Trauma, whether single-episode or complex relational trauma, lives in the body.  Trauma-informed psychologists understand that in order to fully process and work through responses to trauma, therapy must address the somatic experience of the trauma.  When this happens consistently, you will begin to see signs your body is releasing trauma.

In this blog article, we address how neuroception is influenced through the attachment process of attunement; how complex trauma becomes stored in the body, and expressed with flooding and dissociation in response to PTSD triggers; and how to recognize what trauma being released from the body feels like.

As a quick summary, here are the signs your body is releasing trauma:

• Gut muscles relax and unclench
• Breathing patterns change
• Shoulder, neck, jaw, and head muscles can be engaged & upright, yet comfortably relaxed
• Heartbeat slows, blood pressure decreases, and heart-rate variability increases
• Hands and feet are more frequently warmer
• Body experiencing is more present and at ease

Attunement and Neuroception

In healthy parent-child attachment, there is a natural cycle of attunement, misattunement & dysregulation, and repair.  Attunement involves warm, soothing vocal tone of parents (e.g. cooing) and calm, engaged non-verbals that let the baby feel seen and safe (eye contact, physical touch).  This connection soothes the baby’s immature nervous system.

However, it is natural that this attunement cannot last indefinitely.  There are constant interruptions of attunement, whether through normal day-to-day distractions or disruptions, or through the baby’s own imature nervous system.

When this happens, babies will cry, since they can’t verbally communicate their needs.  In response, parents will try through trial-and-error to figure out the ‘just right’ intervention to repair the baby’s distress.

According to Schore (2003), when this cycle of attunement through repair happens consistently enough, this early development environment helps shape the final wiring of the baby’s brain circuitry.  This sensitive period of attachment is generally understood to occur in the first two years of the infant’s life.  How this wiring develops will influence future emotional and social development and coping capacities of the person.

Stephen Porges (2011) calls this neurological perception of the surrounding environment neuroception.  Neuroception influences our balance of seeking safety versus interpersonal engagement.  Healthy attachment experiences allow for a neuroception that is more wired for engagement.  In this respect, it become a reinforcing pattern, because greater amounts of positive social engagement lead to greater well-being.

How to Recognize Complex Relational Trauma

Trauma can occur in a single episode or repeated episodes over time.  A single major traumatic episode is often referred to as ‘Big T’ trauma, whereas repeated ‘smaller’ traumas in a relationship are often referred to as ‘Little T’ traumas.

Complex trauma occurs when there are a series of repetitive, and sometimes escalating, traumatic events.  These often occur a prolonged period of time, and usually in a specific context, such as in an attachment relationship (Courtois & Ford, 2013). In these instances, the traumatic experiences are referred to as complex relational trauma.

Complex relational trauma has many ‘Little T’ traumas with some ‘Big T’ trauma potentially occurring as well.  While there is some subjectivity to differentiating between what is ‘Little T’ and ‘Big T’ in complex relational trauma, a good rubric is that the repeated gaslighting and emotional abuse that occurs in the traumatic attachment is ‘Little T’, whereas ‘Big T’ might refer to physical and sexual abuse, or severe neglect.

What is important to understand is that much of the damage in complex relational trauma comes from the accumulated effect of the repeated ‘Little T’ traumas.  This is particularly the case when children are involved who don’t have a frame of reference or stable identity to be able to fully understand what is happening and why it is wrong.

There is variety to the type of ‘Big T’ traumas – from human trauma such as abuse, neglect or being victimized by war to natural disasters such as earthquakes.  The impact of pervasive developmental abuse or neglect involves significant psychological harm to a survivor’s sense of personhood and the associated psychological functions that come with it (Courtois & Ford, 2013; Herman, 1992).

Signs You Are Traumatized

Now let’s turn to reviewing trauma presentation, including how to recognize the signs you are traumatized.

According to Courtois & Ford (2013), there are three central ‘features’ of complex relational trauma.  They are (1) emotional and/or somatic dysregulation (2) dissociation and (3) compromised  (e.g. damaged, dysfunctional, or problematic) interpersonal relationships.

Somatic dysregulation is the main focus of this blog post, specifically the somatic healing process from trauma and the signs your body is releasing trauma.  Dissociation also can play an important role in the ‘problem’ and ‘solution’, so we cover this area as well in this article.

Trauma is Stored in the Body

Somatic dysregulation means that the trauma is stored in the body.  You might imagine it as lying dormant or out of your awareness in everyday living.  As part of this dysregulation, emotional or somatic responses to PTSD triggers (e.g. cues reminiscent in some way of the traumatic experience(s) tend to manifest in an ‘all-or-nothing’ manner.

Fisher (2022) states that the most important thing to remember is that when there is early attachment trauma, the trauma is remembered somatically.  That means that the trauma lives or is stored in the body.  This storing happens on a subconscious and autonomic level and may be experienced separately from conscious recall of the actual traumatic events that happened.

This bodily storing or remembering of trauma happens through visceral responses, autonomic and muscle memory and habits.  This remembering has a good intention – we are trying to avoid what feels bad and move towards what feels safe.

The problem is that when we feel these somatic symptoms of the trauma, we may not realize we are remembering something from the past.  Instead, it feels like something that must be happening right now.  Essentially, we confuse the past for the present.

The opposite of somatic flooding is freezing, e.g.  ‘shut-down’ mode.  While expressed differently, freezing is still an expression of somatic dysregulation and trauma being stored in the body, and it is equally debilitating.  In a freeze response, the person is immobilized and cannot martial appropriate internal resources to resume normal functioning.

Here it might feel like you are frozen or immobilized.  It might feel like you can’t move.  You might also feel numb or dissociated.  This kind of response could follow the flooding, almost as a response to being flooded. On the other hand, it could also be the initial response, depending on how a person experienced the trauma and the trigger.

Overall, this kind of  traumatic dysregulation means you don’t have the same internal resources to socialize or interpersonally related with others, as compared to someone who hasn’t experienced trauma.  Porges (2011) explains that a traumatized person’s neuroception, or neurological perception of safety, is different than others.  Stated plainly, you just don’t feel safe as easily.

There are still moments, however, where you may feel safe enough to engage with others.  These limited moments for healthy engagement are referred to as a ‘window of tolerance’ (Fisher & Ogden, 2009).  While traumatized individuals have smaller windows of tolerance, therapy can help to expand it.

Example: PTSD Triggers & Where Trauma is Stored in the Body

Here is an example of how trauma gets stored in the body and re-activated in the present when there are PTSD triggers.  Suppose as a child your parent could become unglued seemingly at the drop of a hat (maybe they were a trauma victim, and/or had a substance addiction or significant mood disorder).  When they would get upset, they would start yelling at the top of their lungs.

The experience of this would be terrifying, because you could hear the loudness of their voice and see their face getting flushed and veins in their neck bulging.  Perhaps this signaled the possibility of other abusive behavior, but it also may have been significant in and of itself.

When this would occur, you would experience stomach clenching, a racing heart, and your muscles tensing.  You might even feel like you were hyperventilating because you were so scared.  You would instantly be in ‘fight or flight’ mode because it felt like your survival was at stake.

Now as an adult, you could be completely relaxed one moment and then be surprised to hear someone yelling.  The moment you heard the yelling, e.g. PTSD trigger from your complex relational trauma, your body would immediately activate this somatic bracing.  All the symptoms of living through that trauma would come back, and it would feel like your life is at stake.

In an instance like this, when the emotional and/or somatic response is physiologically over-reactive, the survivor will feel physiologically flooded and have difficulty functioning.

PTSD Dissociation

The second feature of complex relational trauma is dissociation, or a disruption to the experience of self-integrity.  Potential expressions of PTSD dissociation could include experiences of loss of time, loss of consciousness, and loss of one’s sense of self.

Loss of time involves losing tracking of the passage of time while in a dissociative state.  Loss of consciousness means not having conscious awareness of what you were doing during a dissociative state.  Loss of one’s sense of self means ‘not feeling like myself.’

People with symptoms of dissociation often feel ‘out of it’, detached, and disconnected from how they normally feel and identify.  The level of dissociation can vary significantly in complex relational trauma, ranging from dissociative amnesia to Dissociative Identity Disorder (DID).

Regardless of ‘how much’ dissociation you have or how it is subjectively expressed, there are certain general characteristics.  As Van der Hart and colleagues (2006) describe in their structural theory of dissociation, any kind of dissociation involves a segregation and compartmentalization of personal experience across aspects of personality and functioning.

Van der Hart and colleagues call this traumatic or PTSD dissociation a separation between the ‘apparently normal part of the personality’ (ANP) and the ’emotional part of the personality’ (EP).

The ANP is associated with the left brain part of the self that goes about normal life in a more conscious goal-directed manner.  The EP is connected to the right brain part of the self that stores the traumatic memories in the body and anticipates survival responses needed for ongoing survival.

Expressions of traumatic experience can become separated from other aspects of personality and daily functioning.  As a result, PTSD triggers can often result in a profound disruption and shift to the survivor’s quality of self-integrity and self-experience.

What does dissociation have to do with signs trauma is being released from the body?  People who experience significant dissociation are often highly disconnected from the stored trauma in their body.  When PTSD triggers occur, they are often inundated and overwhelmed by the intensity of the somatic experiencing of the trauma.

In order to begin to heal, they need strategies to become more aware of and manage their dissociation, and to therapeutically heal the  trauma stored in their bodies.

Signs Your Body is Releasing Trauma

Before we go through the signs your body is releasing trauma, it is important to understand that it is unlikely to occur without additional intervention.  Trauma therapy and body-based approaches such as yoga help re-wire the mind and prepare the body to release the trauma that has been encoded and stored somatically over time.

This diagram we’ve created above illustrates the progression from trauma stored to trauma released.  We’ll review each of these signs that your body is releasing trauma.

1. Gut muscles relax and unclench

When trauma-based anxiety is expressed through the gut, a common experience is stomach clenching and tight abdominal muscles.  Being in a ‘fight or flight’ mode from trauma can show through symptoms of stomach pain and nausea, as well as intestinal cramping and diarrhea.

When a person has worked through trauma, one sign that trauma has been released is a diminishing of GI symptoms.  These symptoms begin to decrease in frequency and intensity.  Because a person feels safer and more at ease, the muscles in the gut (digestive system) are more relaxed.  There is a calm, looseness to the abdominal muscles during breathing.  The anxious clenching is gone.

2. Breathing patterns change

One notable sign your body is releasing trauma is a shift in breathing patterns.  During trauma activation – in response to a posttraumatic cue or PTSD trigger – people typically respond in one or two ways.

Many people, especially when stressed or flooded, people will breathe rapidly and shallowly with quick breaths (e.g. hyperventilating).  In this type of breathing pattern, the chest muscles are doing most of the work.

For others, a characteristic response is holding the breath, sometimes to the point of feeling like they are going to faint.  This breath holding mirrors a ‘freeze’ response for trauma.  Here the person startles and holds their breath, trying to figure out how to respond.

When trauma is released from the body, the breathing pattern shifts considerably.  I want to point out a few important things here.

First, one reason the breathing pattern has changed is because the person has worked, or is well into the process of working,  through their trauma(s) in therapy.  If you feel less afraid, you are likely to breathe differently.

Second, many trauma-focused therapies feature somatic techniques and strategies.  Identifying trauma-based somatic responses and teaching strategies to change them is an active part of many trauma-focused approaches.  Breath work is a core component of many therapeutic approaches, as well as other related areas, such as yoga.

Healthy breathing involves more use of the diaphragm muscles (‘diaphragmatic breathing’).  When it comes to breathing, one sign that trauma is being released from the body is that the breath more frequently tends to be fuller and slower.  There are much fewer episodes of hyperventilation and/or breath holding.

To help clients develop healthy breathing, trauma-focused therapists focus on exhalation.  A first step is becoming mindful of the exhalation and the important role it plays in activating the parasympathetic nervous system and getting out of ‘fight or flight’ mode.

There are different methods for doing this.  To improve body awareness, a good starting place could be to lie down with a hand on your belly, and simply notice what the hand does as you breathe in and out.  This begins to teach breath awareness by demonstrating how the hand moves with diaphragmatic breathing.  Once someone understands this breath motion, it is easier to teach sitting or standing up.

A complementary approach involves the 4-6 (inhalation/exhalation) rule for every 10 seconds.  Six seconds breathing out in a 10 second cycle primes the body for relaxation.

Some therapists teach a 4-8 variation (over 12 seconds), with 8 seconds for exhalation. This is a more pronounced way of emphasizing exhalation.  Although this is not something that should be practiced for long periods of time, but can be helpful at changing problematic breath cycles.

As a side note, although there are some who teach a 4-7-8 rule, with 7 seconds of breath holding prior to the exhalation, I do not recommend this.  The logic here is that the breath hold primes the person for the exhalation.  This can be true.  It is also true that holding one’s breath for short periods of time is not harmful.

However, because breath holding can be part of a freeze trauma response, I don’t recommend it here.  There is nothing to be gained because the main emphasis is the exhalation.  For this reason, I suggest a 4-8 practice.

As you can see, increasing diaphragmatic involvement in exhalation is an important part of healthy breathing.  My colleague and renowned trauma expert Maggie Phillips (who sadly passed away a year ago) liked demonstrating deep sighs as a way of teaching exhalation.  Watching her teaching a room of therapists how to sigh deeply still brings a smile to my face.

3. Shoulders, neck, jaw, and head muscles engage more naturally and openly

Tense muscle chains from the shoulders can be a somatic hallmark of anxiety.  These muscles are often tensed or clenched as part of a physical bracing  or hypervigilance against potential threats.

As we discussed earlier, trauma is remembered somatically.  The tensing and bracing that occurs in these muscle groups is part of the subconscious, somatic expression of past trauma responses.  This can be part of the day-to-day experiencing, or it can be a rapid response to PTSD triggers of past trauma.

How do these muscles appear in this tensed state?  The head, neck, and shoulders can appear hunched forward or curved.  Similarly, the spine can appear collapsed.  Additionally, the jaw is often clenched.  As a result, somatic symptoms such as headaches and bruxism (teeth grinding) are often present.

Amongst the signs your body is releasing trauma include a more relaxed and naturally engaged presentation of these muscle groups.  What does this look like?When trauma has been released from the body, the jaw muscles are more loose, the lips and facial muscles are relaxed and smooth.  Another sign is comfortable shoulders and upright spine, neck and head muscles.

To help teach clients this healthier somatic experience, Fisher (2022) asks clients whether they would be willing to lengthen their spine from the lower back up.  One helpful visual for this is to imagine a string gently tugging on your head, pulling up the spinal column.  An engaged core also helps with this upright stance.  When I use hypnosis with clients who have bruxism, I will often give a suggestion of imagining a pillow of air in between the upper and lower teeth.

4. Heartbeat slows, blood pressure decreases, and heart-rate variability increases

When trauma is stored in the body, there can be several heart-related effects. Amongst these possibilities include hypertension and higher blood pressure; increased heart rate (e.g. racing heart) in response to trauma-related stress; and decreased heart-rate variability.

Although high blood pressure can be genetically inherited, living in a chronic state of fear from trauma can increase the probability of chronic hypertension and high blood pressure.

In the presence of PTSD triggers, trauma survivors are more likely to have a racing heartbeat.  Heart-rate variability (HRV) describes the degree of variability in time between heart beats.

Generally, when there is a faster heartbeat, there is a lower HRV; and vice versa.  Lower HRV scores are associated with more chronic stress and sympathetic activation of the autonomic nervous system (ANS).

In contrast, when trauma is released from the body, acute and chronic heart issues improve.  There are less occurrences of racing heartbeat and acute stress.  HRV increases and blood pressure issues can improve (decrease in BP).

5. Hands and feet get warmer

In general, when people experience stress, such as in a ‘fight or flight’ episode of posttraumatic stress, blood flow is redirected to internal organs.  This sympathetic response of the autonomic nervous system (ANS) has evolutionary functions in that it allows us to be marshal all necessary resources to respond to the threat.  Perhaps unsurprisingly then, in such a state, the hands and feet are conversely experienced as cold and clammy.

Part of somatic-focused therapy is training clients to use their imagination to elicit a parasympathetic response.  In her book ‘The Affect Regulation Toolbox’ my colleague Carolyn Daitch (2007) utilizes the principles of an autogenic training approach in developing clinical hypnosis suggestions for over-reactive patients.  Daitch explains that anxiety and trauma patients need quick strategies that can reset their bodies and turn around these episodes.

As part of this autogenic hypnosis method, varied and layered hypnotic suggestions are given to imagine the hands and feet warming.  Incredibly, as clients are able to quickly learn and elicit this technique, they can make their hands and feet warm through the power of their own imagination.

This physiological process prompts the body to redirect blood flow and move from a sympathetic to parasympathetic response.  As these bodily extremities began to warm and relax, heart rate slows down and a person moves out into a more relaxed state.

When clients learn techniques such as this in therapy, they become more adept at creating these states more frequently.  This means that hands and feet are more commonly warm, relaxed and dry.  This increasingly consistent physiological experience is one sign that the body is releasing trauma.

6. Body experiencing is more present and at ease

We’ve spent a considerable amount of time focusing on specific parts of the body, and what to look for as trauma shifts from being stored & expressed to being released from the body.  We’ve also described many different examples of how the body expresses trauma during ‘fight or flight’ responses where a person experiences emotional and somatic flooding.

Although we covered dissociation earlier in this article, we didn’t talk about what it feels like (or, more accurately, doesn’t feel like).  Many people who have experienced trauma, particularly complex relational trauma, are often highly out of touch with their bodies.  This is like having an out of body experience, or being cut off or disconnected from your body.  Some people describe this as often feeling numb.

What is really disorienting is that there can be rapid shifts in response to PTSD triggers – before and after dissociation.  You can go from feeling numb to feeling flooded, back to feeling numb.  As a therapist, I would argue that these big shifts are just as stressful as the individual states themselves.

Although we provide some examples in this article, it is difficult to get into the rich and complex process of trauma-focused and somatic therapies.  But one way of describing it is like renewing and deepening your relationship with yourself, and with your body.  Being connected with your body means mindfully feeling it – but in a way that is bearable.

One sign your body is releasing trauma is that there is a greater ease of being.  You are more aware of sensations, what brings them on, the subtleties of what they feel like, and how they emerge and pass.  People who are more somatically connected also are more comfortable moving between ‘parts’ and ‘whole.’  It feels easier to just ‘be’.

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Before concluding this article, I’d like to note that trauma recovery (and posttraumatic growth) is not a linear process.  There are positive milestones and setbacks. The hope is that for every one step back, we take two steps forward. Trauma recovery is about renewing your relationship with yourself, with presence and compassion.  This happens in the mind, spirit and – as reviewed in this article – the body.

Read More: 10 Hopeful Signs You are Healing from Trauma

Sources:

Courtois, C.A. & Ford, J.D. (2013).  Treatment of Complex Trauma: A Sequenced, Relationship-      Based Approach.  NY: The Guilford Press.

Daitch, C. (2007).  Affect regulation toolbox: Practical and effective hypnotic interventions for    the over-reactive patient.  New York: Norton.

Fisher, J. (2022).  Healing the fragmented selves of trauma survivors: Integrating somatic and ego state techniques.  Presentation given to the Minnesota Society of Clinical Hypnosis.

Herman,.J. L. (1992).  Trauma and Recovery.  New York: Basic Books.

Ogden, P. & Fisher J. (2015) Sensorimotor Psychotherapy: Interventions for trauma and attachment.  New York: Norton.

Porges, S. (2011). The Polyvagal Theory. New York: Norton.

van der Hart, O., Nijenhuis, E. R. S., & Steele, K. (2006). The haunted self: Structural dissociation and the treatment of chronic traumatization. W W Norton & Co.