The Link Between Trauma, Nervous System Functioning, and Social Anxiety

In recent years, the fields of psychology and neuroscience have significantly advanced our understanding of the intricate relationship between trauma, nervous system functioning, and social anxiety. This relationship is complex, deeply rooted in our biology, and has profound implications for mental health treatment. This blog post delves into how trauma impacts the nervous system, how this dysregulation can lead to social anxiety, and what contemporary research suggests for effective interventions.

Understanding Trauma and Its Impact on the Nervous System

“Trauma is not what happens to you but what happens inside you” – Gabor Maté

Oftentimes, we don’t realise that we have experienced trauma in our lives. But it isn’t just about bad things happening to us like physical and verbal abuse, it’s also about the things that we needed that we didn’t get when we were children and includes neglect and emotional neglect – like constantly feeling as if you didn’t have someone you could talk to when times were hard. 

Whether from a single event or chronic exposure to stressful situations, trauma can have a lasting impact on an individual’s psychological and physiological state. According to van der Kolk (2014), trauma can fundamentally alter the way the brain processes information, particularly affecting areas responsible for regulating stress and emotions, such as the amygdala, hippocampus, and prefrontal cortex. These changes can result in a heightened state of arousal, where the individual is perpetually in a fight-or-flight mode, even in the absence of immediate danger.

The autonomic nervous system, which includes the sympathetic and parasympathetic nervous systems, plays a critical role in how the body responds to stress. Trauma can lead to dysregulation of the autonomic nervous system, resulting in either hyperarousal (excessive activation of the sympathetic nervous system) or hypoarousal (dominance of the parasympathetic nervous system). Hyperarousal is often characterised by anxiety, agitation, and hypervigilance, whereas hypoarousal can manifest as numbness, depression, and detachment (Porges, 2011).

The Connection Between Nervous System Dysregulation and Social Anxiety

Social anxiety is characterised by an intense fear of social situations where one might be scrutinised or judged by others. Research indicates a strong link between trauma, nervous system dysregulation, and the development of social anxiety. Individuals who have experienced trauma, especially interpersonal trauma such as abuse or neglect, are at a higher risk of developing social anxiety (Simon et al., 2009).

One explanation for this link is that trauma-induced dysregulation of the nervous system leads to a heightened sensitivity to perceived threats. This heightened sensitivity can cause individuals to interpret social interactions as dangerous, triggering anxiety and avoidance behaviours (Stein & Stein, 2008). Neuroimaging studies have shown that individuals with social anxiety often exhibit hyperactivity in the amygdala, a brain region involved in the processing of fear, which may be exacerbated by prior trauma (Etkin & Wager, 2007).

Polyvagal Theory: A Framework for Understanding the Trauma-Social Anxiety Connection

Polyvagal Theory, developed by Stephen Porges, provides a useful framework for understanding how trauma impacts nervous system functioning and contributes to social anxiety. According to this well-researched theory, the vagus nerve, a key component of the parasympathetic nervous system, plays a crucial role in regulating social behaviour and emotional responses (Porges, 2009). The theory posits that there are three evolutionary stages of the autonomic nervous system: the primitive unmyelinated vagus (associated with immobilisation and freeze responses), the sympathetic nervous system (associated with fight-or-flight responses), and the myelinated vagus (associated with social engagement and calm states).

Trauma can disrupt the normal functioning of these systems, leading to difficulties in maintaining a state of calm and social engagement. For example, individuals with a history of trauma may have an overactive sympathetic nervous system, making it difficult to engage socially without experiencing anxiety. Conversely, they may also have an underactive myelinated vagus, which impairs their ability to feel safe and connected in social situations (Porges, 2011).

Therapeutic Interventions: Building Nervous System Capacity

Given the profound impact of trauma on nervous system functioning and the development of social anxiety, effective treatment approaches often focus on restoring this regulation. Here are some evidence-based interventions:

1. Trauma-Focused Cognitive Behavioural Therapy 

Trauma-Focused CBT is designed to help individuals process and integrate traumatic memories, reducing their impact on current functioning. Studies have shown that Trauma-Focused CBT can significantly reduce symptoms of both PTSD and social anxiety by helping individuals reframe their thoughts and reduce avoidance behaviours (Cohen et al., 2004). 

2. Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a trauma-focused therapy that uses bilateral stimulation (typically eye movements) to help individuals process traumatic memories. Research indicates that EMDR can be effective in reducing symptoms of trauma and associated anxiety disorders, including social anxiety (Shapiro, 2017). 

3. Somatic Experiencing 

Somatic Experiencing is a body-oriented approach to healing trauma that focuses on releasing stored energy and restoring balance to the autonomic nervous system. By helping individuals become more aware of their bodily sensations and releasing pent-up tension, Somatic Experiencing can improve nervous system functioning and reduce symptoms of social anxiety (Levine, 2010). 

4. Mindfulness and Yoga

Mindfulness practices and yoga have been shown to positively affect autonomic nervous system functioning by promoting relaxation and enhancing body awareness. These practices can help individuals with a history of trauma learn to calm their nervous systems and reduce social anxiety (van der Kolk, 2014).

Conclusion

The link between trauma, nervous system functioning, and social anxiety highlights the importance of addressing the underlying physiological mechanisms in therapeutic interventions. Trauma can disrupt the normal functioning of the autonomic nervous system, leading to heightened sensitivity to social threats and the development of social anxiety. Understanding this connection can inform more effective strategies for overcoming social anxiety that focus on restoring nervous system health and helping us to feel safer in social situations – both in clinical treatment where this is necessary, and in practices that we can start in our own homes today.  

Want to know more? Check out these free resources by Irene Lyon, nervous system expert.

References

Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2004). Trauma-focused cognitive-behavioral therapy for children and adolescents: An empirical update. Journal of Interpersonal Violence, 19(2), 174-187.

Etkin, A., & Wager, T. D. (2007). Functional neuroimaging of anxiety: A meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. American Journal of Psychiatry, 164(10), 1476-1488.

Levine, P. A. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. North Atlantic Books.

Maté, G., & Maté, D. (2022). The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture. Avery. 

Porges, S. W. (2009). The Polyvagal Theory: New insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic Journal of Medicine, 76(Suppl 2), S86-S90.

Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation. W.W. Norton & Company.

Shapiro, F. (2017). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures. Guilford Press.

Simon, N. M., Herlands, N. N., Marks, E. H., & Pollack, M. H. (2009). The role of trauma in the development of anxiety disorders. Depression and Anxiety, 26(10), 873-880.

Stein, M. B., & Stein, D. J. (2008). Social anxiety disorder. The Lancet, 371(9618), 1115-1125.

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