Trauma: A Somatic Lens
Too Much, Too Fast, Too Soon
As a trauma-informed somatic practitioner and massage therapist I work with a range of clients who live with trauma, including some war veterans.
After serving several tours in Afghanistan, Sam* now lives with complex symptoms that include chronic nightmares, anxiety, depression, mood swings and roving body pain.
This is an example of trauma, or post traumatic stress disorder (PTSD), which the Center for Addiction and Mental Health in Toronto calls: “... the lasting emotional response that often results from living through a distressing event. Experiencing a traumatic event can harm a person's sense of safety, sense of self, and ability to regulate emotions and navigate relationships.”
After suffering alone for years, Sam eventually began to explore a range of interventions like psychotherapy, meditation, gardening, strength training and weekly trauma-informed massage therapy. Their ability to participate in desired activities of daily living slowly began to increase.
A growing interest in trauma as a complex neurobiological response has led to expanded understanding and evolving definitions. One commonly used explanation is that trauma occurs when our nervous system experiences something that is either too much, too fast, too soon, or too little for too long.
Put another way, sometimes the nervous system becomes overwhelmed by a shocking event or intolerable long-term situation. Without adequate resources and support to metabolize and complete the natural fight, flight, freeze or fawn response in the nervous system, it can become “stuck” in the body, resulting in a wide range of challenging physical, emotional and mental symptoms.
Trauma is not the event, although the term gets used that way quite often. Trauma, or PTSD is the set of complex and lasting symptoms that result from the initial event or situation.
A Somatic Lens
In the 1960’s and 70’s, when US veterans started coming home from Vietnam, Dr. Bessel Van der Kolk was working at the Boston Veterans Administration Outpatient Clinic. The experiences he had with his patients led to a career-long exploration of trauma through a somatic, or body-oriented lens. He is well-known for his 2014 book, The Body Keeps the Score.
Van der Kolk’s research, which can be considered pioneering work in the field of somatic trauma recovery, has spurred on, and co-occurred alongside, a number of important thinkers researching and exploring clinical applications for a physiological and neurobiological understanding of trauma.
A range of somatic therapies have been developed and some, such as Somatic Experiencing, have been proven effective through clinical research.
It’s important, when naming relatively recent Western thought as pioneering work, to also acknowledge the lineages of somatically attuned, Indigenous wisdom that have supported and treated trauma in myriad ways, for millennia.
Trauma is Not Singular
An uptick in interest and research on trauma in the last 50 years has led to a growing body of literature about what happens to the human organism when we experience it.
One important development has been the refinement and differentiation of trauma types. We now understand that distressing events are only one cause, and that developmental neglect and abuse are another. More recently, research shows that moral injury—the trauma of being forced to act in ways that violate our moral code—is a unique type of trauma that affects different regions of the brain.
Moral injury commonly happens during wartime but currently there is a great deal of interest in the moral injuries sustained by huge numbers of frontline health care workers during the pandemic.
The research and discussion around trauma, trauma recovery and post-traumatic growth is complex, interdisciplinary and emergent. Somatics play an important role. Much work has been done and even more remains.
I’m grateful to be part of this important conversation.
*Sam is a composite client, with all identifying details removed for confidentiality.
