Trauma
The Trauma Pandemic
Trauma encompasses a wide spectrum of life events, arising from patterns of self-sabotage, violence, promiscuity, sexual molestation, child abuse, poverty, war, neglect, addiction, and more. It is crucial to recognize that marginalized individuals—those who have been excluded, minimized, shamed, impoverished, or bullied—are often among those who bear the burden of trauma. Trauma transcends individual experiences; it resonates across generations, affecting families, communities, institutions, cultures, and societies.
Considering that at least half of the population has experienced Adverse Childhood Experiences (ACE’s), that extraordinary statistics support the numbers coping with the intra-familiar traumas related to molestation, child abuse, poverty of relationships, domestic violence and alcoholism and recognizing that our communities continue to grapple with the transgenerational effects of trauma stemming from numerous crises, disasters, and persistent conflicts, it becomes evident that understanding trauma is one of the most essential lessons we can learn.
Learning about the profound effects of trauma is not only crucial for comprehending the experiences of our friends and family; it also provides invaluable insight into the minds of a significant portion of the population, who are far from being a minority. This is a critical discussion that holds significance across various industries. It is a conversation that transcends boundaries and is pertinent to everyone. Understanding trauma and its effects is a step toward a more compassionate and informed society, fostering empathy and resilience in the face of adversity. We need to use these conversations to rebuild families, build trauma-informed services and better understand the pervasive and complex effects of trauma.
What is Trauma
Trauma represents a desensitized state, an adaptive response to enduring threats. Over time, trauma thrusts both the body and mind into a state of hypersensitivity and hyperactivity, leading to lasting and lifelong alterations in physical, emotional, mental, social, and spiritual health. As this state of heightened sensitivity and hyperactivity persists, desensitization sets in, making it challenging for traumatized individuals to regain equilibrium and return to balance. Gradually, the body and mind often develop coping mechanisms. Sometimes, they are destructive. At other times, they are gifts!
Trauma results in both psychological and physiological changes. Physiologically, individuals undergoing trauma often undergo a recalibration of the brain's alarm system, heightened stress hormone activity, and alterations in the system responsible for filtering relevant information from irrelevant. Psychologically, those who have experienced trauma can become stuck in their growth journey, finding it difficult to integrate new experiences into their lives. The mind, brain, and body all transform trauma, and they collectively hold a record of these experiences. This record is akin to a personal ledger where all our life experiences are stored. The body, mind and brain keep a score.
A key to understanding trauma is understanding the body, brain, and mind record experiences on a personal ledger. This is related to how your body, brain and mind build memories and associations and how dysregulation of the body, brain and mind can lead to trauma. Your Personal Ledger is a historical account of all the people, places and things that have influenced your life experiences, ensuring that each of us perceives and interprets the world uniquely. All transactions (e.g., interactions) with the world are recorded on the ledger, influencing the quality of your overall life experiences.
The memories and associations linked to your experiences play a significant role in shaping and organizing the brain and function and structure. Commencing in the womb, the developing brain begins recording fragments of our life experiences on the ledger, meticulously storing, categorizing, sorting, and filing these experiences, forming a codebook that you use to interpret the world around you. With each experience, we associate and connect the charge of each input to past inputs and the charge of each output to past outputs of experience. These associations enable us to form memories, adapt and change in response to the memories, associations, and experiences stored in our Personal Ledger.
The brain processes experience, generating positive or negative feelings based on the charge, association and connections related to the inputs and outputs of experience. These feelings generate energy and information that serve as feedback mechanisms to maintain equilibrium or disrupt the balance of the system. This state of equilibrium or dysregulation determines whether one has a positive or negative experience. Ultimately, the ledger becomes an indelible record of our life's journey, reflecting the profound impact of our experiences, memories, associations, and well-being. Our ledger serves as a vast database of information that serves as a distributed operation system engaging with the world.
The concept of the ledger functions as an ongoing record of our overall well-being, reflecting the balance within our body and mind across different facets of existence. It encompasses various dimensions: physical health symbolizes vitality, the survival level represents security, the emotional level mirrors our inner state, and at the highest level of human cognition, it embodies a sense of peace. When any of these aspects—health, security, emotions, or thoughts—face challenges or threats, our body activates the stress response to address these issues.
What Happened To You?
Stress occurs when a demand or challenge takes us away from balance – away from our regulated ‘set points.’ When we get out of balance, we become dysregulated and feel discomfort or distress. When we get back into balance, we feel better. Relief of distress – getting back into balance – activates the reward networks in the brain. We feel pleasure when we get back into balance. When we are in balance with our friends, family, community, society, and nature, we are seeking what we need to be stabilised and regulated.
Stress is a natural demand on our body's systems and is integral to our growth, skill development, and resilience. The crucial factor in determining whether stress has a positive or negative impact lies in the pattern of stress activation. Our brain relies on a network of core regulatory systems (CRNs) that extend throughout our entire brain, working in harmony to maintain balance in the face of stressors.
The long-term consequences of stress hinge on the pattern of activation. When our stress-response systems are triggered in unpredictable, extreme, or prolonged ways, they can become hypersensitive or overactive, leading to functional vulnerability. Since these systems extend to various parts of the brain and body, this hypersensitivity can trigger a cascade of risks affecting emotional, social, mental, and physical health. Conversely, consistent, moderate, and manageable activation of the stress-response systems can enhance our resilience ability. A nurturing and predictable environment fosters resilience by strengthening the stress-response systems. However, if these systems are repeatedly activated in prolonged or chaotic ways, as seen in cases of abuse or neglect, they can become hypersensitive and dysfunctional.
The Stress Response
When we are pushed out of equilibrium, our stress-response systems aid us. They trigger the fight, flight or freeze response, during which the brain focuses intensely on the perceived threat, filtering out nonessential input from our bodies and the external world, with a predominant external focus.
On the other end of the arousal-response spectrum, dissociation can occur. This adaptive response makes individuals mentally "disappear" from the situation, immersing themselves in their inner world. Dissociation involves detaching from the external world and directing attention inward. Activities like daydreaming exemplify this form of dissociation. With increasing stress or threat, the dissociative response can intensify, pushing individuals deeper into a protective mode. However, seeking to escape distress can sometimes lead to extreme and ultimately destructive coping mechanisms.
Stress-Response System
Understanding, Communication & Trauma
Understanding and communication is lost when people are impacted by trauma. When the stress response is activated, frustration, anger and fear shut down parts of the cortex. When someone is dysregulated, they simply cannot use the smartest part of the brain.
Communication is about getting some idea, concept, or story from your cortex to another part of the cortex. If we cannot communicate directly from the cortex to the cortex we have to go through the lower parts of the brain. All the rational thoughts from our cortex must get through the emotional filters of the lower brain. Our facial expression, tone of voice, and words are turned into neural activity by the other person’s senses and the sequential process of matching, interpreting, and passing to the cortex takes place. Along the way there are many opportunities for the many of any communication to be distilled, distorted, magnified, minimised, or lost. If the person is regulated, you can connect with them in ways that will facilitate rational communication, but if they are dysregulated, you nothing in the cortex will be easy for them to access.
When people have activated the trauma, they work from a bottom-up sequence known as the Sequence of Engagement. As our brain processes our experiences in a sequential manner information is first processed in their lower areas of the brain where all sensory input is processed. This means that before any new experience has a chance to be considered by the higher, thinking part of their brain, the lower brain has already interpreted and responded to it. It is matched the sensory input from the new experience against the ledger of stored memories of past experiences – before the smart part of the brain even has a chance to get involved. This is why trying to reason with someone before they are regulated will not work and indeed will only increase frustration (dysregulation) for both of you. To communicate rationally and successfully with anyone, you must make sure they are regulated, make sure they feel a relationship with you, and only then, try to reason with them.
We are, in many ways, a reflection of our ancestors. Just as physical characteristics are passed down from one generation to the next, so too are patterns and pathologies of thought, belief, and behaviour. Transgenerational fear is one such example, where the fears of grandparents become the fears of parents, ultimately becoming the fears of their children. Our genes, family dynamics, communities, societies, and the process of intergenerational transmission all play central roles in shaping our understanding of trauma.
Indeed, it often appears that transgenerational and intra-family trauma are deeply ingrained in our society. The history of our experiences within our families, relationships, communities, and cultures, coupled with the narratives presented in the media, all contribute to what is written in the ledger of our collective past. How we make sense of and interpret this information profoundly influences our worldview and forms the basis of our implicit biases. As we process and interpret our experiences, we are actively shaping our worldview and developing implicit biases that are deeply rooted in our understanding of the world.
To gain insight into initiating individual changes, it is imperative that we understand what we inherit and how we inherit it. While genetics undoubtedly play a role in the transgenerational transmission of traits, they are not the sole factor at play. Epigenetics, the science of gene expression modification and control, plays a pivotal role as well. Our genes, although seemingly unchanging, can be influenced to turn on or off based on our behaviours and experiences. Different patterns of stress can lead to either sensitization or resilience, and epigenetic changes are a crucial component of this process.
One critical aspect of epigenetics is that the mechanisms governing gene regulation are reversible. This implies that the environments we create and the challenges we face today can induce changes that reverberate into the future. What we do today matters not only for ourselves but also for the generations to come. Our actions can impact the genetic legacy we pass on, underlining the profound importance of our choices and behaviours in shaping the future.
What Happened To Us?
In many instances, neglect and trauma are intertwined companions along life's tumultuous journey. Neglect, in essence, is entangled with the quantity of attention, nurturing, touch, assurance, and love that one receives. Love, both given and felt, stands as a fundamental human need—a testament to the power of individuals being present, attentive, attuned, and responsive to the needs of their fellow human beings. However, when the backdrop of one's upbringing is marred by deprivation, malnutrition, abuse, or neglect, it becomes a fertile ground for growing up under socialized. In such environments, the crucial neurological development required to experience life's moments at the right times is often stunted.
As one lingers in a deprived developmental setting, the path to recovery becomes increasingly arduous. This bewildering and chaotic world casts us into a perpetual state of dysregulation, leaving us to grapple with our inner turmoil. Growing up in a household or community marked by unpredictability, chaos, and enduring threat—be it abuse, violence, or similar circumstances—often leaves an indelible mark on our stress response systems. These sensitized patterns of stress response can lead to unpredictable, uncontrollable, and prolonged activations of our stress mechanisms, ultimately resulting in an overactive and hypersensitive stress response. Years spent in an environment characterized by chaos, instability, and sorrow gradually desensitize us, transforming us into individuals deeply affected by trauma. However, the presence of nurturing, supportive, and empathetic individuals can offer a lifeline, instilling a sense of belonging and resilience in even the most challenging of circumstances.
What Didn't Happen To You?
Sequence of Engagement
The brain operates in a sequential manner, processing information from the bottom to the top, reflecting its hierarchical organization. At the base of this hierarchy lie the brainstem and the diencephalon, constantly receiving input from the body and the external world through our senses and interoception. This foundational level regulates essential bodily functions such as temperature, respiration, heart rate, as well as patterns of arousal, sleep, appetite, and movement. Moving up the brain's hierarchy, we encounter the limbic system, responsible for governing rewards, memories, emotional bonding, and our emotional experiences. This part of the brain plays a crucial role in our ability to connect and relate to others. At the pinnacle of this cognitive pyramid sits the highly evolved cortex, which enables us to engage in complex thinking, creativity, language communication, temporal understanding, and the formation of values. This top-tier brain region empowers us to express ourselves through words and embrace rational thought.
However, when individuals who have experienced trauma, which accounts for more than half of the population, encounter stress, their capacity for rational thinking is often compromised. Stress, whether stemming from anger, frustration, or other dysregulated emotions, disrupts the flow of incoming information to the brain, leading to a distortion in the message sent to the cortex. Consequently, attempting to reason with a stressed individual can prove futile until they are adequately regulated. In fact, such efforts may exacerbate their distress, causing further dysregulation for both parties. Effective communication and connection are challenging in the absence of regulation, and without these, meaningful reasoning remains elusive.
Whether you find yourself in the roles of a partner, parent, teacher, therapist, or even a police officer, understanding the sequence of engagement is paramount: regulate, relate, then reason. It is tempting to initiate conversations or attempt to soothe the troubled thoughts of a traumatized person. However, when dealing with someone in a state of stress due to trauma, it is imperative to prioritize regulation first—restoring balance to their body and mind. Only after achieving regulation can, one hope to establish meaningful connections. Once these connections are established, the person is more likely to be in a mental and physical state conducive to reasoning. Given that the logical part of the brain is essentially "offline" during a hypersensitive stress response, attempting to reason with the individual before they are regulated is often counterproductive.
When dealing with individuals who have experienced trauma and are in a heightened state of stress, remember that yelling, rationalizing, or offering advice will not provide the help they need. The most effective way to support someone in this state is to assist them in regulating their emotions and restoring their mental and physical equilibrium until they regain the capacity to reason. In a world where a significant portion of the population has experienced trauma, understanding and applying this lesson is perhaps one of the most crucial skills in the modern age.
Bottom Up Regulation
The autonomic nervous system is the brain's most fundamental survival system, consisting of two branches that regulate arousal throughout the body. The sympathetic nervous system (SNS) mobilizes the body and brain with chemicals like adrenaline, while the parasympathetic nervous system (PNS) governs essential functions like digestion, wound healing, and sleep. Ideally, these two systems collaborate to maintain an optimal state of engagement with both our environment and us.
When the autonomic nervous system is well-balanced, we possess a reasonable degree of control over our responses to minor frustrations and disappointments. This equips us to calmly assess situations even when insulted or left out, enabling us to manage impulses and emotions. We remain in a regulated state.
However, individuals with poorly modulated autonomic nervous systems find themselves easily thrown off balance, both physically and mentally. Traumatized individuals often experience an imbalance between their sympathetic and parasympathetic nervous systems, leading to exaggerated responses to relatively minor stresses. Their biological systems, designed to help them cope with life's challenges, falter in meeting the demands. This imbalance not only affects mental and emotional well-being but also renders them susceptible to physical ailments like heart disease and cancer, alongside mental health issues such as depression and PTSD.
A crucial biological marker for this bottom-up regulation is heart rate variability (HRV). HRV measures the balance between the sympathetic and parasympathetic nervous systems. Inhalation stimulates the SNS, increasing heart rate, while exhalation stimulates the PNS, slowing it down. Healthy HRV reflects rhythmic fluctuations in heart rate and signifies overall well-being. Poor HRV, indicated by a lack of heart rate fluctuations in response to breathing, not only impacts cognitive and emotional processes but also influences the body's response to stress.
HRV responses vary along a spectrum, reflecting different states of stress and bottom-up regulation. In well-regulated individuals, slow and regular inhalations correspond to stable heart rate variability, indicative of excellent physiological and psychological health. When someone is upset, their breathing speeds up and becomes irregular, causing their heart rate to desynchronize from their breath. In the case of individuals with a history of trauma, chronic stress responses often lead to a default pattern of rapid and shallow breathing, further disrupting heart rate synchronization. During traumatic episodes or flashbacks, initial laboured and deep breathing causes a rapid heart rate, followed by shallow breathing and a slow heart rate, signalling a shutdown response.
Understanding and addressing the complexities of bottom-up regulation, especially in individuals who have experienced trauma, are vital for promoting physical and mental well-being. Heart rate variability serves as a valuable indicator of the intricate interplay between the sympathetic and parasympathetic nervous systems, shedding light on the impact of trauma on both mind and body. By recognizing and addressing these issues, we can work towards restoring balance and resilience in individuals affected by trauma.