When Trauma Is in the Body: Managing Physical Concerns

Abstract

Many people who have histories of complex trauma have the chaos of their childhoods living in their bodies in that they are more likely to have a number of physical problems. Historically, some clinicians have left the body out of treatment or worse, labeled people with illnesses that are hard to explain as “psychosomatic.” We now know that a number of psychological states as well as adverse child events impact the body in a number of physiological ways. In therapy, some of our clients are harder to reach because they are plagued by physical concerns. After describing the links and proposed mechanisms between trauma and illness, I’ll offer techniques and suggestions for engaging and treating the more somatically oriented person in therapy. I’ll discuss the research on psychotherapy interventions, many of which focus on short-term CBT interventions, and we’ll see that while these interventions can offer some help, longer-term therapeutic relationships using multiple modalities are helpful for people with medical issues, particularly those who have histories of trauma. The buffering hypothesis suggests that social relationships may provide concrete or emotional resources that promote more positive health behaviors and/or more adaptive neuroendocrine responses to stressful events.