Understanding Trauma
Trauma is perhaps the most avoided, ignored, belittled, denied, misunderstood, and untreated cause of human suffering. — Peter Levine
Post-traumatic stress disorder is a mental health condition that involves intrusive thoughts about traumatic incidents, flashbacks, and recurrent stress and anxiety. The sufferer relives the trauma and associated memories repeatedly and uncontrollably. According to the U.S. Department of VeteransAffairs, in the year 2020 alone, about 13 million Americans were suffering from PTSD (NationalCenter for PTSD, 2023).
With every day that passes, yet more people are unfortunate enough to experience something traumatic. Traffic collisions, warfare, domestic violence, sexual assault, fatal ailments, and child abuse are some of the more common traumatic events that people may live through. They leave deep scars and aftershocks such as terrible anxiety, PTSD, and depression.
According to estimates, in any given year, about 5 in every 100 U.S. adults suffer from PTSD (Goldman, 2023). Though there are millions of trauma victims worldwide, a lack of resources forces them to suffer in silence. They endure the terrible blows of trauma- induced symptoms, feeling as though there is something wrong with them. They don't realize that the symptoms resulting from their trauma can be treated through healing practices such as trauma-informed yoga.
This chapter shines a light on the types of trauma, its impacts, and responses or triggers that can present themselves after the traumatic incident.
What Is Trauma?
Trauma is an emotional response to an extremely distressing event that can include an accident, rape, emotional abuse, or natural disaster. Traumatic events don't necessarily have to involve physical harm and can also include emotional and psychological distress. Those who have been bullied, verbally abused, suffered racial discrimination, or felt psychologically threatened can also become victims of trauma. For instance, Barbra Streisand, the world-renowned American singer and actress, developed PTSD after forgetting the lyrics to a song while performing in New York City's Central Park. Following the event, she developed stage fright and couldn't perform live for the next 30 years.
As individuals, we perceive things differently from one another. What might be terrible for one person may not be as bad for someone else. Because trauma is a very personal experience, it is difficult to define. However, in general, we can call any experience that makes us feel frightened to death, under threat, humiliated, rejected, abandoned, ashamed, or brutally hurt a traumatic experience. It is imperative to note that witnessing harm to someone can also cause trauma. According to the Anxiety and Depression Association of America (2000), even a bystander may experience trauma as a result of witnessing a car accident.
Some people believe that trauma is exclusive to adults, but that's not the case at all. Children can experience it due to adverse childhood experiences such as witnessing violence in the home or community, having a family member die by suicide, or undergoing physical or emotional abuse. For instance, Charlize Theron, the South African-born actress and film producer, suffered horrific trauma during her childhood when her mother shot her alcoholic father, who had been physically attacking her. Now that we have delved into what trauma is, it's time for us to explore the various types to further enhance our understanding of the concept.
Types of Trauma
Depending on the severity, symptoms, and duration, trauma can be classified into four major types:
Acute Trauma
Acute trauma is a result of a single distressing event. Its impact lasts for a relatively short duration and usually settles within a month. Witnessing a natural disaster, violence, or a dreadful car accident is an experience that can lead to acute trauma. It is imperative to note that this type has the potential to cause a long-term impact if it isn't treated properly.
ChronicTrauma
Chronic trauma is a psychological response to repeated and prolonged exposure to traumatic experiences. The victim may have been going through the distressing events for months or years. Sexual abuse, physical abuse, bullying, emotional abuse, and domestic violence are some examples of experiences that can lead to chronic trauma. This type of trauma can have a devastating impact on the heart, kidneys, and other vital body organs, so it shortens lifespan.
ComplexTrauma
Complex trauma is associated with exposure to multiple different dreadful events that may or may not have any correlation with each other. This type can lead to long-term physical and mental health issues due to repeated exposure to awful situations. Childhood abuse or neglect, sexual assault, war-relatedThe Power of experiences, and domestic violence are some examples of experiences that can result in complex trauma.
Secondary or VicariousTrauma
Secondary or vicarious trauma, as the name suggests, is a type of trauma induced by repeated exposure to other people's pain. Despite not having suffered personally, people with vicarious trauma can still develop the physical, emotional, and behavioral symptoms of trauma survivors. Therapists, social workers, doctors, firefighters, and others engaged in helping professions are more likely to develop this type of trauma.
Similar to how trauma has various types, trauma survivors can also exhibit various kinds of symptoms. As trauma is a very personal experience, despite suffering from a similar type of trauma, people can exhibit stark differences in how it manifests. For instance, some car accident survivors may experience persistent nightmares about the crash while others may have trouble eating and sleeping. In the next section, we'll take a plunge into the spectrum of symptoms.
Common Symptoms of Trauma
Trauma results in different symptoms for different people, depending on several factors such as the pre-existing stressors in their lives, the support available to them, their natural resilience, personality traits, and their perceptions of an event. However, there are some common trauma symptoms that we'll mention below. This list isn't exhaustive—we are all unique and our bodies and minds react differently to tragic experiences.
Even if you cannot relate to the symptoms mentioned here, know that your pain is valid, and healing is possible. Some common signs of trauma are:
-anger, irritability, and trouble regulating
-mood persistent fear and anxiety that something bad is about to happen -
-recurrent feelings of sadness and hopelessness
-withdrawal from everyday life and people
-insomnia alarming calmness in situations of crisis/chaos a need for
-compression/pressure to feel safe (e.g., tight shoelaces and heavy coats)
-discomfort with silence shakiness
-very little sleep for regular functioning
-sensitivity to heat, smell, and lighting
-unexplained fatigue nightmares racing heartbeat and palpitations
-persistent muscle tension
-tendency to startle easily
-obsessive worry
-irregular appetite (eating too much or too little)
-difficulty concentrating
numbness
recurrent digestive issues
sexual dysfunction
flashbacks
dissociation shame addiction
hyper-vigilance (constantly feeling on guard)
Here are the stories of some trauma survivors that demonstrate the wide spectrum of trauma symptoms we can experience.
For Tracy Morgan, the world-famous American comedian and actor, the trauma of surviving a horrible car accident manifested itself as survivor's guilt, PTSD, recurring flashbacks, and pangs of anxiety every time he got into a car afterward. MonicaSeles, a former world No. 1 tennis champion who is often regarded as one of the best the sport has ever seen, was stabbed in the back with a knife in Hamburg during a court break at a match. The traumatic event, combined with her father's cancer diagnosis, threw her into the pit of PTSD and an eating disorder. Two years after the incident, she gained a lot of weight, which worsened her condition as she also started struggling with self-image. ForWhoopiGoldberg, the American actor and comedian, the trauma of witnessing a plane crash while in mid-flight impacted her immensely. She saw the tragic event while she was enjoying the view from a balcony in SanDiego. Since then, she has struggled with the fear of flying and PTSD. Every time she gets on a plane, she is tormented by the flashbacks and becomes emotional, which ultimately leads to a panic attack. She says that the disaster still lives in her brain and traveling the world for her work has turned into an enormous struggle forher. As can be seen from the three stories discussed above, PTSD is a mental health condition that most trauma survivors generally battle with. However, it is not the only mental health condition induced by trauma. There are many more, and it's time for us to get ourselves acquainted with them.
Mental Health Conditions Associated with Trauma Post-TraumaticStressDisorder
PTSD is a natural and understandable reaction to undergoing trauma. According to research, about 6 out of every 100 people will develop PTSD at some point in their lives. The symptoms of the condition usually appear within three months after the traumatic event but in some cases, they may also show up later. Being unable to stop thinking about the traumatic event, experiencing perpetual anxiety, feeling overwhelming guilt or shame, becoming disinterested in relationships, careers, and hobbies, and having nightmares, suicidal thoughts, and negative beliefs about the world and oneself are some ways in which the disorder impacts the sufferers (National Institutes of Health, 2021). AcuteStressDisorder Acute stress disorder symptoms are like PTSD, but it is a temporary condition that generally resolves within three days to a month after the traumatic event. Nightmares, flashbacks, numbness, emotional unresponsiveness, reduced awareness of surroundings, anxiety, and disinterest in relationships and careers are some signs of the condition. It can be triggered byThe Power of Trauma-Informed Yoga 23 events such as the death of a loved one, threat of death, and serious injury. ReactiveAttachmentDisorder The seeds of reactive attachment disorder (RAD) are sown by traumatic experiences from childhood and develop from feeling neglected and suffering from physical or emotional abuse. Children with this attachment disorder often exhibit emotional withdrawal from caregivers, sadness, irritability, and fear in the presence of caregivers. They also do not seek or respond to comfort when they are upset and experience difficulties in expressing their emotions and forming relationships. If this disorder goes undiagnosed and untreated during childhood, it can linger and continue to trouble the sufferers into adulthood. DisinhibitedSocialEngagementDisorder Similar to RAD, disinhibited social engagement disorder also has its roots in traumatic childhood experiences such as feeling neglected and undergoing physical or emotional abuse. However, unlike RAD, kids with this disorder are overly friendly with strangers. It is as though they try to compensate for the neglect they otherwise experience by connecting with unknown adults. They often approach strangers without any hesitation and may also hug or touch them. An alarming aspect of this condition is that it makes kids likely to wander off with strangers without parental consent.24 Sue Berman AdjustmentDisorder Adjustment disorder is characterized by difficulties in coping after a stressful event. It can lead to physical and psychological symptoms such as fatigue, indigestion, muscle twitches, insomnia, rebellious actions, anxiety, persistent feelings of sadness and hopelessness, crying, withdrawn attitude, inability to focus, and suicidal thoughts. It is possible to heal from the condition with practices such as trauma-informed yoga, but the disorder may linger if the stressors continue to persist. Now, after getting familiar with these trauma-induced mental conditions, it is time for us to get acquainted with the various trauma responses we tend to exhibit. Trauma Responses Trauma response refers to how our bodies respond when we are faced with a physical, emotional, or psychologically threatening situation; for example, an attacker running after us, a car rushing toward us, or someone abusing us verbally. Interestingly, we do not all exhibit the same trauma responses, and they can vary depending on the threatening situations we find ourselves in. For instance, some people tend to freeze when they sense danger while others exhibit a fight response in the form of clenched fists and angry outbursts. There are six types of trauma responses that we demonstrate: fight, flight, freeze, fawn, flop, and friend. The type of trauma response we demonstrate in a particular situation is determined largely by several factors, some of which include our neurobiolThe Power of Trauma-Informed Yoga 25 ogy, the severity of the event, our life history, and the length of exposure. Now, let's delve into the six Fs in more detail. Fight Thefight trauma response is associated with seeking protection through conflict. The innate belief that establishing power over the threat is the way to safeguard ourselves and regain control triggers this response. It results in a strong desire to eliminate the threat before it can harm us. Listed below are some signs and behaviors associated withit: clenched fists crying tight jaw and teeth-grinding aggression in voice or yelling strong desire to kick or smash uncontrollable anger nausea and burning sensation in the stomach Flight As the name suggests, the flight response is associated with a tendency to escape. Those who experience this response want to flee from danger before it can inflict any harm on us. When we are stuck in a flight response, we find it challenging to sit still. Relaxation becomes a distant concept as persistent worry, panic, and restlessness surround us. Listed below are some signs and behaviors associated with the flight response:26 Sue Berman anxiety shallow breathing restlessness or numbness in legs andfeet darting eyes fidgetiness Freeze The freeze response occurs when the brain feels that it is better to go still than to try to fight or flee. The freeze response results in dissociation (feeling like we are watching our body from the outside) and provides an unconscious detachment from the situation. When the body freezes, it feels rigid and becomes immobile. Listed below are some signs and behaviors associated with the freeze response: coldness and numbness paleskin sense of stiffness and heaviness in thebody restricted breathing or breath-holding pounding heart feeling of being stuck in some part of thebody reduced heartrate Fawn Fawning is a trauma response often connected with relational trauma that stems from suffering repeated hurt in relationships. When we are stuck in it, we consistently abandon our needs and happiness to avoid conflicts or disagreements with others.The Power of Trauma-Informed Yoga 27 People-pleasing is an example of the fawn response. Listed below are some other associated signs and behaviors: difficulty with self-expression difficulty sayingno over-apologizing lack of personal boundaries persistent desire to rescue people from their problems denial of personal needs, comforts, and wishes alignment of personal preferences with those of others Flop The flop trauma response is a coping mechanism wherein the body shuts down to deal with distress when fleeing or fighting isn't a viable option. It is similar to how animals play dead when approached by a fearsome predator. Their innate intelligence tells them that running away will only provoke the predator more. When stuck in a flop response, we may become unresponsive or even faint in cases of excessive overwhelm. Given below are some signs and behaviors associated with this response limited emotional expression hopelessness anxiety missed work, classes, and other social engagements loose muscles28 Sue Berman Friend Friend is a trauma response wherein the victim feels powerless and helpless, so they rely on others for help. They may shout or scream for help rather than trying to help themselves. In some cases, they may even make desperate efforts to befriend an attacker. Some other associated signs and behaviors are included below: negotiation with the attacker bribery of the dangerous person lack of confidence constant pleas excessive reliance on others As these responses are largely controlled by the brain, it goes without saying that the organ is severely impacted by trauma. The next section explores how traumatic events affectit. How Trauma A!ects the Brain Trauma leads to structural changes in the brain that impact stress regulation, learning, perception of the world, emotional responses, and other key functions. It is a highly sensitive organ, and it has to be that way as it is responsible for our survival. As trauma is a devastating experience that threatens our existence, once we encounter it, our brains no longer remain the same. Its normal functioning gets disrupted due to the deep-seated fear induced by the experience. The sympathetic nervous systemThe Power of Trauma-Informed Yoga 29 (which is associated with the fight-or-flight responses) goes into an override, and everything is filtered through the lens of trauma or fear. To be a bit more specific, we start living in survival mode, where we look for threats in everything and stay on guard to mitigate them before they can harmus. Some time back, ArianaGrande, the talented American singersongwriter and actress took to her Instagram account and shared her brain scan with her followers. The image indicated the physical changes PTSD had induced in her brain. She had developed the trauma disorder after witnessing a suicide bombing at her concert in Manchester in the UnitedKingdom, in which 22 people lost their lives. The amygdala, hippocampus, and prefrontal cortex are the three major parts of the brain that are affected by trauma. Are you intrigued to know how these vital parts are influenced by traumatic experiences? Without waiting any further, let's begin our exploration. HowTraumaAffects the Amygdala, Hippocampus, and PrefrontalCortex TheAmygdala The amygdala is a small, almond-shaped part of the brain that is responsible for storing and processing memories, especially traumatic ones. If you saw a brain scan, you wouldn't believe such a small structure controls our fight-or-flight response. It is like a fire alarm that triggers the release of adrenaline, glucose, and30 Sue Berman norepinephrine to rev up our minds and bodies to combat threats and ensure survival. Trauma often results in an overactive amygdala that is highly attuned to potential threats. The consequences are excessive stress and anxiety. Traumatic memories can also make the amygdala misfire, even if there is no actual threat. Research has also shown that traumatic experiences can bring a change in the volume of the amygdala. For instance, childhood trauma increases the volume of the amygdala, leading to hypervigilance, poor decision-making, panic attacks, PTSD, and other issues. TheHippocampus The hippocampus is the part of the brain that governs learning, emotional regulation, and the storage of memories. Research has proven that traumatic experiences bring a reduction in the size of the hippocampus. Consequently, trauma survivors struggle with emotional issues, mood disorders, chronic stress, and depression. ThePrefrontalCortex Have you ever wondered which part of the brain is involved in complex thinking processes such as planning for the future and critical thinking? Whether the answer is yes or no, meet the prefrontal cortex, which is responsible for complex thinking processes, also known as executive processes. It is actively engaged when we are involved in planning our goals and ambitions for the future. Surprisingly, trauma can suppress the prefrontal cortex and lead to impaired executive functioning,The Power of Trauma-Informed Yoga 31 impulsive decision-making, learning difficulties, and short attention span. As the brain and the body are integrally connected, trauma also wreaks havoc on the body. In the next section, we'll focus on the overall impact of trauma on our lives, physical and mental health, and overall well-being. The Impact of Trauma Unaddressed trauma is behind 8 out of 10 leading causes of death (Basile, 2020). Research has validated that unresolved trauma leads to heart diseases, kidney diseases, cancer, lung diseases, diabetes, suicide, and drug overdose. It is also behind the emergence of anxiety disorders, depression, obsessivecompulsive disorder, and many other mental health issues (Su et al., 2015). According to shocking research, those who suffer from adverse childhood experiences (ACEs) are 1.4 times more likely to develop diabetes, twice as likely to have heart disease, stroke, or cancer, and 5 times more likely to suffer from major depression. As per the Centers for DiseaseControl and Prevention (2023), we can prevent 21 million cases of depression and 1.9 million cases of heart disease by preventing ACEs. These revelations may have made you ponder the connection between trauma and diseases. As discussed earlier, trauma results in an overactive sympathetic nervous system, which is associated with the fight-or-flight response. Prolonged activation of the sympathetic nervous system contributes to high cortisol (the stress hormone) levels in the body. It suppresses the immune system and causes inflammation, digestive issues,32 Sue Berman depression, anxiety, high blood pressure and sugar, an increase in cholesterol, and other physical and mental health issues. Speaking particularly about kids, prolonged exposure to cortisol can lead to developmental issues, disrupted puberty, weak bones, obesity, blood clots, and disruption in the metabolic mechanism. Chapter Takeaways In a world where so many of us have experienced trauma, we are not alone in our efforts to heal. Trauma can take on various forms, and each is unique to the individual's experience. While trauma experiences can vary widely, trauma symptoms and responses tend to be consistent. Without healing, trauma can impact us mentally, emotionally, and physically long after the incident has occurred. Trauma-informed yoga is an avenue of processing and healing for trauma survivors. Trauma is inflicted without consent, but it can be healed through intention and therapeutic avenues. In scientific terms, it is defined as an emotional response to a terrible or life-threatening event such as rape or a car accident. Trauma manifests itself as various symptoms such as unresolved anger, irritability, persistent anxiety, insomnia, and shaking. What makes it so hard to recover from is the fact that it sends our nervous system into overdrive. Once faced with a disastrous situation, our brains try to prevent any similar situations from arising again; theyThe Power of Trauma-Informed Yoga 33 constantly stay on guard. All it takes is a premonition for us to fall into the fight-or-flight response. Relaxation and inner joy become elusive and living in survival mode becomes our new reality. However, healing is possible, no matter how deep-seated the effects of trauma are. As recognizing our trauma triggers is imperative to embark on a smooth healing journey, the next chapter is centered around it. You might be wondering why being familiar with trauma triggers is so important. Encountering our triggers on our healing journey can make it a scary and discomforting experience for us. Once we know what triggers us, we can customize the process of healing accordingly, ensuring that we respond in a way that supports emotional and mental regulation.
