As someone who’s experienced a range of trauma over their life, I’m always interested in learning about the different ways how trauma affects someone. Normally, I focus on the mental health implications, like panic attacks, social anxiety and Post-Traumatic Stress Disorder. I’m experiencing all of these symptoms at the time of writing but trauma doesn’t only affect us psychologically. Trauma can have profound physical consequences too. Therefore, this podcast episode merges clinical psychology and biological psychology so you can learn how trauma affects the heart, why trauma has physical impacts on our body and what can we do about these impacts. If you enjoy learning about trauma psychology, biopsychology and mental health, then this is a great episode for you.
Today’s psychology podcast episode has been sponsored by Biological Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.
Brief Introduction To Trauma
Whilst I talk about trauma on the podcast a fair bit, I wanted to briefly recap the importance of trauma within clinical psychology in case there are any new readers or listeners tuning in to this episode. Therefore, trauma is the term given to an extremely difficult experience in a person’s life that has a profound impact on them. This can include being involved in or witnessing life-threatening diseases, severe injuries or accidents, assaults, sexual violence and deaths of loved ones and so on. As well as trauma is common within society with at least 50% of adults in the United States experiencing one or more traumas in their lifetime (Wisco et al., 2022). Also, I’ve mentioned before in a previous episode, this is why trauma-informed approaches are so important, because they’re about recognising trauma is common and we need to support people.
Furthermore, I’m guilty of this too but when it comes to trauma, we particularly only think about trauma as a psychological concept with psychological impacts. Which come to think of it doesn’t make a lot of sense, because traumatic events are physical, tangible events that happen to a person so it makes no sense why its impacts would only be psychological in nature.
In this podcast episode, you’re going to be learning about the physical impacts of psychological trauma and why we need to acknowledge their existence. Since if we ignore the physiological impacts of trauma and Post-Traumatic Stress Disorder then this could prove deadly for our clients.
Why Is Trauma A Mind-Body Condition?
To some extent, I have no issue with the current official and extremely oversimplified dialogue about psychological trauma is very focused on the psychological and mental experience of trauma. You only need to look at the DSM-5 to see how trauma focuses on the intense emotional and behavioural responses that the traumatic event causes. For instance, the PTSD and acute stress disorder symptoms as listed in the DSM-5 focus on the anxiety, avoidance of trauma-related stimuli and situations and hypervigilance. Personally, I have no issue with that whatsoever because these are the things I severely struggle with after my sexual assault and these intense emotions and severe behavioural responses are horrific at times and rather debilitating. It was only three nights ago at the time of writing that I was watching a romance because I didn’t read the trigger warnings and I saw a sex scene. I screamed, panicked and I felt paralysed for 20 minutes just dealing with the perfectly innocent scene I had just witnessed.
Needlessly to say, I will be reading trigger warnings a lot more carefully in future.
However, the issue is that trauma probably needs to be reconceptualised a little more because there is a growing body of neuroscience research showing how trauma has a major impact on our biology and our physical body (O’Donnell et al., 2016).
Now there are some researchers saying trauma has a greater physical impact than the psychological impact, and I have some thoughts on this argument. I have no doubt there is research demonstrating how significant and damaging trauma is on our physical body, but as someone who has experienced two major types of trauma in their life, I have to admit I don’t buy this argument. It is the anxiety, Post-Traumatic Stress Disorder, depression, suicidal ideation and on and on and on that causes me to struggle because of my trauma. It is the intense emotions and psychological aspects of dealing with being sexually assaulted that causes me to be paralysed as times as I deal with the intrusive thoughts and physical sensations of what happened to me.
It is the psychological aspects that hurt me the most.
The only physical aspects of the trauma I have to deal is the sweating and increased heart rate and rapid breathing whenever I have a panic attack. As well as the physical sensations of my body effectively remembering what he did to me amongst a few other bits. I don’t doubt all these physical trauma responses are having a physical impact on my body, but to say physical impacts are the most damaging and the most painful for a trauma survivor just doesn’t sit right with me.
You might disagree but this is my lived experience.
One of the areas most impacted by trauma is the heart.
How Does Psychological Trauma Impact The Cardiovascular System?
As you can imagine, whenever we experience a traumatic event, the brain activates our flight-fight-freeze response which is a biological process. During this process, the pituitary gland, hypothalamus and adrenal glands (typically referred to as the HPA axis) work together to produce a powerful and rapid stress response that floods the body with neurotransmitters and hormones in an effort to protect and save us.
It is these hormones and neurotransmitters that are believed to alter the normal functioning of our major organs including the heart.
Interestingly, whilst our fight-or-flight response is meant to save us during traumatic situations, it can be deadly too. Due to there are times when people have had heart attacks as well as strokes during natural disasters so it is possible to die from stress-induced cardiovascular events. There are even times when these cardiovascular events kill more people than the natural disaster in question (Babaie et al, 2021).
In addition, whilst our flight-or-fight response is a biological mechanism that evolved as an emergency response to help our ancestors thrive. Our ancestors were almost always able to rest and recover after the activation of this mechanism, whereas in this modern era we cannot do that because of chronic stress. This is a modern problem because modern trauma and modern stressful events mean the fight-or-flight response gets activated more often so this response can be activated for months or even years after the traumatic event.
I know this might sound strange or impossible but I agree with it. Since I sort of believe my fight-or-flight response is starting to only calm down after 17 weeks after being assaulted but whenever I go outside, whenever I go into certain situations and whenever I am inside, even more so when I’m in a locked room, all the physical stress responses return and I am on high alert. I know if I need to escape in case someone hurts me again, my body is only a second away from activating my flight-or-fight response. As well as there have been plenty of major incidents over the past 17 weeks where I have been okay in one moment, something small has happened and then I have freaked out and my flight-or-fight has been activated.
I doubt my flight-or-fight has rested in the past 17 weeks.
Therefore, with humans not resting and able to recover after each activation of our flight-or-fight response, our physical body is getting battered by our endless stress responses. This means our cardiovascular system and heart slowly become dysfunctional and damaged so this raises the risk of heart attack and stroke over time.
Why Is The Trauma-Heart Relationship Bidirectional?
Lastly, what’s interesting about trauma and its physical impacts is that trauma is both a cause and an outcome of heart problems. Due to there is research, like Edmondson and von Kanel (2017), showing a strong link between trauma and chronic and acute cardiovascular risk. As well as there is separate evidence showing how strokes and heart attacks cause trauma reactions amongst the survivors (O’Donnell et al., 2021).
This shows the trauma-heart relationship is bidirectional and they can both cause and be a consequence of each other.
However, the issue with trauma and cardiovascular health problems is that because trauma is psychological in nature as are the emotional and behavioural responses, these aren’t assessed in emergency rooms or cardiovascular wards. This means the trauma symptoms that are causing clients a massive amount of psychological distress and are causing further damage to their heart, these are not being treated. Meaning the cardiovascular damage and the trauma symptoms simply continue.
Which is why I flat out love holistic work and the biopsychosocial model, despite the jokes about it being the bio bio bio model. I’m an idealist at heart so I still believe in the aim of the biopsychosocial model.
Biological Psychology Conclusion
On the whole, if you take anything away from today’s episode, it needs to be that trauma survivors and other people experiencing chronic or acute stress need to be educated on how to reduce potential cardiovascular risk, and they need to be treated. As well as whenever someone goes into a medical setting to have treatment for a cardiovascular-related health problem, they should be screened and assessed for psychological trauma so they can be helped, supported and their trauma treated if needed so their cardiovascular symptoms don’t get worse.
Of course, I am very cynical when it comes to medical settings embracing psychological concepts because most medical settings in my experience are ruled over by white older men who firmly believe in the biomedical model and they have little time or patience for psychology. There is absolutely nothing wrong with white older men but I wish they were more accepting towards psychology.
Anyway, a great argument to make to them and other medical directors about this issue might be to mention, if you spend the time and money assessing clients for trauma and treating it earlier on. It means their symptoms will not get worse, they won’t need as long or as intense medical treatment and they can be discharged sooner from the hospital. That means the hospital can save money, which is something hospitals and medical settings love. I don’t blame them because their budgets are beyond awful at this point.
Penultimately, I want to mention that I know a lot of this podcast episode doesn’t directly apply to us aspiring or qualified psychologists. We are trained to become experts in psychological matters so our knowledge about physical health is limited and I don’t always think that is a bad thing. Since the worst thing that could happen with this neuroscience research is that people use it to shift trauma treatment into the biomedical model where the main focus is on the physical symptoms, the hormones and neurotransmitters and everything that is physically happening to a client.
That just will not work for trauma treatment.
Of course, there always needs to be psychoeducation about how trauma impacts a client physically, especially when it comes to PTSD, panic attacks and anxiety. Yet I think it’s okay that psychologists mainly focus on the psychological aspects instead of letting the medical doctors rush in and focus on the biological aspects, like they do with depression with their anti-depressants that don’t actually work. I still love Read and Moncrieff (2022) for their brilliant work against the biomedical model for depression.
Anyway, the real point of this episode is two-fold. Firstly, we all need to become aware, appreciative and acknowledge that psychological trauma has a physical impact. Secondly, we need to pressure medical settings to realise psychological trauma impacts physical health and if we want to save lives, improve the physical health of clients and decrease cardiovascular-related health problems that cost medical settings a lot of money each year. Then psychologists and medical doctors need to work together as equal partners to help tackle the physical aspects of trauma.
Awareness is always a good first step towards change.
Ultimately, I’ve mentioned on the podcast a lot of times how trauma is common in society, and I am a total fan-person of the trauma-informed approaches that we are starting to shift towards in clinical psychology. Therefore, if we fail to appreciate the physiological impact that psychological trauma has on a person then not only are we negatively impacting the physical health of our clients but we could be risking major public health consequences with an increase in cardiovascular-related deaths.
Something we have to avoid at all costs.
I really hope you enjoyed today’s clinical psychology podcast episode.
If you want to learn more, please check out:
Biological Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.
Have a great day.
Biological Psychology References and Further Reading
Babaie, J., Naghipour, B., & Faridaalaee, G. (2021). Cardiovascular diseases in natural disasters; a systematic review. Archives of academic emergency medicine, 9(1).
Edmondson, D., & von Känel, R. (2017). Post-traumatic stress disorder and cardiovascular disease. The lancet. Psychiatry, 4(4), 320–329. https://doi.org/10.1016/S2215-0366(16)30377-7
Fenster, R. J., Lebois, L. A., Ressler, K. J., & Suh, J. (2018). Brain circuit dysfunction in post-traumatic stress disorder: from mouse to man. Nature Reviews Neuroscience, 19(9), 535-551.
Galli, F., Lai, C., Gregorini, T., Ciacchella, C., & Carugo, S. (2021, July). Psychological traumas and cardiovascular disease: a case-control study. In Healthcare (Vol. 9, No. 7, p. 875). MDPI.
Lei, M. K., Beach, S. R., & Simons, R. L. (2018). Childhood trauma, pubertal timing, and cardiovascular risk in adulthood. Health Psychology, 37(7), 613.
Read, J., & Moncrieff, J. (2022). Depression: Why drugs and electricity are not the answer. Psychological Medicine, 52(8), 1401-1410.
Noble, N. C., Merker, J. B., Webber, T. K., Ressler, K. J., & Seligowski, A. V. (2023). PTSD and depression severity are associated with cardiovascular disease symptoms in trauma-exposed women. European Journal of Psychotraumatology, 14(2), 2234810.
O’Donnell, C. J., Longacre, L. S., Cohen, B. E., Fayad, Z. A., Gillespie, C. F., Liberzon, I., ... & Stein, M. B. (2021). Posttraumatic stress disorder and cardiovascular disease: state of the science, knowledge gaps, and research opportunities. JAMA cardiology, 6(10), 1207-1216.
Perryman, K., Blisard, P., & Moss, R. (2019). Using creative arts in trauma therapy: The neuroscience of healing. Journal of Mental Health Counseling, 41(1), 80-94.
Ressler, K. J., Berretta, S., Bolshakov, V. Y., Rosso, I. M., Meloni, E. G., Rauch, S. L., & Carlezon Jr, W. A. (2022). Post-traumatic stress disorder: clinical and translational neuroscience from cells to circuits. Nature Reviews Neurology, 18(5), 273-288.
Wisco, B. E., Nomamiukor, F. O., Marx, B. P., Krystal, J. H., Southwick, S. M., & Pietrzak, R. H. (2022). Posttraumatic stress disorder in US military veterans: Results from the 2019–2020 National Health and Resilience in Veterans Study. The Journal of Clinical Psychiatry, 83(2), 39779.
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