The Traumatized Body and Mind

This article was first published on the "Caesura" page.

For a significant part of the psychiatric and psychological tradition, how a person responded to trauma was attributed, above all else, to that person's "inner capacity": how coherent, how resilient, how adaptable, or how already-vulnerable they happened to be. In this view, the external event functioned mainly as a stimulus that brought to light weaknesses or conflicts already present within the person; if someone was, by temperament, "coherent and resilient," they could pass through even profoundly traumatic events without sustaining a paralyzing psychic wound.

Extensive research in recent decades, however, has called this understanding into question. While the role that a person's inner capacities play in shaping their response to a traumatic event cannot be dismissed, once an event exceeds a certain threshold of severity, chronicity, or sheer shock, very few people remain untouched by its traumatic consequences.

In what follows, I want to consider some of the most common mental and bodily responses to traumatic events. As it is never a simple matter to separate the psyche from the body — and it is especially useful, when thinking about trauma, to regard the body-mind apparatus as a single interwoven, interconnected network — it is likewise no easy task to distinguish the aftereffects of trauma from the trauma itself. Put differently: what we are looking at are not merely "traces" that trauma has left settled upon body and soul, but, in a certain sense, the trauma itself, continuing to live within us in this particular form.

In the face of overwhelming events, the psyche suspends many of its ordinary functions. Certain bodily and mental activities shut down, while others are strengthened in ways that can be startling. Mechanisms are set into motion that, under ordinary circumstances, would appear strange, contradictory, or useless. And yet, if we are able to see them as strategies devised for enduring the moment of trauma, they not only become meaningful to us but come to seem, given the circumstances and the position we were in, all but inevitable.

Although each of us responds to traumatic events in our own particular way, most of these responses can be gathered into three broad categories: hyperarousal, intrusive re-experiencing, and numbing. In what follows, we will look at the most salient expressions of each.

Before going further, it is worth recalling that this list of symptoms should not be used as a diagnostic guide or as a label for a psychiatric disorder. If any of these signs is disrupting your ordinary life, it would be best to seek help from a psychiatrist, psychologist, social worker, or counselor.

And it is worth remembering, too, that many trauma survivors pass through remarkably similar experiences. Although we are not meant to regard these responses as permanent fixtures, nor to remain passive in relation to them, it would be equally unfair to view them as marks of weakness, defect, or illness.

Hyperarousal

This is perhaps the most conspicuous bodily face of trauma's aftermath. In the encounter with sudden, severe blows, the mind is often given no opportunity to perceive and comprehend the event by its usual means. Any hesitation could prove fatal, and even hundredths of a second can matter, and so the process by which the brain receives, encodes, and stores information passes not along its customary routes — the routes that give rise to long-term verbal and narrative memory — but along shorter paths whose principal aim is survival, not the comprehensive understanding of the situation.

In this process, the psyche mobilizes every resource at its disposal to escape the danger: through the rapid simplification and appraisal of threat (Is this friend or foe? Dangerous or safe? Should I flee, fight, or freeze?), and through the summoning of intense emotion.

The trouble is that this heightened arousal can remain lodged in the body-mind apparatus long after the event itself has passed. Hyperarousal keeps warning the body that danger might return at any moment. This is why, even at a considerable remove from the traumatic event, we may still startle easily, feel restless, sleep poorly, grow quick to anger and aggression, struggle to concentrate, and find ourselves overwhelmed by various sensory stimuli — sound, smell, light — beyond what seems warranted.

Intrusive Re-experiencing

The second category of symptoms consists of the intrusion of thoughts and sensations connected to the traumatic experience. This might be considered the most distinctly psychological face of the traumatic experience, since it pertains chiefly to the workings of the mind, and it leaves us with the sense that we have no control over our own thoughts and feelings.

In the experience of trauma, even though the danger has passed, the mind cannot simply let it go. It is a common experience among trauma survivors that images, bodily sensations, nightmares, and flashbacks connected to the event return again and again.

Sometimes even a seemingly trivial trigger — a sound, an image, a word, a smell — hurls us back into the middle of the traumatic scene from the past, summoning the memory with the full vividness and physical and emotional force it once carried, as though the whole event were happening again, right now.

These experiences can be deeply distressing, and they can badly weaken our sense of agency over our own lives. Even so, it is important to remind ourselves that these are the common, comprehensible responses of a traumatized mind and body.

In overwhelming trauma, the hormonal and neurological flood of the catastrophic moment often prevents the memory from consolidating into a coherent, meaningful form. What remains are scattered fragments of experience. These mental and bodily experiences return precisely as "intruders," as uninvited guests, because they were never given, in their own time, the proper opportunity to be processed, understood, and integrated.

Out of the combination of the first and second categories of response, important behavioral patterns take shape — patterns which, if we remain unaware of them, can perpetuate the cycle of trauma or even intensify the injury.

When we find ourselves thinking, "Danger is lying in wait, I must stay alert, I must do something" (hyperarousal), together with "I have no mastery over what is happening to me" (the intrusion of memory), we may, without knowing it, begin to act in ways that reconstruct the scene of the event, whether openly or in disguised form.

The compulsive tracking of bad news; the repeated viewing of distressing images even while knowing it will leave us feeling worse; returning to the site of the event before we are ready to do so; or remaining within relational patterns that repeatedly return us to the familiar scene of fear, humiliation, and injury — these are all examples of behavior of this kind.

The issue here is not that we dislike ourselves, or take pleasure in injury and suffering. In many cases these behaviors cannot be adequately explained by the label "masochism"; rather, they are our unconscious attempt to "understand" the traumatic event, to make meaning of it, and to gain some mastery over it.

Numbing

The third category of response, the opposite of the first two, is of the nature of contraction, numbness, or inaction. The psyche cannot remain forever in a state of hyperarousal. When everything becomes too painful, too frightening, or too bewildering, we sometimes come to prefer minimizing our contact with the experience altogether.

In this state we may find ourselves, without wanting it, becoming unfeeling, or crying less; having nothing to say; withdrawing from the news; distancing ourselves from other people; growing indifferent to things that once mattered to us deeply; or sensing that a wall of glass has been drawn between ourselves and life, one that will not permit us to "touch" it.

Psychic numbing is closely bound up with the unconscious defense of dissociation. When we feel powerless before an external injury, and see every possible action as futile, we sometimes forestall further harm by splitting off, within ourselves, from various parts of the experience.

We might, for instance, hear devastating news and find that it stirs nothing in us at all; an important image might pass through the mind without our being able to find a name for it; the body might react intensely while no accompanying thought is present; or, in more severe instances, we might feel that we are not inside our own body, or that the world around us is no longer the world it once was.

It is important to remember that numbness does not mean indifference. Sometimes numbness is the last route the psyche can find to avoid total collapse. At the same time, if this defense becomes entrenched, it deprives us of relationship, of pleasure, of grief, of healthy anger, of desire, of curiosity, and of the very feeling of being alive.

One further point: the mental and bodily responses to trauma often follow an oscillating pattern. Alternating cycles form — between forgetting and the intrusion of memory, between intense emotion and numbness, between impulsive behavior and total behavioral restraint, between excessive vigilance and psychic shutdown.

These oscillations, understandable as they are, do not on their own bring about the resolution of the traumatic experience. The intrusion and incursion of memories submerges us in the event all over again, while numbness and dissociation strip us of the possibility of finding meaning within it.

In confronting the bodily and psychological responses to trauma, the starting point is understanding, not combat. Freedom from trauma is not achieved by insisting on forgetting, or by simply pushing past the experience. A psyche that has — for entirely comprehensible reasons — remained in survival mode does not return to life through instruction, advice, or blame.

The process of healing begins from the place where the body can once again experience a measure of safety, and the mind can begin to draw the scattered fragments of the event nearer to one another. Only then will the episodes of intrusion, numbness, and hypervigilance gradually give way to experiences that can be thought, and that can be spoken.

Payvand Jalali, Psychoanalytic Therapist