Brain on Trauma: Unpacking the Neurobiology of Pain

A male surfer rides a capping wave in the ocean. His back is to the camera as he balances on a blue surf board. There's a sail boat in the background.

Trauma-Informed Care encourages practitioners to understand the roots of trauma—the impact of a traumatic event or events on the body, brain, mental health, and our wellbeing.


The word trauma means “wound,” which captures the impact of a traumatic experience or experiences. As practitioners, when we’re empathetic, engaged, and compassionate toward those we serve, we can carry out effective conversations and therapies that support healing.


Trauma and the Brain

How does trauma impact the brain structures? Does it affect our neuropathways?


Trauma may impact our systems in various ways. When we experience powerlessness, we may become traumatized. The traumatic experience—feelings of powerlessness and lack of control—can rewire our neuropathways, causing us to become dysregulated and out of balance. When we’re dysregulated, we may experience an array of experiences. Sleep interruptions, panic, stress, fear, a general loss of wellbeing, inappetence, and many other physical symptoms can present from trauma. A stress response from a childhood trauma, natural disaster, emotional trauma, or another impactful event can change brain function and impact our neuronal systems.


Our bodies are designed to keep us in balance—a state called homeostasis. Disruption to our balance and sense of control takes us out of this “status quo” state. We may start to have repeat reactions to a wound reactivator (“trigger”) or an outsized response to events. Simply put, we can become reactive vs. responsive to situations that re-activate the unhealed wound of trauma. Suddenly, the memories evoked by a smell, sound, or interaction can bring out those same feelings we experienced during the trauma, even though they may not be directly related to the traumatic event.


We can imagine a surfer getting pulled under the water’s surface by an oncoming wave. Even though our bodies fight to get upright when the wave hits, we experience a strong response called fight-flight-freeze mode. This fight-flight-freeze mode can occur during any “wave” of stressful experiences that bring out the memory. Sometimes, we may not even be aware of the trigger, or it may come from a seemingly innocuous situation (like a dog barking, a smell, a song, or reading an email from work).


When our bodies go into fight-flight-freeze, we can be pulled into an altered, dream-like state where nothing feels real or stable. We often feel as though we’d do anything to get out of this mode. Each time our trauma response is re-activated (“triggered”)—even if we’re not in immediate danger—we might return to the state of fight-flight-freeze.



During a fight response, the individual may feel an urge to confront or defend against a perceived threat or danger. When a memory subconsciously triggers feelings from past trauma, they may react aggressively or confrontationally (physically or verbally). They may feel defensive or react in a seemingly disproportionate manner to an event.



The flight response is a protective reaction that prompts individuals to escape or retreat from danger, ensuring safety. When a past trauma or stressful memory is evoked by a sense, like a sound, smell, or visual cue, the individual may experience the powerful urge to flee or withdraw from a situation, even if it’s objectively safe. This may be described as passive-aggressive.



When a person is in the freeze state, they may become immobilized or unable to respond to a threat. They may feel stuck or paralyzed. When an experience or memory resonates with their trauma’s emotional landscape, an individual may feel unable to move. They may shut down and/or go into a state of hypervigilance.


When something happens that hurts us or causes us trauma, we may struggle with keeping our internal systems in a steady state because we experience fight-flight-freeze. To maintain balance, external changes must stay within narrow limits, just like the minute adjustments a surfer makes to stay above the waves.


Once we start to regulate following a trauma, we can shift out of survival mode and start to get into a space of self-repair, where we begin healing, surviving, and eventually thriving again. We move away from the fight-flight-freeze mode and begin to have an appropriate reaction to re-activating (“triggering”) situations.


Inside the Brain Structure

When we face traumatic experiences, our brain shifts our body into high alert. Our brain is wired to keep us safe, but when we experience trauma, it may put us in a state of hyper-awareness. When the wounding experience is re-activated, we may have difficulty discerning a real vs. a perceived threat, i.e., a bear for real chasing us vs. the thought of a bear chasing us. Reactivation can occur from memory triggered by a day-to-day interaction, like a deadline at work or a harsh tone of voice from a caregiver and send us back into fight, flight, or freeze mode as when we experienced the wounding, the trauma.


What’s going on inside our brain during trauma? What causes us to react to perceived threats, even if they are objectively safe?


Trauma impacts several areas of the brain. First, there’s the hippocampus, the part of the brain that plays a role in memory formation, organization, and storage of new memories. The hippocampus helps us connect emotions and senses (like smells or sounds) to these memories. When we experience trauma, the hippocampus becomes less efficient, which leads to trouble with memory recall, intrusive memories, and flashbacks. The brain is struggling to encode and store our traumatic memories.


The amygdala is a crucial brain structure for processing emotions, especially fear and threat detection. It can cause us to release stress hormones. In trauma survivors, the amygdala can become larger and hypersensitive. This leads to a strong response to perceived threats. It can also cause intense emotional reactions to traumatic events like anxiety, panic attacks, and trouble with emotional regulation.


Finally, the prefrontal cortex is the brain structure involved in complex behaviors like decision-making, planning, moderating social behavior, and self-regulation. Trauma can disrupt the functions of the prefrontal cortex, directly impacting these higher functions. It can lead to problems with stress management, concentration, and planning tasks.


Each time we return to a sense of powerlessness or an external factor triggers the traumatic memory, our body goes back into that altered state of fight-flight-freeze. While not every upsetting event will impact our brain’s neuropathways, each person reacts to stress and trauma differently. Some folks may experience a long-term traumatic reaction.


Trauma and Mental Health

Trauma becomes the progenitor of certain mental health conditions like post-traumatic stress disorder (PTSD). Many mental health conditions can also lead to substance abuse, exacerbate anxiety disorders, or cause us to have an outsized fear response. Often, when the trauma heals, the symptoms go away or lessen. A Trauma-Informed Care approach supports the healing process.


So, what is Trauma-Informed Care? Any provider can create a safe space by showing up with empathy and compassion. In our Trauma + Resilience and MI offerings, we explore what we call the “three layers of Trauma-Informed Care.” This concept was identified by Dr. Dmitri Topitzes, a thought leader in trauma, trauma-informed care, and trauma healing.


  • Trauma-sensitive
  • Trauma-informed
  • Trauma-focused

Trauma-Sensitive Care means that the practitioner has a general awareness of the prevalence, types, and symptoms of trauma. An example is the knowledge you might be reconnecting with or learning from reading this post. However, trauma-sensitive care doesn’t directly address the trauma.


Trauma-Informed Care includes a Trauma-Sensitive approach along with a trauma assessment. This approach to trauma care leads to referrals for appropriately trauma-focused services and education. A provider may go through some basic cognitive and emotional regulation techniques. This approach can help build motivation and restore a sense of balance.


Finally, Trauma-Focused Care is a healing intervention wherein the practitioner helps to support the individual in ways that mitigate post-traumatic symptoms and chronic stress and support the healing of the wound(s) from which those symptoms originated. These might include approaches like Instinctual Trauma Resolution and Brain Spotting.


Healing-Focused Care as an Approach to Trauma

Our Healing-Focused Care Model, which integrates a variety of frameworks, including Motivation Interviewing, supports the healing of trauma by acknowledging an individual’s experiences and emotions. We do this by creating a safe space founded by expressions of empathy, acceptance, and compassion. When we deliver services in this trauma-informed manner, we honor and respect individual experiences and identities. We must always view a person as someone who has all they need inside them to heal from their trauma. We must know that a person is NOT their trauma.


At Share Collaborative, we weave our Healing-Focused Care approach throughout our trainings. The values of Healing-Focused Care start with compassion. From compassion comes Acceptance and from their Cultural, Gender, and Historical Reverence. This helps us form a collaborative partnership with each individual, leading to the Evocation (drawing forth) of Empowerment—helping people find their way to recovery. Empowerment is not about installing power. Empowerment is drawing out their power to go on their healing journey.


When a person’s identity isn’t honored, it can re-activate their past trauma that may have come from their experiences when they felt powerless or vulnerable to systemic inequalities. Healing-Focused Care supports empathy for these past experiences, helping practitioners understand where each individual is and meeting them on their path, even when their experiences have been quite different from our own. Empathy is the great equalizer of experience.


Healing-Focused Care helps support providers as well, with skills like depersonalization. That means that when a person is angry or reactive to a situation, we can recognize that the emotions aren’t directed at us, and we can depersonalize the experience while still being empathetic. We can hear dysregulated aggressive verbal behavior as the trauma talking. We can empathize (deeply understand) what they’re going through and use that understanding to guide our conversations. We can also recognize that we must serve and protect our own wellness, too. Empathy is the great balancer between understanding and becoming symptomatic or taking on someone else’s wounded experience, their pain.


Healing Focused Care helps provide space for reasoning and processing a traumatic experience or experiences. When a served person has moved out of their trauma, they can start to view it more objectively. They can begin to see how positive actions might benefit their lives and move them toward their goals. They become empowered in their own journey to wellbeing.


Unfortunately, many people experience trauma, and it can have a profound impact on their health, confidence, and relationships. By offering Healing-Focused Care, those of us in human service-based organizations can support folks in our care on their healing journey.


If you would like to further explore the Healing-Focused Care model, please reach out. Our team of facilitators can guide you through the approach to Trauma-Informed Care.

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