Trauma can be held in the body, leading to physical symptoms years later — such as headaches, jumpiness, chronic pain, and dissociation.
When you have an overwhelming experience, your logical mind might feel “over it” before your body does.
In his 2014 book “The Body Keeps the Score,” trauma expert Bessel van der Kolk, MD, talks about how trauma affects not just our minds but our bodies, too. The body can remember trauma even if we’re unaware of it.
With the right support, healing is possible. Therapies that connect the body and mind — like cognitive processing therapy (CPT), prolonged exposure (PE) therapy, and Eye Movement Desensitization and Reprocessing (EMDR) therapy — can help you process trauma held in your body.
Experts believe that trauma impacts your brain and body causing your nervous system to stay on “high alert,” always ready to face the next threat.
Trauma is not physically held in the muscles or bones — instead, the need to protect oneself from perceived threats is stored in the memory and emotional centers of the brain, such as the hippocampus and amygdala. This activates the body whenever a situation reminds the person of the traumatic event(s).
Many people continue to feel the effects of trauma — known as post-traumatic stress — for years after the traumatic event. Trauma may show up in the body as:
- feeling easily overwhelmed
- feeling “on edge”
- muscle tension
- chest tightness
- trouble sleeping
- memory issues
- brain fog or trouble focusing
- anxiety and avoidance
Trauma can also exacerbate medical conditions like chronic pain and headaches.
Experiencing trauma can shrink your window of tolerance, which is the sweet spot where you feel like you can handle stressful situations without them becoming too much. This is known as your distress tolerance. Trauma is one factor that can shrink your window of tolerance.
“If you have an experience that you keep reliving from the past or feel that you have the experience of being ‘triggered,’ that might be a sign that you have trauma that needs to be addressed,” says Blessing Uchendu, a body-centered psychotherapist based in NYC who uses EMDR and Somatic Experiencing to educate and treat clients with trauma.
“While in the Western world we might be inclined to first visit a physician with our physical ailments, it is worth considering getting trauma treatment from a therapist if your physical symptoms aren’t resolved,” she says.
What is trauma?
Trauma is an emotional or physical response to one or more harmful or life threatening events or circumstances with lasting adverse effects on your mental and physical well-being, according to the Substance Abuse and Mental Health Services Administration (SAMSHA).
Trauma and the brain
When we have not fully processed an overwhelming experience, our amygdala — the part of our brain that activates the fight, flight, or freeze response — may become overactive, explains Leah Aguirre, a licensed clinical social worker and EMDR therapist in San Diego, California.
This can increase the level of stress hormones in your body, like cortisol, leading to an underlying feeling of being “on edge” much of the time.
“Basically, our brain is telling us, don’t relax — you need to be prepared for anything. Even if we know logically that we are safe, our body is telling us otherwise,” she explains.
It can be all but impossible to talk yourself out of it, as the part of your brain that handles rational thought and self-regulation is, essentially, offline.
“[In the case of traumatic stress,] when our amygdala is activated, we have limited access to our frontal lobe — the part of our brain that is involved in executive functioning,” she says. “We are really only focused on our survival and staying safe, which can make it difficult to be present and interact with the world in a meaningful way.”
Trauma triggers will vary depending on each person.
But, basically, anything reminiscent of your trauma can activate a survival response. Even if you don’t remember specific details, your body sure does. “The experience gets locked into your body with the associated sights, sounds, and smells,” says Uchendu.
Trauma triggers can include:
- places or objects
- people or certain characteristics of people
- emotional states
“Most talk therapy employs what we call ‘top-down’ processing. It’s focused on our thoughts and engages the prefrontal cortex in the brain to resolve trauma,” says Uchendu.
While that’s great, one challenge is that it can be difficult to engage your logical mind when the body is dysregulated. That’s where body-centered modalities come in, says Uchendu.
“When bottom-up processing is used, it allows the trauma symptoms in the body to be processed and the nervous system to be regulated. This allows for the prefrontal cortex to come online [gradually, over months in therapy] and be able to fully engage with thoughts, logic, and reason,” she says.
1. Cognitive processing therapy
Cognitive processing therapy (CPT) is a common therapy option for healing trauma.
“CPT is similar to cognitive behavioral therapy (CBT) in that it assists in helping individuals to identify and challenge unhelpful or irrational thoughts or narratives related to a traumatic event. It also teaches skills to counter or decrease the emotional dysregulation that is tied to past trauma,” explains Aguirre.
The American Psychiatric Association (APA) says that CPT is “strongly recommended” for treating PTSD.
2. Prolonged exposure therapy
Prolonged exposure (PE) therapy teaches people to approach trauma-related memories and feelings gradually. Over time, the person can learn that these memories are not dangerous and that they don’t need to avoid them.
The APA also strongly recommends PE for treating PTSD.
Eye Movement Desensitization and Reprocessing (EMDR) works to reduce and clear the emotional charge associated with a specific traumatic memory, says Aguirre.
“It can help individuals connect to more positive and adaptive beliefs that are related to the event. I have found this modality incredibly beneficial and provide so much relief in the clients that I see in my practice,” she says.
You may find it helpful to find an EMDR therapist through the EMDR International Association.
4. Somatic Experiencing (SE™)
Created by renowned trauma researcher and author Peter A. Levine, Somatic Experiencing (SE™) is thought to help you:
- recognize your trauma symptoms
- draw on resources to overcome them
- safely revisit memories for processing
You may find it empowering to work with a somatic experiencing practitioner through Somatic Experiencing International, says Uchendu.
5. Certain types of talk therapy
Aguirre says talk therapy can help you glean powerful insights into how trauma has impacted multiple areas of your life, including:
- mental health
- physical health
- core beliefs
- world view
Not all types of talk therapy are effective for trauma, but traditional CBT and psychodynamic therapy have shown promise in this area.
“[Talk therapy] allows for the process of untangling thoughts, feelings, and sensations that are connected to past trauma. It essentially creates awareness of how the traumatic event (or events) manifests in your behaviors and ways of thinking,” she says.
You might consider using Psych Central’s Find a Therapist resource to find a therapist near you.
6. A movement practice
A growing body of research suggests that exercise — when used in addition to other therapies — can help with post-traumatic stress disorder (PTSD).
You may find it helpful to work with a trauma-informed yoga instructor in your practice.
Trauma has an interesting way of keeping the past “in the now.”
“Even if you are not consciously thinking about a traumatic event, our brain has evolved in such a way that, when we are exposed to a trigger, our body will instinctually jump into survival mode,” says Aguirre.
But you don’t have to live this way forever. Various therapies have proven effective in healing post-traumatic stress.
To learn more about trauma, Uchendu and Aguirre recommend these books:
- “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma” by Bessel van der Kolk, MD
- “Waking the Tiger: Healing Trauma” by Peter A. Levine, PhD, and Ann Frederick
- “My Grandmother’s Hands: Racialized Trauma and the Mending of Our Bodies and Hearts” by Resmaa Menakem, MSW, LICSW