In recent years I've done a deep dive into the research and clinical practices relating to trauma. I've begun a 3-year training in Somatic Experiencing (SE), a powerful trauma healing modality. And, I've been doing my own trauma healing work with an SE therapist for nearly a decade. What I am seeing is this: when we view almost any human experience through the lens of trauma, it looks different. When we understanding what trauma does to the body and the mind, everything makes more sense. We begin to understand WHY.
Trauma is a word both underused and overused in our culture. It is underused in the sense that harmful experiences are dismissed as "little t trauma" or as not traumatic at all. It is overused in the sense that just about anything can be called traumatic, whether it actually is or not.
So what is trauma? Trauma is NOT what happens to a person. Trauma is not the event or experience itself. Trauma is what happens INSIDE a person when something painful happens to them. It's a particular way the the body or the heart get injured, and emotions and energy get trapped, when a person is rendered powerless (or left alone and helpless) in the face of harm. The nervous system gets rewired to distrust cues of safety and become hypervigilant to cues of danger. The nervous system is doing it's job, which is to protect us. When we experience something painful, and we can't fight back or flee, we have no one to talk to about it, no one to acknowledge our feelings, it registers in implicit memory and in the tissues of the body. The nervous system mobilizes to, above all, make sure you NEVER have to feel something like that again. It keeps you safe. It also steals your vital life force and disconnects you from yourself, maybe just a little, maybe a lot. Sometimes completely.
In a recent interview, Peter Levine, the creator of Somatic Experiencing, cited a statistic, that 90% of the time when someone goes to a doctor, no medical cause can be found for their symptoms. 90 percent of the time. Medicine is not equipped to take the inquiry beyond that. Medical investigation asks what's wrong. If the tests say "nothing," then the doctor has no tools. They are likely to either say it's all in the person's head, or to label it as a "syndrome." A syndrome, in medicine, is a documented state of ill-health with a specific set of signs and symptoms but no clear medical explanation. Most syndromes are controversial and none of them has a standard, effective medical treatment. Tens of millions of Americans suffer with syndromes as varied as chronic fatigue, fibromyalgia, chronic Lyme, irritable bowel syndrome, and many more. Even auto-immune disease and cancer -- though they are classed as diseases (in that they have biological markers that can be detected and treated) cannot be explained by medical science. Both are instances of the body essentially turning on itself -- healthy cells or systems going rogue and causing damage. But why? We don't know. Evolutionarily it makes no sense that at organism would, essentially, self destruct. With both cancer and auto-immune disease, most medical treatments cause immense collateral damage. And we know nothing about how to prevent them.
So asking "what's wrong? is clearly not working. With some notable exceptions like infectious diseases (where modern science has worked miracles) medical science can neither locate not fix the root problem. It can only cut things out, kill things with chemicals, and suppress symptoms with medications. Do these treatments save lives? Absolutely. I'm not arguing against their use. I'm just saying they are not tools for healing.
People start to heal when they can investigate not "what's wrong with me," but "what happened to me."
After my own 20 year journey with chronic pain, and 3 surgeries in 3 years that not only failed to solve the problem but devastated me and left me disabled, I was lucky enough to find a therapist who asked me what had happened to me. It is not an exaggeration to say she saved my life. As I moved past that crisis, I trained to be a health coach and started working with others like me who had chronic symptoms that eluded diagnosis and treatment. And the common denominator that I saw, over and over, was bodies, minds, and nervous systems locked in a chronic state of stress. I began working with people to identify and address the stressors that they COULD control, and people got better. They felt better even if symptoms persisted. They understood what was going on. They regained some sense of agency and control over the bodies, which had been lost in the medical odysseys they had all traveled. I was going through the same process right along with them, learning from them as much as from my own experience.
We were working to relieve chronic stress - to give the body and mind restorative experiences where relaxation and regulation became possible. With chronic stress, the nervous system gets locked in a stress physiology. It loses access to its innate capacity to calm down and re-regulate, to return the body to homeostasis. The organism becomes chronically dysregulated. Most immediately, it's their physical pain and other symptoms that are triggering the stress response. But if you ask "what happened to you," almost always, the chronic stress was there first, before the physical symptoms.
Either way, there is no healing without addressing chronic stress. And chronic stress is caused by trauma.
I'm not saying that chronic pain and illnesses don't have organic, physiological causes. (This point is critically important. I've seen few things do as much harm as being told "it's all in your head" or "there's nothing wrong with you" when people are clearly physically suffering. That in itself is a trauma. I've had clients say to me, "I almost wish I had cancer. At least then they'd know how to help me." With every new medical test they are, perversely, hoping for a positive result). Something has wallopped the body from the outside. People get injured. They get viral and bacterial infections that evolve into chronic syndromes.
But some people's acute symptoms resolve with treatment and other people's do not.
That's the mystery.
Medically speaking, my back was "fixed." I have titanium in my spine where once there were herniated disks. The nerve pathways are clear. And, I still have chronic back pain. Failed Back Surgery Syndrome is a medical diagnosis with its own billing codes.
We can begin to unravel the mystery by providing a safe holding environment where people can tell their stories. What happened to you? Why and how were those experiences traumatic? What did you need when they happened that you did not receive? And how did that change your physiology - because it always does. Always. Then and only then can we give people tools -- tools to use with a practitioner and tools people can use themselves -- to begin to calm the chronic threat response, the wailing alarm that is constantly sounding in their mind/body.
A body in a stress response cannot heal. In his wonderful book Why Zebras Don't Get Ulcers, Robert Sapolsky goes system by system to explain what happens to the body during the stress response. All resources go to energizing the main muscle groups to prepare them to fight or to flee. It's a crisis - any bodily function that can be paused until the emergency is over will be paused. The immune system is suppressed. Digestion is slowed or stopped. Reproductive hormones stop being produced. And certain parts of the brain go dark. It's physiological triage. It's essential to the survival and evolution of every species.
The stress response doesn't cause lasting harm when it's a short-lived and occasional. Imagine a gazelle being chased by a cougar. It either escapes or it dies. Either way, it's over fast. The threat is resolved. If the gazelle escapes, its body goes back relatively quickly into homeostasis - a healthy, regulated state where all systems are again functioning properly. There's no trauma.
What happens, then, when the threat does not resolve? When the threat is ongoing? Or when a traumatic experience rewires the nervous system to believe that threat is present and ongoing? The body doesn't function properly and some form of symptom is going to show up.
With this understanding, imagine how different medicine would be if people were asked "what happened" as well as "what's wrong?" If the criminal justice system focused on what happened to the perpetrators rather than on punishment and isolation? If teachers focused on what had happened to "disruptive" children rather than punishing or medicating them? If twelve step programs encouraged people to stand up and say "I am Joe and this is what happened to me," rather than "I am Joe and I am an addict." Forever and always an addict with a character flaw, rather than a complex human being who'd been injured. Forever a felon. Forever a person with ADHD or a kid wtih Oppositional Defiant Disorder.
Sometimes "what happened" is individual. But often it is trans-generational, structural, or systemic. Whole groups are traumatized by oppression by race, gender, sexual orientation, gender identity, body size, religion, ability, and more. These types of trauma are only just starting to be recognized and explored. They can explain a lot about the disparate outcomes and persistent inequalities that are everywhere in our society. It's an essential and powerful set of inquiries and conversations and should always be a part of the inquiry into "what happened -- or what
is happening -- to you."
When we understand what happened, we can access compassion - compassion for others, compassion for ourselves. It's harder to hold onto hatred, to perpetuate harm, when the heart feels true compassion. And if I've learned one thing through all of this experience, is that healing cannot happen without compassion. Not in an individual body, not in a family, an institution, a nation, or a world.