The first time I met Stevie (not her real name), she ran out of my consulting room after only 20 minutes. When she later rang to apologise, she couldn't explain why she had fled, only that she simply had to. But she wanted to come again the next week and try and get answers, because this was something she also found herself doing in other situations.
Stevie did return the following week and this time made it to the end of the session as we looked at what happened immediately prior to her fleeing. It took us a while to figure it out, but, eventually, she realised that the incense I often burn in my consulting room had triggered a memory of being abused as a child. The person who abused her always had some burning, and ever since then Stevie had been acutely sensitive to smells. It meant she sometimes found herself in complete terror and needing to get out of a situation but without understanding why, because her trauma was largely blocked from conscious awareness.
During traumatic events, the body's fight, flight or freeze emergency response floods our system with the stress hormone cortisol. This temporarily shuts down an important area of the brain called the hippocampus and stops it from doing its job of recording an explicit memory of what happened. Consequently, we can't then consciously remember and retrieve information about the event, including, crucially, temporal details - so it often feels like the trauma is still happening now, when in fact it was, perhaps, 20 years ago.
The hippocampus also regulates another key brain region in trauma: the amygdala, which is responsible for our survival instincts, emotions and implicit memory. During trauma, while our explicit memory system typically goes offline; the functioning of our implicit memory system is actually strengthened by the amygdala's release of another stress hormone, adrenaline.
Implicit memory is largely unconscious and non-verbal but has a powerful effect on our lives since it's frequently what lies behind our suffering. Think riding a bike or swimming - once you learn, you never forget; you simply ride or swim without needing to consciously remember or explain how to. That's your implicit memory in operation. But think how this might work with regard to your early attachment experiences: if when you're a baby, your mum responds quickly and sensitively when you cry, your learning and implicit expectation will likely be that other people are safe and reliable. If, however, she is neglectful, then maybe you will find as an adult that you avoid close relationships, out of expectation that others will only cause pain.
Sometimes clients struggle to make sense of their experience - "Why would I get so anxious in a shopping centre? It's not like anything bad ever happened to me in one". But the feeling of being overwhelmed or trapped among busy shoppers may in fact be very similar to the feelings experienced in past trauma.
Suppose when you were five that your mother fell ill and died suddenly but no one paid you much attention or explained what was happening. This would have been extremely stressful to a young child and their hippocampus would have gone offline. Fast-forward to adulthood and the person becomes anxious in small rooms very similar to those where he last saw his mother, but he hasn't a clue why - because the events and environment around this time weren't recorded as explicit memories. But the overwhelming feelings of fear and confusion would have been stored implicitly, waiting to be triggered in situations that evoke similar feelings.
With my client Stevie, her brain had obviously recorded an implicit memory of the environment where her abuse took place; but not the associated temporal details that would have helped her brain to file the event as historical. Instead, to all intents and purposes, Stevie's body, when triggered, reacted as though the abuse had never ended.
These early interactions determine how our brains develop, with the brains of infants very sensitive to their particular family life. Our relationships up to the age of two are especially important because the hippocampus only comes on stream during the second or third year of life. So in the first years, experiences register mainly in the amygdala and, consequently, are only accessible through habitual behaviours, sensations and emotions.
Paying attention to our bodies is vital for letting go of the traumas that keep many lost in the past, ensuring their brains keep reacting as if what took place long ago is still happening now. We generally find that people have poor memory for their early traumas, so it's the body that will often indicate more clearly the issues a client is struggling with. It's a way of making the implicit explicit. For example, Peter's* parents were overly strict and controlling and any signs of dissent from him led to harsh punishment by his father. As a child, Peter (*not his real name) was understandably very angry about the restrictions on his individuality, but he wasn't able to express this out of fear of the repercussions. So, when I first saw him, one of the things he complained about a lot was chronic tension and pain in his shoulders - a result of how he had suppressed his anger by contracting his shoulder muscles, something commonly seen with inhibited anger. One of the things that proved important during Peter's therapy was taking up yoga, where he learned how to open up his posture and deepen his breathing - thereby helping to "rewire" old brain patterns that had outlived their usefulness.
As a therapist, I know there might be a disconnection from or lack of attention to the body when a client answers questions about their feelings by referencing their head, eg, "My head just feels full". Because the body is actually where we feel our emotions, and it's where memories of what has happened to us are stored as sensations, habits or postures. But the trouble is, traumatised brains are hypersensitive to any reminders of the original distress. As a result, survivors often feel bombarded by painful or overwhelming sensations, so they try their best to ignore their bodies and escape into their heads. They become, as it were, disembodied.
But the more you have to "dial out", the harder your body will work to get your attention, eg, through pain, migraines, muscle aches, stomach issues, etc. Hence why you often see health issues among trauma survivors.
An Australian study of soldiers before and after their deployment in Afghanistan and Iraq, conducted by brain researcher Alexander McFarland and cited by trauma expert Bessel van der Kolk, highlights how trauma disturbs people's relationships to themselves, their bodies and other people. The frontal lobe of the brain is concerned with socialising with others, spontaneity, memory, self-perception, etc; while the brain stem looks after regulatory functions like breathing, eating, digestion and sleeping.
The study found trauma significantly disrupted the frontal lobe while at the same time causing marked agitation in the brain stem with subsequent physical effects. The brain changes, which I think can be assumed to occur in all trauma survivors, mean the person isn't likely to be open to the world around them since it's hard to engage meaningfully with others if you're exhausted or have a sore stomach - ie, if your body simply feels bad. This will resonate with many trauma survivors, I'm sure, who often feel very self-absorbed and struggle to connect with others. It's worth clarifying that any experience that left you feeling overwhelmed, unsafe, powerless, and profoundly stressed counts as trauma - from a car crash to rape to, as a child, not feeling you had a safe person to rely on. You might investigate for yourself right now what your own relationship to your body is like: can you feel the chair underneath you or your feet on the floor? Can you feel the thumb on your right hand? And your stomach? Do you notice when you are hungry, cold or in pain? Do you tend to hold your breath a lot? If you answered no to most of the first four questions and yes to the last, then you might benefit from paying more attention to your body.
Trauma has nothing to do with the thinking part of your brain, it has to do with your body being reset to interpret the world as a dangerous place, as Bessel van der Kolk has said. The clinical value of this is that therapists can work with the body to undo the postural and emotional habits that keep the trauma present. They can help clients calm their agitated brains and regain a sense of their body as a safe "container". We can use our bodies to change our minds; rewire traumatised brains and, ultimately, to heal.
Client confidentiality has been respected
Gayle Williamson is an IACP-accredited psychotherapist practising in Dublin. Contact her at www.ferneytherapy.ie