In order to understand and recognize trauma responses one needs to be familiar with the concept of trauma and its symptoms. Originally trauma was associated with someone who was directly exposed to a traumatic event. However, the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) broadened the definition of trauma to include people who were not directly involved in the traumatic event but who learned about a traumatic event experienced by another. The DSM IV defines trauma as experiencing an event outside the range of usual human experience that would be markedly distressing to almost anyone; a serious threat to his or her life or physical integrity; serious threat or harm to his children, spouse, or other close relatives or friends; sudden destruction of his home or community; or seeing another person seriously injured or killed in an accident or by physical violence.
Trauma symptoms can be expressed days, months, or even years after the traumatic event. Symptoms may suddenly arrive through a trigger in the environment and might appear as emotional, cognitive, or physical symptoms. Sometimes the mind is not able to make sense of the internal signals, especially when the person has experienced an overwhelming event or stressful situation. The mind might continue to communicate to the nervous system the necessity to prepare to flee, fight, or freeze. Adrenaline is disbursed and the cycle might perpetually continue until the body-mind perceives that it is safe and resourced again and recognizes it can rest. We do not choose the emotions we feel, but we have choices about what we do with them. Bessel van der Kolk explains that one important aspect of trauma treatment is to stay in the present without feeling or behaving according to irrelevant demands belonging to the past. Psychologically, this means that traumatic experiences need to be located in time and place and distinguished from current reality.
One tool that somatic psychotherapists employ is the tool of body awareness. This enhances our ability to stay in the here and now. There are many more tools and each theory has its own techniques. More than three out of four Americans can expect to be exposed to a traumatic event at least once in their lives. One third of those exposed to trauma develop chronic or at least transient symptoms of PTSD [Post Traumatic Stress Disorder]. Sapolsky explains that PTSD is a physiological reaction to overwhelming and ongoing stress and is a fight or flight response. As a result, specific hormones are released that alter such things as skin sensitivity, alertness, heart rate, digestion, and learning skills. Additionally, hormones such as cortisol are excreted to expand pain tolerance. Cortisol can also cause hypervigilance, preparing the traumatized person to act at a moment’s notice. Other physiological reactions include an adrenaline rush which can raise heart rate, cause heart palpitations, produce pupil dilation (increasing visual changes), and stop digestive physiology. Due to a disbursement of glucocorticoids, the body may react with constipation, diarrhea, headaches, and sleep disturbances. Epinephrine and norepinephrine slow down the blood flow to the digestive system and extremities. These hormones can even inhibit learning skills and cause attention deficit or confusion.
Studies have found that sexually abused women and veterans show a decrease in the size of the hippocampus, causing learning and memory loss. PTSD affects parts of the brain that are associated with language, visual, and motor responses. During flashbacks, the Broca areas of the brain (responsible for verbal functions) slow down which may cause an inhibition of verbal expression of feelings while sensorimotor memories including visual images, tastes, sounds, smells, anxieties, fears, and pressures can still be recalled.
Trauma leaves memories not only in the mind but also in the body. All non-verbal messages (such as those perceived by our senses) are collected in the implicit memory (subconsciously)whereas verbal messages are processed by the linear language centers of the brain and are stored in explicit memory (consciously) for easy access. Rothschild explains, “When PTSD splits mind and body, implicitly remembered images, emotions, somatic sensations, and behaviors become disengaged from explicitly stored facts and meanings about the traumatic event(s), whether they are consciously remembered or not”. Van der Kolk emphasizes that contemporary research on the biology of PTSD affirms that stress hormones and memory processing are altered by traumatic events. It is now thought that people hold an implicit memory of trauma in their brains and bodies.
Candace Pert, author of Molecules of Emotions: The Science Behind Mind-Body Medicine, suggests that not only does the brain carry memories but that cells and proteins (referred to as neuropeptides) hold and transport them throughout the entire body. Levine points out that memories are not literal recordings of events but rather a complex of images that are influenced by arousal, emotional context, and prior experience. Memories may even transform over time as new experiences add layers of meaning to the images. Levine asserts that psychological wounds are reversible and that healing comes when physical and mental releases occur. According to Levine somatic psychology offers tools to effect these releases by raising body awareness and first locating feelings in the body.
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