Alex Klassen, MSW, RSW

We often think of trauma in the context of accidents, physical harm, or violent events. If there's one thing we've learned in our work with clients, it's that the development of chronic pain/symptoms can in itself be traumatizing. Here's what you need to know.

DEFINING TRAUMA

Trauma is not the event that occurred, but our autonomic nervous system response¹. The same event could be traumatizing for one person, and not for another. It’s not black and white; trauma can be more and less severe in its impact. Trauma can be defined as nervous system dysregulation, including an overactive sympathetic and/or dorsal vagal state, that remains stuck in the body¹.

Symptoms of trauma can look like:

Overactivation of the sympathetic system:

• Physical symptoms: difficulty breathing, increased heart rate, difficulties or inability to sleep, tingling, cold sweats, dizziness, chronic pain, tension, tinnitus and other physical symptoms^1,2
• Mental symptoms: racing thoughts, worry and obsessive thinking, anxiety, irritation, panic, or rage^1,2

Overactivation of the dorsal vagal system:

• Physical symptoms: exhaustion, low energy, low muscle tone, numbness, poor immune function, issues with digestion, chronic pain/symptoms, and chronic fatigue^1,2
• Mental symptoms: lacking motivation or interest, dissociation, depression, numb, disconnection in relationships, lack of responsiveness^1,2

So why does this matter when it comes to chronic pain and symptoms? It matters because when we experience trauma, our nervous system can become sensitized meaning chronic pain, fatigue, dizziness, and/or other chronic symptoms are triggered. 

TRAUMA AND CHRONIC PAIN/SYMPTOMS

There are major links between trauma and chronic symptoms:

• Adults are 2.7 times more likely to have chronic widespread pain if they have significant trauma in their past³
• A meta-analysis study on trauma showed a significantly increased likelihood of developing Fibromyalgia and a 4-time higher likelihood of developing chronic fatigue syndrome⁴
• Chronic nervous system dysregulation is associated with inflammatory bowel diseases, functional digestive disorders, and IBS^5,6
• PTSD is associated with higher rates of dizziness/vestibular concerns⁷

These studies teach us that trauma can be a factor in triggering and perpetuating chronic pain and symptoms. Our nervous system lets us know, through chronic pain and symptoms, that it is feeling dysregulated and in a state of survival. As Deb Dana states, “Trauma replaces patterns of connection with patterns of protection”⁷, and because of this shift, we become much more likely to develop chronic symptoms. This is why trauma is a major factor that we focus on when treating chronic pain and symptoms.

SENSITIZATION TRAUMA

Sensitization trauma occurs during the onset, progression, or relapse of chronic pain/symptoms, resulting in our nervous system having an overactive sympathetic (fight/flight) and/or dorsal vagal (freeze/shutdown) response. Unfortunately, sensitization trauma remaining untreated can result in chronic pain and symptoms worsening over time.

Sensitization trauma occurs because:

• We feel very unsafe/dysregulated by the onset, progression, or relapse of symptoms
• Fear, confusion, frustration, or hopelessness while trying to diagnose the problem and dealing with the medical system
• Stigma from medical practitioners or individuals in our lives (being mistreated or being made to feel “crazy”)
• The onset of symptoms occurring due to another health crisis or injury that caused a sense of high danger
• Scary physical procedures or surgeries
• Made worse if treatments weren’t helpful
• Significant reduction in ability and change in lifestyle
• Hope is gathered and broken by failed treatments or interventions
• Flare-ups or setbacks reduce hope and trust in our bodies

RELEASING SENSITIZATION TRAUMA

For many people with chronic pain and symptoms, sensitization trauma must be processed for symptoms to reduce or dissipate. This is why our Somatic Safety Method course provides a detailed process to help you develop your somatic skills, identify trauma, and restore safety with guided practices.