About the fear in your throat and the knot in your stomach

About the fear in your throat and the knot in your stomach

Study on trauma

07-12-2021 · Interview

Traumas are not just in your head, but also in your body. Sometimes patients start to tremble, to shake or they don’t feel anything at all anymore. Others grow quiet and can no longer find the words.

From the various studies in her PhD thesis Beyond dis-ease and dis-order, one stands out, says Anne Marsman, who did her PhD on the long-term effects of traumatic experiences in youths. She put two tests in front of test subjects. With the one, they had to remember as many words as possible within a particular time frame, with the other they received minor painful current surges administered through an electrode on the index finger. In the meantime, Marsman measured the tension in the trapezoid muscle, a measure for the amount of stress.

"What I found exceptional," says Marsman, "is that you can see the impact of drastic events in younger years at the level of the body, how it reacts to stress. For example, we saw an increased stress reaction and that pain stimuli hit harder in people with such a history.” 

Also, these were healthy test subjects, Marsman emphasises. “In people who have been abused or neglected and who have become trapped in their traumas, such physical tension and sensitivity to stress is much higher. If you then think about how much stress we deal with every day... certainly in the unpredictable times in which we now live. We don’t realise sufficiently how great that impact is."

Immune system

Of all Dutch people, 50 to 80 per cent has at some time experienced one or more of these drastic events, says Marsman. "Of this group, approximately 14 per cent develops a posttraumatic stress disorder."

Her thesis is about "overwhelming incidents in one’s youth that a child cannot comprehend. These could be threats, abuse, or the lack of something due to neglect or poverty."

It was at the end of the nineteen-nineties that it first started to become clear how detrimental such experiences can be to mental and physical health in later life. It was the time when the American internist Vincent Felitti published the results of his, by now classic, ACE study, in which medical information was combined with a questionnaire about so-called adverse childhood experiences (ACE). It appeared that these traumas experienced in childhood were connected with diseases in later life, such as cancer, cardiovascular diseases, depression, and addiction.

Marsman: "A prolonged high stress level disrupts the immune system and the hormonal regulation and constantly activates the nervous system. So, it is not so strange that this results in many more physical complaints."

Speech centre

The ACE study has been repeated in many countries, each time yielding the same results. The shocking thing was that almost a quarter of the participants reported to having experienced three or more traumatic experiences. "They often appeared to occur in clusters, which is not so strange. Growing up, for example, with a parent suffering from a psychiatric disorder, increases the chances of poverty, addiction or aggression in the family. And if a child is abused, there is often more going on than just that."

The fact that traumas are contained in the body, is also argued by the Dutch-American researcher and psychiatrist Bessel van der Kolk, whose book The body keeps the score (2014) has been on the New York Times bestseller list for three years. "When I read that book, I thought: that is how it is!"

Marsman, who herself looks back on a traumatic past, in which she developed an eating disorder when she was thirteen, gives a concrete example. "For years, there have been things that I cannot talk about, not even in therapy. The words just won’t come. Then I read in Van der Kolk’s book that the speech centre in the brain can switch off when people think of the trauma. He saw that in the scanner. The body simply refuses."

Body work

Cognitive therapies prevail in Mental Health Care in the Netherlands, the focus being on talking and thinking. Marsman, herself a psychologist, argues for more attention to be put on the body in trauma and other treatments. "It is important to make people aware what is happening with their bodies. When you are angry or sad, you will feel that somewhere in your body. That is when you feel as if you cannot digest anything or you have a knot in your stomach. When you are afraid, your breathing gets stuck. By learning to relax, the fear can lessen. In that way, you can influence your mind with your body. But for people who have experienced trauma, that is often not enough. You have to help them feel safe in their bodies again, to cope with their feelings, to regulate stress. You won’t manage that just by talking.” 

With an eating disorder, for example, therapists often zoom in on behaviour, the calories, the kilos. "But an eating disorder is about much more than that, it often has to do with trauma too. As far as I am concerned, it should be much more about the meaning of complaints and behaviour. And about the relationship with your body. Why is that so difficult? Why do you not feel the connection, or do you not want to feel it?” 

Methods that come under 'body work' can be very valuable, except they are not covered by insurance companies because there is too little scientific proof. "I find that hard to understand, also because I experience the added value myself. Many therapists swear by EMDR, but that doesn’t work for everyone. Be open to alternatives and respect patients’ experiences, the physical ones too!"

Foto: Alex Stijlaart

Categories: news_top, Science
Tags: trauma,PhD,Marsman,eating disorder,body image,instagram

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