Shining a spotlight on traumatisation - by Gail Donnan
Trauma is not only a term reserved for war zones or disaster, it can be anything that has a long lasting negative effect on our well-being. Research suggests that 70% of the world’s population is living with the effects of trauma. For the purpose of this blog, this could include receiving a medical diagnosis, life changing surgery, long term illness, accidents, hospital stays, body changes, medication side effects, neglect, caring for a loved one, grief and how we are understood and cared for. Cultural ignorance, the current NICE trauma treatment guidelines and a lack of trauma-informed approaches in the UK can leave many of us feeling invalidated and traumatised. If you or someone you love feel you may be traumatised it is not something to ignore. So many traumatised people find themselves stuck between medicine and mental health with neither discipline really holding accountability.
Trauma and the Brain
Interestingly, what happens to us after the ‘event’ is the actual trauma, sometimes the ‘event’ is so powerful it overwhelms the brain’s response due to naturally releasing a high level of stress chemicals to cope. This survival response means that the smart part of our brain that’s needed to process information goes temporarily offline. So what happens to the residual information that should have been processed? Absolutely nothing, it sits day after day in the lower regions of the brain that manage our emotions and sensory information in the nervous system (Limbic System) so we continue to respond to the danger by re- experiencing it. Traumatisation is the memory system gone awry. Dr. Neil Bindermman from The Person Centred Neuroscience Society refers to this as “acquiring a mind injury”. After all these years I still prefer using the word ‘traumatised’ as opposed to ‘trauma’ , as I find it more relatable.
The Three Distinct Stages of Traumatisation
Traumatisation can be from one solitary event, but can also be the circumstances leading up to the event, the incident or event itself however that presents for us and the circumstances following (minutes, hours, days, weeks, months). This last stage includes how we are cared for, how we are listened to and if we feel validated and understood. Trauma lands where we have no networks to think, tell or have a concept of time. Everything seems mixed up and it may not have a beginning, middle and an end, we may lose our ability to focus, to concentrate and make decisions. It is in this lower area of the brain that input from all the senses enter, vision, touch; smell and hearing and taste. None of this goes directly to the smart part of the brain (prefrontal cortex) for us to gain some perspective. Incoming signals are matched against previously stored experiences, re-enforcing the stress response.
The Physical Effects of Traumatisation
Because the ‘smart part’ of our brain goes temporarily offline and the trauma resides in the lower regions which are mainly autonomic (outside our conscious control), we experience traumatisation through bodily/somatic symptoms. These could present as anxiety, panic, shaking, fear, twitching, insomnia, headaches, tummy aches, more visits to the loo, numb areas, pins and needles in our extremities, shortness of breath, difficulty swallowing, tight throat, weakness, disordered eating, heart palpitations, pounding head, feeling sick, sweating, tension, pain and inflammation.
Flashbacks
There is a misconception that flashbacks are merely visual but research shows that they come in many sensory forms such as sounds, sights, smells, taste and touch. Even places, people and situations, times of the day, week, year, a season and colours can be triggers.
Are the effects different for everyone?
Simply yes and let me explain why. Many of us may be living with the effects of Adverse Childhood Experiences (ACEs before the age of 18) such as emotional abuse (recurrent), physical abuse (recurrent), sexual abuse (contact), physical neglect, emotional neglect, substance abuse in the household (e.g., living with an alcoholic or a person with a substance-abuse problem), entail illness in the household (e.g., living with someone who suffers from depression or mental illness or who had attempted suicide), mother treated violently, divorce or parental separation and criminal behaviour in household (e.g., a household member going to prison). These will affect how, as an adult, we respond to overwhelm and triggers. Despite the effects of the above, if as a child we had an emotionally available buffer, maybe one parent, teacher or caregiver that supported us safely, we will fare better in adulthood. Genetics also play a role in how our body deals with traumatisation. This is why some of us look like we are having a disproportionate reaction to things.
Treating Traumatisation
First we have to understand trauma properly and viscerally. American psychiatrist and researcher Dr. Bruce Perry explains it perfectly “all experience is processed from the bottom up, meaning to get to the top, “smart” part of the brain, we have to go through the lower, not-so-smart part of our brain. This sequential processing means that the most primitive, reactive part of our brain is the first part to interpret and act on the information coming in from our senses. The brain is organised to act and feel before we think”.
Treatment Approaches
Over many years I have seen a multidisciplinary approach works well, which means it must be person centred, holistic, including clinical and non-clinical therapeutic approaches. I start by avoiding the question “what is wrong with you?” and replacing it with “what happened to you?” An important question is also around “when was the last time you really felt well?”
If you have the means to work with a trauma-informed Somatic Therapist, Somatic Psychotherapist or Emotional Freedom Technique practitioner (EFT) I would recommend these as a good starting place. Many people with somatic complaints understandably go straight to their GP rather than searching out a professional somatic therapist or complementary therapies. Regulation is paramount for all of our safety, but can be voluntary in certain therapies within the UK, so always check the qualifications, credentials, insurance and any professional bodies the therapist is registered with to make sure you are in safe trauma-informed hands.
Our body should feel like the safest place on earth, but trauma and illness robs us of this. Somatic work will help your body feel safe and trauma symptoms improve. If you don’t have access to a therapist I would suggest starting with gentle relaxation and meditation, conscious breath work which signals to the body that you are safe and it will move out of fight or flight mode and into rest mode. It is easy to be stuck in fight mode, to be angry at everything and everyone – this is a normal traumatised reaction. Meditation is also a key player in inducing sleep and improving immune function. If you are able, perhaps try some gentle restorative and trauma-informed yoga or Qigong which help wake up the vagus nerve to help you relax. Find yourself a quiet space somewhere and have some comforting anchors such as favourite aromatherapy oils and a throw/scarf or weighted blanket to wrap around you.
Traumatisation is helped by rewiring the nervous system and I would recommend this online, easy to use programme Rewire Therapy https://www.rewiretherapy.net/
Further Resources and About Gail
Gail Donnan is an Interdisciplinary Psychologist, Trauma-focused EMDR Psychotherapist, Somatic Therapist, Advance Menopause Practitioner, Author, Trauma Survivor and Founder of The Trauma Centre in North Yorkshire. She is also an external trauma-informed trainer for the NHS and regularly speaks around trauma treatments in the UK.
The right knowledge and education are important around traumatisation, we are not broken or permanently damaged, there is hope to heal from trauma. You will find lots of information on our website www.ripontraumacentre.org which is a Community Interest Company (not for profit) set up in 2021 to address trauma within community mental health.
Please note that none of this advice is intended as a substitute for professional diagnosis or treatment rather intended to compliment your medical team’s advice.
References:
Crinnion, M. (2021). Experts. [online] Luma3. Available at: https://www.luma3.uk/experts
https://drdansiegel.com/brain-insights-and-well-being/ [Accessed 1 Aug. 2021].
Emerson, D., Sharma, R., Chaudhry, S. and Turner, J. (2009). Trauma-Sensitive Yoga: Principles, Practice, and Research. International Journal of Yoga Therapy, 19(1), pp.123–128.
Gabor & Daniel Mate – The Myth of Normal 2022
Nadine Burke Harris The Deepest Well 2021
Bruce Perry and Oprah Winfrey – What Happened to You 2022
www.ripontraumacentre.org
Rewire Therapy https://www.rewiretherapy.net/
Sinha, A.N. (2013). Assessment of the Effects of Pranayama/Alternate Nostril Breathing on the Parasympathetic Nervous System in Young Adults. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, (7).
van der Kolk, B. (2014). The Body Keeps the Score: Mind, brain and body in the transformation of trauma. London: Penguin Books.
