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What is a trauma?

Psychological trauma is an extremely upsetting or threatening experience that exceeds the nervous system's capacity to adapt at the time it occurs.

Trauma can take many forms and does not depend on the severity of the event, but rather on how it is experienced, processed, and stored in the brain.​

It leaves a lasting imprint on the brain, body and psyche.

It is an emotional injury caused by a direct or indirect event (or series of events) perceived as too intense, too sudden, or too long-lasting for the brain to process normally.When a traumatic event occurs (accident, aggression, sudden bereavement, disaster, etc.) what we call acute stress occurs. This is an immediate and intense reaction, occurring in the hours or days following the trauma. Acute stress is the body's and brain's normal response to extreme danger.

It can manifest itself as anxiety, agitation, sleep disturbance, confusion or dissociation (a feeling of unreality, detachment from oneself). This reaction is often transitory, and tends to disappear within a month.

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On the other hand, if these symptoms persist beyond one month, intensify or are accompanied by lasting suffering, we speak of post-traumatic stress disorder (PTSD). PTSD occurs when the traumatic event has not been “integrated” or digested by the brain. The person then regularly relives the trauma through flashbacks, nightmares, intrusive thoughts or, on the contrary, develops traumatic amnesia, where the memory of the event is partially or totally inaccessible to consciousness.

Reactionary and adaptive behaviors may develop, such as avoidance (refusing to talk about it, fleeing certain places or people), hypervigilance (frequent startles, constant tension), emotional numbness (difficulty feeling emotions or connecting with others), as well as addictive disorders, for example.

 

Physical consequences of psychological trauma
The brain instantly modifies its functioning in response to this trauma, which in the case of post-traumatic stress disorder (PTSD) has serious functional consequences. The amygdala becomes overactive and alerts to danger, the hippocampus atrophies and mismanages memory of the event, and the prefrontal cortex becomes less able to regulate emotions.
These physical reactions reflect the memory of the trauma inscribed in the body, sometimes referred to as “implicit traumatic memory”. The body thus retains a trace of an event that the brain was unable to process or integrate.

These changes in the brain have a profound and lasting impact on the body, directly affecting the nervous and immune systems, as well as the overall functioning of the organism.

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The most common effects include:

  • Chronic muscular tension, diffuse pain (particularly in the back, shoulders or neck);

  • Persistent sleep disorders (insomnia, frequent awakenings, nightmares);

  • Chronic fatigue, feeling of exhaustion even after rest;

  • Digestive disorders (stomach ache, nausea, intestinal problems) linked to disruption of the enteric nervous system;

  • Weakening of the immune system, making the person more vulnerable to infection;

  • Palpitations, sweating, trembling, reminiscent of physiological reactions to initial danger (“fight or flight” reactions);

  • In some cases, somatoform disorders may appear: physical pain or discomfort with no identifiable medical cause, but very real for the individual.

  • In the long term, untreated trauma can lead to serious illnesses such as cardiovascular disease and hypertension.

 

However, thanks to neuroplasticity, the brain can gradually repair itself with appropriate therapeutic support.

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Van der Kolk, B. A. (2019). Le corps n'oublie rien : Le cerveau, l'esprit et le corps dans la guérison du traumatisme (S. Jouan, Trad.). Paris : Éditions Albin Michel.

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