Many trauma survivors experience physical symptoms as a direct result of psychological trauma. It can be very difficult to know what symptoms are caused by trauma, or separate to it. Physical symptoms do need treatment – regardless of the cause – but those caused by trauma often respond less to physical treatment.
Trauma and the Body
If this all sounds rather strange then think of the briefer physical effects in our bodies when our minds are under pressure… racing heart and sweating before a job interview, a headache as a result of an intense argument, and the exhaustion of depression. And, of course, flashbacks occurring after a trauma trigger…
These physical effects from trauma are referred to as ‘somatization’ or ‘somatic dissociation’, and are the body’s way of bringing some of the trauma held unconsciously into the conscious mind. It feels an awful experience, but just like flashbacks, our mind is trying to help us heal.
Pierre Janet, another pioneer in the field of dissociation, documented a range physical symptoms in patients with what was later named dissociative identity disorder. These historical accounts formed the basis for the current Somtaform Dissociation Questionnaire (SDQ-20) developed by the top traumatologists Nijenhuis, van der Hart and Vanderlinden. The SDQ-20 has proved an effective tool in aiding differential diagnosis of Dissociative Identity Disorder, particularly when compared with schizophrenic disorders, borderline personality disorder and bipolar disorder.
Carolyn Spring, director of charity Positive Outcomes for Dissociative Survivors talks about her physical symptoms, and how they linked to her trauma.
– Somatoform Dissociation Questionnaire (SDQ-20). Nijenhuis, van der Hart and Vanderlinden. (enijenhuis.nl)
– The Scoring and Interpretation of the SDQ-5 and SDQ-20: Update 2003. Ellert R.S. Nijenhuis. (enijenhuis.nl)
Akhtar, Salman (2009). Comprehensive Dictionary of Psychoanalysis. ISBN 1780493037.
Nijenhuis, E.R.S., Spinhoven, P., Van Dyck, R., Van der Hart, O., & Vanderlinden, J. (1996). The development and the psychometric characteristics of the Somatoform Dissociation Questionnaire (SDQ-20). Journal of Nervous and Mental Disease, 184, 688-694.
Nijenhuis, Ellert R.S.. European Society for Trauma and Dissociation: The scoring and interpretation of the SDQ-20 AND SDQ-5:Update.
Nijenhuis, ERS, van der Hart, O, Vanderlinden, J. Somatoform Dissociation Questionnaire (SDQ-20).
International Society for the Study. Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision. Journal of Trauma & Dissociation, volume 12, issue 2, 28 February 2011, page 115–187. (doi:10.1080/15299732.2011.537247)
The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment. Babette Rothschild (2000).ISBN 0393703274.