" Trauma is perhaps the most avoided, ignored, belittled, denied, misunderstood, and untreated cause of human suffering. ...most of us have experienced trauma, either directly or indirectly. "
– Peter A. Levine, 1999
Note: The following is excerpted from A Pioneering Program for Restoring the Wisdom of Your Body, by a Peter A. Levine, 1999, and contains references to traumatic material. These are Peter's words, not mine. All rights reserved to Peter A. Levine.
What is trauma?
"Trauma is perhaps the most avoided, ignored, belittled, denied, misunderstood, and untreated cause of human suffering. Although it is the source of tremendous distress and dysfunction, it is not an ailment or a disease, but the by-product of an instinctively instigated, altered state of consciousness. We enter this altered state — let us call it “survival mode“ — when we perceive that our lives are being threatened. If we are overwhelmed by threat and aren’t able to successfully defend ourselves, we can become stuck in survival mode. This highly- aroused state is designed solely to enable short term defensive actions; but left untreated overtime, it begins to form the symptoms of trauma. The symptoms can invade every aspect of our lives, and are powerful enough to destroy the very fabric of our individual, cultural, economic, political, religious, and spiritual aspirations.
Perhaps the most important thing to understand about trauma is that people, especially children, can be overwhelmed by what we usually regard as common, every day events. Until fairly recently, our understanding of trauma was limited to the experiences of “shellshocked“ soldiers and victims of catastrophic accidents and injuries. However, this narrow view does not encompass the whole truth. Overtime, a series of so-called minor mishaps can have the same damaging effect on a person as major traumatic events such as war or rape. In this sense, most of us have experienced trauma, either directly or indirectly."
Trauma and the individual
"No two people experience or manifest trauma and exactly the same way. What is harmful to one person may be accelerating to another. Many factors are involved in this wide range of response to threat, including an individuals age, history of trauma, family dynamics, and even genetic make up. Understanding these differences will keep us from judging each other Dash an attitude that can seriously impede healing. When we are traumatized, we need support, not judgment.
The vast disparity in individual perceptions and reactions makes it difficult to establish a working definition of what is traumatic. What we do know is that it is not the event itself that is traumatic; it is the individuals perception of and capacity to respond to the event. If one perceives a situation to be life-threatening, then that situation is potentially traumatic.
Our responses to perceived threat can be affected in both obvious and subtle ways. For example, a traumatized war veteran who reacts intensively every time a car backfires is responding in an obvious way. When a person who suffered torture and confinement breaks out in a cold sweat inside a crowded elevator, that is also obvious. However, most of us who have been overwhelmed by a series of every day events have responses that are not as easily traced."
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Stress and trauma
"Recently, “trauma “has been used as a buzzword to replace “stress,“ as in “I had a traumatic day at work.“ This is misleading and trivializing. Certainly, all traumatic events are stressful; but all stressful events are not traumatic. The symptoms of stress can be reversed by removing the causes of stress, and temporary relieved by techniques such as massage and medication. Trauma, by contrast, is a fundamental fracture. It is about loss of connection — to ourselves, our families, and the world around us,. This loss is often hard to recognize, because it happen slowly, over time. We adapt to the subtle changes; sometimes, without even noticing them. Trauma requires deeper investigation than distress, and it’s healing leads to a far more meaningful, long-term transformation."
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Causes of trauma
"Trauma is trauma, no matter what caused it. It is a relevant whether someone else would find the same event traumatizing. For example, sudden loud noises like thunder or the angry shouts of adults can traumatize infants and young children. Of course, thunder and shouting are really life-threatening; but when it comes to trauma, it is the perception of threat that is the critical factor. Under normal circumstances, a car backfire and it’s not a threat. But to someone who has been traumatized by war, the sound of an out of tune automobile can conjure up previous situation that we’re literally life-threatening.
The causes of trauma can be divided into two main categories:
– Events that are almost always dramatic, no matter who experiences them.
– Common, jarring, unexpected events that can be traumatic under certain circumstances.
The first category includes the obvious causes of trauma:
– War.
– Severe childhood emotional, physical, or sexual abuse.
– Experiencing or witnessing violence.
– Rape or assault.
– Catastrophic injuries and illnesses.
–Loss of a loved one.
The second category includes seemingly ordinary events that traumatize more often than we might expect. As you read, notice your own body‘s response to the list. Begin bringing awareness to your bodily, “felt“ sense of the things you experience. Pay attention to sensations like tingling, muscles tightening or loosening, increased or decreased heart rate, numbness, paralysis, temperature changes, etc. You may see fleeting images; different colors or shapes may appear in your inner field of vision. You may experience thoughts or emotions, or you may have a little or no response. Pay attention to the things that occur automatically, that you are usually not conscious of. Try to objectively notice whatever happens, almost as if you were an outside observer. Make a mental note of it and move on.
Here is a list of potentially traumatizing occurrences that may not be so obvious:
– Minor automobile accidents (even fender benders), especially those that cause whiplash.
– Invasive medical and dental procedures, particularly when performed on children who are restrained or anesthetized (the use of either creases of potential for trauma)— Even adults who rationally know that these are helpful may experience certain procedures (like a pelvic exam) as an attack.
– Falls another so-called minor injuries, especially when children, or elderly people are involved (for example, a child falling off a bicycle).
– Natural disasters (earthquakes, hurricanes, tornadoes, fires, floods, volcanoes).
– Illness, especially with a high fever.
– Accidental poisoning.
– Abandonment (being left alone), especially for young children and babies.
– Prolonged immobilization, especially for children casting, extended splinting, traction.
– Exposure to extreme heat or cold (especially for children and babies).
– Sudden loud noises (especially for children and babies).
– Birth (for both mother and infant).
Remember that this is simply a partial list, intended to give you a rough idea of potentially traumatic events. There are many other similar situations and occurrences that may cause trauma under certain conditions."
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The biological nature of trauma
"Human responses to thread are primarily instinctive and biological, and secondarily psychological and cognitive. They comprise three and eight action plans; fight, flight and freeze. These three responses are common to all mammals. When we send threat, our bodies and minds enter the first stage of what is called “and arousal cycle. “Are muscles tense, and we begin to search for the source of possible danger. If we locate the source and perceive it to be a real threat then we enter the second stage. Mobilized, our body and and to do it adrenaline and is all, that is. In the third stage, we discharge this energy by completing the appropriate defensive actions (namely, fighting or fleeing). The fourth and final stage ensues with the nervous system, no longer aroused, returns to a state of equilibrium.
If we are overwhelmed by a threaten are unable to fight or flee, we instinctively employ the third action plan, the “freezing response“ (also known as the “immobility response“ or “playin’ possum“). This defensive maneuver serves two purposes. First, it may fool the attacker into losing interest, allowing us a chance to escape. Second, we will not suffer any pain if we are injured or killed while in the state, because in immobility, consciousness seems to leave the body (psychologists call this phenomenon “dissociation“). But even though we are immobilized, our nervous system is still highly aroused. We have not been able to discharge any of the fight-or-flight Energy our body has mobilized long Dash leaving us in a state somewhat like that of a car whose accelerator and brakes are being floored at the same time. It is impossible to complete the arousal cycle when you cannot move.
Animals who survive an attack by using the freezing response simply allow for the biological discharge of excess energy and completion of the arousal cycle. Essentially, they do this after the event by shaking and trembling in a way that restores spontaneous breathing. This instinctive action allows the nervous system to regain its balance.
Unfortunately, humans have a much harder time completing this process. There are two main reasons for this difficulty. One, the survival energy is so intense that it frightens us; and two, we are uncomfortable with surrendering our conscious control to involuntary (unconscious) sensations. Because of these fears, our rational brains often try to override the completion process. When this happens, the nervous system remains in a state of arousal. Even if the threat is gone, brain and body respond as if it still exists and continue to spew out the fight-or-flight chemicals.
For example, when a molester overpowers a child, the youngsters instinctive survival energies are restrained and overwhelmed. Typically, the child cannot initiate, let alone complete, an escape attempt. The child, just like any organism, grasp survivable means to control the intense, potentially overwhelming energy generated in response to the threat. These different methods of “damage control“ become the symptoms of trauma.
Automobile accidents are less obvious, but often equally overwhelming — in part, because things usually happen too quickly for strategic defensive manures. By design, motor vehicles deter the full discharge of instinctive survival energy. Even if you have a chance to react to the threat of an oncoming vehicle, the most you can do to avoid impact is to turn the wheel. This action may successfully prevent an accident, but your body has already generated enough energy to help you escape a savage, saber-toothed tiger. Instead, all you have done is to swerve out of the the of the path of a shiny Jaguar.
In the same way, many every day threats – in contrast to threats in the wild – do not allow for adequate discharge of energy. The excess energy, rather than being transformed, becomes bound in the body and mind. The symptoms of trauma are the result."
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Symptoms of trauma
"Trauma is not a disease; it is a state of “dis-ease.” Discomfort is a signal to us that something inside needs our attention. If the signals go and answered, they eventually evolve into the symptoms of trauma.
Each individuals experience is unique, so compiling a complete list of every noon trauma symptoms would be a huge task. However, certain symptoms are considered universal because they are common to Most traumatized people. In general, some symptoms to do up here sooner than others. The lists that follower not for diagnostic purposes, but rather to help you get a feel for how trauma symptoms behave.
Not all the symptoms listed here are caused exclusively by trauma, of course; nor has everyone who exhibits one more of the symptoms been traumatized. The flu, for instance, can cause Malay similar to some trauma symptoms. The differences that the symptoms of flu generally go away in a few days, while those produce by trauma do not.
Specific symptoms in their order of appearance:
Typically, the first symptoms to develop after an overwhelming event are:
– Hyperarousal. The most common signs are physical long – increased heart rate, difficulty breathing (rapid, shallow, panting, etc.), cold sweats, tingling, muscular tension – mental — increasing thoughts, racing thoughts, worry.
– Constriction. The nervous system focuses all our resources on the threat by constricting both our bodies and our perceptions. Blood vessels in the skin, extremities, and internal organs constrict to make more blood vessels available to the muscles, which are tensed in preparation for defense of action. Constriction alters breathing, muscle tone, and posture.
– Dissociation. A separation of awareness from physical reality, which protects us from the impact of escalating arousal. If a life-threatening event continues, association protects us from the pain of death. It is a common means of enduring experiences that are, at the moment, beyond endurance.
– Denial. This Is a form of dissociation requiring lower Levels of energy. In this case the disconnection is between the person in the memory of or feelings about a particular event (or series of events). We may deny that an event occurred, we may act as though it was unimportant.
– Feelings of helplessness, immobility, or freezing. If hyperarousal is the nervous systems accelerator, immobility is it sp. When both of these states occur at the same time, a feeling of overwhelming helplessness results. This is not the ordinary since helplessness that affects us all of us from time to time. It is a feeling it being completely immobilized and powerless act. This is not a perception, belief, or trick of the imagination. It is real. The body feels paralyzed.
The following are the symptoms that tend to Service concurrently with or shortly after trauma (several of them can, however, also show up later).
– Hypervigilance (being “on guard“ at all times).
– Intrusive imagery or “flashbacks.”
– Extreme sensitivity to light and sound.
– Hyperactivity; restlessness.
– Exaggerated emotional and startle reactions to noise is quiet, quick movements, etc.
– Nightmares and night terrors. Abrupt mood swings (rage reactions, temper tantrums, shame).
– Reduced ability to deal with stress (easily and frequently stressed out).
– Difficulty sleeping.
– Fear of going crazy.
The next symptoms that may appear include:
– Panic attacks, anxiety, and phobias.
– Mental blankness or spaciness.
– Avoidance behavior (avoiding certain circumstances that remind us of previous traumas).
– Attraction to dangerous situations.
– Frequent anger or crying (do not take this personally; the person — especially for child — need your support).
– Abrupt mood swings.
– Exaggerated or diminished sexual activity.
– Amnesia and forgetfulness.
– Inability to love, nurture, or bond with any other individuals.
– Fear of dying or having a short life.
The final group of symptoms include those that generally take longer to develop. In most cases, they will have been preceded by some of the earlier symptoms (although again, there is no fixed rule about when and if a symptom will appear). This group (could)includes:
– Excessive shyness.
– Diminished emotional responses.
– Inability to make commitments.
– Chronic fatigue or very low physical energy.
– Immune system and certain endocrine problems, such as thyroid dysfunction or psychosomatic illnesses — particularly headaches, neck and back problems, –asthma, digestive distress, spastic colon, severe premenstrual syndrome, and eating disorders.
– Depression; feelings of impending doom.
– Feeling like the “living dead”: detached, alienated, and isolated.
– Reduced ability to formulate plans and carry them through.
Symptoms of Trauma can be stable (ever-present) or unstable (come and go); or they may remain hidden for decades. Usually, symptoms do not occur individually, but in clusters. They often grow increasingly complex every time, becoming less and less connected with the original trauma experiences. This makes it increasingly difficult to trace the symptoms to the cause, and easier to deny the importance of the traumatic event in one’s life.
Any or all of the symptoms listed here can appear, regardless of the precipitating event. In every case, our bodies of retain the crucial information that links symptoms to the original trauma. This is why it is essential that we learn to trust the messages our bodies are giving us. Symptoms of trauma or internal wake up calls. If we learn how to listen to them, to increase both physical and mental awareness, we can begin to heal our traumas."
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Traumatic Reenactment
"As we have seen, exposure to trauma generates immense amounts of instinctive energy. The inability to discharge this energy leads to an ardent desire for completion: an opportunity to release the trap power of the fighter flight reflex. Our culture awful‘s little understanding of this phenomenon in few avenues for healthy resolution. Consequently many of us compulsive re-create situations that arouses in the same ways as the trauma did originally am dash unconsciously hoping this time, we will be able to complete the process.
The urge to resolve trauma to reenactment can be severe and compulsive. We are inextricably drawn into situations that represent replicate the original trauma in both obvious and covert Waze. The sex worker with a history of childhood sexual abuse, the ex-combat soldier who joins a police swat team, the accident prone person, and the repeated victim of abusive relationships are common examples of this phenomenon.
In general, we reenact our trauma into ways. The first, acting out is the result of externalizing are feelings of violation by committing violence on others. The second, which I’ll call “acting in,“ is much more predominant in our culture. Here, people become their own victims as they try to contain the feelings of violation brought about by their traumas. The huge and growing market for anti-anxiety and anti-depressant medication is a societal symptom of widespread acting in. "
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Acting Out
"Does violent reenactment result in completion and resolve the trauma? The answer is almost certainly no. If that were the case, people who act out violently would not need to make repeated attempts to discharge, as they typically do. Instead, after one violent act, most peoples nervous systems would normalize and they would go on with their lives.
Acting out violently may provide temporary relief and a false feeling of victory and pride; but without biological discharge, there is no completion. Instead, the cycle of shaman violence reoccurs. The nervous system remains highly activated, compelling people to seek the only relief they know: more violence. The traumatized person continues to behave as if the traumatic event is still happening — because biologically speaking, it is.
Why is reenactment unable to completely discharge survival energy? The answer is simply stated is system overload. The ability to discharge is very powerful biological energy but both emotional and intellectual portions of the brain in a position they are not able to handle not adapted to handle. Overwhelmed with undischarged energy, the emotional and rational brains focus on finding an external threat to explain the nervous system‘s intense activation. The emotional brain responds by translating instinctive energy into emotions (anger, rage, and shame). This leads to fearfulness and confusion. The rational brain explains the resulting distress by creating an idea: revenge, justice, “nobody cares,“ “everybody is out to get me everyone is out to get me,“ etc. It begins to randomly blame external “enemies.“ This hyper vigilant search for the threat sets the stage for violent reenactment, trampling opportunities for the renegotiation that can bring real healing."
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Acting In
"The vast majority of traumatized people act-in: they turn their terror, rage, and shame inwards, where it systematically undermines their health and well-being. Doctors estimate that they can find nothing medically wrong with at least 8% of patients who seek their help. A significant portion of these people are probably suffering from undiagnosed symptoms related to trauma and stress.
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Substantial emotional and social support is becoming increasingly available as our societies understanding of trauma grows more sophisticated. Still, denial in the need to feel in control mean that we rarely get the help we need immediately following a potentially traumatic incident. This is the critical time when we can most easily discharge the intense energy mobilize to defend ourselves — literally shaking and trembling through the inability, shame, and rage. Sadly, many people regard this behavior is frightening or inappropriate, and try to stop it rather than giving themselves (or us) crucial he needed support."
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Awakening
"Several Buddhist and Taoist traditions describe four paths to awakening: sexual ecstasy, meditation, death, and trauma. These are the ultimate catalyst for profound surrender and awakening. Unfortunately, most of us are not prepared to receive the opportunities offered by these powerful teachers.
So many of us have experienced glimpses of sexual ecstasy, our focus on titillation, seduction, and performance of an obscure as the possibility for deep emotional and spiritual surrender. Achieving “ego Dash death“ through meditation requires years of dedication; very few people have a team this ultimate accomplishment of meditative discipline. The process of dying, a final chance to make peace with herself, has been given over largely to doctors, drugs, and machines. Even in support of unconscious settings, the act of spiritual surrender is often overshadowed by remarks over having waited until the end of life to accomplish it.
Trauma is the fourth pathway to awakening. In transforming trauma, we face an uncertain world. We must enter a reality stripped of the illusion of safety and learn an entirely new way of being, like a newborn child. In this new world, our instinctive energies are not limited attacks of flight or uncontrolled violence. Rather, they are our heroic energies — the wellspring of our creative, artistic, and poetic sensibilities. We can summon these instinctive forces to propel us into the wholeness of our intelligence.
Trauma is about thwarted instincts. And instincts by definition, are always in the present. When we allow them their rightful domain, we surrender to the “eternal now.” With mutual presence of mind and body, we can gain access to the source of our energy and vitality."
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