Trauma's Physical and Emotional Toll on the Body
The brainstem (reptilian brain) links the brain to the rest of our body. In recent years, much of the discussion on the neurobiology of trauma has centered on the vagus nerve. The vagus nerve is a big, long nerve canal that runs the length of our brain stem. Dr. Stephen Porges, originator of the polyvagal theory and author of The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation (2011) states that it's useful to conceptualize the vagal nerve as a pipeline that contains many other nerve fibers that connect from various areas of the brain to different functions in the body. The pipeline contains both the sympathetic nervous system, activated during "fight and flight" responses, and the parasympathetic nervous system, associated with ordinary body function and being calm, cool, and collected. Most organs in the body (e.g., the heart, the lungs, the gut) require both the sympathetic and parasympathetic nervous systems to work together in a balanced manner to achieve healthy functioning. Thus, much of the talk around the polyvagal theory involved balance-how to we bring a person whose sympathetic nervous system is on overdrive, back into balance?
When the autonomic nervous system works too hard, for too long, physical illness and other body-related complications can result. If you are interested in a very readable and understandable article on the polyvagal theory you might like Ravi Dykema's (2006) interview and discussion with Stephen Porges (see References & Resources for link). As further evidence of trauma's toll, let's take a look at sobering list of problems that correlate with early childhood distress; e.g., abuse, neglect, and household dysfunction (Center for Disease Control, 2013):
- Alcoholism and alcohol abuse;
- Chronic obstructive pulmonary disease (COPD);
- Fetal death;
- Health-related quality of life;
- Illicit drug use;
- Ischemic heart disease (IHD);
- Liver disease;
- Risk for intimate partner violence;
- Multiple sexual partners;
- Sexually transmitted diseases (STDs);
- Suicide attempts;
- Unintended pregnancies;
- Early initiation of smoking;
- Early initiation of sexual activity;
- Adolescent pregnancy.
This correlation between childhood distress and adverse health consequences was established using a measure called ACE (Adverse Childhood Experiences). The higher the ACE score (i.e., number of adverse life experiences in childhood), the greater the likelihood that one or more of these adverse health conditions will eventually develop. Examples of adverse childhood experiences included: verbal humiliation or insult; physical violence; being neglected; having an incarcerated parent; going through the divorce of a parent; growing up in an alcoholic home; and, growing up with someone who attempted suicide. The ACES study has generated much discussion and interest. For instance, there is a popular blog Aces Too High.
In his book, The Body Bears the Burden: Trauma, Dissociation, and Disease, Dr. Scaer explains that when traumatic memories are stored in the parts of the brain that regulate the body (i.e., the limbic and reptilian brains), the symptoms of traumatic stress are likely to result (Scaer, 2007). Scaer's commentary may offer you a useful summary about everything covered in this section on trauma and the brain. Trauma expert Linda Curran (2012) interviewed Dr. Scaer and other experts in trauma neurology in the documentary Trauma Treatment for the 21st Century. The general consensus of this panel of experts was clear: Talk therapy is inadequate for trauma treatment. This is because the trauma is stored in one part of the brain (the limbic system in the mammalian brain) while talking, listening, and understanding verbal communication (the "stuff" of talk therapy) accesses a different part of the brain (the neocortex).
Talk therapy relies on our ability to evaluate things in reasonable and rational manner. This type of therapy is generally insufficient to promote traumatic healing because unprocessed traumatic memories are stored in a region of the brain that knows no logic or time (midbrain, limbic system). This is why survivors of trauma can have a rational understanding of what happened to them. They can understand that 'it' was not their fault. They can recognize that the past is in the past. They can know with absolute certainty that the people who hurt them in past cannot hurt them any longer. Nonetheless, all this knowledge and information is rather useless if the traumatic memories remain stored outside of the neocortex. You can reason with yourself all you want, but the body is still crying out for help.
A very brave, visionary trauma survivor named Nikki Myers was willing to share some of her story with me. Nikki Myers grew up during the 1960s amidst the social upheaval of the Civil Rights movement in the United States. She remembers being a 9-year-old girl watching the news and seeing people of color, people who looked just like her, being hosed, gassed, and beaten. Even though she was raised in the northern United States and never in the direct path of physical harm, those images were so disturbing it capsized her faith in herself, and her trust in authority. As Nikki explains:
Something had to be wrong with me if these people who looked like me were being treated this way. Everything I'd learned in school taught me that government and authority was to be respected, so if government and authority was doing this to children like me, I must be flawed.
Nikki is the founder of a growing program called Y12SR®, the Yoga of 12-Step Recovery. Nikki, a recovering addict and survivor of multiple layers of trauma, launched the program about a decade ago. Y12SR® meetings are not affiliated with12-Step fellowship groups such as Alcoholics Anonymous. Instead, the meetings combine the essence of a 12-Step discussion meeting, with a yoga class. The guiding principle of Y12SR® is that the issues live in our tissues. As Nikki explains, when you are in the physical posture of a yoga pose, or even a simple stretch, and you feel those muscles quiver, your body is working something out. Remember when we mentioned that all 3 parts of triune brain must work together in an integrated manner? Trauma causes a disconnection, while movement and breath work cause integration.
Nikki disclosed that even to this day, when reflecting upon those memories, a strong visceral reaction is provoked. Does this sound familiar to you? If you are nodding your head yes, there is a good chance that some remnants of trauma, abuse, neglect, or other adverse life experiences are still stuck in the parts of your brain that play out in the body. However, this does not mean that you are without help or hope when it comes to healing the brain and ultimately the body. In the next section, we will take this discussion deeper as we explore options for healing the impact of traumatic stress.