009: How Trauma Impacts The Body and Mind

Transcript

Karen Conlon, LCSW:

Hello, and welcome once again to the So, How’s Therapy Podcast, a podcast that demystifies, debunks, and destigmatizes what happens in the therapy space, all for you. I’m your host, Karen Conlon, and in today’s episode, my guest and colleague Danielle DiCamillo, a licensed clinical social worker is here and we are going to be talking all about trauma and anxiety and how these two impact the body and mind.

Because guess what, folks? We cannot separate the two.

If we are experiencing trauma and anxiety, they do impact the body and mind. So I’d like to welcome Danielle. Danielle, so glad to have you here. Can we start off first by you telling us a little bit about yourself and how you even got to working with the mind and body connection?

How Trauma Became A Specialty of Danielle’s

Danielle DiCamillo, LCSW:

Sure. Thanks, Karen. Yeah, I’m a licensed clinical social worker, working at Cohesive Therapy NYC. And prior to working here, I was a clinician at previous clinics in hospitals, and prior to that, I was teaching yoga for over a decade. And I’ve always been fascinated by the mind-body connection. And that really originated originally when I was a dancer, which was my first career, way before social work. So social work was that missing piece of the puzzle for me to really understand the connection between the mind and the body.

Karen Conlon, LCSW:

That’s so interesting, that you started off with something that involves movement, and really being a dancer, you really need to be in tune and aware of your body and what your body’s saying to you, right?

Danielle DiCamillo, LCSW:

Absolutely. You have to be able to listen to the information it’s providing to you. When I was a dancer, I don’t know that I was doing that, but reflecting back on that experience, for sure, your body is always providing you with feedback to your internal landscape.

Dance, Yoga, and Trauma

Karen Conlon, LCSW:

So you went from being a professional dancer to then studying yoga and becoming an instructor. Was there any connection between the yoga work that you did and trauma, or was there a connection that came later? How and when did that all happen?

Danielle DiCamillo, LCSW:

I studied with the Trauma-Conscious Yoga Method Institute, which is a trauma informed practice with some somatic psychotherapy.

Somatic Psychotherapy

Karen Conlon, LCSW:

What is that? What is somatic psychotherapy? Because for our listeners, and even some of our therapists who are not really familiar with somatic work, can you tell us a little bit about that? What is that, first and foremost?

Danielle DiCamillo, LCSW:

So somatic psychotherapy is a way to explore the inner world through experiencing the somatic experience, which is essentially your physical experience. So going in and understanding what are some of these sensations telling me, what am I feeling, what’s happening there? And one part of somatic work could be yoga, for example, and that’s really what I’ve been honing in on, but there’s different types of somatic practices.

Karen Conlon, LCSW:

So it’s really the practice of listening to your body, I mean, in like the most layman of terms, right? The practice of listening to your body, what it’s telling you, becoming aware of that, correct?

Danielle DiCamillo, LCSW:

Absolutely. Yep.

Karen Conlon, LCSW:

Let’s move, then, to the trauma piece. How is becoming aware of your body helpful? And I know that that’s a really big question and loaded, I mean, because there’s so many answers, but just generally speaking, why is it important for us to be aware of our body signals?

How Trauma Is Stored In The Body

Danielle DiCamillo, LCSW:

I think, first off, science has revealed that trauma is first stored in the body as an implicit memory. And I think that that’s one of the most valuable pieces of information that I want to share with everyone today. I would like to pause that for a moment and talk a bit about what is trauma, because I don’t know that we all have an understanding of what trauma is. What I tend to do is I change the language a bit and I change the language to big T and little T. I want to be really clear that I’m not minimizing anyone’s experience that may be listening, but I think it’s a good way to frame it for people to really understand the umbrella of trauma.

So in terms of big T, I think that’s the one that people have a better understanding of, in terms of, okay, big T could be considered 9/11 or a big natural disaster. But then there’s the little T category that I think is a bit misunderstood at times. And what is under a little T would be considered emotional abuse, physical abuse, any type of ism, racism, sexism, all of those isms are definitely under that umbrella, along with lack of attunement, right? From a caretaker, being rejected chronically. So all of those things can also be considered trauma, depending on the person’s experience, as well.

Big T and Little T Trauma

Karen Conlon, LCSW:

So these two categories, big T, and the T standing for trauma in both cases. So we’ve got big T, which is those things that I guess everyone could agree, would be difficult to disagree that this is trauma. And then the other category that you’re talking about, that small T trauma, which I think is a misnomer, by the way, because it’s called small T, kind of implying that it’s not as serious or not as impactful. And I think that’s because, like we were saying before, it’s not something that everybody would necessarily agree on or would look at it as trauma, but is the small T, or can small T type of trauma, those types of traumatic experiences that are not so obvious, that are sometimes even invisible, can those be as impactful to the mind and body as the big T trauma?

Danielle DiCamillo, LCSW:

Absolutely. They can fire off the same signals to the mind body that they’re in danger, or something is being alarmed. So absolutely.

Implicit Memory

Karen Conlon, LCSW:

Okay. I want to go back to a word that you mentioned earlier, because I think we’re onto something here with this big T, small T, and how the body stores things. You mentioned implicit memory before. I know that we often talk about, in the therapy space, as therapists, about implicit memory versus explicit memory, but for the non-therapists out there, can you give a little explanation about what implicit memory is versus explicit memory?

Danielle DiCamillo, LCSW:

Sure. So explicit memory is more of conscious memories. So it’s more of a sequential event happening. So for example, you might know on Wednesdays, you have an appointment with your doctor every week. It’s written down, it’s on the schedule. Whereas implicit memories is more about unconscious memories, and they’re not formed in an integrated way, that they’re actually formed in a disintegrated way.

And an example of that would be, and I love this example, because I think it’s the most relatable, is somebody riding a bike. So you might not ride a bike for five years, but you get back on that bike and it feels familiar. There’s something about the experience that resonates and it feels super familiar. And that’s how trauma relates to the implicit memories. There’s some times that all of a sudden you’ll be engaging in something and recognize that you’re having that same feeling or sensation, and you’re unable to articulate and verbalize that.

Explicit Memory

Karen Conlon, LCSW:

Is it something that’s internalized versus something that’s not?

Danielle DiCamillo, LCSW:

So it’s more of an unconscious memory that is basically sitting in the body. And I also think this brings up a good point, because something that’s always resonated with me, by Peter Levine, who talk so much about somatic work, is he refers to unresolved trauma being frozen residue of energy. And I think that that correlates directly to implicit memory of the body. So there’s something about the experience that feels immobilizing in the body, in the limbs, that needs to be released.

Karen Conlon, LCSW:

I love that statement by Peter Levine, because when you talk about frozen residue of energy and you think about some of the consequences of trauma, we often times see people going into fight or flight responses. We also see people going in the opposite direction and have a freeze or a numbing response. And a lot of times when people are experiencing trauma, there are physical manifestations of it, which also include a real lack of energy.

Danielle DiCamillo, LCSW:

Oh, absolutely. There’s definitely physical impacts that happen when encountering trauma that can be long lasting. Some of them are feeling super fatigued, also could be having flashbacks, the tightness in the chest, the rapid heartbeat, shortness of breath. All of those things are things that can happen when you’re experiencing trauma. And on that note, also anxiety in general. So I just wanted to also add that in. And then there are also psychological impacts that happen. So some of them are the intrusive flashbacks, not being able to recall an event, the negative cognitions, feeling hopeless, this also sense of being hyper alert.

Intrusive Thoughts and Negative Cognitions

Karen Conlon, LCSW:

Again, just thinking about folks who might be listening who are not familiar with these terms, intrusive thoughts and negative cognitions, what do those look like? Can you give us some examples of those?

Danielle DiCamillo, LCSW:

Sure. So intrusive thoughts might be thoughts or flashbacks related to the experience, the original experience, and negative cognitions could be related to the self, like self blame or low mood, feeling hopeless.

Karen Conlon, LCSW:

They’re thoughts, right? These cognitions are thoughts that are either floating around all the time, or maybe driving that person’s bus, and they’re not aware of it, like feeling low self-worth or feeling unworthiness or hopeless or helpless. We have feelings and we also have thoughts. And while those are two different things, a lot of times they feel like they’re interchangeable. But at the end of the day, when we are talking about some of the psychological impacts of trauma in regards to thoughts, the important thing is to know that sometimes we’re aware of them and sometimes we are not aware of them, and not being aware of them is one of the things that makes it more difficult to understand what’s actually happening to us sometimes, right?

Danielle DiCamillo, LCSW:

Yeah.

The Brain Is Always Trying To Help Us

Karen Conlon, LCSW:

Also, in terms of the brain and implicit memory and explicit memory, we’ve talked about that, but in terms of the brain, the brain is always trying to help us in one way or another. It’s always trying to protect us, but sometimes in trying to protect us, it may go on overdrive as we experience an overload of anxiety. On the contrary, sometimes it just numbs us and just makes us fall flat emotionally, psychologically, physically. Do you want to talk a little bit about those parts of the brain? Because I think this is so fascinating, I think people really need to understand and know a little bit more about these main parts of the brain and how they impact everything with our everyday lives and our functioning.

Danielle DiCamillo, LCSW:

Yeah, so there’s the brainstem, which is the oldest part of the brain. It’s located in the back of the brain. And there’s also the limbic part of the brain that’s responsible for detecting threat or alarming the body that something’s wrong. And then there’s the cortex, which is in the front of the brain. It’s the thinking part of the brain, which we’re all very used to using, thinking a lot.

So the brainstem, again, is at the back of the brain, and that connects to the vagus nerve, which runs all the way down through the intestines, through the throat, into the abdomen. And it connects all of these physical organs that we need to breathe, to digest.

The Limbic System

Karen Conlon, LCSW:

Major, just major functions. So this limbic part of the brain, basically when there’s threat, when there’s something that is dangerous, a signal comes from that part of the brain down to the rest of the body?

Danielle DiCamillo, LCSW:

Exactly. Exactly. And it signals to the body that something’s wrong. It’s, again, going back to that implicit memory in the body, something’s going on. What we try to do in terms of helping to regulate that experience is to help you feel more at rest and digest and ease.

Karen Conlon, LCSW:

Let’s say we’ve got an implicit memory, when I was five years old, I got bitten by a dog. That becomes now, what? Is that an implicit memory or an explicit memory?

Danielle DiCamillo, LCSW:

Implicit memory.

Karen Conlon, LCSW:

Okay. Because it’s internalized now, right?

Danielle DiCamillo, LCSW:

Mm-hmm (affirmative).

Trauma’s Impact On The Mind and Body

Karen Conlon, LCSW:

Okay, so now I have this memory of me having gotten bitten by a dog when I was five years old. As time goes by, I continue to develop this fear around that trauma that happened with the dog when I was five years old, to the point that I can see a cute little Maltese, three pound stuffed animal looking thingy, and all I can think about is the threat. That’s all that my body can respond to, is the threat. Why? Because I have this implicit memory of a dog biting me, and my limbic part of my brain, which is my alarm system, that’s the one that takes over. It kind of hijacks my brain and sends signals down to my body. What happens when these high alert signals happen in my body? What am I expected to feel?

Danielle DiCamillo, LCSW:

It depends. For some people, it is this feeling immobilized. It can feel, just freezing. It could be I can’t breathe. For some people, you’re feeling like your digestion is off. Tightness in the chest, even dryness in the throat.

Karen Conlon, LCSW:

Can you tell us a little bit more about what happens with the GI, with the digestion piece, when our brains are going into overdrive or there’s an implicit memory that triggers high alert signals?

Vagus Nerve

Danielle DiCamillo, LCSW:

Basically, what happens is, again, going back to the vagus nerve, it basically activates going into overdrive, which for some people, that can be experiencing the digestion challenges, and for them that could look like different things. It could be IBS related. It just depends on the individual.

Karen Conlon, LCSW:

And what about the rest of the body? Are there any other physiological changes that are going on, as well, when we have high alert signals?

Danielle DiCamillo, LCSW:

It depends for the person, but sometimes you can, even having some type of insomnia or hyper alertness. And so hyper alertness is almost like this restlessness that could be happening through the body. And also rapid heartbeat is something that happens for some of us. It just depends. It depends on the way that your body has a physiological response.

Shutting Down

Karen Conlon, LCSW:

We’ve been doing a lot of talking about the high alert, but one of the things that has come up in practice with some of my trauma clients is the opposite, where they might have a trigger, and what that ends up looking like is the opposite of everything that we’re talking about. There’s a numbing and a complete slow down of everything. Can you talk a little bit more about that piece? Because that’s the piece that a lot of people don’t actually talk about when it comes to trauma and the body’s trauma response.

Danielle DiCamillo, LCSW:

My first thought is shut down. So instead of being on overdrive, you’re completely shut down at that point. I also like to explain it as, and I think you used this word, too, Karen, this numbing. Being frozen, immobilized, can just be completely shut down, having no access to the bodily sensations, what’s happening, and let’s go a step further, not even understanding your emotions, either.

Karen Conlon, LCSW:

And that’s a big one, because not understanding your emotions, not understanding what’s happening, can actually result, and we see this so much in trauma survivors, but this can result in feelings of shame, and this particularly in cases of sexual assault, sexual abuse, where sometimes the body reacts by not fighting, just freezing.

And then there’s this immense amount of shame that is carried along by the survivor, because there’s this constant thought about, why didn’t I do something? Why didn’t I fight back? Why is it important for people to understand that fighting back may not have been an option, that their body’s reacting that way for a reason?

Danielle DiCamillo, LCSW:

Because it’s important for people to understand that at that time, their coping mechanism was to shut down, and that’s what protected them.

Freezing Up

Karen Conlon, LCSW:

I think often times we talk a lot about trauma in terms of PTSD, even. When we talk about PTSD normally, those are very obvious symptoms and manifestations, and people can identify them. And even people who are not therapists might say, “Oh, you look like you might have some PTSD around that.” There’s not a lot of understanding about people freezing up. There’s not a lot of understanding about people not doing anything, almost shrinking when something happens.

This is an important piece of understanding trauma, because even if you are not a therapist or a mental health professional, if you are experiencing someone in your life who is kind of showing up that way sometimes, I’m not saying that they necessarily have trauma in their lives, but it’s an important thing to remember, is that sometimes the body copes with stressful situations by responding in a freeze or numbing way.

I’d love to be able to turn our conversation now towards looking at some practices that people can walk away with. I’d love for you to give us some tools or strategies that people might be able to start to use and implement, just kind of easy to go to tools.

Conscious Breathing

Danielle DiCamillo, LCSW:

The first tool that comes to mind is breathing, conscious breathing, to really allow us to become present in that moment. It’s really important. And also, to recognize what’s happening in the breath is a really important part, as well. Because sometimes when we are stuck in this fight or flight response, the breath can be reversed. So it’s important to check in with how am I breathing? What does that look like? What’s happening in the body? So that’s one tool that I think is very helpful and very beneficial. And it’s a practice. It’s not something that you do once and it just cures everything. It’s something that the longer that you do it and the more that you’re able to do it, you are helping to signal to the body that you’re safe.

Karen Conlon, LCSW:

Yeah. And diaphragmatic breathing is one of my favorite ones to teach people. Breathing in general I find to be a great tool. I’m so glad you brought it up, because it’s discreet. It takes practice. It’s not always so easy. I find that sometimes people, let’s say if they have a background in, I don’t know, singing, they find it easier, for example, to learn diaphragmatic breathing, because they have to do it anyway for what they do. It basically tells the body when you’re doing it, it purposefully and conscientiously, like you’re saying, it signals the body. It’s a way of you taking control and being able to use this as a tool to tell your body that everything is okay, that there is no actual danger, and that you can slow things down. But diaphragmatic breathing is just one type of breathing. Can you tell us about maybe one or two other types of breathing?

Danielle DiCamillo, LCSW:

Some other breathing practices, I refer to them as pranayama practices, they are alternate nostril breathing, which is…

Karen Conlon, LCSW:

How do you do that? Let’s practice. I want to alternate nostril breathe right now.

Danielle DiCamillo, LCSW:

Get yourself nice and oriented. Feel your feet on the floor. Ground. And if you like, close the eyes or steady your gaze, whatever you feel is best for you. And then today we’ll do alternate nostril breathing actually with our thumbs out. So the rest of your fingers can go in.

Karen Conlon, LCSW:

We should hold our hands, like if you’re doing a thumbs up, like if you’re giving somebody a thumbs up, right?

Danielle DiCamillo, LCSW:

Yep. Thumbs up. From there, you’re going to seal your right nostril off or close it off with your right thumb. And then you’re going to exhale out of your left nostril, inhale in through your left nostril, close your left nostril off, and then exhale out of your right nostril as you release your thumb. And again, inhale in through your right nostril, close off your right nostril, exhale out of your left nostril.

Karen Conlon, LCSW:

And so as you do this more and more, you do feel your body kind of calm down. How many times, and at what pace, would you recommend that people do this? So like a set of what, two or three? We did a set of two.

Danielle DiCamillo, LCSW:

So doing the left and the right side is one full cycle. I would probably do at least 10 cycles. The other part that I think is also helpful in sharing, it’s also helpful for the brain, in terms of helping your thoughts become more cohesive when you’re practicing this, this breath practice.

Karen Conlon, LCSW:

So we’ve got diaphragmatic breathing, and you call it left and right, or right and left? Does it matter?

Danielle DiCamillo, LCSW:

No, it doesn’t matter. I call it alternate nostril breathing.

Karen Conlon, LCSW:

Okay, alternate nostril breathing. What about other types of tools? We’ve done a couple of breathing techniques. What about other types of tools, if we’re not looking or we’re not in a place where we can actually do breathing techniques? Maybe our body is too hyper or too highly triggered to do any type of these breathing exercises, although I know that there are breathing exercises that you can do when your body is highly triggered, but is there another different type of tool that we can provide to people to implement?

Grounding

Danielle DiCamillo, LCSW:

Sure. Yeah. So another tool would be grounding. And this is something you can do anywhere. You can do this anywhere. You can do this sitting in your chair. You can do this standing. You can do this while other people are around, is rooting your feet down, returning back to the present moment, and allowing yourself to be present, whatever that means for you.

Karen Conlon, LCSW:

And you know, in terms of grounding and just getting yourself back to the present moment, one of the things that I would like to add to that is an exercise that I’ve done also with clients, which is quite helpful, I think, too, involves this, what you’re just saying, just having yourself or having people focus on their hand, perhaps. Just focus on the hand, notice the fingers, just allowing yourself to get grounded and focusing on a particular object. In this case, I use the hand because it’s right there on your lap. It’s usually not an object that is triggering. It’s just your own hand.

That being said, you might be in a space where there is a lovely painting that brings you peace, that maybe signifies harmony. You could look down at your feet, also. That’s another place to look. So while you’re grounding yourself, maybe finding something that you can come back to that is not triggering.

Danielle DiCamillo, LCSW:

Yeah, it’s like returning to a safe place.

Demysify, Debunk, Destigmatize

Karen Conlon, LCSW:

Is there anything, before we wrap up, Danielle, that you think is important for people to know so that we can either debunk or demystify or destigmatize? Is there anything that you would like for people to walk away with?

Danielle DiCamillo, LCSW:

Going back to what we talked a bit about in the beginning, with this little T and big T, I would like to debunk this idea that trauma is only for those who’ve experienced some big challenges. I would like to validate everyone’s experience, whether it’s been emotional trauma, however that resonated with you in the beginning, because I think with acknowledging that, there’s this therapeutic outcome that could feel really empowering.

Karen Conlon, LCSW:

And even for people who are not in therapy, being able to know that your experience matters, that your trauma is not so small that it’s not worth mentioning. Your feelings matter, is I think a really great place to start. Thank you for saying that, and thank you for validating all those experiences.

Guys, this is just, this is my jam right here. I love this. Danielle, thank you so much for coming on today. This is great. And you’ve given us a really, just a great overall umbrella of information about trauma. I mean, we know that there’s just so much and so deep in terms of this particular topic. And being able to introduce this to people who don’t know anything about trauma is incredibly helpful.

If you want to know more about our practice or this podcast or Danielle DiCamillo, please be sure to head over to Cohesive Therapy NYC, or if you’d like to check out our show notes and find resources and links, you can get in touch, you can head over to cohesivetherapynyc.com/podcast. Thank you once again for being here. And I look forward to seeing you again, when I ask So, How’s Therapy?