Trauma and the body: why your body remembers what you want to forget

As a psychiatrist I often hear it: 'Rationally I know it is over, but my body does not believe it.' That is exactly what trauma is about. Drastic experiences nestle not only in your thoughts, but in your body, in an alarm system that just will not switch off. In this article I explain how that works, why 'just talking it through' is far from always enough, and what does help.

Trauma does not live only in your head

With trauma we often think of memories: images that come back, thoughts that keep churning. But anyone who works with traumatised people sees that the body plays at least as large a role. A heart rate that shoots up, a body that tightens, an inexplicable nausea, in short: the body reacts as if the danger is still there.

That is because a drastic experience is not 'tidily' stored as an ordinary memory with a time stamp of 'past'. It remains, as it were, raw and active, with all the accompanying physical alarm signals attached to it. You know it is over, but your nervous system has not yet processed that message.

This realisation takes away a lot of shame. Your 'exaggerated' physical reactions are not putting it on or weakness; it is a body that has learned to be on alert. Do you recognise that your body sometimes reacts before you have even realised why?

The alarm system that stays on

In danger your autonomic nervous system switches at lightning speed into survival mode: fight, flight, or, if neither is possible, freeze. Your heart rate and breathing speed up, your muscles tense, your attention narrows to the threat. Extraordinarily useful at the moment itself.

With trauma that system stays, as it were, 'on'. Even long after the danger has passed, your body reacts to memories, sounds, smells or situations as if it is happening again. A slamming door, a certain tone, a crowd, and your body is back in the starting blocks.

That explains why people with trauma are often irritable, jumpy or constantly tense, and sleep badly. It is not character; it is a survival system that no longer knows the war is over.

Too much or too little: the window of tolerance

Therapists often use the image of the 'window of tolerance': the zone in which your tension is bearable and you can think and feel clearly. Within that window you can process, learn and be in contact.

Trauma easily pushes you outside that window. If you shoot above it, you end up in hyperarousal: over-alert, panicky, angry, your heart pounding, you cannot sit still. If you drop below it, you land in hypoarousal: numbed, empty, absent, as if you are no longer fully present (dissociation). Both are ways in which your system tries to protect itself against being overwhelmed.

An important goal of trauma treatment is to help you stay within that window more often, or return to it faster. Only within that window can real processing take place; outside it your system goes into survival mode and learning is almost impossible.

Physical complaints without a clear cause

Because trauma sits in the body, it often expresses itself physically too. Chronic fatigue, headaches, muscle pain and tension, stomach and bowel complaints, palpitations, a tight feeling on the chest. People sometimes carry it from doctor to doctor for years, without a physical cause being found.

That 'nothing was found' does not mean it is all in your head in the dismissive sense. It means the cause may lie deeper, in a chronically overloaded stress system. Body and mind are not separate departments; tension you cannot get rid of often finds an outlet in the body.

This connection is still too often missed. If you read this and think 'maybe that is how it is for me too', it is worth examining, with attention to both your story and your physical complaints.

Why 'talking about it' is sometimes not enough

Talking about what happened to you can be healing, but with trauma it sometimes gets stuck on precisely that. The part of your brain that stored the overwhelming experience is not the verbal, reasoning part. So you can know exactly that it is over, and yet feel the opposite with your whole body.

Sometimes endlessly retelling it in detail even makes it worse, because in doing so you activate the alarm again and again without processing it. That is why, with trauma, methods that take hold at a different level than just the words work well.

That is no plea against talking, but a nuance: with trauma we often need more than a good conversation. We have to help the nervous system itself to come to rest.

What helps: treating the body along with it

Effective trauma treatment therefore focuses on processing and on regulation of the nervous system. Proven trauma-focused methods such as EMDR and trauma-focused cognitive behavioural therapy help reduce the charge of memories, so that your body learns that the danger is over. (We wrote a separate article about EMDR.)

In addition the body gets an active role. Skills to calm yourself, breathing, grounding, bringing your attention back to the here and now, and sometimes body-oriented forms of therapy, help you stay within your window of tolerance. Often treatment begins with this stabilisation, before the heaviest memories come up.

That build-up is not a delay, but safety. You first learn to regulate your system, so that processing becomes manageable afterwards. Pace and order we always attune to what you can handle.

Learning to calm your system yourself

Outside the treatment too you can help your body. A calm, lengthened out-breath gives your nervous system the signal that it is safe. Grounding helps: feel your feet on the floor, name what you see and hear, hold something cold, bring yourself back to the now when a memory drags you along.

Movement, rhythm and enough sleep are no side issue with trauma; they help an overloaded system come out of the highest gear. And safety and connection with people you trust are perhaps the most powerful soothers we know, our nervous system comes to rest in good company.

These skills do not solve the trauma, but they give you a grip while you work on it. Which small way of calming yourself could you try out today?

Trauma and your background

How trauma arises, how it expresses itself and how you are allowed to talk about it are connected with your language, culture and life history. In some worlds there is a big taboo on it, or complaints are named mainly physically. What feels safe or threatening differs from one person to another.

That is why we treat trauma within a culturally sensitive approach and, where possible, in your own language. Precisely with experiences where words fall short, it makes a difference that your clinician understands your world and senses what remains unspoken.

Does your body still carry the traces of something you would rather forget? Then know that this is explicable and treatable. You do not have to unravel it yourself first to come forward; we do that together.

Sources

This article is informative and does not replace personal advice from a care provider. In doubt, or do you have questions about your own situation? Feel free to contact us.