Holding on to unprocessed past trauma can feel like you are walking through life carrying around a weight on your shoulders. Trauma can impact your thought processes and how you see yourself, the world, and others. It can also cause you to develop and carry around different defense mechanisms or ways of protecting yourself that can become maladaptive outside of the traumatic situation. Trauma can impact how you understand, process, react to, and manage your emotions. Additionally, trauma can result in carrying around somatic or bodily tension, which may make you feel as though you are constantly walking around on guard or in ‘fight or flight’ mode. All of these responses can continue throughout your life long after you experience the trauma.
Experiencing trauma can clearly have significant impacts on a person’s life, but what a lot of people do not realize is that trauma literally can change your brain chemistry and genetics, impacting an individual’s developmental trajectory and who you become. Neuroplasticity is the ability of the brain to change, grow, and reorganize. Studies have shown that brain plasticity continues throughout adulthood. However, our brains are especially sensitive to early childhood experiences, and these experiences alter the way our brains develop, ultimately impacting how our genes are expressed. It is called the study of epigenetics. The fact that our early environment and experiences can affect the brain’s development, and our genetics means that childhood trauma can cause lifelong impacts on an individual.
The Adverse Childhood Experiences Study (Felitti et al., 1998) examined the relationship between adverse or traumatic childhood experiences and adult health outcomes. The categories used to define an adverse childhood experience included the following:
- Physical abuse by a parent
- Emotional neglect
- Sexual abuse by anyone
- Domestic violence
- Living with family members with mental illness
- Experiencing the incarceration of a household member
- Loss of a parent
- Growing up in a household with an alcohol and/or drug abuser
- Emotional abuse by a parent
- Physical neglect
This study found that the more ‘adverse childhood experiences’ or ACEs a person experienced in childhood, the higher their likelihood of developing various physical and mental health impairments, as well as poor social outcomes. They found that the more ACEs one has, the increased likelihood of that individual having autoimmune disorders, psychotic disorders, increased risk of suicidality, increased risk of cancer, heart, lung, and liver disease, obesity, and substance abuse. They also found that people exposed to 6 or more ACEs contributed to a 20-year reduction in lifespan. It seems to be that adverse childhood experiences lead to lifelong impairments by causing disruptions in the way the brain develops. The impacted brain can result in social, emotional, and cognitive impairment, leading to risky health-related behaviors. These behaviors can then result in increased disease, disability, and social issues, leading to the possibility of an eventual early death due to these factors.Oftentimes, these adverse childhood experiences are repeated from generation to generation, causing intergenerational trauma, in which traumatic events become normalized, and maladaptive ways of coping with trauma can be passed down through generations through both learning and biological/ genetic processes.
The study of “developmental traumatology” looks at the psychological and biological consequences of childhood trauma (Debellis, 1999) and considers the ways the brain’s structure is impacted by trauma. The brain of a child experiencing a normal, non-traumatic childhood should be “learning-focused,” however, research has found that childhood trauma can result in a child’s brain becoming survival-focused rather than learning-focused, which causes changes to brain structure and functioning (Ford, 2009, 2010). Some of the brain changes that may occur as a result of traumatic stress during key developmental periods include changes to the following:
- Corpus Callosum: The corpus callosum connects the left and right sides of the brain and impacts memory, language processing, and learning. Trauma can affect the size and growth of this part of the brain, impairing or leading to delays in cognition and learning.
- Hippocampus: The hippocampus works on converting short-term memories into long-term memories. People who experience childhood trauma may have smaller hippocampal volumes, leading to the memory deficits that people with a trauma history often experience.
- Amygdala: The amygdala is the area of the brain that processes emotions and fear responses, including the “fight or flight” response. Trauma can cause impairment to this area of the brain, making it more difficult to process and regulate emotions and correctly estimate threats or danger.
- Prefrontal cortex: The prefrontal cortex controls executive functioning skills, including emotion regulation, decision-making, planning, self-control, reasoning skills, and other personality parts. Trauma can cause this area of the brain to be smaller, have decreased connections to different areas of the brain, and impair these key executive functioning skills.
- HPA axis: The HPA axis controls the body’s stress response through communication between the hypothalamus, pituitary, and adrenal glands. It involves the release of the stress- hormone cortisol. In times of distress or trauma, the HPA axis releases cortisol to help us manage the stressful situation, putting us into the “fight or flight” response. However, a history of trauma can impact the HPA axis by leading to its overstimulation (creating chronic stress and an overactive fight or flight response) or under-stimulation (creating poor ability to cope with stress) of the body’s stress response system.
The above are all key brain areas essential to healthy development and functioning throughout the lifespan. These brain changes are even more likely to occur when someone experiences complex trauma or exposure to a series of traumatic events over a wide-ranging period of time. Exposure to multiple adverse childhood experiences listed above would be an example of complex trauma, as there was repeated exposure to various traumatic events over time. When repeated trauma occurs, the brain becomes used to operating in “fight or flight,” causing brain and bodily trauma reactions long after the trauma has ended.
While trauma can have long-lasting impacts on our brains, bodies, and genetics, people are resilient, and healing is possible. Various types of therapy modalities can be utilized to help people heal from past trauma. Some examples include:
- Trauma-Focused Cognitive Behavioral Therapy: Trauma-Focused CBT focuses on helping individuals change their beliefs and thoughts about the traumatic event, ultimately impacting how they feel and behave. It helps individuals improve their ability to cope with the trauma, find meaning, and create an accurate trauma narrative so that they can move forward in their lives.
- Prolonged Exposure Therapy: Prolonged exposure therapy works to activate and change the fear pathways in the brain to relieve trauma symptoms and fear. It involves repeatedly exposing the client to feared stimuli (traumatic memories and real-life situations) that they would normally avoid to neutralize the fear over time.
- Eye Movement Desensitization and Reprocessing (EMDR): Traumatic memories are processed in a disconnected way, in which the brain cannot process that the danger is over. EMDR helps the individual reprocess and integrate the traumatic memories in a neutral way to reduce trauma symptoms. In EMDR, the client briefly discusses the memories of the traumatic experience while the focus is on an external stimulus such as bilateral eye movements or tapping.
- Somatic Experiencing: Somatic Experiencing focuses on the bodily symptoms and sensations associated with trauma caused by being stuck in a “fight, flight, freeze” response. Some of the symptoms may include hyperarousal, dissociation, or immobility. Somatic Experiencing teaches the client to normalize bodily sensations and allow normal physiological processes to occur.
De Bellis, M. D., Keshavan, M. S., Clark, D. B., Casey, B. J., Giedd, J. N., Boring, A. M., Frustaci, K., & Ryan, N. D. (1999). Developmental traumatology: II. Brain development. Biological Psychiatry, 45(10), 1271–1284. https://doi.org/10.1016/S0006-3223(99)00045-1
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
Ford, J. D. (2009). Neurobiological and developmental research: Clinical implications. In C. A. Courtois & J. D. Ford (Eds.), Treating complex traumatic stress disorders: An evidence-based guide (pp. 31–58). The Guilford Press.
