Skip to content

Trauma, how it works and how we can deal with it

In this blogpost we’ll look at what trauma is, the way the body responds to trauma, and why we need to work with the body when working with trauma, and to recognise when we might need to use trauma-informed grounding techniques. 

Gabor Mate says that, ‘Trauma is not what happens to a person, but what happens within them. Trauma is an unhealed wound that a person is compelled to defend against by means of constricting his or her own ability to feel, be present, and respond flexibly to situations.’ There are a lot of different therapies emerging around this new understanding of trauma.

Trauma is something that we hold in our body. And if it remains unhealed, it makes it difficult to be in the present because it makes us hyper-aware that we could be at risk of something happening to us again. That’s why grounding techniques are so useful because they give us a way to come back to the present if we become traumatised.

Arielle Schwartz describes a way to understand the link between trauma and the body. A healthy stress response is when a traumatic event happens, we have an increase in cortisol, which we could call the fear hormone, and we have an increase in cortisol adrenaline in the body. Then that allows us to be mobilised, to fight or run, so we can protect ourselves. Then we have some resolution and homeostasis, which is when our body is able to go back to a normal state of being once the traumatic event is finished. 

However, some people have what Arielle Schwartz describes as an unresolved stress response and we hold it in the body. We suffer a traumatic event, we have an increase in cortisol, but when it stays with us, the mobilisation phase (when we normally use up all of the

cortisol) is blocked. We are trapped, and are unable to run. When small children are in frightening situations at home, they depend on the people that are scaring them to survive, as they can’t run away. So when their mobilisation is blocked they go into different

states of freeze or collapse (immobilisation) or even a kind of helplessness as they can’t get away from the trauma. And sadly, this defensive action remains in the body and the mind. When they grow up, that unspent cortisol, that unspent stress response is still in the body. Beacon House is a UK service which provides help for people suffering from trauma and has a good video showing how trauma affects us, plus other useful resources about trauma and how to heal it (see references below).

Peter Levine talks about somatic experiencing, or a body-mind therapy focused on healing trauma by helping people to draw their attention to their bodies. Bessel van der Kolk talks about traumatised people feeling ‘chronically unsafe in their bodies’, which is what anxiety and post-traumatic stress are. He continues, ‘The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded with visceral warning signs.’ When we have been through trauma, we often become hyper-vigilant, when we can’t relax, and when we can see in our bodies signs of something bad happening. It is very hard to be in the here and now, which is why we need to work with the body when we work with trauma.

Deb Dana takes Stephen Porges’ Polyvagal Theory and makes it usable in therapy. The vagus nerve, which runs right down through the body, as the highway for the autonomic nervous system, is responsible for keeping us safe and keeping us alive. It’s in charge of things that we don’t even think about, such as breathing and digestion. It’s like a cable with lots of fibres in it. Stephen Porges says 80% of the fibres go from the body up to the brain (bottom-up), which is a different way of thinking about the body and mind connection. We often think that the brain’s in charge and that it manages the body, but when talking about trauma, the body is the thing that’s in charge. Only 20% of communication is from the brain to the body.

So when our body is stuck in this defensive state, when it’s hypervigilant and tense, and all the cortisol and adrenaline is still there in the body, our brain invents a story to try to explain what’s happening. We may feel anxious or depressed and so need to calm the body down to show it that it’s safe here and now, and by doing so, calming the mind. It’s very important not to discount how important it is to work with the body and to understand what’s happening in the body.

If there’s any kind of trauma work that we might need to do in therapy, it’s important to talk to people about how we’re going to help them to feel safe when working through it, and allow them to manage that before getting to the actual trauma (if we indeed do, as sometimes talking therapy isn’t appropriate and body work is what a person needs). First we we talk about anything that’s really difficult for them, then we can show them some techniques, as not all of them work for all people at all times. Then we can ask them to think about which ones work for them and how they feel in their body, whether it calms them, and helps them be in the here and now. Having practised a technique together and it works for a person, if they experience some difficult feelings in their body at any time, they can use it. 

It’s very difficult to access rational thought when we feel trauma and are in a defensive state. All connection between the amygdala and the limbic system (where we have emotions) and the prefrontal cortex (where rational thought happens) ceases. When people can’t think properly, we need to get their brain back online through the body so that we can access rational thought. 

It’s important to be able to know if a person is in a defensive or survival state.  The best place for us is the social engagement system, because here we can access the higher rational thinking brain and it’s where we can thrive and engage with people. 

Polyvagal Theory is about the link between the body in trauma. When people are in a fight-flight mode, they may fidget or have very wide eyes (so that we can look for danger), have shallow breathing, have raised shoulders and breathe into their shoulders. However, when they’re in shutdown mode, they seem flat, and their faces will be blank as they feel they are in a collapsed place. The body collapses and there is less tension in them as there may be a deep sadness, or feeling of grief there. 

Work with the body is often called somatic work, and there are lots of different types of body work, or bottom-up work. One type is orientating, or directing our attention and senses to the here and now. Grounding is being aware of your existence (the weight of your body, the feel of your body) in the here and now. Peter Levine, talks about containment, or the idea of bringing awareness to your body as a container, as a boundary to the world. You’re not exposed as you belong in your body which keeps you safe. Accessing the cranial nerves involves engaging the social engagement system in the area of the vagus nerve, to help us feel safe. We manipulate the body in order to get this part working, access the social engagement system and get it working. Breathwork works well as it’s one of the only things in our autonomic nervous system that we have control of. We don’t have control of things like digestion and blood flow, but we do have control of breathing and that can bring the heart rate down, calming us down. Movement can be as simple as just walking around the room, rocking, swaying or tuning into what the body needs. People just need to get moving, because when they are in more defensive states they might be fidgeting, so if they can move through that mobilisation and do something with their energy, it can help to bring them back to the here and now. And equally, if they’re in a shut down place it helps to get them back to mobilisation, to bring them back into the here and now. Connection, through co-regulation, is being another safe person for someone. Below the steps for each technique are explained. 

Orientating: directing our attention and senses to the here-and-now

The 5,4,3,2,1 technique:

Name 5 things you can see.

Name 4 things you can hear.

Name 3 things you can feel.

Name 2 things you can smell.

Name 1 thing you can taste.

Take a deep breath in and out.

Grounding: being aware of the weight/feel of your body in the moment (Arielle Schwartz)

Bringing awareness to the body:

Notice the parts of your body that make contact with the chair. 

Push your body deeper into the chair so that you can feel it holding your weight.

Bring awareness to your feet touching the floor.

Slowly press your feet into the floor. 

Bring awareness to how it feels to engage your leg muscles.

Disengage the leg muscles. 

Bring your awareness to how it feels to relax them.

Repeat the sequence, noticing how the changes in your body and muscles feel.

Containment: bringing awareness to the body as a container, a boundary to the world (Peter Levine)

Jin Shin Jyustu energy flows:

Put one hand on your head, and the other over your heart.

Sit this way until you feel some sort of body or state shift.

Move your hand from your head to your tummy.

Sit this way until you feel a state shift.


We can do tapping (Peter Levine) if we need to do something a bit more active. It can be a really powerful tool where we gently tap the body, helping us to feel where the body ends and the world begins, and feel that we are contained in this body.

Butterfly hug:

Another way to feel contained is to do a butterfly hug, where we put one hand on one side of our body and shoulder and hug ourselves in a lovely hug. Then we can tap this butterfly hug until we feel a shift and feel calmer.

Accessing the cranial nerves: engaging the social engagement system in order to feel

safe (Peter Levine)

Chanting ‘voo’ (Peter Levine):

Take a deep breath in.

As you breathe out, chant the sound ‘Vooo’.

This is most powerful when done with another person.

The Valsalva manoeuvre (to be done with caution especially if you have heart issues):

Hold your nose.

Close your mouth.

Try to blow air out for x seconds.

Breathwork: slowing down the heart rate to calm the body

Square breathing (or ‘box’ breathing):

Slowly exhale through your mouth until you feel you have emptied all breath.

Slowly inhale to the count of 4; be aware of your lungs expanding, and the air moving into your abdomen.

Hold your breath to the count of 4.

Exhale through your mouth to the count of 4.

Then hold your breath for the same count of 4.

Repeat this process as many times as necessary.

Movement: rocking, swaying, tuning into what the body needs

Move around the room:

If you are fidgeting or struggling to sit still, there’s a chance that you are feeling cortisol or adrenaline in the body.

Tune into the fidgeting, and move in any way that feels right to you to allow you to expel or express that fight/flight energy.

You could experiment with swaying, rocking or simply walking around the room.

Connection: co-regulating the nervous system with a safe person

Be a safe and calm nervous system:

People’s nervous systems communicate with each other through mirror neurons.

If we are calm, an anxious person’s nervous system will know this and this will allow them to feel more safe.

Imagination and memories:

Imagining or remembering a place or person that you felt safe with can also calm the nervous system. Some people might use their imagination, others might like a picture or video of a child, partner, friend, place or pet to help them to remember a feeling of safety.

We need to be aware of re-traumatization, as one size doesn’t fit all. We are all individuals and what works for one person won’t work for someone else. Our nervous systems are moulded by the experiences we have. It might be that one person has had one particular

traumatic experience, and their nervous system will respond differently to how someone else would experience it, due to a series of different factors, such as how old they were, or what was happening to them at the time. All of these different things will have made a huge difference, so we can’t make any assumptions. As therapists we need to be there with them as their safe person when we first try a technique, so that, if they do become distressed, we can regulate them and keep them safe. We can invite them to try it and then ask them how it feels for them, making sure that they don’t take ownership if it doesn’t work. Some people can close their eyes, while for others that may make them feel unsafe. And still others can do breathing activities, while for others it makes them anxious and they would prefer to move around. Psycho-education is very important as it allows people to give informed consent to work in a particular way. 


Chapman E (2021) Using Trauma-Informed Grounding Techniques in Therapy,

Counsellor CPD

The Window of Tolerance by Beacon House

Leave a Reply

Your email address will not be published. Required fields are marked *