma defies the conventional narrative structure of memory. Rather than neatly arranged recollections with a beginning, middle, and end, traumatic memories manifest as fragmented flashbacks. These fragments consist of disjointed sensory elements—images, sounds, and bodily sensations—initially devoid of connection to the present beyond evoking fear and panic. Despite the absence of a linear story, the mind seeks to impose meaning on these disjointed elements. Humans harbor an innate drive to make sense of past experiences, crafting narratives to give meaning to traumatic memories. The degree to which we resonate with these narratives and the level of arousal they instill in us profoundly influences what we remember. Studies have shown that the remembrance of a particular event, and its accuracy, largely depends on its personal significance and the intensity of emotion experienced at the time. The more emotionally charged an experience, the more likely it is to be remembered, albeit potentially inaccurately (Van der Kolk, 2014, p. 137, 177).
fMRI studies have shown that during traumatic flashbacks the Broca’s area, a critical speech center in the brain, shuts off. As a result, individuals find it challenging to articulate their thoughts and emotions verbally. The inability to access language impedes the capacity to convey experiences, express emotions, and communicate needs or boundaries effectively. Moreover, it's not uncommon for the left hemisphere of the brain to deactivate during traumatic events. This directly impairs executive functioning skills, including the ability to organize experiences into logical sequences, identify cause and effect, understand long term consequences of actions, or create future plans. The clinical term for the difficulty in verbalizing emotions is alexithymia. Many traumatized children and adults who struggle with alexithymia encounter challenges in attending to their well-being, engaging in self-care, and establishing meaningful interpersonal relationships, as they grapple with a profound sense of disorientation and emotional numbness (Van der Kolk, 2014, p. 100).
During traumatic events, intense emotions activate the amygdala in the limbic system to release stress hormones such as cortisol and adrenaline. These hormones elevate heart rate, blood pressure, and breathing rate, preparing the body for a fight or flight response. Ideally, our stress hormone system should respond swiftly to threat, then quickly return to equilibrium. However, in traumatized individuals, the stress hormones spike rapidly and take much longer to return to baseline. In cases of Post-Traumatic Stress Disorder (PTSD), the stress hormone system fails to return to baseline after the threat dissipates. Consequently, as long as the trauma remains unresolved, the body continues to secrete stress hormones, reacting disproportionately even to mild stressors. Traumatized individuals respond to stress as they do to trauma, continuously releasing excessive amounts of cortisol and adrenaline (Van der Kolk, 2014, p. 67).
Continuous activation of the stress cycle leaves traumatized individuals feeling chronically unsafe within their own bodies. They exist in a perpetual state of hypervigilance, constantly anticipating potential threats. In an effort to manage this overwhelming anxiety, many develop coping mechanisms to ignore or numb their emotions entirely. However, when stress is not recognized and addressed directly, somatic symptoms arise as the body attempts to cope. Research has shown a link between trauma and the emergence of unexplained bodily sensations, including autoimmune disorders, chronic back and neck pain, fibromyalgia, migraines, digestive issues, spastic colon/irritable bowel syndrome, chronic fatigue, and certain forms of asthma (Van der Kolk, 2014, p. 100).
Protective factors
Despite the challenges posed by trauma, there is encouraging news: protective factors exist that can facilitate healing and prevent further trauma. To begin the healing journey we first need to engage the safety system of the brain before trying logical approaches and new ways of thinking. Genuine recovery requires convincing the mind, body, and brain that it is safe to relinquish the grip of trauma. That happens only when individuals feel safe at a visceral level, allowing them to establish a connection between this newfound safety and memories of past helplessness. This process serves as the cornerstone for initiating profound healing and reclaiming agency over one's own well-being (Van der Kolk, 2014, p. 212).
Mindfulness. One effective method of communicating safety to the brain is through the practice of mindfulness. Practicing mindfulness has been shown to increase bodily awareness and diminish the activity of the amygdala, leading to decreased reactivity to potential triggers. Additionally, recalibrating the autonomic nervous system through techniques such as conscious breathing, movement, and touch can profoundly impact one's well-being. Scientific research has corroborated the efficacy of these practices, demonstrating that modifications in breathing patterns can ameliorate issues like anger, depression, and anxiety. Furthermore, yoga, with its emphasis on breath work and movement, has been found to positively influence a broad spectrum of medical conditions, including high blood pressure, elevated stress hormone secretion, asthma, and lower-back pain (Van der Kolk, 2014, p. 212, 64, 271).
Therapy. Physically re-experiencing past traumas in the present, within a safe and supportive environment, can be transformative. This process enables individuals to revisit traumatic memories and emotions in a controlled setting, while reframing and recreating new narratives. By engaging in therapeutic reworking of past traumas, individuals have the opportunity to rewrite their story, infusing it with elements of safety, support, and resilience. Research supports the efficacy of this approach, revealing that calming the fear center of the brain can lead to a reduction in trauma-related symptoms and an improvement in executive functioning. By mitigating the hyperarousal and hypervigilance associated with trauma, individuals can experience enhanced cognitive abilities, greater emotional regulation, and an overall improvement in their quality of life (Van der Kolk, 2014, p. 302, 325).
Healthy Relationships. Establishing safe connections with others is fundamental to meaningful and fulfilling lives. Social support stands out as the most powerful defense against being overwhelmed by the effects of stress and trauma. It is through these supportive relationships that we find refuge, comfort, and reassurance. Moreover, the most natural way for human beings to feel comfort is by seeking closeness with others. This instinctual response offers immediate relief and fosters a sense of connection and security that aids in navigating challenges and promoting emotional resilience (Van der Kolk, 2014, p. 212, 103).
Sense of Agency. Trauma robs individuals of their autonomy, leaving them feeling powerless. Recovery thus entails reclaiming ownership of one's body, mind, and life. The ability to take action and exert agency in times of adversity plays a pivotal role in the long-term impact of trauma. When individuals have the capacity to move and actively protect themselves during unsafe situations, it significantly diminishes the likelihood of lasting psychological wounds. This capacity to act empowers individuals, instilling a sense of efficacy and control over their circumstances. By gaining agency, survivors of trauma can forge a path towards self-actualization (Van der Kolk, 2014, p. 55, 97, 205).
References:
Van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books.