Seattle Therapy Expert Explains the Connection Between Trauma and Anxiety

Image from Unsplash by Jeremy Lapack

Are there times you feel anxious, stressed out, or have a panic attack? Is it new or something you’ve dealt with for a while? Overwhelming anxiety or physical sensations such as a racing heart, shortness of breath, stomach discomfort and more can be extremely distressing. Would you consider these responses part of a trauma response? The reality is the relationship between trauma and anxiety is interconnected. The anxiety you experience could be related to a past trauma.

Understand How Trauma Influences Anxiety

Traumatic experiences tend to live in the body, as well as the mind. Therefore, after a traumatic event or ongoing trauma, the body responds to a specific threat with a fight, flight, or freeze response. Anxiety tends to live in the fight/flight realm and can be characterized by mobilization. Shutdown, or the ‘freeze’ response doesn’t tend to be associated with anxiety but typically more with immobilization or depression. Anxiety triggered by a specific traumatic event tends to be more focused, for example, you got in a car accident and now you get highly anxious while riding in a car. It can be more general, for example, social anxiety may be related to attachment wounds you experienced as a kid. Single event and ongoing traumas can contribute to an increase in anxiety, although the relationship to that anxiety and the subsequent intervention may look different. 

You can experience anxiety without trauma. Anxiety is your nervous system’s response to a perceived threat. That perceived threat can come from an internal or external source. Internal sources can be a feeling or sensation that feels like a threat, it can also be negative self-talk. External sources can be interpersonal interactions, conscious perceptions of a threat, or cues to your nervous system that might not enter your conscious awareness (shadows, temperature, etc.) The term ‘anxiety’ can encompass a wide variety of physical sensations such as: racing heart, sweating, shaking, shortness of breath, choking, chest pain, nausea, dizziness, chill/heat, fatigue, tension, or numbness. Anxious thoughts can include worry, detachment, irritability, and fear. Anxiety can also impact sleep. You can experience these symptoms after trauma as well. They both have to do with feeling unsafe, and a posttraumatic stress disorder diagnosis requires additional symptoms.  

Anxiety’s Influence on Trauma

If you struggle with anxiety and then experience trauma, it may make recovery more challenging. People who experience high levels of anxiety often get stuck in worrying about the future or feel unsafe in the present. Should something traumatic happen, some people may interpret this event as a confirmation that they need to worry or focus on the future to exert control. Recovering from paralyzing anxiety and trauma both require working on present moment awareness and one’s relationship to ideas of control. Both anxiety and trauma can keep you feeling stuck and require attention when they impact your daily functioning.

State Versus Story

How you discuss your problems and challenges directly impacts your experience. Instead of identifying what’s going on with you through a narrative, it can be helpful to peel back the layers that came before the story. It’s helpful to get back to asking, ‘what is going on with me?’ in relationship to your nervous system. This is the difference between what you communicate as your story versus observing what is going on in your nervous system. This observational skill can more accurately reflect what’s happening with you in the moment rather than buying into some narrative of yourself you’ve constructed. The image below maps out what pieces build up to the story you tell yourself.

Neuroception  ——>  Perception ——>  State  ——> Feelings ——>  Behavior  ——>  Story

·      Neuroception refers to the way your nervous system unconsciously processes cues within your environment.

·      Perception refers to the way you consciously engage your senses to become aware.

Image from Pexels by Gabby K.

·      State relates to what state your nervous system is in using the paradigm of safe/social, fight/flight, or freeze.

·      Feelings means identifying what emotion is going on for you.

·      Behavior refers to your actions.

·      Story is the narrative you create from these processes.

Assessing Anxiety

In my work with clients, it’s important that I assess your relationship with the symptoms you’ve been experiencing. When did they start? Do they occur around anything specific? Are they general? It’s helpful to differentiate between generalized anxiety versus anxiety that results from a traumatic incident(s). Although many treatment approaches are similar, there are some slight differences. In my experience, general anxiety can still be associated with a past trauma, but if the anxiety is more defuse and generalized the person might not be aware of the connection. A thorough assessment of your history is important in understanding the structures contributing to ongoing symptoms.

About the Author: Seattle Therapist Chelsea Kramer LMFT

Chelsea Kramer is a Seattle Therapist who works with individual and families facing grief, anxiety and trauma, with special focus on medical challenges, reproductive health, and life transitions.

Learn more about Chelsea’s specialties: grief, anxiety, infertility, pregnancy loss, chronic illness, menopause, medical trauma

Learn more about Chelsea

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