Is stress actually a collection of what I call microtraumas? A person with chronic stress might manifest symptoms similar to someone who has experienced war, a natural disaster, an accident, or an injury. Many people come to therapy with no known trauma but still exhibit the same symptoms as those who've experienced significant traumatic events. Even without identifiable trauma, many clients face the same difficulties. In the past, we might have attributed this to repressed trauma and gone on therapeutic fishing expeditions to uncover forgotten traumas. However, that's not how the brain works.
This video is about how the brain actually works, and in reality, a life of microtraumas begins to equal the full weight and scale of any other trauma. If we haven't met before, I'm Dr. Richard Nagar. Today, I'm talking about microtraumas and stress. Stress can be conceptualized like a pharmaceutical scale where microtraumas are stacked on one side. When enough of them are stacked, the scale eventually tips.
At this point, the weight of these stressors equals the impact of large-scale trauma. To be clear, I'm not suggesting that a bad experience with a customer at work is the same as being injured by an IED. However, there's no need for a competitive misery contest in mental health. What I'm stating is that the responses and the end result of both trauma and chronic stress look remarkably the same.
So how do microtraumas work? Let's take the case of a grocery store clerk who has a negative encounter with a particularly vicious and threatening customer. When they go home from work and reflect back, they're bothered by the encounter. That night, when they go to sleep, the brain processes these emotions and the encounter. It defragments them, places them in the mental filing cabinet where they belong, and then they wake up the next morning largely forgetting the previous day's toxic stress. However, a week or two later, while dining with friends, someone at the table might share an experience from their work. This jogs the subconscious memory, and the person will then retrieve the visual, emotional, and somatic revivification of the forgotten event. By doing so, the microtrauma response is reinforced. Through the mental process of deletions, distortions, and generalizations, it might even become amplified to a greater extent than the initial event, and the relived experience is perceived even more stressfully.
Now, imagine over the course of a year working in that retail environment, there are numerous stressful workplace events: difficulties with other customers, supervisors, transportation, and a paycheck that’s less than the rate of inflation. All of these stressors from work and other computed life stressors, such as endless war on the TV news, economic uncertainty, and the reality of dysfunctional families, create a net negative life experience. It reminds me of the book "Where the Wild Things Are," where it says, "and in and out of weeks, almost over a year to where the wild things are." In this case, the wild things are the island where microtraumas rear their ugly heads.
Each of these things might be normal life events, but at the end of a period of chronic stress, they hold the weight of compounded microtraumas equal to any other type of trauma. Bessel van der Kolk says that the problem with trauma is that when it's over, your body relives it. In the case of chronic stress, the body relives it too. A stressful event might be over, but the brain continues to reactivate because neurons that wire together fire together. The physical manifestations of stress, the emotional manifestations, and the psychological manifestations are intertwined, resulting in a constant state of hyperarousal.
Trauma is different from stress, but stress is caused by microtraumas and should be recognized as such. The weight of chronic stress can equal the dangers of even severe PTSD. Van der Kolk has said stress is not trauma, but there's evidence to the contrary. The effects of both PTSD and chronic stress are on par with each other. Chronic stress and PTSD both cause structural changes like reduced hippocampal size and increased amygdala activity. PTSD and chronic stress both show increased amygdala activity and decreased prefrontal cortex function, which disrupts emotional regulation. Both conditions involve disruptions in the HPA axis, although chronic stress typically leads to high cortisol levels while PTSD shows heightened cortisol sensitivity. Neuroimaging studies show that both PTSD and chronic stress exhibit increased amygdala activation and decreased prefrontal cortex regulation. Both PTSD and chronic stress are associated with anxiety and depression, but while PTSD also includes flashbacks and hypervigilance, chronic stress can lead to cognitive impairments, substance use, and hypervigilance as well.
If you toss a stone into a still lake, the rings of ripples continue to spread, altering the entire surface. Similarly, stress has a ripple effect that impacts not just our mental state but also our physical health and behaviors. If you were to drop a basket full of pebbles onto the water at the same time, the ripples would overlap and intensify. This is similar to the effects of cumulative stress, where multiple stressors build on each other, leading to a more severe impact on our overall well-being. The stress response might not be as observable as trauma, but the body continues to act like a dissipating wave from the initial stressful event. The results are the same: fight, flight, or freeze. Van der Kolk says that after our traumas, our responses are about survival, and this is the same in chronic stress. Those who are chronically stressed are just surviving, and their instinct is about self-preservation, even though it's often deployed in ways that are self-defeating.
Stress and microtraumas can lead to decreased immune function, increased inflammation, a higher risk for chronic diseases like heart disease and diabetes, and can negatively impact our sleep, eating habits, and ability to cope with challenges. It can even lead to hopelessness and despair. Although PTSD and chronic stress share common effects on mind and body, they have similar solutions. What are these solutions? A proven set of strategies that include experiential somatic therapies such as multi-channel eye movement integration and bilateral stimulation. Both have been shown to be effective in addressing PTSD and chronic stress. These types of therapies are at the heart of our physical experiences with both big traumas and microtraumas.
Throughout my career, I’ve been saying we can only be as well emotionally as we are physically, and the most important truth that van der Kolk shared with us in his writings is that the body does keep the score. Any therapy that fails to address the somatic, the things experienced by and of the body, will fail to be holistic.
In other words, we can only truly heal from trauma and chronic stress if we address both the thinking, the psychological, as well as the somatic experiences of stress. These types of approaches aren't really new. The father of modern neurology, Jean-Martin Charcot, almost 200 years ago, recognized that there was no dichotomy of mind and body; the mind is the body. His approach to treating patients was with hypnosis, a somatic approach that utilized behavioral, emotional, and physical responses. S. Freud was a student of Charcot. He was also a neurologist, and he studied with him in Paris for several years, recognizing the somatic dimension as key to understanding and healing from psychological distress.
In recent years, we've seen a resurgence of these somatic therapies in the mainstream mental health field. Along with EMDR and bilateral stimulation techniques, there are methods like somatic experiencing and sensory motor psychotherapy that focus on the body's role in healing from trauma and chronic stress. These approaches recognize that our bodies hold onto the memories and emotions associated with traumatic experiences, and by working with the body in therapy, we can release and process these stored sensations and emotions.
Incorporating somatic practices into our daily lives can have a profound impact on our well-being. Mindful movement practices like yoga or tai chi can help us connect with our bodies and regulate our nervous systems. Biofeedback, autogenic training, and hypnotherapy allow us to end the mind-body duality and recognize that the mind is in every cell of the body. This is crucial for managing stress and promoting emotional well-being.
It's also important to note that while these therapies can be incredibly beneficial, they might not be enough on their own. Life is complex. Whether you experienced a single traumatic event or are dealing with chronic microtraumas in your daily life, it's crucial to integrate talk therapies, personal development, and somatic approaches to address the complexities of our minds and bodies and find true healing and balance. If you'd like to learn more about experiential somatic therapies or the brain science of hypnosis, like, subscribe, and share my videos with others. Please hit the subscribe button to be updated when I release new videos.
