Trauma and Dissociation

During extreme stress our nervous system numbs painful emotions. It is temporarily helpful. If left unresolved, this dissociative response leads to difficulty in relationships, emotional impulsivity, and coping strategies like addiction.

Trauma and Dissociation

Maintaining homeostasis through arousal cycles, activation and deactivation, is regulated through the sympathetic and parasympathetic branches of the ANS. Rapid increase of sympathetic charge, as we jump out of the way of a suddenly crossing bicyclist, is down regulated by the parasympathetic branch, allowing us to settle as they pass by without collision. We return to homeostasis.

When threatening experience, such as abuse, sexual assault, or surgery overwhelms the nervous system’s impulse to respond, the self-protective impulse is suppressed inside, and the body does not return to homeostasis. The suppression of incomplete life-preservation impulses, and resulting traumatic stress, leaves us with a variety of physical and mental symptoms. We may cycle through feeling ‘jumpy’ to feeling nothing at all.

Dissociation, tonic immobility, and freeze are all ways of expressing the parasympathetic side of the nervous system. Parasympathetic imbalance may create problematic symptoms, such as; digestive and immune functioning, sleep disturbances, poor blood and oxygen circulation. In trauma and somatic dissociation there may be a suppression of hormones, heart rate, and blood pressure. On an emotional level we may feel confused, numb, slow, reactive. On a social level we may feel disconnected, rushed, or stuck in anger or sadness, leading to depression. We may feel extreme regret for what we didn’t say at the time that we most wanted to say it. We may feel mad at ourselves for what we didn’t do in the moment, not realizing the complexity of the conservation biology involved. The brain is flooded with reality numbing endorphins, inhibiting memory retention by the neo-cortex. This adds to the confusion of flashbacks by those suffering from PTSD. A common symptom of freeze is the feeling that one is crazy, unable to correlate the memory of the past with current body sensations, emotions, and triggers.

In a healthy functioning parasympathetic nervous system, balanced with the capacity for full regulation of ordinary life stress, we have the ability to recover from activating experience, to deactivate, digest, play, rest, and relate in an intimate way once again. During deactivation and rest from an activating yet successful stress response, vital life energy spreads out again to the rest of the system; secretion of digestive enzymes, stimulating intestinal motility and peristalsis to move food through the digestive tract, intestinal sphincters relax, circulation systems flow, and insulin releases.

With parasympathetic imbalance found in trauma and dissociation we have an increased risk for symptoms and illnesses, such as low blood pressure, dizziness, chronic fatigue, diarrhea, and sleep disturbance. We may take a long time to come down from stressful events, and turn to drugs or alcohol to self-medicate. The survival biology is drawing energy away from social engagement processes, growth, and reproduction mechanisms, as well as the integration of information, such as memory, learning, education, and aptitude for language.

A leading trauma expert, Van der Kolk speaks to how the body manages this overwhelm through the mechanism of dissociation, by compartmentalizing the experience into different sensorial channels, split off from a cognitive awareness of the whole experience. This compartmentalized and unfinished integration of the whole experience gives rise to the difficulty in therapy, to finding curative therapeutic interventions, not just management of, but solutions in resolving trauma, traumatic stress symptoms, and post traumatic stress disorder (PTSD).

Bessel A. van der Kolk M.D. has focused his work in the arena of post traumatic stress since the 1970s, integrating developmental, biological, psychodynamic and interpersonal aspects of the impact of trauma. His work in ‘Psychological Trauma’ was the first integrative text on the subject, filling in the far ranging impact of trauma on the entire person and the range of therapeutic issues which need to be addressed for recovery. He was co-principal investigator of the DSM IV Field Trials for Post Traumatic Stress Disorder, (PTSD). His current research is on how trauma affects memory processes and brain imaging studies of PTSD. In his article, ‘Dissociation and the Fragmentary Nature of Traumatic Memories: Trauma and Dissociation’, he writes,

“….Dissociation refers to a compartmentalization of experience: elements of the experience are not integrated into a unitary whole, but are stored in memory as isolated fragments and stored as sensory perceptions, affective states or as behavioral reenactments. While dissociation may temporarily serve an adaptive function to trauma, in the long range, lack of integration of traumatic memories seems to be the critical element that leads to the development of the complex bio-behavioral change that we call Post Traumatic Stress Disorder…People who have learned to cope with trauma by dissociating are vulnerable to continue to do so in response to minor stresses. The continued use of dissociation as a way of coping with stress interferes with the capacity to fully attend to life’s ongoing challenges.” – Bessel Vander Kolk.

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