The Physiology of Shock and Trauma

The Physiology of Shock and Trauma
And Somatic Methods of Treatment

Annie Brook, MA LPC

I am former director of the Body Psychology tract for the Somatic Psychology Masters program at Naropa University in Boulder, Colorado. I am also a Body-Mind Centering® teacher, a licensed professional counselor, and certified as a BodyMind Psychotherapist. I’ve written this article because of the increased effectiveness I’ve seen occur in treatment when there is awareness by the clinician of how to process shock through the body.

The effects of shock and trauma and the impact this has on clinical treatment are now becoming recognized in the field of psychotherapy. Knowing about shock, how it appears in the psychotherapeutic relationship, the subtlety and pervasiveness of its presentation, and how to work with it is the intent of this article.

Since the late ‘70's I’ve worked as a therapist in private practice, in hospitals, clinics, and in public schools. Always I have had an interest in the body’s integration of the emotional story, and how it was part of the expression of the soul. This interest led to continued and diverse studies in family therapy, personal story exploration through theater and art, and body consciousness. I have studied bioenergetics, transactional analysis and neo-Reichian work and then trained in family systems work with the Leadership Institute of Seattle. I moved deeper into the body based fields, studying with and assisting Bonnie Bainbridge Cohen, who founded the School for Body-Mind Centering®. I also trained with and assisted Susan Aposhyan who developed Body-Mind Psychotherapy. Susan was the former head of the Masters program in Somatic Psychology at Naropa University.

I have experienced the work of colleagues in the field of shock and trauma, such as those connected with IBP, Hakomi, William Emerson’s work, The Tara approach with Stephanie Mines, the work of Bessel Van der Kolk, and also dialogued with practitioners about their approaches. One thing I have noticed and wondered about in the field is that there can be a propensity to organize around shock wherein the nervous system becomes hyper vigilant in identifying shock and being seen as "shocked" and damaged. I have experienced this both as a trainee and as a client and would caution all of us in the field to examine how we may unconsciously be activating the shock field in this direction. Rather, I would hope the focus is placed more strongly on the support to sequence shock through the nervous system and to find the path of ease even in the treatment of it. The idea of a path of ease, and that support precedes movement, meaning in this case that shock will heal organically when the biological and conceptual/psychological/emotional supports are in place, was introduced to me through the work of Bonnie Bainbridge Cohen and the School for Body-Mind Centering®. The further work with Susan Aposhyan in Body-Mind Psychotherapy has supported the psychological work which guides clients to find ways to stay present with shock and allow it to sequence without reactivating a traumatic loop. The combination of this work and my own exploration has given me tremendous personal healing and clinical resources to support awareness of healing modalities for trauma.

This article is a combination of personal story and effective intervention methods. I hope it will inspire you to explore the effects of shock patterns both personally and in your professional sessions. To help you more thoroughly understand and integrate the aspects of shock awareness and treatment this article addresses, I have started this article with the following experiential exploration. This will allow a relevancy of embodied learning to be in the foreground as you read this, and you may want to read this thoroughly when you have the time to do the experiential exploration.

Experiential exercise: Gently introduce awareness of shock into your kinesthetic body by listening and speaking. Slowly say the word ‘shock’ a few times. Notice how the sound of it has a certain power in its’ beginning, a richness in its’ middle, and an abrupt interruption at its’ conclusion. This power, richness and interruption of energy are literally what happens in the body during the nervous system response we call shock. Shock response occurs when we believe we are in life threatening circumstances. The organism of our body overrides its own nature in order to protect and sustain life. The willingness of an organism to interrupt its natural power and expression is based on a healthy instinct to survive.

Before I give you a thorough physiological explanation, let’s first look at how to recognize shock. By definition shock is a jolt, a scare, a start or a terror, a jostle or a surprise. Shock can bewilder, astonish, daze, paralyze, stun or stupefy us. These responses are symptoms of a shock response. Trauma is more often a one time event, and can be processed through in the moment if there is or enough use of the balance of sensory and motor nerve response in the body. An event can be relieved of its traumatic impact if there is a supportive person present, such as a parent being able to say to her child, ‘this is difficult, but I am here with you’. Shock is different in that it sets up a template pattern that future experiences organize around. Shock stacks up and when it is triggered a person will sequence all the way back to feeling the sensations and the enormity of the initial incident. They will bring to the current moment the response from the past that contains the power and magnitude of the original seemingly life threatening situation that caused the frozen response. When you observe disassociation in a person, intensity of response beyond the current circumstances, a vacant or zoned out affect, hyper- vigilance, or depression, look for an undercurrent of shock in the nervous system.

Shock interrupts one’s ability to stay present, relational, and oriented in present time. Shock is the nervous system’s protective response to overwhelming stimuli. It is a healthy mechanism that keeps us from endangering ourselves in what appears to be life-threatening circumstances. Shock heals when there is enough support present in the environment and in our body for the stimuli that was inhibited to sequence its way to completion. Bonnie Bainbridge Cohen, founder of The School for Body-Mind Centering®, describes shock as a reversal of the nerve firing.

To understand what this means, let’s look at the normal flow of information through the nervous system. In a non-shocked state, the nervous system is designed to receive sensory input, digest it, and relay out a motor response. Sensory nerves input stimuli and motor nerves respond by directing muscle and organs into action. Inside the bones of the spine from the skull to the tail is the central nervous system. At the very center of this column is gray matter made of nerve fibers called the gray commissure. In cross section this looks like an ‘h’ with two legs pointing towards the front of the body and two towards the back. Sensory nerve impulses come in the back two legs, or horns, and go into the center of the gray matter, which houses internuncial nerves. These nerves relay the sensory input directly into motor responses, as in a reflex, or up to the brain in more complex firings. The brain assesses, filters, and sends down a motor response that goes out into the tissue and produces an action. Most simply, this is a sequence of sensory input from the back horns, which then sequence through the internuncial nerves in the center and finally fire out the front horns via the motor nerves. Let’s call this process a sensory-motor loop.

In order to understand how fundamental this sensory motor sequence is to behavior, simulate the feeling in your body by doing the following experiential exercise:

Experiential exercise: Stand and place your hands out behind you. Use your hands and arms to simulate the nerve fibers of the body. Imagine that they are the nerve pathways which include sensory nerves that channel into the spine, internuncial nerves that take the sensory input through the center, and motor nerves that move out the front of the spine and effect the actions of the muscles and organs. Imagine sensory input and let it stream through your arms until you have a felt sense of this energy. Allow it to flow through your arms and into the back horns of the gray commissure at the center of your spine. Feel how this impulse goes into your core, passes through your internuncial nerves, and then motors out your front as you swing your arms and bring your hands to the front of your body. You can motor further by stepping forward as you do so. Repeat this a number of times. Gather the sensory impulse from behind and motor it out the front. Do this until you feel the sense of satisfaction that develops from the organic flow of the sensory-motor loop.

Next simulate the experience of shock. Feel the sensory impulse come in through your hands in back, take it to your center internuncial nerves, and hold it there. Don’t let the sensory impulse have a motor resolution. Do this a few times and notice what happens to your emotional response. What do you do as your body holds in the nerves? Look for signs of tension, anxiety, and discomfort, and notice what happens to your breath. What you are feeling is the state produced when a sensory impulse is inhibited in its organic expression. Find relief by repeating the first exercise where you simulated the flow of the sensory-motor loop. Let the sensory impulse sequence to a motor response. Notice how this return to flow relieves and renews the body. Take a few breaths to complete the exercise.

Let’s investigate how this process of shock works. When you simulated a shock state, what literally happened in your body is that the sensory nerve impulse was stopped when you held it in the internuncial nerves. This gave your body the message that it was unsafe to feel or express the impulse. Impulses are electrical in nature, are strong, and need to go somewhere. When the sensory impulse is inhibited, it appears to backbleed down the sensory nerve fibers and is stored in the body tissue next to the motor nerves. This held feeling and reversal of impulse is what dampens energy flow and escalates the emotional body into feelings of withdrawal or anxiety.

Shock patterns from the past can become visible during certain forms of bodywork. Deep tissue bodywork can awaken unconscious memories when touch triggers the stored past impulses that were unexpressed. Highly emotional cathartic work often engages a stored shock response (and helps it sequence to completion, thus freeing the nervous system). This can be useful, however, the precaution and danger in repeated cathartic work is that the nervous system is habit forming. Repeated catharsis can make a neural pathway that gets overly used and limits the full resolution of the shock. You can tell this is happening when emotional expression leaves one drained and exhausted rather than renewed.

Some theorists believe that shock happens not just via the nervous system but includes the glandular system known as the endocrine system. Bonnie Cohen believes the endocrine and nervous systems are directly linked as the messenger systems of the body; the endocrine sending the chemical messages through the fluids, and the nerves sending the electrical impulse through the nerve pathways. Bonnie speaks of them as a linked system called the neuro-endocrine system and believes that what we call shock in therapy terms happens physically when we first hold in the fluid of the lymph, and then reverse the impulse in the nerves.

© 2001 Annie Brook. All rights reserved.