Most of us will experience trauma at some point. In fact, one particular study shows that around 60% of men and 51% of women in the general population have reported at least one traumatic event in their lives.[1] Trauma does not discriminate. Many cases do have a wider historical context – perhaps being abused as a child. But traumatic events can occur on any day, at any time. It may be a car accident or the sudden loss of a loved one; there is no criteria to experience trauma.

It is the direct personal experience of an event that involves actual or threatened death or serious injury.[2] Unlike some cases of pain, trauma is long-lasting and the effects far-reaching. This is not a case of ‘grit your teeth’ or ‘tough it out.’ It is an experience that remains embedded in the memory – volatile and easily triggered. Trauma is usually related to the event itself. The subsequent impact this has on someone is defined and discussed as Post-traumatic Stress Disorder (PTSD).[3]

PTSD is characterised by three clusters: intrusions, like flashbacks, nightmares; avoidance or numbing, for example, avoiding reminders associated with the event and a loss of affect; and hyperarousal, where a person may feel anxious, startled or have difficulty sleeping.[4] There is growing evidence and literature that suggests PTSD and the effect of traumatic events need to be considered a major environmental challenge. The consequences can have a serious impact on an individual’s physical and psychological health.[5] It is stress that can ruin someone’s life. Here, we look at how trauma exists in the body and the impact of these events on both psychological and physical health.

Different Types of Trauma

Trauma can be categorised by three types: acute, chronic and complex. Acute is where someone has been exposed to a singular traumatic event. This may involve a freak accident or a natural or man-made disaster. Chronic trauma is when a distressing experience is either repeated or prolonged. This type of trauma is most commonly associated with domestic violence or child abuse. And finally, complex trauma is exposure to varied and multiple traumatic events, like prisoner of war camps, prostitution, and organised child exploitation rings. [6] Every traumatic event you can think of can be assigned to one of these three categories. There are, however, a number of traumatic experiences that occur more frequently than others. The most common are: someone severely injured or killed; being involved in a flood, fire, natural disaster; being involved in a life-threatening accident.[7] All of these events can affect people differently. Depending on a person’s mental state at the time of an incident, long-term implications vary. It is, however, worth noting that multiple exposures can greatly affect the intensity of not only psychological symptoms, but physical symptoms too.[8]

Why is PTSD such a long-term disorder?

As mentioned, most PTSD is embedded and deeply rooted. A large proportion of experiences stem from childhood or past memory and are difficult to address and resolve. The nature of these events is upsetting and uncomfortable for people to talk about. This means that they are often buried as a self-preservation mechanism. When this happens consciously, it is considered suppressed trauma; when this happens subconsciously, it is considered repressed.[9] It has been referred to as ‘trapped energy’; stuck within the body; capable of overwhelming our cognitive systems.[10] It can be stored and hidden away. But it reveals itself through a number of symptoms, and if untreated they can cause serious damage.

What are the effects?

Trauma has both an initial and later impact. Right after a particular event, emotions are heightened, and nerves shaken. The initial effect can make people feel exhausted, confused, sad, anxious agitated. The severity of an experience is evident when these early responses intensify and persist as time goes on. These may include distress without periods of relative calm or rest, severe dissociation symptoms, and intense intrusive recollections that continue despite a return to safety.[11]

  • Psychological

Emotional reactions to trauma can vary and are significantly shaped by the individual’s sociocultural history. Common feelings include anger, fear, sadness, and shame. Despite these intense feelings, emotions are often reserved. This is because people who have experienced traumatic events see emotional expression as losing control; they heavily associate this with their traumatic experience. As some people struggle to show emotion, others struggle to control it. Again, this is due to trauma dysregulating a person’s emotional state. Numbing is just as common. This is a biological process whereby emotions are detached from thoughts, behaviours, and memories.[12]

  • Physical

Trauma is sometimes only seen as a psychological issue. But it can have a truly adverse effect on physical capacity. There are a number of fairly minor implications, including insomnia, nightmares, racing heartbeat, aches and pains or fatigue.[13] Uncomfortable and distressing, yes. But compared to other symptoms, they are slight. In fact, exposure to trauma can have a direct impact on an individual’s immune system. Chronic PTSD has been heavily linked with cardiovascular problems, such as electrocardiogram abnormalities, atrioventricular defects, and infarctions.[14] There is also a link between trauma and reproductive disorders. Although this link has been investigated less thoroughly, there is evidence that shows trauma to be associated with chronic pelvic pain, sexual problems, infertility and miscarriage, preterm delivery, and low birth weight.[15]

Triggers

Trauma is hidden and often trapped. But it can be unleashed. If someone has experienced a traumatic event, they may respond badly to previously neutral and nonthreatening stimuli. This is a resurgence of feelings attached to that particular event, and may involve a person, a place, or an object. But research has shown that triggers may not necessarily be directly related to the original trauma.[16] People may be unaware of triggers until they face one. This element of the unknown is what makes trauma so difficult to address and resolve. It is also why it requires such deep and detailed treatment.

Trauma is upsetting and for many disturbing. But it is there, and until it is treated, it will continue to have a crippling effect on a person’s ability to function both mentally, and physically. The traumatic nature of these events is why people are so quick to suppress everything related to them. This emotion is trapped, but when triggered it can have an adverse effect on how people think and how they behave. It is vital we understand that trauma does not disappear. It lives on within the body but can reveal itself at any time. Whether it is acute, chronic, or complex, traumatic experiences stay with you, and will continue to do so, unless something is done about it.

References:

[1] D’Andrea, W. et al. 2011. Physical Health Problems After Single Trauma Exposure: When Stress Takes Root in the Body in Journal of American Psychiatric Nurses Association, [online], available at: http://www.traumacenter.org/products/pdf_files/japna425187.pdf [accessed 18 June 2020].

[2] Schneider, J. C. et al. 2012. The Long-Term Impact of Physical and Emotional Trauma: The Station Nightclub Fire, [online], available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0047339 [accessed 18 June 2020].

[3] D’Andrea, W. et al. 2011. Physical Health Problems After Single Trauma Exposure: When Stress Takes Root in the Body in Journal of American Psychiatric Nurses Association.

[4] ibid.

[5] McFarlane, A.C., 2010. The long-term costs of traumatic stress: intertwined physical and psychological consequences, [online], available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816923/ [accessed 18 June 2020].

[6] Children’s of Alabama. Online File. How emotion/psychological trauma affects the body, available at: https://www.childrensal.org/workfiles/Clinical_Services/CBH/How_Trauma_Affects_the_Body.pdf [accessed 18 June 2020].

[7] D’Andrea, W. et al. 2011. Physical Health Problems After Single Trauma Exposure: When Stress Takes Root in the Body in Journal of American Psychiatric Nurses Association.

[8] ibid.

[9] Eckelkamp S. MindBodyGreen Blog. 2019. Can Trauma Really Be 'Stored' In The Body?, [online], available at: https://www.mindbodygreen.com/articles/can-trauma-be-stored-in-body [accessed 18 June 2020].

[10] ibid.

[11] Substance Abuse and Mental Health Services Administration. 2014. Understanding the Impact of Trauma in Trauma-Informed Care in Behavioral Health Services, [online], available at: https://www.ncbi.nlm.nih.gov/books/NBK207191/ [accessed 18 June 2020].

[12] ibid.

[13] Children’s of Alabama. Online File. How emotion/psychological trauma affects the body.

[14] D’Andrea, W. et al. 2011. Physical Health Problems After Single Trauma Exposure: When Stress Takes Root in the Body in Journal of American Psychiatric Nurses Association.

[15] D’Andrea, W. et al. 2011. Physical Health Problems After Single Trauma Exposure: When Stress Takes Root in the Body in Journal of American Psychiatric Nurses Association.

[16] ibid.