In my last blog I noted that when fight or flight have failed, we move from stress to true trauma. Instead of being hyper-activated by the sympathetic nervous system, we move to hypo-activation mediated by the dorsal vagal nerve of the parasympathetic nervous system.
The parasympathetic nervous system is controlled by the tenth cranial nerve, known as the vagus nerve, from the Latin word meaning ‘vagrant or wanderer’ because it travels from the brainstem into the chest and abdomen to regulate many of the visceral organs. It innervates the muscles of the throat, and the organs of respiration, circulation, digestion, and elimination.
Work in the 1990s by Stephen Porges revealed that calling this a single nerve is actually quite misleading because it has two distinct branches. The first branch is the ventral vagus nerve which is the ‘happy place’ and I will talk more about that the next time.
The second branch is the dorsal vagal nerve which interacts with the hormones released by the endocrine system when the situation is overwhelming and the person feels helpless and hopeless. They fear they will not survive. It shuts down metabolic activity during immobilisation, death feigning and hiding behaviour as the person strives to be ‘unseen’.
The heart rate, blood pressure and respiration are decreased. The muscles collapse, the person loses all energy to have an impact on their life and enters a state of helplessness. The body freezes and the HPA floods the system with pain numbing opiates. Medically this is the state known as tonic immobility. It can be seen as an emergency brake.
In this hypo-metabolic state the person may feel shame, disgust, hopeless despair and then a profound detachment or dissociation wherein they watch events as if they were out of their own body, like an independent witness. At this stage, the right anterior insula is severely inhibited, such that the victim is unable to feel their body or their emotions, a condition known as alexithymia.
Dissociatively detached people are remote from their sense of identity and their self. Bessel Van der Kolk reports that, Almost every brain-imaging study of trauma patients finds abnormal activation of the insula. This part of the brain integrates and interprets the input from the internal organs – including our muscles, joints, and balance (proprioceptive) system – to generate the sense of being embodied… trauma makes people feel like either somebody else, or like nobody. In order to overcome trauma, you need help to get back in touch with your body, with your Self.
Regarding the prevalence of trauma underlying physiological pain and suffering, Peter Levine notes, If frightening sensations… are not given the time and attention needed to move through the body and resolve/dissolve (as in trembling and shaking), the individual will continue to be gripped by fear and other negative emotions. The stage is set for a trajectory of mercurial symptoms. Tension in the neck, shoulders and back will likely evolve over time to the syndrome of fibromyalgia. Migraines are also common somatic expressions of unresolved stress. The knots in the gut may mutate to common conditions like irritable bowel syndrome, severe PMS or other gastrointestinal problems such as spastic colon. These conditions deplete the energy resources of the sufferer and may take the form of chronic fatigue syndrome. These sufferers are most often the patients with cascading symptoms who visit doctor after doctor in search of relief, and generally find little help for what ails them. Trauma is the great masquerader and participant in many maladies and ‘dis-eases’ that afflict sufferers.
If you feel as if you have one of these physical conditions, I invite you to visit for somatic work, potentially to work with the traumatic source, not just the symptoms.