Why is Trauma Created
Trauma is created because the body failed to mobilize in response to the production of stress hormones in the body over a prolonged duration of time. Stress hormones are secreted into the body from the brain's Hypothalamus when danger is sensed. The human brain is the most advanced, complex machine in the world, yet at the heart of the brain, it is very primitive. The most primitive part of the brain is the brain stem, which will always take over when our threat of survival is activated. During any threat of survival, the brain will secrete stress hormones like adrenaline with one purpose: to mobilize the body to reduce the threat.
How is Trauma Formed
Trauma is formed over a series of stage responses within the body. It is during these stages that map out the prolonged duration of time mentioned in the previous section. The duration of time for the formation of trauma could be seconds, minutes, hours, days, or even years. Science cannot measure the first instance of a trauma, yet, neuroscience research can recreate a trauma (retelling a traumatic experience) and analyze the body.
Most people have likely heard of fight, flight, and freeze as trauma responses. However, there is a few specifics that one should know throughout the forming of a trauma. In fact, the formation of trauma is very chronological.
Stage 0: Social Engagement
Trauma starts in a preliminary stage that I will call Stage 0: social engagement. When our brain and body sense any level of discomfort or our level of safety is threatened, we will reach out for help and comfort. Social engagement is a preliminary stage during the formation of trauma because our primitive brain is not activated yet. Our emotional and survival brain is not taking over the body, yet.
Many young adults actually don't have a Stage 0 because they weren't taught social engagement when they were young. When a child is hungry, they are fed. When they are cold, they get a sweater. When they are lonely, a parent provides touch. These are forms of social engagements that often can turn into adult-level traumas if children were not given any form of comfort.
If social engagement does not remove the threat or someone does not inherently have strong responses of social engagement, they will move to Stage 1.
Stage 1: Fight or Flight
The emotional brain is now activated and in control. The sympathetic nervous system is now signaling the Hypothalamus to secrete stress hormones. The adrenaline fills the body and tells the body to mobilize. Anything to remove the threat of danger. We fight off the attacker (external threat) or flee from it.
Fight and flight are actions that mobilize the body to hopefully deactivate the sympathetic nervous system response, which is controlling the heart, lungs, and muscles. These are the most primitive organs in the body. We need the heart to pump blood. We need the lungs to breathe. We need the muscles to move the body.
If the body fails to eliminate the stress hormones using the actions of flight or fight, Stage 2 is activated.
Stage 2: Freeze
Freeze is a method of preservation. The human body cannot run away or face the external threat, so the nervous system literally tries to preserve the body by freezing. Sometimes, freezing is itself an action that helps eliminate the stress hormones that are still activated in the body at this time. I find the stage of freezing interesting because it's synonymous with putting food in the freezer. The freezer job is to delay a process or stop something in time. However, our bodies are freezing in hopes for the external threat to go away and preserve the state we are in.
If freezing does not eliminate the stress hormones in the body, the final stage is activated.
Stage 3: Fold (Collapse)
Stress hormones are still present. The human body failed to take action and the external threat is still present. It's in this final stage of folding that the formation of what will be known as a traumatic experience and memory will be created.
The human body is in a state of hopelessness and helplessness. Once the body folds or collapses, the reptilian, primitive part of the brain, the brain stem is now fully activated. Nothing else matters. During this stage, the nervous is system is switching back and forth between sympathetic and parasympathetic states because the body does not know which is healthier for survival.
When our body folds, the parts of the brain that are responsible for awareness and sense of self are completely shutdown and offline. When awareness and sense of self do not exist, we do not exist. Essentially, we cease to matter in this instantaneous moment. In my opinion this is the exact reason why recovering from trauma is the most important journey in human nature because it's in our human nature to identify with our sense of Self. Trauma takes that away.
The Lost and The Found: Healing from Trauma
Dr. Bessel Van Der Kolk (the author of The Body Keeps The Score) writes:
"As long as the trauma is not resolved, the stress hormones that the body secretes to protect itself keep circulating, and the defensive movements and emotional responses keep getting replayed."
As long as we do not heal from our past traumatic experiences, we will continue to not only be lost in the world, but more importantly - lost in our own bodies. The truth about healing from trauma is about restructuring our own internal physiological responses to around trauma so we can literally find our true self: The Found.
In between losing ourselves and finding ourselves (The Lost and The Found), there is the healing, which requires a tremendous amount of work. The work we do in healing trauma is a profound journey that deserves attention and patience. As a professional therapist over the last 20 yeas, I've noticed the growing field of neuroscience research prove so many fascinating methods for healing trauma. There is one common thread that overlaps in almost all trauma therapy methods: involving the body. The scientific community is in full agreement that talk therapy is just not enough anymore to heal trauma.
The Middle, The Messy, and The Magic
The path towards recovering from trauma is a process. Some could be short and some are every long. It requires work and it isn't easy. It's quite messy. However, it is pure magic because of the power it creates within the body and the mind.
Recovery and healing from trauma is messy not because of the confusion, but because everyone is different and a combination of methods may be needed. However, the clear part of this process is the fact that there a few simple truths that must come out of the road to recovery:
Being calm, in control, and focused in response to various sensory inputs such as images, physical sensations, sounds, thoughts, smells, etc
The ability to be fully in the present moment, alive, and engaging with others
Uncovering the adaptive ways you've managed to survive so nothing is invisible within your body and mind
The road in accomplishing these milestones is not straight. Each truth that must be achieved occur at different parts of the recovery process. The important question is what kinds of therapy and trauma healing methods should be implemented. From my experience, the most successful therapy methods all work with befriending the emotional brain (the part of the brain responsible for holding on to the traumatic memory).
The two main general approaches to healing trauma are the bottom-up method and the top-down method.
Bottom-Up
The bottom-up method symbolizes the direction in the brain at which you recover. Geographically, the brain is mapped with the bottom portion consisting of the Limbic System (the emotional brain and brain stem) responsible for feelings and emotional responses. The Up (top) part of the brain is the Prefrontal Cortex (PFC). The PFC is thinking brain responsible for logic, reasoning, conscious, and decision making. A bottom-up approach is rewiring the nervous system in which the thinking the brain follows. All bottom-up healing approached involve some type of visceral, movement, breathe, rhythm, and vocal communication. These methods create or induce felt sensations throughout the body, which the top part of the brain acknowledges. One example of a bottom-up healing approach is EMDR therapy (discussed below).
Top-Down
The top-down approach is geographically opposite method to healing trauma, starting with the PFC and moving down the Limbic System. There is a specific region of the PFC called the Medial Prefrontal Cortex (MPFC) which is our self-sensing system part of the brain. The MPFC is the region of the brain that allows us to understand, watch, and notice what is going on inside our own bodies. We cannot directly access the Limbic System of the brain, however, our MPFC communicates with it. Therefore, the top-down approaches to healing trauma are all focused around mindfulness: the act of noticing. The MPFC is where our awareness is located. Mindfulness and awareness are the two major elements to top-down trauma therapy. By practicing mindfulness, the MPFC allows us to strengthen emotional regulation.
Eye Movement Desensitization and Reprocessing (EMDR)
One trauma healing method that I specialize in is called EMDR. EMDR is a bottom-up approach to healing trauma. The purpose of EMDR is to be able to access their traumatic memory system (traumatic experience) while reducing the feeling of being triggered or emotionally overwhelmed. People who struggle with overcoming traumatic experiences require transforming their fragmented memories into completed and whole memories. Traumatic memory lives in the implicit regions of thew brain, meaning that we cannot deliberately control the memory. This is why we get triggered.
The implicit part of the brain is subconscious. The nervous system must be activated to communicate with traumatic memory. EMDR works as a bottom up approach because it incorporates bilateral stimulation (BLS). The various types of BLS include auditory, visual, or tactile external stimuli in a rhythmic pattern. The purpose of BLS is to help activate both halves of the brain during the sharing of a traumatic experience. Activating the entire brain stops someone from being stuck in the past and helps ground them to the present moment. By implementing BLS, clients are able to focus, access, and reprocess negative memories while moving forward with a. more positive outlook.
EMDR therapy works to identify the who, what, where, when, and the why within a traumatic experience. Identifying the fragmented, unprocessed, key factors that are at play within a traumatic experience is essential for moving forward on the path of healing.
Multi-Method Approach
Over the course of my career, I've witnessed people (including my clients) heal from more than one approach. Almost all trauma healing methods involve some form of bottom-up and top-down. EMDR works wonderfully with narrative therapy. Additionally, yoga is an incredible tool for healing trauma because yoga can be a top-down (mindfulness, awareness) and bottom-up (breathe) approach. There are dozens of proven trauma therapy methods, but all roads to recovery must involve the body, not the just the mind.
Thank you for reading!
-Beverly Teller M.A., LMFT
