Cumulative trauma may be mistaken for anxiety

Photo by Jan Canty on Unsplash

Most people are not aware that there are two classifications of trauma:

Type 1 Trauma –One off events

Car accident, severe physical injury, natural disaster or soldiers on the front line (acute trauma). Can result in PTSD.

Type 2 – Ongoing helplessness (cumulative trauma).

Stressful or abusive relationships in child or adulthood, ongoing bullying, burnout, personal losses, divorce, discrimination, abandonment, loneliness or any situation that causes feelings of being trapped, helpless or a sense of unsafety, that develops into an ongoing preoccupation. It is the emotional response to disturbing events.

This is not to say that anybody that experiences the above develops a trauma response, it is unique to everybody and the experiences we have encountered previously play a part.

Putting it simply anxiety is our bodies response to a thought or perceived threat however, trauma is a response to an experience that has occurred.

You may be surprised to know that chronic and persistent stress (Type 2) can have a similar affect on the body and mind of somebody that has had Type 1 acute trauma or PTSD.

Trauma occurs as a result of the fight, flight and freeze response in our body being activated by a stressor we cannot escape from i.e. a difficult relationships in childhood or adulthood, or any situation that causes persistent negative feelings where we feel repeatedly under threat. Type 2 cumulative Trauma is a set of events that eventually results in changes to our biology, perception of life, and our ability to cope.  Where we may have been relatively carefree and able to handle challenges of daily life before, we struggle to do that now. 

Type 2 trauma develops more covertly over a longer period of time, so it is difficult to pinpoint.  We gradually normalise to unsettling bodily sensations like restlessness, anxiety, rumination, palpitations or unhealthy coping strategies like alcohol, over or under eating, self-harm, avoidance etc.  Also, nightmares, feeling numb and shutdown can be other signs.

If we are subjected to ongoing stressors that create a repeated fear response, our bodies adapt and keep us in a more heightened state.  From an evolutionary sense, our biology is set up to keep us alive, i.e, if we have a frightening experience like a near car crash, if we are verbally or physically attacked or any event that is personally frightening for us, our bodies release chemicals for us to escape (fight and flight).  Our heart rate and oxygen supply increases to enable our muscles to mobilise to escape.  Our system will also create a body memory for each event, this is the evolutionary sequence to create future warning signals, so we can escape this threat if it happens again – this response can happen unconsciously, for example if somebody makes us jump, our body reacts spontaneously, or in other words a trigger.  Our five senses also come into play with body memories for example a smell can take us back to an event or set of events that troubled us.

The complication occurs when we have repeated triggers or repeated experiences that arouse our fight and flight (body memory).  Just by thinking about an experience, or having repeated stressful experiences, our body can automatically fire off the survival chemicals which reinforces pathways/connections in our neurotransmitters, along with body memories.  The response therefore gets quicker and more intense leading to hypervigilance, hyper arousal or anxious states.

This is a complex process and the brain areas involved are HPA axis, hippocampus and amygdala which sends signals to our body via the nervous system.  Unfortunately, this process is unable to distinguish whether we are in a real-life threatening event or not – it will fire off regardless.   Think cave man fending off wolf or bear attacks, this is really what this powerful part of the body/brain has evolved for and it doesn’t quite fit for our 21st century life issues and the overstimulation and complexities we deal with.

In counselling sessions, I would spend time where appropriate explaining this process, it helps clients know that as humans we have unconscious bodily processes and it’s not our fault that we have unhealthy coping strategies, relationship issues etc we just need to be aware of them and the associations.  Generally, via exploration in counselling sessions we start to uncover some of the unconscious reactions that are overwhelming the hidden/vulnerable parts of us, with the aim of making them conscious so we can work to process them. Where appropriate we would explore techniques, interventions to temper the signals, to calm the responses and over time lower the hypervigilance and physical responses.  We need to teach the body it is safe and allow the client to develop some mastery over these uncomfortable and life affecting feelings.