Updated: Mar 26, 2019
Not enough adults understand how trauma silently handicaps some children in day-to-day functioning that appears to have nothing to do with trauma. As an adult who struggled in childhood with the aftermath of trauma, I want to help others understand what might be going on with traumatized children and what you should know about it.
The consequences of trauma are many, for both adults and children. Recent articles, blogs and online discussions demonstrate rapidly growing awareness of this. A study by Elsey et al., (2015) reported an association between trauma exposure in early childhood and incidence of emotional disturbances and risky behaviors later in life.
Trauma and Sensory Integration
An area that has so far received little attention is the connection between trauma and sensory integration. In an early post I wrote about the impact of trauma in the pre-verbal stage on me. I inherited from this a chronic feeling that life is not safe. Every day, any moment, something terrible could happen. “Hyper-alert” is a term often used to describe adults with post-trauma and PTSD symptoms. Children who were traumatized early enter life with a similar instinctive stance of being alert and fearful, and it is of course the sensory systems that mediate their experience of the world.
Sensory Integration and the Seven Senses Research in Sensory Integration (SI) has greatly expanded understanding of how the body, brain, and emotions interact in processing sensory inputs. Ever found yourself yelling at people you love when you’re tired? Or unable to think in the presence of loud noise? Or annoyed by smells or sounds that others barely notice? Those are your daily reminders of the interactive relationship of body, brain, and emotions. An overload or stressor in one inevitably affects the other two.
The brain is processing sensory input all the time and our emotions are affected as well. The impact of noises, sounds, and smell varies from person to person and changes across a day and across life. Sometimes we are over-sensitive, other times we are under-responsive to sensory inputs, and each of us has patterns unique to us.
Although people speak of “five senses”, there are actually seven data systems inputting to the brain: sense of touch, sense of sight, sense of hearing, sense of taste, sense of smell, sense of balance, and sense of body position.
According to Kaiser et al., “sensory input is organized in a manner that enables an individual to establish a sense of where the body is in time and space, to feel safe in one’s own body, and to accurately perceive the body’s relationship to the environment”.
Add the word “not” before a few of the verbs in Kaiser’s definition of sensory integration, and you have an accurate description of how I felt in my body, in space and time, for as far back as I can remember, into my late twenties. In other words, I have sensory integration issues*. Although research in Sensory Integration and trauma is pretty recent and small in data, my experiences as a trauma survivor and as a therapist have convinced me that understanding the overlap between these two greatly improves ability to respond usefully to trauma.
The Egg and the Chicken Did I have sensory integration issues first, making me unusually vulnerable to trauma? Or did early trauma disrupt normal development of my mechanisms for sensory integration? I don’t know – I was too young to have narrative memories at that time.
But it doesn’t really matter. What matters is recognizing that trauma and sensory integration are deeply interwoven. Trauma greatly affects sensory integration, drastically altering survivors’ responses to sensory experience. For example, they have emotional reactions they did not have prior to trauma to certain sensory experiences of hearing, seeing, smelling, or touching things.
It is not just a simple matter of "being reminded" of painful past events, though that can be a factor. It is that the whole system for processing sensory inputs is altered. Someone in trauma or deep grief may feel overwhelmed, physically weakened, and defenseless, for example, in the presence of loud noise that has no apparent association with the traumatizing event.
For those working with trauma survivors, the key takeaway here is that working with survivors around sensory integration issues has great payoffs in reducing the impact of trauma. Skillful use of sensory integration techniques can both help mitigate the symptoms of trauma as well as assist survivors to develop sustainable regimes of life management that make them less vulnerable to restimulation on the longterm.
Connecting Sensory Integration to Trauma Treatment Traumatic experiences initially are imprinted as sensations or feeling states, and are not collated and transcribed into personal narratives (van der Kolk et al., 1997). In other words, traumatic experiences are primarily handled in the sensory processing networks of the body and lower brain functions, rather than the higher functions of narrative memory and rational thought. Trauma survivors respond instinctually to reminders of traumatic events conveyed to them through sight, sound, smell, etc., with responses that are poorly or not all regulated by conscious awareness (van der Kolk et al., 1997).
This has many implications for treatment which we are only beginning to understand. One of the most important is that therapies that are restricted to higher brain functions - eg: talk therapies - have limited effectiveness with trauma survivors. Talking alone simply doesn't engage the sensory systems that are most impacted by trauma.
This was borne out in a pilot study in 2010 by Kaiser et al., which examined the possible benefits of psychotherapy if combined with sensory integration (SI) treatment as compared to psychotherapy alone in treating complex traumatic stress among adult who experienced childhood trauma. Results indicated a significantly higher level of improvement for the group that received psychotherapy treatment and SI.
Self Sustainability, Self-Care and Sensory Integration These insights suggest new possibilities for work with trauma. The challenge is to figure out strategies that more directly engage the lower brain and associated sensory systems that we now know are the primary interface of the individual with trauma. This will take time, but we are advantaged by the already existing work of sensory integration professionals who have been devising strategies for engaging and balancing the sensory process systems for years, in particular with children.
When I finally realized some years ago that, in addition to early trauma, I have sensory integration issues, I started experimenting. Through trial and error I have figured out simple ways to reduce my instinctual responses to sensory inputs and to help apply rational thought processes in times of high stress. I’ll write more about this in future posts.
I now incorporate these exercises along with basic psychoeducation info into work my clients, and the Expressive Trauma Integration framework I use in therapy and training.
Expand Your Own Sensory Processing Awareness If the idea that sensory processing is linked to trauma is new to you, view this short video simulating how people on the autistic spectrum experience the world around them as conveyed via their sensory inputs.*
Everyone struggles with sensory processing at times. You’ve probably had the experience that when you are tired or stressed, your levels of sensitivity change. You may react differently, with less flexibility, to changes in light, sound, smells, etc. By increasing awareness of sensory processing, you can increase your ability to manage your life well and support those you care for, even if trauma or other serious challenges are not an issue.
If you see a child who appears not to be coping well in school or social environments, consider the possibility that this child may have sensory processing issues. Read about sensory processing and look for ways to alter the volume, intensity, and mix of sensory stimuli the child is experiencing.
I am convinced that sensory processing awareness will greatly advance stress management and treatment of trauma. Please share observations or anecdotes from your own experiences that would shed light on this nexus.
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------------------------------- Endnote* People on the autistic spectrum has sensory integration issues, but not everyone with sensory integration issues are on the autistic spectrum
References: Elsey, J., Coates, A., Lacadie, C. M., McCrory, E. J., Sinha, R., Mayes, L. C., & Potenza, M. N. (2015). Childhood Trauma and Neural Responses to Personalized Stress, Favorite-Food and Neutral-Relaxing Cues in Adolescents.Neuropsychopharmacology.
Kaiser, E. M., Gillette, C. S., & Spinazzola, J. (2010). A controlled pilot-outcome study of sensory integration (SI) in the treatment of complex adaptation to traumatic stress. Journal of Aggression, Maltreatment & Trauma, 19(7), 699-720.
SPD foundation http://spdfoundation.net/about-sensory-processing-disorder.html
SPD Australia http://www.spdaustralia.com.au/the-seven-senses/
Van der Kolk, B. A., Burbridge, J. A., & Suzuki, J. (1997). The psychobiology of traumatic memories: Clinical implications of neuroimaging studies. Annals of the New York Academy of Sciences, 821, 99-113.