As we transition into the theory section of this series, it is crucial to acknowledge the scope and boundaries of the theories under discussion. This series offers a basic understanding of some significant theories concerning trauma, but it should be viewed as a preliminary step rather than a comprehensive examination. It serves as an invitation for researchers to expand upon the extensive body of knowledge on the neurobiology of trauma, where numerous clinicians and theorists have made significant contributions to understanding the intricate connections between the body, nervous system, and mind (Levine, 1997; Rothschild, 2000; Porges, 2011; Ogden, 2015; van der Kolk, 2014; Fisher, 2017).
Theories are dynamic constructs; they evolve and change over time as new evidence emerges. The presented understanding in this series may evolve or be updated in the future as our collective knowledge deepens, diversifies, and becomes more inclusive.
The complex interplay of power, privilege, and consent – or more critically, the absence thereof – becomes of paramount importance. Trauma survivors often grapple with these issues, which can further complicate their healing process. As we delve into theory, let’s keep these aspects at the forefront, understanding that they significantly influence the lived experiences of those who have survived trauma.
Diversity and Differences in Trauma Theory
In the realm of trauma, it is important to critically examine the popular theories that dominate the field. While attachment theory (Bowlby, 1969; Ainsworth et al., 1979) is widely recognised in trauma theory, it is important to acknowledge its limitations and biases (Kagan, 2021). Attachment theory has predominantly been developed and studied through a white Western lens, which can introduce biases and restrict its applicability to other cultural contexts. This Western bias may not fully capture the diverse variations in bonding and attachment styles observed in different settings, including those within neurodivergent communities.
It is crucial to acknowledge the significant impact of flawed research, particularly in cases where individuals who deviate from traditional societal norms are often pathologised rather than embraced and respected for their differences. This is the realm of misdiagnoses, where trauma, which is fundamentally the root of most mental health conditions, is accurately assigned to whites, while other populations at higher risk are often overlooked (Sibrava et al., 2019).
Understanding Trauma’s Impact on the Body
Trauma arises from stress so overpowering that it exceeds our capacity to cope or process the associated emotions. This stress can be attributed to a single event or persist through repeated, chronic exposure to stressful situations. Violence, neglect, loss, marginalisation, disaster, warfare, and accidents all represent potential sources of such stress.
Much akin to a physical injury, trauma resides profoundly within our bodies. Our physiological selves retain memories of traumatic incidents, often storing them as sensory experiences. A particular sound, smell, or touch connected to the traumatic event might provoke a deeply embodied response. This happens due to our nervous system, the body’s built-in protection mechanism designed to react instinctively to danger.
Think of the nervous system as the body’s intricate electrical circuitry, regulating everything from our heartbeat to our emotional responses. Upon facing a threatening situation, the nervous system springs into a state of hyperactivity to safeguard us. This aroused state manifests as the “fight, flight” response we’re so familiar with. Our hearts race, our breath quickens, and our muscles prepare for immediate action—all in response to a perceived threat.
Distinguishing Stress from Traumatic Stress: The Window of Tolerance
Understanding the difference between common stress and traumatic stress is key. The former, a part of daily life, arises from common challenges like meeting work deadlines or navigating a bustling commute.
This routine stress exists within the “window of tolerance” (Siegel, 1999) – an optimal zone of arousal where we can effectively manage our day-to-day responsibilities and maintain emotional equilibrium. Within this window, our nervous system adeptly handles the stressors we routinely face.
However, traumatic stress goes beyond this window. When confronted with a traumatic event, the resultant stress can overwhelm our usual coping strategies, pushing our arousal state outside the window of tolerance. This shift could lead to hyperarousal, evidenced by anxiety, anger, or panic, or hypoarousal, marked by feelings of numbness, disconnection, or a sense of shutting down.
While the concept of the window of tolerance offers a useful framework to spot potential trauma responses, it’s vital to note the inherent complexities. Trauma reactions are diverse and multifaceted and may not align perfectly with a single model. As such, attempts to comprehend trauma and its various manifestations should consider a broad range of responses beyond this metaphorical window.
Expanding our Understanding: The 5F’s
To deepen our comprehension of trauma responses, let’s delve into the ‘5F’s’ – Fight, Flight, Freeze, Fawn, and Friend. These automatic nervous system responses, triggered when we perceive threats, provide valuable insights into how individuals react to trauma.
Initially, the model focused on Fight and Flight (Siegel, 1999), which later expanded to include other survival strategies. The Freeze response (Bracha, 2004) represents a state of immobilisation when neither resistance nor escape seems viable. The Fawn response (Walker, 2013) captures appeasing behaviours during complex trauma. Lastly, the Friend or ‘Tend and Befriend’ response (Taylor et al., 2000) illustrates how individuals seek social connections to cope with stress.
Here’s a brief outline of the ‘5F’s’:
- Fight: This response engages when a person perceives a threat, they believe they can overcome. It triggers aggressive behaviour aiming to neutralise the threat.
- Flight: The flight response springs into action when a person recognises a threat but doubts their ability to combat it. Instead, the body gears up to escape the danger swiftly.
- Freeze: This response occurs when a person identifies a threat but doesn’t see a viable way to resist or flee. They may become immobilised and unresponsive, similar to how some animals ‘play dead’ when threatened.
- Fawn: Characterised by appeasing behaviour, the fawn response aims to avert danger. Individuals relying heavily on this response may prioritise others’ needs over their own as a defensive strategy.
- Friend (also known as ‘Tend and Befriend’): This response entails seeking social interaction and creating bonds as a defence mechanism. The rationale behind this strategy is that forming social bonds can help individuals manage stress and enhance survival chances.
Dissociation: Understanding its Forms and Effects
Dissociation is a psychological state where there’s a detachment within an individual’s consciousness, perception, memory, or identity. Often surfacing as a defence mechanism during traumatic episodes, it allows individuals to cope with a distressing reality by creating a buffer from the traumatic experience.
Dissociation can manifest in various forms, each revealing a unique aspect of the individual’s disconnection from their physical self:
- Depersonalisation: This phenomenon induces a feeling of detachment from one’s own self. Individuals may feel like onlookers observing their own body and mental activities from an external vantage point, similar to viewing themselves in a film.
- Derealisation: This aspect involves disconnection from the immediate environment. Individuals may perceive their surroundings as dreamy or distorted, creating a sensation of an unreal or unacquainted world.
- Amnesia: In the context of dissociation, amnesia refers to the inability to recall specific time periods, events, people, or personal details. This memory loss typically concerns traumatic or stressful incidents.
- Identity Uncertainty or Alteration: This facet relates to a lack of certainty about one’s identity. Individuals may sense different identities within themselves, occasionally feeling these identities govern their behaviour.
- Changes in Affect, Behaviour, Consciousness, Perception, Cognition, and/or Sensory-Motor Functioning: These comprehensive alterations can encompass sudden mood swings or emotional changes, unexpected behavioural shifts, a sense of disconnection from one’s body, altered time perception, or changes in sensory perception.
Secondary Traumatic Stress: Vicarious Trauma
The final theoretical concept to highlight is that of vicarious trauma, also known as secondary traumatic stress. This term refers to significant personal changes resulting from empathetic engagement with traumatic stories or materials. Professionals like researchers, therapists, and social workers who work closely with trauma survivors are particularly vulnerable to this effect. Essentially, vicarious trauma encompasses the indirect experience of the emotional and psychological consequences of trauma (Pearlman and Saakvitne, 1995).
The symptoms of vicarious trauma can be similar to those of direct trauma exposure, which can include, but are not limited to, heightened anxiety, emotional numbing, avoidance tactics, and shifts in worldviews (Baird and Kracen, 2006). Importantly, our understanding and acknowledgement of vicarious trauma have greatly influenced the development of self-care methods, stress management techniques, and supervision structures in professions dealing with traumatised groups (Trippany et al., 2004).