The Anatomy of Harm: How Abuse Impacts Your Brain, Body, and Psyche

Psychological abuse can have profound and lasting effects on individuals, particularly when the abuse is perpetrated by those they trust, such as friends, close colleagues, or family members. Ongoing psychological/emotional abuse, particularly if experienced early in life, is a significant predictor of trauma post-traumatic stress (Hoeboer et al., 2021).

The Anatomy of Harm

Workplace bullying, as defined by Einarsen et al. (2003), Leymann (1990), and other scholars, is a form of psychological abuse with life, health and mind-altering consequences.

Targets of workplace bullying frequently report a range of emotional reactions, including fear, anxiety, helplessness, depression, irritability, social isolation, and shock (Grynderup et al., 2017; Nielsen et al., 2015; Verkuil et al., 2015). These responses correspond to the PTSD symptoms defined in the DSM IV-TR: re-experiencing, avoidance, and heightened threat perception (American Psychiatric Association, 2000). Consequently, researchers have found that victims of workplace bullying frequently display symptoms associated with post-traumatic stress disorder (PTSD) (Mikkelsen & Einarsen, 2002; Leymann & Gustafsson, 1996).

Defining Trauma

Leading trauma experts provide a nuanced definition of what trauma is. Judith Herman (1992) describes trauma as an overwhelming experience that exceeds an individual's psychological capacity to cope, fundamentally disrupting normal adaptation. Bessel van der Kolk (2014) views trauma as a bodily experience that becomes "stored" in somatic memory, affecting neurological functioning beyond immediate psychological responses. Peter Levine (1997) defines trauma as a disruption of an individual's natural self-regulatory systems, creating a persistent state of physiological dysregulation. Bonnie Badenoch (2017) emphasizes the relational aspect of trauma, stating that it often arises from feelings of isolation and abandonment during distressing events. She highlights the significance of interpersonal relationships in both the experience of trauma and the healing process.

Neurological Impact

Trauma fundamentally alters brain architecture, particularly impacting critical regions such as the prefrontal cortex, amygdala, and hippocampus. These neurological changes manifest through hyperactive salience networks, increasing threat sensitivity, compromised executive functioning, impaired memory processing, and reduced cognitive flexibility. Individuals who experience trauma often face significant cognitive challenges, including difficulty concentrating, memory fragmentation, reduced problem-solving capabilities, and heightened emotional reactivity.

In The Developing Mind, Daniel Siegel (2012) highlights how relationships shape the brain's development and functioning. He posits that the integration of neural networks is crucial for emotional regulation and cognitive processing. Disruptions in these processes due to trauma can lead to incoherent narratives and difficulties in self-regulation, impacting overall mental health (Siegel, 2012).

Bonnie Badenoch (2008), in Being a Brain-Wise Therapist, integrates interpersonal neurobiology into therapeutic practices. She emphasizes the importance of understanding how trauma affects brain function and how this knowledge can be applied to enhance therapeutic relationships. Badenoch's work illustrates that effective therapy must consider the neurobiological underpinnings of trauma, allowing therapists to create an environment conducive to healing (Badenoch, 2008).

Impact on the Body

Trauma exposure triggers fundamental biological transformations that manifest through various physiological symptoms. These changes include critical alterations in the hypothalamic-pituitary-adrenal (HPA) axis, leading to chronic stress responses that profoundly affect overall health (NCBI Bookshelf, 2001). Such changes may result in gastrointestinal, cardiovascular, neurological, and musculoskeletal disorders.

Individuals who have experienced psychological trauma often report somatic complaints, which are physical symptoms without a clear medical cause. These can include sleep disturbances, muscle tension, and gastrointestinal issues (Levine, 1997; NCBI, 2001).

The Adverse Childhood Experiences (ACEs) study established a clear link between childhood trauma and various chronic health conditions later in life. Individuals who experienced multiple types of childhood adversity were found to have increased risks for conditions like cancer, diabetes, and respiratory diseases (Felitti et al., 1998).

Impact on the Psyche

Donald Kalsched (2014) explored how trauma can fragment the self, complicating recovery efforts. The emotional landscape of survivors often includes feelings of isolation and disconnection from their sense of self.

Individuals who have experienced emotional abuse are at a three-fold higher risk of developing depressive disorders compared to non-abused individuals (Finkelhor et al., 2012).

Impact on Current/Future Interpersonal Relationships

Trauma profoundly disrupts an individual's capacity to form and maintain healthy relationships. Judith Herman (1992), a pioneer in trauma studies, highlights how traumatic experiences can lead to the development of insecure attachment styles, challenges in establishing healthy emotional boundaries, potential social withdrawal, and intense emotional regulation difficulties. Research indicates that trauma can lead to maladaptive relational patterns where survivors may struggle with communication, leading to misunderstandings and conflicts in their interpersonal relationships (Herman, 1992; Zaleski et al., 2016). This relational dysfunction can perpetuate feelings of isolation and exacerbate mental health issues.

Individuals who experience trauma may also unconsciously reenact past traumas. This phenomenon occurs when individuals seek out partners who resemble their previous abusers or exhibit similar traits, driven by a desire to resolve unresolved conflicts from their past. Individuals who experience trauma as children may gravitate toward partners who reflect the abusive traits of past relationships, hoping to change the outcome this time around (Herman, 1996; van der Kolk, 1989). This pattern can perpetuate cycles of emotional pain and disappointment (PMC, 2011).

Impact on Coping Mechanisms

Gabor Maté (2010) emphasizes the connection between trauma and addiction, suggesting that unresolved trauma can lead individuals to seek unhealthy coping mechanisms. For some, this might manifest as substance abuse; for others, it may involve overworking or engaging in compulsive behaviors such as gambling or overeating.

Healing and Recovery After Abuse

The journey toward healing from complex trauma is intricate and multifaceted. Expecting a person who has endured repeated psychological abuse to manage their emotional and physiological responses as if they are unaffected by their past experiences is unrealistic and unjust.

Peter Levine's Somatic Experiencing® approach focuses on healing trauma through body awareness, allowing survivors to process traumatic memories indirectly by tuning into bodily sensations rather than directly confronting distressing thoughts (Levine, 1997; Payne et al., 2015). Survivors often experience visceral reactions that trigger protective mechanisms as their bodies instinctively remember the potential for harm. SE® recognizes these protective mechanisms and aims to help individuals regain a sense of safety and control.

Effective trauma treatment requires a nuanced approach that integrates various therapeutic modalities tailored to each survivor's unique experiences (Herman, 1992). Comprehensive interventions should consider emotional landscapes, individual triggers, and historical contexts to foster genuine healing. By creating supportive environments that honor individual experiences, we empower survivors to reclaim their lives, rebuild their identities, and navigate the complex landscape of trauma recovery. Simplistic solutions fail to encompass the complexities of trauma recovery and can inadvertently invalidate a survivor's lived experiences, reinforcing feelings of isolation (Herman, 1992; Zaleski et al., 2016).

By fostering an understanding of these intricate dynamics, we can create an environment conducive to genuine healing and resilience, enabling survivors to reclaim their lives and rebuild their identities in ways that honor their experiences and promote their well-being.

References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., Text Revision). Washington, DC: Author.

Badenoch, B. (2008). Being a Brain-Wise Therapist: A Practical Guide to Interpersonal Neurobiology

Einarsen, S., Hoel, H., Zapf, D., & Cooper, C. L. (2003). The concept of bullying and harassment at work: The European tradition. In S. Einarsen, H. Hoel, D. Zapf, & C. L. Cooper (Eds.), Bullying and emotional abuse in the workplace: International perspectives in research and practice (pp. 3–30). Taylor & Francis.

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., ... & Marks, J. S. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245-258. Link.

Finkelhor, D., Turner, H. A., Shattuck, A., & Hamby, S. L. (2012). The Long-Term Health Consequences of Child Physical Abuse, Emotional Abuse, and Neglect: A Meta-Analysis. Child Abuse & Neglect, 36(1), 1-10. Link.

Grynderup, M. B., Nabe-Nielsen, K., Hogh, A., & Hansen, A. M. (2017). Does the Association between Workplace Bullying and Post-Traumatic Stress Disorder Symptoms Differ by Educational Level? Journal of Employment Counseling, 54(4), 164-175. Link.

Herman, J. L. (1992). Trauma and Recovery: The Aftermath of Violence—from Domestic Abuse to Political Terror. Basic Books.

Herman, J. L. (1996). The Compulsion to Repeat the Trauma: Re-enactment, Revictimization, and Mastery.

Hoeboer, C., de Roos, C., van Son, G. E., Spinhoven, P., & Elzinga, B. (2021). The effect of parental emotional abuse on the severity and treatment of PTSD symptoms in children and adolescents. Child abuse & neglect, 111, 104775. Link.

Kalsched, D. (2014). The Inner World of Trauma: Archetypal Defenses of the Personal Spirit. Routledge.

Levine, P. A. (1997). Waking the Tiger: Healing Trauma. North Atlantic Books.

Leymann, H. (1990). Mobbing and psychological terror at workplaces. Violence and Victims, 5(2), 119–126. Link.

Leymann, H., & Gustafsson, A. (1996). Mobbing at Work: Environmental Factors and Health Consequences. Journal of Occupational Health Psychology, 1(1), 27-40. Link.

Maté, G. (2010). In the Realm of Hungry Ghosts: Close Encounters with Addiction. North Atlantic Books.

Mikkelsen, E. G., & Einarsen, S. (2002). Bullying in Danish Work-Life: Prevalence and Health Correlates. European Journal of Work and Organizational Psychology, 11(1), 1-30. Link.

NCBI Bookshelf (2001). Understanding the Impact of Trauma - NCBI Bookshelf. Link.

Nielsen, M. B., Tangen, T., Idsoe, T., Matthiesen, S. B., & Magerøy, N. (2015). The Relationship between Workplace Bullying and Post-Traumatic Stress Disorder Symptoms: A Longitudinal Study. Journal of Occupational Health Psychology, 20(4), 469-481. Link.

Payne, P., Levine, P., & Crane-Godreau, M. A. (2015). Somatic experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 6(93). Link

Siegel, D. J. (2012). The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are.

van der Kolk B. A. (1989). The compulsion to repeat the trauma. Re-enactment, revictimization, and masochism. The Psychiatric clinics of North America, 12(2), 389–411. Link.

van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, Body in the Healing of Trauma. Viking.

Verkuil, B., Atasayi, S., & Molendijk, M. L. (2015). The Relationship between Workplace Bullying and Mental Health: A Review of the Literature. International Archives of Occupational and Environmental Health, 88(3), 299-313. Link.

Zaleski, K. L., Johnson, D. K., & Klein, J. T. (2016). Grounding Judith Herman’s Trauma Theory within Interpersonal Neuroscience and Evidence-Based Practice Modalities for Trauma Treatment. Smith College Studies in Social Work, 86(4), 377–393. Link