Sensory Modulation and Developmental Trauma

Our inborn fight, flight, freeze responses are automatic responses that help us cope when faced with dangerous situations. When we feel threatened, these subcortical mechanisms are triggered automatically. When triggered, our bodies experience an increase in physiological arousal and in muscular tension that hastens our ability to escape from the perceived threat, and or prepare our muscles to engage for fight. When we are unable to move away or strike back, in response to something dangerous, we are left with the option to freeze. The freeze response is the point where one becomes predisposed to traumatic stress disorders. The immobility of a freeze reaction is an incomplete response to danger. When one is frozen by fear as a means to survival, the body is often left in a state of hypertension and heightened physiological arousal that can remain even when the danger has passed.

The body-based remnants of traumatic experience became very clear to me the day I meet “Kylie”, a 9-year-old girl whose parents brought her for an evaluation due to concerns regarding her difficulties with sensory processing. I vividly remember the day I opened the door of my clinic to greet her. The look on her face was not what I was expecting. She resembled a terrified animal endlessly scanning their environment for danger. Her eyes were held wide open as if she needed to take in every bit of information and her body was very stiff—not in an over extended posture, but in a curling-in to protect herself from some unseen threat.

This young lady’s demeanor began to make sense during an interview with her mother who revealed that she had been adopted in early infancy. There was no information about her parents or birth history as she was found on the street with her umbilical cord still attached. This began to explain her appearance of being frozen in fear. Her parents’ main concerns were gaining insight on and supporting her unusual responses to sensation, as well as an unexplained tendency toward self-harming behaviors that had recently emerged.

Our defense mechanisms are not controlled by the cognitive part of our brain

In my work with individuals with sensory processing and sensory modulation challenges, I often encounter children with histories of overt traumatic experiences. What I have come to understand through more advanced training in the field of trauma is how the domain of sensory processing and Sensory Integration overlaps with the emerging fields of trauma disorders of extreme stress and developmental trauma.

One of the main theoretical areas of overlap between these two fields is the understanding of the body’s hardwired mechanisms for survival and defense. Our defense mechanisms are not controlled by the cognitive part of our brain. Instead these innate protective patterns originate in key subcortical mechanisms in our brain. When these subcortical structures are triggered, we experience the body’s preprogramed physiological and muscular reactions of fight and flight. When these responses are not adequate to resolve the dangerous nature of the threat, we are then relegated to the most primitive defense strategy—freezing. The freeze response occurs when the fight, flight responses are aborted as the organism’s best chance for survival is to freeze or submit. This is well known in the animal kingdom as “playing possum” or the death feigning response. The experience of immobilization or “freeze response” during a life threatening event is the basic ingredient for the imprint of trauma on the body.

Re-examining “Kylie’s” story, though she was under no threat to her survival when she arrived at my clinic, her body and sensorimotor system still carry the imprint of the trauma which led to her defensive attitude and posturing. All of her senses were primed toward defense and hyper vigilance. Her state of arousal was so heightened she had moved into a state of shut down. Shut down is the brain’s highest level of defense where one often disconnects from sensations coming from their bodies in an attempt to cope with strong bodily sensations and emotions. This state explains her attempts at self harm that Mom reported in her sensory history (that we use in our clinic).

Our first step was to create safety within the environment and the therapeutic relationship

Treatment in her case was multifaceted. It required viewing sensory processing through a trauma informed perspective, along with co-treatment with a Psychologist who was well versed in supporting individuals who have experienced trauma.

Our first step in working with this young lady was to create safety within the environment, as well as within the therapeutic relationship. From this foundation a variety of sensorimotor strategies were then used to support her in regulating her arousal, releasing some of the tension held in her body, and finding true stability and equilibrium in the physical body.

When you hear “Kylie’s” history, it is not difficult to imagine that such a traumatic beginning would form an imprint of trauma with subsequent sensory processing and arousal regulation issues. As clinicians, we also see children who have not experienced a horrific event, but perceive everyday events as if they are indeed a threat to their well-being. The very same mechanisms in the brain that turn on during an overwhelming event are activated in children who show strong over responsivity to everyday sensation. Although not perceived by the outside world as traumatic, the school bell or a fire alarm can set off a very similar cascade of reactions within the brain that impact daily life function. In part two of this blog we will contrast “Kylie’s” case with the case of a three-year-old whose auditory defensiveness was impacting his development, as well as creating havoc within the family.

If you’d like more in-depth information on trauma and regulation, I recommend our course Trauma Informed Approach to Sensory Processing Disorder and Arousal Regulation.

~Sheila M. Frick, OTR/L

References:

Berceli, D. (2005). Trauma releasing exercises (TRE): a revolutionary new method for stress/trauma recovery. North Charleston, SC: BookSurge.

Levine, P. (2014). Getting to the Root of Trauma: Why It’s Critical to Understand the Role of Memory in Trauma Therapy [Webinar]. In NICABM Rethinking Trauma Webinar Series. Retrieved from http://www.nicabm.com

Ogden, P., Minton,K., & Pain,C. (2006). Trauma and the Body: A sensorimotor approach to psychotherapy, NY: W.W. Norton.

van der Kolk, B. (2003). The neurobiology of childhood trauma and abuse. Child & Adolescent Psychiatric Clinics of North America, 12, 293-317.

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

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